I have been practicing massage therapy in Southampton for the last 17 years, and find it an invaluable tool in physiotherapy.
In my practice, I offer three types of massage; relaxation massage, therapeutic massage, and sports massage.
Blending it with manual therapy and various other concepts can be very powerful. I use it frequently in the treatment of back pain and other musculoskeletal issues can maximize the therapeutic effect.
More importantly, it leads to better patient outcomes.
Many people can benefit from massage. However, it is important to use it wisely and appropriately.
About this article
This article aims to shed more light as to what therapeutic massage is, and why it can be beneficial to you. I will also explain the difference between the main types of massage, and if it is good for everybody. Finally, you will learn what a therapy session looks like.
“Massage can be very therapeutic because, when you are touched, your body chemistry is altered in a positive way. This includes factors that suppress pain and that stimulate growth and your immune system
Massage Therapy – a natural form of treatment
Massage is the most natural form of therapy. It can be really helpful and is recommended in musculoskeletal injuries like back pain or sports injuries. Runners suffer from all sort of soft tissue strains, and massage can bring about massive pain relief (read my article on the calf injuries and rehab approach)
It has never been more popular than now and there are so many types of massage to choose from! So much to choose from!
One used to have to go to luxury spas and upscale health clubs to have it done. These days, massage therapy is increasingly affordable and offered in businesses, clinics, hospitals, and even airports.
The internet and social media are full of adverts encouraging you to try massage and make an appointment.
Different types of massage therapy
Massage is a general term for touching, pressing, rubbing, and manipulating your skin, muscles, fascia, tendons, and ligaments. It can be performed with the use of hands, feet, or various tools. I often recommend foam rollers to my patients.
If you have not heard about fascia, I recommend you read further about it as it is a fascinating subject.
Massage is like a medication. It means it is there to help, but too much of it can be harmful and even lead to more pain.
A very strong and long massage may not always be appropriate, and cause muscles to tighten up further, go into spasm, and become more painful.
It depends on the condition your muscles are in. Simply put – sometimes less is more.
There are many different types of massage, but we will concentrate o 4 main ones:
Massage Therapy – Swedish Massage
Swedish massage is the most popular massage there is.
It was invented by a Swedish fencing instructor named Per Henrik Ling in the 1830s. When he was injured in the elbows, he cured himself using gentle strokes around the affected area.
He later developed the technique and made it very popular.
It’s a classic that will help you relax and feel much better!
5 types of strokes make up the massage and the pressure can be as light or as firm as you like. It uses long strokes, kneading, deep circular movements, vibration, and tapping to help relax and energize you.
After this massage, you will feel as light as a feather!
Massage Therapy – Deep Massage
Deep tissue massage involves applying firm pressure and slow strokes to reach deeper layers of muscle and fascia (the connective tissue surrounding muscles).
It’s used for chronic aches and pain and contracted areas such as a stiff neck and upper back, low back pain, leg muscle tightness, and sore shoulders.
It is usually more powerful than Swedish massage so know what you are signing up to, and discuss with a massage therapist if you are not sure if this is the best option for you.
I sometimes recommend starting with a gentler massage and then progressing with time to a more advanced, stronger one.
If your body is not used to massage it makes sense to try a gentler version of massage first to see how you respond.
You are more likely to feel exhausted after a deep massage, but who knows, it may be exactly what your body wanted.
Massage Therapy – Sports Massage
This is similar to Swedish massage, but it is adapted more to sportspeople. It involves the manipulation of muscles, fascia, tendons, and ligaments to benefit a person engaged in regular physical activity.
When a person exercises, their body is subjected to different types of physical loading.
The body can adapt to a great extent.
Our muscles and other soft tissues, bones, the brain, and the nervous system respond appropriately.
However, increased stresses are placed on the body in the process.
This may result in injury, muscular tightness, or aches. This happens especially when we want to progress too quickly.
Massage therapy can become a great ally to athletes as it can help:
- prevent or treat injuries
- Improve flexibility
- Maintain a high level of performance
- Facilitate training before competition or race
Massage Therapy – Trigger Points
Trigger points are those painful knots and bands that you can easily palpate under your skin.
They often refer pain to other parts of the body. Massage can relax muscles and help unwind those knots. Very often one session is not enough and sometimes massage is not sufficient to tackle trigger points and more advanced medical attention is required.
I have found an interesting article on trigger points by Paul Ingraham. It is well worth a read!
Benefits of Massage
Massage is good for your muscles
There are a lot of benefits to be achieved through regular massage therapy treatments. Whether your need is to have a moment of relaxation, reduce muscle tension or attain relief from chronic pain, a therapeutic massage can enhance your overall sense of emotional and physical well-being.
First and foremost, massage therapy relaxes muscle tissue and reduces painful contractions and spasms. It can also lead to reducing nerve compression by muscles. This may be particularly good for people having a radiating type of pain in their leg or arm, Muscles, when tight and shortened, can squash the nerves.
One of the theories behind muscular pain and stiffness says about the decreased blood supply to muscles and nerves. As a result, you may feel pain and discomfort. Massage can restore normal muscle tension and allow muscles to work properly..
And not only muscles…
Massage comes under the umbrella of complementary and integrative medicine. It’s also increasingly being offered along with standard treatment for a wide range of medical conditions and situations.
We know that more research is needed to confirm the benefits of massage. However, so far, some studies have found massage useful in (click link to find more info on each condition) :
- Anxiety and mild depression
- Digestive disorders
- Insomnia related to stress
- Myofascial pain syndrome
- Soft tissue strains or injuries
- Sports injuries
- Temporomandibular joint pain
Massage – a substitute for medical treatment?
Many people like to have a massage as it simply produces feelings of caring, comfort, and connection. It is a great way to wind down and feel better about oneself.
Therapeutic massage can completely remove muscular tightness and tension.
These are the main culprits causing back pain and limiting the range of motion in your spinal joints.
Despite its benefits, massage isn’t meant to replace medical treatment for the above conditions.
It is more of a complementary treatment. Something you may like to consider as an option to add on. Let your doctor know you’re trying massage, and be sure to follow any standard treatment plans you have. It is better to be safe than sorry.
When to avoid massage?
You may think that everybody can have a massage. There are, however, situations when it is not recommended. It may not be appropriate for those with:
• Severe osteoporosis – check with your doctor! Milder forms of osteoporosis should be ok. Bleeding disorders or take blood-thinning medication – Massage may not be a good idea as it does affect your blood vessels twisting, rolling, and squashing them, So again, best to check with your doctor.
• Burns or healing wounds – it is not rocket science, why would you like to have a massage on damaged skin?
• Deep vein thrombosis – A big no, no! You really do not want to have a massage with a clot in your vein. Massage can make things worse in this scenario
• Fractures – but once your bones healed up nicely, it should be ok!
• Severe thrombocytopenia; in other words, blood clotting problems. Check with your doctor
It is also best to discuss your condition with your doctor, especially if you are pregnant or you have cancer or unexplained pain.
Some forms of massage can leave you feeling a bit sore the next day. But massage shouldn’t ordinarily be painful or uncomfortable. If any part of your massage doesn’t feel right or is painful, speak up right away. Most serious problems come from too much pressure during massage.
Before and during massage
You don’t need any special preparation for massage. It is best to avoid a large, heavy, meal before.
Before a massage therapy session starts, your massage therapist should ask you about health, medical history, and allergies.
Your massage therapist should explain the kind of massage and techniques he or she will use.
Depending on preference, your massage therapist may use oil or lotion to reduce friction on your skin.
They also can maximize therapeutic effect and be of great benefit to you and your health.
Tell your massage therapist if you might be allergic to any ingredients.
In a typical massage therapy session, you undress or wear loose-fitting clothing. Undress only to the point that you’re comfortable.
It is best to take off any jewelry and watch.
You generally lie on a table and cover yourself with a sheet or a towel.
You can also have a massage while sitting in a chair or side-lying.
Your massage therapist should perform an evaluation through touch and palpation to locate painful or tense areas and to determine how strong massage should be.
Tell massage practitioner what you expect and how strong massage you would like.
You do not need to suffer, have an unpleasant experience, and leave with trauma.
Very often people think they should have a stronger massage as it is more powerful and effects will last longer. This is not true.
A massage session may last from 30-45 minutes, depending on the type of massage and how much time you have. No matter what kind of massage you choose, you should feel calm and relaxed during and after your massage.
If a massage therapist is pushing too hard, ask for lighter pressure.
Occasionally you may have a sensitive spot in a muscle that feels like a knot.
It’s likely to be uncomfortable while your massage therapist works it out.
But if it becomes painful, speak up.
Finding a massage therapist
As I mentioned before, there are more and more massage therapists around.
In a way, this is good as the field becomes more competitive.
However, it may be difficult for you to choose the right person to do a massage for you to the standard you would expect.
Ask your doctor or someone else you trust for a recommendation.
Don’t be afraid to ask a potential massage practitioner such questions as:
- What are your training and experience?
- Are you certified or registered
- How much is it?
- Do you do home visits?
- What massage would you recommend for me and why?
The way to think about massage is that it is a natural therapy.
It can help you in many ways providing you see an experienced professional who knows what they are doing.
Massage is especially good for aches and pains originating in muscles.
It may be useful in other conditions too, but more research is needed in this area.
Disregard any thoughts that massage is only a feel-good way to indulge or pamper yourself.
On the contrary, massage can be a fantastic tool to help you with your health and well-being, whether you have a specific health condition or are just looking for another stress reliever.
And do not forget to ask your massage therapist for some good self-massage techniques that you can use at home!
I am a Chartered Physiotherapist and Master Myofascial Therapist practicing in Southampton, Hampshire. I was working in the NHS between 2008 and 2021. My speciality lies in treating musculoskeletal conditions and providing community rehabilitation.