Category Archives: For Massage Clients

Video: Self-massage for TMJ Pain/dysfunction

Want to try some massage for your own jaw? Follow along with me as I demonstrate an easy myofascial release technique that takes just a few minutes! Do you feel that sense of ease and freedom afterward? Let me know in the comments, and feel free to share with friends and massage clients!

Video: Does Massage Flush Toxins?

Does massage flush toxins? Does it break up lactic acid? Check out my new video on the topic:

If you’ve followed me for a while, you know the ending. The whole “toxin” thing is a persistent myth, and it’s based on a misunderstanding of our internal environment. It assumes that there are areas of stagnation within muscles, and that these areas need to be wrung out so that fresh fluid can pump in. The fact is that the body is constantly refreshing the fluid between and within cells, especially highly vascular tissue like muscle. With every heartbeat and every little movement, circulation carries on.

I want to make one thing clear: I get it. The idea of stagnant fluid makes sense. After all, we get up and feel stiff. Doesn’t that mean that the muscle itself is stiff? The toxin thing makes a kind of sense too. If we feel pain, or just feel heavy or tired, doesn’t something need to be flushed out?

These ideas resonate with us because they match our macroscopic world. When a hinge is stiff, it needs oil. When we sit in a chair often enough, it wears out. But our bodies aren’t just macroscopic and static; there’s a rich, busy microscopic world at work, even when you’re sitting still. If chemicals start accumulating in a cell (carbon dioxide, lactate, salts, etc.), our organelles, channels, and pumps bring it back to homeostasis. If tissue becomes hypoxic, capillaries dilate to increase the local blood flow. If there’s damage, macrophages and fibroblasts mobilize to fix it up. The “stagnant tissue” idea falls apart upon closer inspection.

If you tell clients about toxins, I know it’s because that’s the information you were given. The only reason I’m trying to put the brakes on this myth is because clients take this information to heart. They hear about these toxins and start wondering if they’re sick. They can carry this toxin idea with them for the rest of their lives.

Instead, what if we emphasized how robust their homeostatic mechanisms are? What if we talked more about how resilient they are, both in body and mind? As massage therapists, we can choose to focus on the wholeness of each person, rather than on something being broken. We can make this case silently through our hands, and we can openly tell people: “Even though you’re in pain, your body is resilient, and change can happen.”

Let me know what you think. If you used to talk about toxins, what have you changed when talking to clients? What do you say when a client asks, “is massage good for flushing toxins?” Thanks for reading!

Photo credit: threephin via Flickr, CC BY-SA 2.0

For Massage Clients: Your Body is Just Right

Your body is exactly as it should be. It’s perfectly fine for your body to be the way it is, and to do the things a body does.

That means that you can be any shape and size, and that’s how it should be. Your skin can have hair, and stretch marks, and cellulite. Your stomach can make noises, your armpits can be fragrant, and you can snore when you fall asleep. Never apologize for being fully and thoroughly human.

Via Anna, CC BY-NC-ND 2.0

If you’re in pain, we want to help you have less of it, and to help you accept it. There is no “should” when it comes to pain, and judging and blaming your own body only makes things worse. What would it be like to work with your painful back or knee, to act in partnership? To accept yourself on good days and bad?

One of the beautiful things about massage is that it’s about the big picture. It’s an hour where we work with you as a whole person. While you might get some extra attention to your stiff shoulder, we won’t pick you apart into pieces. We want you to feel more integrated and connected, and to realize your wholeness on a deep level.

We want you to realize that you are your body, and that you’re just as you should be.

3 Rules for Reducing Chronic Pain

I was sedentary for the first, oh, 20 years of my life. My only exercise was lugging my backpack, dense as a neutron star, from class to class because I was too lazy to make the detour to my locker.

I had back pain. Man, did I have back pain, and it was ever so mysterious.

Poor kid.
Poor kid.

That’s me about 18 years ago, taking a “before” picture (I think I was planning to start lifting weights… didn’t happen). Please realize that I thought I was in a completely neutral stance, feet even, shoulders relaxed, etc., and please notice how completely I failed. One foot was forward, one hip was hiked, one arm was rotated inward, and my entire torso was displaced 2 inches to the left.

Our bodies do the best they can with the stimulus that we give them. While our brains have access to a ton of information, the body will get limited cues, such as “needs to walk short distances,” “needs to sit for long periods,” and “needs to occasionally haul heavy loads.” Based upon these inputs, our bodies adapt. Mine had decided that I needed to be shaped a certain way to meet the needs of playing lots and lots of video games.

Rule #1: Change the messages you send your body, and it will adapt.

There’s a reason your muscles grow when you start lifting heavy weights. There’s a reason your ankles and feet become stiff and inflexible when you stand for 10 hours a day. There’s a reason your posture changes when you sit for months on end.

These reasons can be kind of mysterious, but the body seems to have its own logic. The muscle growth is an easy one, but why the stiff and painful feet from standing all week? Well, your body has received the message that you need to be stable in an upright, static position. You’re constantly using the small muscles of your low legs to keep yourself in a very specific ankle posture, so your body (in its infinite wisdom) decides to tighten those muscles in a more permanent fashion.

Sure, this can lead to intense pain after your day of standing, or to the inability to engage in certain things you used to be able to do, but your body received your message loud and clear: My survival depends on extended periods of standing. What else are your legs supposed to think, based upon their limited information?

So, change the message. If you need to sit at a computer all day, you do what you gotta do, but get up often, and venture completely out of your C-shaped sitting posture whenever you can. Change the message from “needs to sit for hours” to “needs to sit, then needs to do cartwheels and the YMCA.”

Really want to send your body an interesting message? Do yoga. That doesn’t just tell your body that it “needs to be flexible,” it proves something to your brain.

Rule #2: Prove to your brain that you can move painlessly.

There’s an interesting phenomenon that takes place when you’ve had pain for a while: Pain increases. Yeah, chronic pain increases your sensitivity to pain. How screwed up is that?

Well, from a survival perspective, it makes sense. When you receive painful stimulus often, your brain kind of perks up its ears and listens really hard. Things that used to be painless are now unpleasant, because the brain is paying extra attention to any possible sources of damage or danger. This actually accounts for most of the pain in osteoarthritis: It’s not how much cartilage you’ve lost, it’s how hard your brain is listening to those creaky joints.

Your brain is acting like an overprotective parent, forcing you to take more breaks, stay inside, and not do the potentially dangerous things you used to do. How? By using pain as a lever. Feel like shooting some hoops after recovering from ankle surgery? Enjoy your back spasms, human.

So, we’ve got something to prove to our squishy gray friend. This hypersensitivity likely plays a part in all chronic pain conditions, so we need to dial it down a bit. If pain cranks it up, then periods of painlessness will damp it back down. Specifically, periods of painless activity.

This means moving gently, even when everything hurts. Especially when everything hurts. One of the best treatments for osteoarthritis is walking, as crazy as it seems. It means stretching while staying within your pain threshold, and receiving massage that doesn’t hurt. It means being active in a way that challenges your current notion of what you’re capable of.

It also means not torturing yourself. Stretching in a painful way, receiving deep tissue massages that leave you aching for days, “pushing through the pain” when you work out: These can all increase your pain sensitivity. Prove that you’re capable, but don’t be a masochist.

Rule #3: Handle your stress.

This is the hard one. Getting up and stretching occasionally isn’t so hard. Walking even when you don’t feel like it is doable. Reducing stress is a tall order, complex in ways that we’re still learning about.

Stress-management includes addressing how you sleep, your interpersonal relationships, your financial situation, and lots of other stuff. While there are some tricks to reducing your stress levels, like meditation, and working out, and eating right, only you know the major sources of stress in your life. As we go forward, we’ll keep addressing this problem, but in the meantime, realize that stress and anxiety influence your perception of pain, and they can even cause mysterious pain (and other symptoms) in your body.

Oh, by the way, I no longer get the crippling back pain episodes, or the neck “cricks,” or the knee pain. My torso is no longer displaced 2 inches to the right, and my hips are level. I started moving, and lifting things, and doing fun stuff like capoeira.

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My feet are still flat as heck though.

For Clients: How to Prepare for Your First Massage

Massage is scary. There, I said it. I should know: When I went into massage school, I was terrified of the touching, the vulnerability, the possible nudity, the drum circles, the… man, how did I make it? Anyway, I stuck with it for one reason: Massage is awesome.

Let me tell you about my first massage. I was 19, and I was sick and tired of my back betraying me for seemingly no reason (I know the reasons now, and they were legion). I had been to physical therapy (helped some), and now I was giving chiropractic a shot. It was… okay. Lots of back cracking, but I mostly liked the machine that loosened my back up beforehand.

One day, the chiro asked me if I’d like to add on a massage. I said yes, and I was directed to a little room where a nice man greeted me. He asked me a few questions, and then… it hit me. I was about to let a stranger touch me, no, massage me, while I lie there in my jean shorts. Wait, was I allowed to keep my shorts on? How was I supposed to lie? Was I supposed to let him know when I was ready, or would he knock? I suppose he could have explained things a little better, but it’s easy to assume that people know the drill when you work at a high-volume place like a chiropractor’s. I’m pretty sure I did something wrong (ignored the face cradle maybe, or perhaps I was curled up under the table), but he quickly got me situated and then…

Well, my back wasn’t miraculously healed, and my chakras remained way out of balance, but my mind was blown. This was far better than any stupid back-loosening machine. This was a certified bodyologist, someone who knew way more about my pain than I did. Not only that, but I realized something: Human touch is communicative. It’s soulful and expressive, it speaks to a primal part of the body/soul apparatus that I, a touch-deprived dweeb, did not know existed. That massage therapist was soon replaced by a machine that shot water jets.

My Point…

I’m glad that I was blindsided by the opportunity for a massage. Why? Because if I had scheduled it a week in advance, those worries that lasted 3 minutes would have stretched out for days, and I might have psyched myself out. Do I need to shower? Is my body weird? Will it be gross for her/him to massage me? Do they make you get all-the-way naked, and will they see my butt? Good heavens, what if they touch my butt?!

Scary stuff. Some of these thoughts may have occurred to you, or you might have other worries. If you’ve done your research and picked a promising massage therapist, you shouldn’t worry too much. That said…

A Little Preparation Is Warranted

If you stink, wash up. A washcloth run over your armpits and feet can cover a multitude of sins. If you don’t stink, don’t worry.

If you have a wound or a plantar wart, make sure it’s covered in a sanitary way. No big deal.

If you have a skin disorder that is non-communicable (most cases of acne, psoriasis, and eczema are just fine), just make sure to note it on the intake form, and don’t worry about it. We’ve seen it a thousand times before. If you’ve got something communicable, or if you have any sort of open sores, wait until a doctor clears you.

Don’t come in high or drunk.

That about covers it.

“That’s It? What About My Hairy Le…”

Let me stop you there. We don’t care about your leg hair. We don’t care about your rough heels, or your “weird toes,” or your need for a manicure. And for heaven’s sake, we don’t care about your “back fat,” or your cellulite, or how you’ve gained sooo much weight and you’re so embarrassed.

Actually, let me take that back: We do care that you’re embarrassed. We hate it for you. We want you to feel comfortable in your body, as it’s the only one you’ve got. If you’re seeing a bodyworker (that’s what some of us call ourselves) who’s been in business for a while, you’re probably seeing someone who just plain loves human bodies. Tall or short, big or small, broken or whole, we love your body. That came out weird, but it’s true. We’re in this because of the amazing variety of human forms, because the body never ceases to be fascinating. Basically, what I’m saying is this: When you come to a massage therapist, bring your body.

“So… Are They Going to See My Butt?”

Hopefully you’re worrying less about the physical preparation (“don’t stink”), but maybe you’ve still got some mental preparation to do. Allow me to put your mind at ease:

Any reputable massage therapist will be concerned for your modesty. They will be fine if you leave your underwear on, and you can even tell them that you’d like to keep everything on. That said, should you choose to go starkers, no massage therapist worth their salt will ever see anything interesting. While we may want to work on your butt cheek (lots of important muscles live right around your hip bone), your butt crack will remain covered and out of sight. In fact, not only do we not want to see your bits, we don’t want you to wonder whether you’re exposed. If things are feeling too drafty, inform the massage therapist. If they can’t fix it, find someone more skilled at draping technique.

This… is way fancier than my massage office.

During the Massage

We will likely want you face-down on the table, with your face in that crazy cushion that looks like a toilet seat. Some massage therapists might want you to start face-up, but they’ll let you know. Consider removing your necklace and any dangly earrings, and putting them somewhere secure. Only undress as much as you’re comfortable with, and lay down under the top sheet. The massage therapist will knock after a few minutes. If you aren’t ready, please say so in a clear voice.

If the face cradle is uncomfortable, or if the room temperature isn’t right, or the music’s too loud, please say so. These things are easy to fix.

The massage therapist will likely have you flip over halfway through the massage. Pretend you’re flipping over in bed and you’ll do fine. You’ll probably be asked to scoot down toward your feet so that the massage therapist can take the face cradle away.

That, dear reader, is all you need to know for your massage. You don’t need to help move your limbs or your head unless the massage therapist asks. We’re strong, and we’re good at moving limbs around. You don’t need to make small talk, or apologize for anything. Take this opportunity to listen to your body, and the communication that’s occurring silently.

You also don’t need to stay quiet. If you feel like talking, there’s no reason to hold back. In fact, if something doesn’t feel quite right, we need your feedback. I know that the person working on you is supposedly an expert, but their intuition might be leading them astray. If something hurts, or if you could use more pressure, I encourage you to speak up. When it comes to your body, you’re the expert in the room.

After the Massage

After the massage is over, the massage therapist will leave the room so that you can get dressed. Take your time, and sit on the edge of the table for a minute if you feel light-headed. You don’t need to “make the bed” or anything, those linens will be changed after you leave.

Once you step out, the massage therapist will want to know how you’re doing and whether any pain feels better. There are no right answers to these questions.

You might need to pay the therapist directly, or there might be a receptionist who will take care of those things. You’ll be pointed in the right direction. You might be asked to schedule your next appointment, or if you’d like to buy something (a package of massages, a membership, etc). Keep in mind that your brain is mushy and suggestible right now, so you should probably leave big decisions until later.

On tipping: There is no standard tipping etiquette here in the US. Tips tend to be more common in spa settings, and less common in medical settings. I’ve always found $10 per hour of work to be well-appreciated. You can hand this directly to the provider, or leave it with the front desk. If you’ve got any questions regarding tipping or payment, please feel free to ask.

To Sum Up…

Worry less and enjoy your massage. There’s very little that you need to do; let this be one hour out of the month where you realize that the less you do, the less effort you put forth, the fewer expectations and preconceptions that you layer on top of the experience in your mind, the more you will accomplish.

Any other questions or concerns? Fellow MTs: Anything to add?

Photo by willowtreemassagetherapy