“No Pain, no gain” - more effective massage?!
“No pain, no gain”
In many minds the effectiveness of a remedial massage treatment seems to be directly proportional to the level of pain experienced during the treatment (that was a geeky way of making this comparison, wasn't it? #geekydany). So let's dive into a little conversation about this statement (mmhhh, monologue? you folks can't really talk back...)
I feel I first need to make a discourse and dive into some technicalities (talking about geeky, hehe). Remedial massage makes use of depth (=pressure), speed of movement, and relaxation to be effective. Well, you could also add frequency of treatments to the list, but that's for another post. As you can already see from this enumeration, depth alone is not a panacea here! Depth needs to be adapted to the very muscle to be treated (if it is your deepest backside muscle giving you grieve, I would definitely apply more pressure than to a tiny muscle on your throat - got the picture?). Reason being? Well, pressure 'disperses'. As I shouldn't use a scalpel to remove the upper muscle layers first (outside my scope of practise...unfortunately), I need to ensure that I apply appropriate pressure to induce a change in the deeper muscles I want to treat.
Simple as that.
Speed is THE most important tool in my toolbox EVER. That doesn't even give it credit, the 'EVER' I mean. Multiply this word a thousand times and we get closer to its level of importance. Going slow allows the tissue to yield to my pressure and to release tension. I speak from experience here: what I feel underneath my fingers.
And what fellow therapists feel...and generations of therapists before us. As much as I would love to cite a million scientific papers (got a scientific mind after all!), to date there are only the following hypotheses to explain this observation. The first hypothesis is that by avoiding the activation of muscle spindle cells, the connected reflex (=muscle stretch reflex) doesn't come on. This makes muscles more 'amenable' to receiving the benefits of a massage. In simple terms, the muscle stretch reflex's job description is to prevent muscle damage caused by a quick change of muscle length (elongation). To prevent damage the muscle contracts and therefore shortens. (Think of a situation when you rolled your ankle - the righting reflex kicked in possibly even before you could start swearing - that was in part due to the stretch reflex).
Going slow in a treatment also allows to induce change in connective tissue. This falls into the specialty of Myofascial Release. Again, a very young research discipline... Up until approx. 15 years ago myo-fascia was only seen as a nuisance that needs to be cut off in a postmortem to get to the 'real stuff' underneath. Little did we know how important it is in living organisms. Little discourse into myofascial release...
Think of stretching your muscles: if you go hard and fast it
(1) hurts like hell ,
(2) doesn't lengthen your muscle properly,
(3) is therefore much less effective than taking time to do it
(personal observation: effectiveness of quick stretches close to absolute zero).
Massage actually works - in part - by stretching muscle tissue. When I press my hands in that deep backside muscle from earlier in this post, the only option it has is to yield to my pressure by....well...stretching aka releasing unnecessary tension.
The speed of strokes also determines the effect the treatment has on your nervous system... relaxation! We humans are - biologically - pre-historic beings. Our nervous programming hasn't changed a lot (operation system overdue for an update...download delayed **sigh**). We are all governed by two default modes of our unconscious (autonomic) nervous system: fight/flight, or rest/digest. The latter is responsible for a relaxed state of our bodies. We are all very familiar with these terms, I guess?! No need to go into details? Great!
I can pre-empt a question in your mind right now:
“How on earth could I possibly feel stressed (aka activated fight/flight mode) lying on a massage table?”
Answer: if someone gives you the feeling that you are being smashed-up.
Deep and painful pressure and speeding through your muscles as if they were on a German Autobahn. Pain is a signal in our body that something is not quite right. A lot of pain may even mean our survival is at stake. Again, outdated operating system .... 20k years ago there were no massage therapists around so our nervous system didn't learn to distinguish a real threat from a **cough, cough** over-zealous therapist. Fight/flight mode also activates skeletal muscles to prepare you to fight for your life or run away (and who could blame you for running away from that overzealous therapist's clinic...). Activation is equal to an increased level of tension in a muscle. On the other hand, rest/digest mode is your unconscious mind appreciating the safe environment you are in....and it sends signals to the muscles that they can relax and 'melt away'.
Yes, exactly what we want!
So, what makes a good massage a good massage then?
This is subjective and there is no one set standard anywhere to go by…but I would urge you to consider the above. It is not as if there was a 'Massage Health Act 2022'...
However, ya know, sometimes it feels so when discussing this topic with fellow massage therapists… **winking**.
The rule to go by is how YOU feel after the treatment. And no, I don't mean 'feel' as in smashed-up-by-a-wrestler kind of feeling.
Can you feel that the issues you presented with have improved a bit?
Less tension?
More flexibility?
Less restrictions of movements and less pain? Can you see yourself coming back for another treatment?
Have you enjoyed the session?
Keep in mind: you can't really expect a complete recovery after one session... Rome wasn't built in a day either
If yes to all of the before, good signs you have just received a 'good massage'.
Some last few words on pain. There is a difference between productive pain and unnecessary pain. "Ha", you may think now, "she contradicts herself!". Wait a sec before you judge me. Massaging out Trigger Points and ship loads of tension can get uncomfortable, temporarily. Yet it is that kind of discomfort that releases when you breathe through it, and the next few massage strokes actually feel pleasant. Therefore: productive pain. This is VERY different to feeling happy that the hour of massage is finally over as all you cold think of for the past 59 min was
"RUN for your LIFE!"
Exaggerating a bit here....I admit. But I think you got it.
As with all my posts on any of my social media outlets, you are welcome to disagree respectfully & politely. I even look forward to hearing from some opponents to what I have written... may make for some interesting conversations! I only challenge you to try a balanced massage approach one day: get a massage that uses depth in a productive way. And compare it back to the tortured feeling you may be familiar with of the past "No pain, no gain!" type of remedial treatments.
I can speak from experience, I have had both! :-)
Stay relaxed,
Daniela
First Image: 'intense-massage' Drawing by Claude Serre.jpg