Also I have found equally as ineffective the use of massage in such a way as to enter the soft muscle tissue abruptly and with enough pressure to cause bruising and extreme pain. In the world of exercise one may be able to get away with the belief “No pain; No Gain”, though I have my doubts. But, in the world of massage abrupt deep pressure does not promote long term healing for a variety of reasons.
1. Injury or re-injury of tissue
2. Development of perceived pain relief cycles
3. Psychological dependence on perceived pain relief cycle
4. Inhibitor to proper assessment and treatment
I have often been regaled by my clientele with tales of deep tissue massages that caused bruising, days and even weeks of extreme pain, fever, nausea, muscle contusions, and strained tendons.
Any of these by themselves is enough to turn the novice from ever receiving massage again, but to those who suffer severe and chronic pain, suffering through one or more of these seems to be a small price to pay for a chance at wellness. Too often I meet people who have, through no fault of their own, adopted the “No pain, No gain” philosophy in efforts to rid themselves of pain or to help manage their pain. I will say that pain can come in treating some conditions such as Plantar Fasciitis or some forms of hip pain, but this pain should be of short duration and not so severe as to cause the client long term after effects. For the majority of massage treatments techniques should be applied thoughtfully, intelligently, patiently, and gently. For example, I have personally witnessed a frozen shoulder of 27 years be released gently and pain free. I myself have helped to eliminate certain forms of hip pain involving overly tight muscles deep in the pelvic bowl.
Many of the techniques used to achieve pain free release are those that have been used for years, such as myofascial release and PNF stretching. These techniques are used either as a sole treatment or as part of a protocol. One such technique is Myofascial Release. While myofascial release can employ techniques involving deep pressure that delivers considerable pain to its recipient, there are ways to use this time proven technique with little to no pain to the client and yet achieve lasting results.
Extreme pain during massage also inhibits long term healing by setting up a neuro pathway of perceived pain relief cycles that reads something like this:
Chronic pain
Massage pain
Nerve exhaustion (perceived pain relief)
Induced muscle pain
Chronic pain
Each time a client receives a “deep tissue” massage done incorrectly, this cycle occurs and soon a pattern emerges in which not only does the pain return, but the body comes to expect this and adapts. The result is years of perceived pain relief that never truly addresses the cause of the pain. The perceived pain relief is actually nerve exhaustion. The nerve becomes tired and briefly shuts off. That is why the same pain returns just a few days later.
Due to a lack of understanding on both sides of the equation, this perceived pain relief cycle also can set up a type of dependency in which the cause of the pain is never resolved and the client becomes dependent on massage as a form of pain relief rather than finding a pathway to true healing. It is true that massage performed on a regular basis is beneficial, but not as a sole prescription for relief of chronic pain improperly accessed or treated. As a natural consequence, it could be years or never that a client’s pain is adequately resolved. It is therefore, the opinion of this author that to continue massage once the pattern of perceived pain relief is recognized is both unprofessional and unethical. It is important also to point out here that there are conditions for which massage can be utilized in a healthy professional manner as part of a pain management protocol in conjunction with other medical treatments.
By contrast, a properly trained and compassionate massage therapist will be able to properly assess a client’s pain and shortly determine if he or she has the skills to promote long term healing. If not, a referral should be given to a more skilled therapist or another medical disciple altogether. Thus it becomes the responsibility ultimately for the client to be his/her own health advocate. Here are a few questions you can ask if you suspect you may be caught in a perceived pain relief pattern.
1. Why do I have this pain?
2. Why does my pain return consistently two or three days after massage?
3. How long will it take for me to begin to experience long term pain relief?
4. Should I seek medical attention for my pain?
If the answer to any of these questions is “I don’t know”, you might want to consider a visit to the doctor and at the very least seeking out another massage therapist with greater experience.
In conclusion, deep tissue massage if employed with intelligence and thoughtfulness can be highly effective, but done improperly can cause more harm than good. Is can be VERY frustrating for those in search of pain relief to turn to deep tissue using that old thought pattern of “No pain, No gain”. But instead, you are encouraged to spend a few precious hours researching the type of massage you really need and whether or not the establishment you have chosen has on is staff those capable of employing massage properly and effectively. Unfortunately, western medical persons may or may not be informed enough to answer all your questions concerning massage. However, they can guide you in the appropriateness of massage for you and may even have massage professionals to which they can refer.
Melissa Jarufe, LMT
September, 2015
