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Hello! I am new the the massage professionals forum so hopefully I am doing this correctly! I am looking for some perspective/insight on the topic of what it means to be a massage therapist in terms of the expectations we place on ourselves and our profession as well as those our clients impose on us as professionals. One of the reasons I have joined online is that I live in a smaller rural community where I work with a lot of other massage therapists but rarely seem to be able to engage in a professional discussion about the job. Usually the talk is abruptly ended because no one seems to want to talk about the possibility that they are not giving their clients what they want or admit the uncomfortable feelings that come with learning to provide effective massage work. Its as if everyone has popped out of massage school knowing it all.  I feel quite the opposite! I have been doing massage therapy for five years and I feel like there is so much more to know that I haven't even touched upon the amount of information I have yet to learn.  I feel like I am the only one who thinks that. I have noticed that there is a label placed on massage therapists to be "miracle workers." Although, I undoubtedly trust the power of touch, I also am aware of the limitations of a year of massage school and a couple introductory CE classes. When I look into professionals who teach in specific areas of bodywork, I see that they have practiced for years and years to get to the point to where they are able to effectively address complicated issues that many clients come to me for relief from. I guess I am feeling a bit overwhelmed as I am moving beyond basic relaxation massage into the more advanced massage that our profession is demanding of us. I can only take continuing education as I can afford it so any insight or perspective to boost my morale at the moment would be great. 

Thanks!

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Hi Sadie!

Yes, I would consider them 2 different modalities.

Generally, what I do is ask each client what they want help with for each session and then I do whatever modality (most often more than one) I need to in order to accomplish that goal.  Sometimes people just want a good, all-over massage and that's what they get!  But the vast majority of the time, my clients want a particular issue solved.  I'm a problem-solver more than a massage therapist.

I don't know if that helps at all...

Also, I do a LOT of client education about deep pressure and what's acceptable and what isn't.  For example, if the pressure changes their breathing it's too much.  We have some brutal therapists in town and I get a lot of people who never want to be treated that way again.

You can explain to your clients that if they experience pain that changes their breathing (or if they think "If I just breathe through this, it will be OK!") that the therapist is actually creating micro tears in their muscle tissue.  The burn they feel is NOT lactic acid being worked out of the muscles; it's those micro tears happening.

I work a bit differently than my friend and mentor Gordon.  He gets a lot of short sessions that are in just for pain relief-- trigger point work, which he excels at. 

If the client has a specific complaint, after warming up the tissue, I seek the cause of their pain, which invariably will be a trigger point, more often, multiple trigger points in that area.  After that is taken care of, I proceed into Swedish massage. I'm working slow enough that I can usually tell when I am on a tender spot; relying on client guidance, I palpate for the the primary TP, the most painful spot (there can be several satellite TPs in an area the size of a silver dollar).  I release that one TP which usually will take out its children at the same time, then proceed with the stroke until I encounter another. 

I almost always begin with the client prone.  To find and release the problematic trigger points from occipitals to sacrum and give a great massage to the entire region takes on average about 20 minutes.  I work like this throughout the session.

Quite often they come in just for a relaxation massage, telling me, "No, I don't hurt anywhere."  In this case, I proceed giving  them a great massage.  But I always explain trigger points, that if it isn't causing ROM restriction and pain now, it will later, and what I'll do if I encounter one.  Invariably, I encounter a couple.

While giving that great massage, if you are working slowly, and actually moving muscle, when you encounter a trigger point (usually feels like a wee knot, but not always), even if the client has already zoned out and would have to be awakened in order to get them to respond verbally, if you are listening with your fingertips, you can feel the tissue itself react with a barely perceptible quiver.  Even working through clothing, you can find and release their trigger points.

So, for me, trigger point work and massage are not treated as separate modalities.  


Sadie Haney said:

Pressure. I does always seem to be the complaint (when it is a complaint that is) that its too soft, you can never get deep enough or it hurts....deep tissue or relaxation.

So, would you guys consider trigger point therapy and massage therapy just two totally different therapies then? Because I feel like if  giving a massage therapy session where the client is wanting you to give them a deep tissue massage to " work out their pain" as they think thats what you are doing, and expects you to rub and knead them, that that is completely different then giving a trigger point therapy session where you are communicating with them throughout the session with the goal of doing what works (trigger point therapy) to fix their issues. 

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