C. A. Keith
So you want to relax and head to your massage appointment. You’re wondering if you’ll feel better in a few days, right? Or are you stocking up on the Ibuprofen and Naproxen in anticipation of what I prefer to call ‘run over by a bus’ symptoms. “No pain, no gain, right?” I hear.
As a College Instructor, as a Registered Massage Therapist, and as a friend, I say, “No way! I don’t buy into that, one bit and neither should you!”
Types of Pain
In the context of massage, there is point tenderness, achiness, trigger points and tight muscles. An elbow pressed in to a muscle too deeply can evoke severe pain. With trigger point treatment, the recommended practice is to compress the trigger point at the most tender spot. This pressure can tighten up surrounding musculature if the patient holds their breath momentarily.
Then, if the patient is bouncing off the table and holding their breath, it is a pretty safe bet that the pressure is too intolerable for that person at that time.
What should you expect?
So what should you do to ensure your patients and clients have the best experience possible, not just today but every time they come to see you?
What should patients expect when they go to a new massage therapist or clinic?
In this blog, I am talking about causing extreme pain.
Alternative Methods
Explain to the patient/client that they may experience feelings of discomfort but they still need to be breathing comfortably and easily. Keep pain within their tolerance.
If the patient is jumping off the table and muscles are spasming or twitching uncontrollably, they’re screaming; then back off! Lighten up your pressure, change your technique and try again later. Slow your tempo down so it is perceived as a relaxing technique.
Try muscle stripping over the tender areas instead of direct pressure. Most people can’t tolerate direct trigger point therapy; and shouldn’t have to. The job can get done effectively with limited amount of pain and discomfort.
Purpose of Massage
According to the College of Massage Therapists of Ontario, the scope of practice “is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissues and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain.” (Massage Therapy Act, 1991)
A patient shouldn’t be told no pain, no gain. At no time is anyone happy with extreme pain. The scope of practice for Massage Therapists is to relieve pain not to have someone endure days of feeling like they’ve been run over by a bus. How does one gain success with putting patients in extreme pain?
Even the pain scale of 0 to 10 (0 being no pain, 10 being the most pain you’ve ever felt, and 7 being the gold standard) can be very subjective. One might assume that the pain they should experience should be closer to the worst pain ever experienced. That would be an error.
What causes pain?
Massage is supposed to benefit the patient. When we evoke extreme pain to our body, whether by massage or working out at the gym, the body fights back and not in a good way. If someone is lifting weights that are so heavy that there is extreme pain, they will get hurt. Often pain is the body’s safety net to stop us from what we are doing. Pain chemicals are sent in response to swelling and discomfort to stop the person from further damaging tissues.
Pain that is excruciating and intense should be alleviated immediately by one thing; stop what you are doing and reevaluate. Everyone’s tolerance to pain is different. One thing remains the same across the board, if the patient is holding their breath due to pain, then it is way too much and you must make changes immediately before the patient gets injured.
No Pain, no gain… Right?
No pain, no gain? Absolutely not!
There is really no gain to getting hurt. Massage is meant to improve condition. As a RMT it is our job to educate, follow through with what we are teaching, and make the experience a good one. Learn to lighten up. The job still gets done properly and comfortably.
Choose to be the turtle rather than the rabbit when working with patients. The task doesn’t really take that much longer to get the goals of the patient performed successfully.
The promise that I hold close to my heart, compassionate caring, is important to me. My patients require a caring compassionate touch compared to the ‘run over by a bus’ for days feeling.
I may have much backlash as so many massage therapists are still telling people no pain, no gain but I prefer to be the turtle than the rabbit.
Patient care is not a race. It is compassionate caring and working with their goals, within their pain tolerance.
Let massage be the kind of pain management not the need for pain management!
C. A. Keith 