My Practice

What is Therapeutic Massage?

Recently a client said she wanted a good therapeutic massage. I thought, I’m perfect for you because that’s exactly what I do. Later, I began to think more about our conversation and thought I would share my thoughts with you.

All massage is therapeutic in nature. The difference between types of massage is based on your goals. Say you get a massage because that’s how you relax and take care of yourself. That is therapeutic. You are recognizing that your body and mind are craving something healing. By getting a massage, your nervous system has a chance to get out of a stressful and chaotic state and into a parasympathetic state where breathing is slowed and the body is at rest. Or, say you can’t lift your arm over your head without feeling pain. That would also call for therapeutic massage. The techniques and approach are different, but the outcome is the same- your brain gets the message that your body is in a safe space and that those pain or stress alarms can slow their roll while your body receives work.

So, back to my story. I figured out that this patient regarded therapeutic massage as deep pressure massage. This patient believed that receiving a certain level of depth equated feeling better. Level of pressure is a sensory preference so I get that. I have scoliosis and my back doesn’t like deep pressure, but my runner’s legs love a firmer pressure. I feel pain when someone works deeply on my back but feel relief when the work is deeper on my legs. It’s my brain’s perception of pain and pleasure; it’s not a request that comes from the tissues in my body. And while I’m on the subject of deep pressure, I’ll give you a little intro into a topic for another blog: deep pressure is not a requirement for change because change does not happen at the tissue level.

I have heard of Swedish massage referred to as a “fluff” or “fluff and buff” massage and I don’t care for those terms at all. Those ideas minimize the importance of self-care and insults the people who like a more flowing massage and whose goal is strictly relaxation. If you feel better after your massage than before the massage, then your massage was therapeutic.

And since your body responds to what is happening in your brain, guess how all my rehab massages start. You got it- those same long, flowing effleurage strokes. The same strokes that make up a relaxation massage. Why? Because if you are in pain, your brain is screaming “danger” and the last thing your body needs is my elbow shoved directly into that shoulder that isn’t moving your arm above your head. The long, flowing, slow strokes are meant to move your brain and body into a more relaxed state- breathing slows, the pain signals get quieter, and your focus is on something other than discomfort. This concept is referred to as descending modulation– the good feels are louder than the bad feels. Deeper work can take place at this point, if that is your goal.

I have no problem with “deep work”, but that work will be combined with Swedish-style strokes and Active Engagement techniques, and will be at a depth that is comfortable for me and safe for you. And, most importantly, all of it will be therapeutic.

Related Topics / Blogs:

Stress, Anxiety, and Massage

How to Have a Good Massage