Category Archives: Massage Tips and Tricks

Fibromyalgia and Massage: How to Help without Hurting

What is fibromyalgia, and how should we deal with it as massage therapists? Should we press directly on tender points, or avoid them? Should we use deeper pressure, or only lighter work?

If you’re completely unfamiliar with this condition, it means widespread pain that isn’t related to injury or overuse. If you’ve got fibromyalgia, a lot of your body hurts, and no one can quite tell you why. There are no lesions on MRI or CT scans, there are no strains or sprains; you just hurt. On top of that, there are other common symptoms: Poor sleep quality, fatigue, memory problems (often described as “brain fog”), and depression. You can read more at this Mayo Clinic article.

Fibromyalgia tends to be cyclical, with many sufferers noticing periods of flare-upĀ and remission. Your clients will have bad weeks and good weeks, and finding out where they are in that cycle can help you determine how to proceed. More on that in a second. ... continue reading.

Massage Tutorial Video: Working with Mature Scar Tissue

How do you work with a client with older scar tissue? Here’s a video about my strategy:

I talk about some myofascial-inspired techniques for working with scar tissue, but mostly I discuss my general approach.

When I work with an area with extensive scarring, my primary concern is with the client as a whole. When someone has a visible/palpable area of past trauma, it can be easy to become hyper-focused on the region. While plenty of direct work may be warranted, this can leave the client feeling dissected, and it can feed into the narrative that this is their “bad leg” or “bad shoulder.” Certainly focus in, but always integrate the area back into the bigger picture.

Conversely, it can be tempting to avoid an area of past trauma. With a burn scar, or hip replacement, or amputation, we might feel like treating the area carefully. While I like this impulse (I think we should always approach the body with kindness and care), it can also unconsciously feed into a stigmatizing narrative where the site of past injury feels like “that thing” rather than “me.” ... continue reading.

Massage Tutorial Video: How to massage a “crick in the neck”

New massage tutorial video! This one’s on working with stiff necks, or “neck cricks.” As always, I come at this from a myofascial perspective, rather than trying to stretch the kink out or “break up knots.” I do a quick anatomy review of levator scapulae, and then I demonstrate my protocol on a client:

This is one of the few areas where I feel like massage can “fix” acute pain in one or two sessions. If I work slowly and give this area the time it needs, I can typically help them stand up from the experience with much of their range of motion restored.

I think that the “neck crick” phenomenon exemplifies one of reasons why massage is so useful. A little muscle in our neck gets irritated, and suddenly we have a huge amount of impairment. Rather than feeling like a spasm, it can often feel like a bone is out of place, which is a scary sensation. Suddenly, many of our tasks of daily living become more difficult, and even sleep can be out of reach. ... continue reading.

Massage Tutorial Video: Thumb-free massage techniques

Got hurt thumbs? Want to give an entire massage without using your thumbs, even once? Check out my new tutorial video:

You guys know that I’m a proponent of the “thumb vacation” when you’ve got pollex pain. If it acts like an injury, it needs to be treated like one: Rest, inflammation management, and rehabilitation. You wouldn’t tell a client with a hurt knee to “keep doing what you were doing,” so why do we treat ourselves with any less kindness?

The tricky part is implementation. How do I do petrissage? How will I apply deep pressure to certain areas, or scoop up muscles that beg to be scooped? In the video, I demonstrate some strategies that I’ve developed while my own thumbs were out of the game.

It will feel awkward the first few days, no doubt about it. Your flow will be off, and you might feel like you’re giving a worse massage. Don’t psych yourself out! Your clients will love the new techniques (you’re still the amazing therapist that they know and love), and you’ll find yourself coming up with some pretty exciting massage technology as you ease into it. In the end, it’s a great time to force yourself to innovate and broaden your repertoire. ... continue reading.

Massage Tutorial Video: “I threw my back out!” (Low back spasm)

What do you do when a massage client comes in with an “out” lower back? In this new video, I demonstrate a gentle myofascial release protocol to reduce spasm and guarding over the course of about 20 minutes.

While I do eventually incorporate direct work, the name of the game is slow and broad. By engaging the sheets of fascia that encompass the area of spasm, we can do some great indirect work on areas that would otherwise try to keep us out. As I say in the video, I don’t like the word “fixing” when it comes to massage, but I can typically get a substantial reduction in symptoms for these clients in a single session.

I’d love to hear your strategies! Do you incorporate heat? Movement? Do you tend to work more directly? There are many ways of approaching this problem, so let’s help each other out! ... continue reading.