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I've found myself being really taken aback by the number of people who have come into my clinic asking questions about massage, and stating that it hurts.

What are your feelings on whether massage hurts or not?

How do you respond when people insist that it should hurt or it's not effective?

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Good morning Sally,
I have found this common when people have been to practitioners who are less than skilled in communication, warming up/ preparing tissue for deeper work, work too fast, too deep, have an agenda, or a big ego. I don't think massage should hurt more than a "good hurt." I think that causing someone more pain is not respectful, doesn't address their condition, and is not necessary 95% of the time.
Massage can hurt when working on scars, injuries, very tight tissue, yet it's not helpful in all cases. I agree with James W. that painful therapy can cause emotional scars and makes clients more tense.
Besides, from a marketing view, would you go back to a therapist who had hurt you? I have had several clients leave their former therapist for this reason. One of my regulars had a therapist in Boston who dislocated her jaw, after telling her to "just bear with it" during her sessions. I can't imagine doing this to someone.
As far as massage being less than effective, I tell clients that it only needs to be deep enough to reach the involved tissue layer, no floor sanding or scraping. I hate it when a therapist grinds on an area too long and then I'm sore for days.
Thank you, your response mirrors my sentiments exactly, I must admit I think I visibly cringed today when talking with a gentleman about the problems he was having with his ITB.
He said something along the lines of "But it's going to be sore isn't it, because you need to scrape away at the ITB"
I let him know that it was possible to work on areas like that without it being painful and uncomfortable, but reminded him that if there is any bruising or current injury, that it may hurt a little.
I think I need to ponder this more and write something up for my clinic website.
I have found that there are some therapists out here that preach the "no pain, no gain" philosiphy. I agree that in some cases there will be some pain and discomfort. But it shouldnt last the entire massage and with every single stroke u apply. I try to let them know the best of my ability that just because i am not trying to break you into pieces doesnt mean that the work is not effective. I believe in working smarter, not harder. I use different techniques to counter some of that macho massage stuff. I do believe this is going to be a battle for the ages because I here this kind of stuff from other therapist all the time
My goal as a therapist is to work within each clients tolerance for pressure. Depth is good but only to the point that a client can accept it without guarding or resisting the work. Specifically I tell my clients that it is a myth that massage has to hurt to feel good and then refer them to the University of Miami Touch Institute massage research studies to disprove that argument. Science supports the value of compassionate touch. I feel it is my duty to listen not only to what the body is telling me from nonverbal cues and breath but what the client offers before, during, & after. This is how I "connect" with my clients.
I feel that if a client was left hurting in the past it was from a practitioner who was inadequately trained, not present, or who just didn't care for the well being of the client.
I have never had anyone continue to argue this point after I explain my approach and work with them.
In a nutshell, work within their pain scale &
monitor what their body is telling you.
I tell people that there are many different approaches to massage/bodywork, and that I prefer to minimize any discomfort during the session because I get better results that way. Further, I tell them that any pain they feel is a result of how their brain chooses to interpret some of the information it is receiving, and that we can retrain their brain to interpret that information differently. If the work is too aggressive, we may reinforce a negative interpretation.

If a person insists that massage must hurt in order to be effective, I let them know I tend to start more gently because I need to understand how their body responds to what I am doing before I escalate the intensity of the work. I also let them know that I used to be very popular for extremely painful work, but that I have found ways to improve effectiveness without so much pain. Therefore I will start off more gently... if they really want me to make it painful later, I always have that ability.
I'm in agreement that massage should never hurt. the 2 things I tell my clients to address this notion is this...

1. Massage can be "uncomfortable" when working deep tissue in areas that are knotted or tight. However, the pain should only be uncomfortable and not intense or severe. I tell the client that when they are feeling uncomfortable, to let me know so we can breath through it. If we can't breath through it then it's too deep or too specific of work and I will adjust accordingly.

2. It has been my experience that nothing can be "cured" in one session. I think many times the "no pain, no gain" philosophy comes from clients who also think that they can come in and be cured of chronic aches and pains that have built up over years. They think that one session of pain will make everything go away. When they realize that I work slowly to relieve issues, they begin to let go of the misguided philosophy they come in with.

just my .02
Depends who the client is, the technique used, required speed of a good outcome, condition of tissues etc etc.

This is all part of your judgement of approach, the way you talk to your client the way you know when to stay quite.

If you use v gentle techniques on a top athlete they may not return even if they get a good outcome, same as the massage therapist who works too deep too quickly on a frail client.

I hate to admit it, but yes, I have on occasion made clients much too soar for much longer than the technique intended even though at the time, I felt, and the client confirmed, I was working within their comfort zone. Its worth remembering any intervention can cause a flare up of the tissue's no matter how carefull we are.
I have a Cranial osteopath to whom I refere clients and even though she uses the most gentle of techniques a flare up can sometimes (very rarely) follow her treatments.
I agree with you 100% on this :)
It depends on your approach and intent. We as Therapists treat a wide variety of conditions with very different modalities. It is all good if the clients feel benefited. We want that but even this we can't expect every time with every client.

Luciana Borba Johnston said:
I feel pretty strongly that massage should not hurt. It is true that when you are first working ischemic muscle it may be a little tender but I would describe it as a "good hurt" in the sense of...if it were me I would be aware of the tender sensation and I would not want it to stop because it feels relieving and I can relax through it. I feel that if it just plain hurts and the client cannot relax then there is no reflexive benefit to the massage and the therapist is missing the mark.

Further, deep tissue does not necessarily mean heavy pressure. Deep tissue refers to the manipulation of deeper tissues which sometimes can be done with moderate, comfortable pressure. I think when it comes down to it the most wonderful thing we can give our clients is relaxation and a balance effect in the nervous and endocrine systems. When their muscles are re-oxygenated and ROM is improved that's a bonus :)
Thank you, I was just about to start a discussion on this very subject. I have had many a client say to me that when they received deep tissue massage that it really hurt and some have walked away with bruises and some bearly walking or being able to move their head at all after their session. Now I'm not really new the the Massage business I have been massaging for about 6 years and just received my license this past February due to financial issues trying to complete schooling. I was told by my instructors that proper warming of the muscles as well as communication with the client and that the depth is mostly to their treshold. So Jody like you said is it because of ego's that they are not putting their clients needs first?
it really is a matter of educating the client. I had some people who asked for some really deep/fast work and I discovered with time that most of them were completely disconnected from their body. I explain the same view as you guys, the progression in the work, the limit of the muscle,etc. But sometimes it doesn't change the client point of view: it has to hurt. You have to adjust yourself.
i have been worked on by a fellow therapist several times and when i tell her to lighten up cause it hurts a lil too much; she tells me to hold on just a sec she's almost finished. Come on, i am in excruciating pain and you are going to tell me to hold on. that isnt good ethics in my opinion. Like Jody said, she is one who works too deep too fast, sometime.

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