No Pain, More Gain

When I’m working on a client for the first time, there are two reactions that seem to top any other that I get.
The first is, when asking how the pressure feels, through gritted teeth they will say “No Pain No Gain, I can take it”. The second is normally some reflection on a past experience where the massage treatment was a painful ordeal, some may even describe it as horrific, and it then leads to years of them avoiding receiving another treatment.

As massage therapists though, our role is supposed to follow the belief of “do no harm” after all, the work we do is supposed to offer some type of benefit to the client. At the end of the day, regardless of treatment type or therapist, we want our clients to feel good. So why are so many of us still under the impression that a massage has to be painful to be beneficial?

If you haven’t seen a video demonstrating Non-newtonian fluid, check this video out:

What does this have to do with massage?
What we see when demonstrating the Corn Flour suspension similar to that in the video above, we see that applying force or pressure to the suspension is greeted with resistance. If we were to place our hand onto a corn flour suspension, and just rest it there lightly, the suspension would give way and our hand would slowly sink into the mixture.

This is the key to achieving great results when we massage, especially if we are hoping to work muscles that lay deep within the body.

When massaging, we tend to work generally, then specific, then generally again to finish up. If we were to go straight into a treatment working hard and deep with no warming of the tissue, or work with the client the client will most likely tense up. Contract the muscles in the area we are working, and probably end up feeling a bit weary of us.
How are we going to get results if our client is on edge and can’t relax?
If the superior muscles of the body are contracted, we’ll never be able to reach those underneath.

You can’t tickle a feather when it’s laying under a rock.

The Telegraph published an article in August titled “The Sheer Hell of Sports Massage.”

The title is just the first thing that I have issues with, as well as the term “Sports Massage”, Oh and the mention of Toxins Arghhhhhh but that’s a blog article for another time.
Just reading the title shows that this belief is something many people far and wide truly buy into.

But lets talk about pain for a second, because the problem with identifying pain is that it is very subjective. It’s what we personally perceive. What may feel pleasant to one person, may be absolute agony to another. This is why we use pain scales. A scale of 1-5 can be quite limiting, so I like to extend it to a scale of 1-10.

It gives us several ways to interpret the pain that our clients are experiencing.
First we have the number on the scale, I always ask where they feel they are on the pain scale “at rest” this is just sitting around relaxing, no physical exertion or strange positioning.
I then ask them to compare this to when they are in pain from their illness or injury, and identify where it would be on the scale.

Personally, I never want to cause any more pain than what they are currently experiencing. There may be a few rare exceptions where this may happen. But my goal is to reduce pain, and help my clients feel BETTER, not have them leaving in worse condition than they arrived.

So we’ve communicated verbally pain thresholds and current pain levels. That’s the easy part.
Now this is where we really have to work hard as a therapist, we now have to listen with not only our ears but also our hands and fingers.
We are listening for a change in our clients breathing pattern, particularly for signs that they may be holding their breath. We are then feeling through our sense of touch for muscles contracting, limbs jerking, for a sensation that the client is pulling away from you.

These are all signs that they are uncomfortable or are in pain, so we need to take a step back.

The key to getting deep into underlying muscles is to work slowly.
Trust, Warmth, and slow application of pressure are the keys to a good deep massage.
If you are stretching with a client, if they are contracting, tensing, you aren’t going to get a feel for the true end point of the stretch. You’re going to be stopped well before you can stretch the client to their true extent.

This is where we, as therapists, need to through our ego out the door. Inflicting pain on our clients shouldn’t be a badge of honour. We shouldn’t be trying to make the massage more painful than the last therapist.
Our goal is to make it more effective. We need to understand our clients need through proper assessment. Be focused and fully present during the session listening with our ears and with our hands. We also must ask our clients how they are feeling, and don’t take fine for an answer.
We all know, especially coming from women, sorry ladies, but “fine” very rarely ever means that they are fine. If that is the answer you get from a client, it’s time to change the question.
Try “would you like more pressure? or maybe a little less?” Even just a simple question that just needs a Yes/No response would be good. The more you work with a client, the less you will need to ask, but in those early days COMMUNICATION IS KEY.


But what about clients?
There is a vulnerability about being on a massage table, at the hands of a therapist, and some find it difficult to speak up if they are feeling pain or discomfort.
Please be re-assured that we want your feedback. We NEED it. If a therapist ignores your feedback, and works to their own routine or own plan, they aren’t the therapist for you. We are there to meet your needs, provide you with a service and this is where you get to call the shots.
If you don’t like an area being massaged, PLEASE let us know.
If the massage feels pokey, or scratchy we need to know.
If you are in pain PLEASE don’t suffer in silence, we need to know so that we can provide you with the best treatment possible.

We are here to facilitate the bodies natural ability to heal itself, that does not include causing any further discomfort or damage.

Let’s work on changing public perception.
Deeper doesn’t always mean more painful.
Painful doesn’t always mean better.
Bruises after a massage are not something to be proud of.

We can change these beliefs, one massage at a time.