Here are some frequently asked questions about massage therapy and my practice.
Have a question that isn’t answered below?
FAQ’s about massage therapy.
What is the value of therapeutic massage, both short and long-term?
This is actually two questions.
1. What is the short-term value of therapeutic massage?
The short-term value of therapeutic massage is relief of pain and increased freedom of movement. Not all bodily aches and limitations are appropriate for treatment with massage therapy, but when therapeutic massage is appropriate it works to help correct imbalances in the skeletal muscles that result in pain and limitation. There are competing theories on how this happens; here are two of them.
Muscle tissue that is starved for oxygen supply from blood circulation (referred to as ischemic) releases a constant supply of irritating chemicals that the sensory nervous system interprets as pain. The mechanical pressure of massage therapy opens up these muscle fibers to a proper level of blood supply, ‘washes away’ the noxious chemicals and restores normal function of the affected muscle tissue.
A second theory suggests that massage corrects sensory nerve information that distorts the resting state of our muscles. Our overall posture is determined by a set of ‘instructions’ from the sensory nervous system that tell the muscles what their resting position is supposed to be. After injury, this set of instructions is altered to account for the protection and healing of injured soft tissue. This reaction is called muscle splinting and is common in joint sprains and whiplash incidents. It is facilitates a good recovery from a soft tissue injury. Sometimes, though, the protective pattern outlasts the original injury and what’s left is a group of muscles that are protecting a now-healed injury site. These unnecessarily contracted muscles are now themselves a source of pain and restricted movement. Therapeutic massage ‘resets’ these sensory nerves to re-establish a normal postural pattern.
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2. What is the long-term value of therapeutic massage?
Let’s assume for a moment that you have no pain or other complaints that have a material consequence in your daily life. Does therapeutic massage have any value for you? It very well might.
If there is some physical performance objective that you just can’t quite reach because your body just doesn’t quite get you there, then therapeutic massage could make the difference. I’m not talking about turning a jockey into a linebacker, here. I’m talking about dropping a distance runner’s mile splits by a few seconds or increasing the amount of time you can spend at your favorite hobby before some physical discomfort makes you quit. It may not be an everyday aggravation, but it’s something that stands between you and the quality of life you really want.
Therapeutic massage can support you in changing your posture and movement over time. That change will allow you to do more of the physical activities you love or just help you do them better.
But wait… there’s more! There is also the entire collection of benefits for which massage is most-often cited: lower stress, enhanced sense of well-being, better circulation and lower blood pressure. Since every individual takes to a given therapy differently, you can only know if massage therapy will help you by trying it out.
Is massage therapy expensive?
Not really. A massage at my office costs $90, and in return you get an hour of my undivided attention on whatever you think is most important. Some of my own friends and family won’t give me that. I say it’s a steal.
Can you predict how many sessions I will need?
Only in a very general way. It depends on the situation and the individual being treated. As a general guide, one-time injuries may take just a few sessions and long-standing issues require more time. A weekend warrior overuse injury might require just an appointment or two. Years of chronic headaches might take weeks or months to work through.
What we can know is what changes to look for to determine if massage therapy is helping you. We can watch for changes in pain patterns and the duration of relief that you receive from your massages to know whether we are making progress or just treading water. It is perfectly reasonable to expect that you will have the likely outcomes explained to you and have some sense of what you can expect next in the process of treatment.
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What should I expect on my first massage therapy visit?
You should expect a gracious welcome and a terrific experience. Your massage therapist wants this to be a comfortable and pleasurable experience for you. If you already know what you like in a massage, express this preference as best you can to your new therapist. My personal preference is to let my massage therapist do what they do best, and only modify their work if I have a particular request (ex. a stiff neck or overworked calf muscle), but it’s just that – my personal preference. Ask respectfully for what you want; most therapists want to support you in this.
Where will my massage session take place?
Massage work is done in many environments. I have a small office in a professional building and do most of my work there. I also make house calls and do some chair massage work in corporate offices and at special events. You will also find massage therapists at gyms, health clubs, chiropractors’ offices, and spas.
What should I wear during the massage?
You should wear what you are comfortable wearing. Bear in mind that no matter what you decide to wear you will always be draped with a sheet or towel. The therapist only moves this draping to work on a particular part of your body – the part of the drape that covers your leg will be moved so the therapist can work directly on that leg. Even so, you can receive an enjoyable massage with no clothing on (under the drape) or in sweatpants and a t-shirt (still under the drape). Or anything in between. A simple guide if you are concerned is: if you have to think about it too long, leave it on.
What do I do during the massage session?
Mostly you lay on a really comfortable table feeling wonderful and wondering just why it is you don’t do this every day. And in the middle somewhere you will be disturbed by the massage therapist asking you to turn over which, due to a practical problem as yet unsolved by our profession, you are required to do completely on your own. Yes, it’s unfair, but please rest assured that we are working on it.
How will the massage feel?
Really, really great.
Will the massage oils used during the massage make me break out?
Allergic reactions to massage oils and lotions are rare, but not completely unheard of. If you have allergies that you already know about, by all means tell your therapist so they can prevent a problem. The particular oil that I use (cold-pressed apricot kernel oil) has never caused a reaction with any of my clients.
Is a massage always appropriate?
There are rare circumstances where massage should be avoided selectively (a joint or a limb) or completely. See contraindications below. Apart from that, it is always the right decision to get a massage.
How long will the massage session last?
The most common session length is an hour. Longer or shorter sessions are sometimes appropriate. I personally prefer an hour and a half when I receive a massage. And when I treat some medical complaints (headaches for example) I find that half-hour sessions are more effective than longer ones.
How do I find a massage therapist?
The best way is to find someone recommended by someone whose judgment you respect. Sometimes you don’t have a good network in the geography you are searching, in which case I recommend using the American Massage Therapy Association’s locator service. Go to www.amtamassage.org and click on “Find a Massage Therapist”.
What does a massage therapist’s certification or license mean?
A therapist’s credentials mean different things in different jurisdictions. In California I hold a voluntary credential called a certification. This certificate requires that I have a minimum of 500 hours of massage therapy education, have passed a background check, and agree to uphold a set of professional standards set forth in California State law (California Business and Professions Code, Sections 4600 – 4620) and monitored by the California Massage Therapy Council (CAMTC). This certification gives me the right to tell you that I am a Certified Massage Therapist (CMT).
When I practiced in the state of New York I was credentialed as a Licensed Massage Therapist (LMT). What that means is that I completed a state mandated massage therapy curriculum including both scientific and practical (hands-on) instruction and passed an exam required by New York State.
The purpose of both of these types of credentials is to prevent practitioners with insufficient basic education from doing harm to the public and to discourage the use of massage businesses as fronts for prostitution.
What if I am overweight or embarrassed about my body?
This is a tricky question in only this one respect: your massage therapist doesn’t judge your body type. So while being embarrassed about one’s body is commonplace in our society, your massage therapist can respond to this only by treating you with the respect and kindness to which you are entitled.
Do I have to be completely undressed?
Do I have to use a towel or a sheet as a drape?
Can I talk during a massage?
Yes. Always and only at your discretion.
Will a massage hurt?
No… with only very rare exceptions. The exceptions involve treating conditions like tendinitis, where the specific technique used (in this case cross-fiber friction) does cause a certain amount of discomfort.
How often should I receive a massage?
No… really, how often should I receive a massage?
In order to receive the ongoing, cumulative benefits of a general relaxation massage, I would recommend every week at best, every other week at the outside. Less frequently than that and you are always playing catch-up with the accumulated tension since your last massage. For addressing specific complaints (such as neck and shoulder pain or minor injuries), getting massage on an “as needed” basis is completely fine. Bear in mind that most problems are easier to address early in the process than they are later. Better to come in when your back begins to feel tight and sore rather than waiting until it’s too painful to get out of bed.
Can I just set up an appointment or do I need any sort of referral?
You do not need a referral to get a massage. Call to schedule an appointment at your convenience.
Are there any preparations I need to make before my appointment?
None that you need to make, but here are some suggestions that might make your appointment a little better. Allow a little extra time to travel to your appointment just in case you get delayed on the way. Allow a little more time after your appointment so you don’t have to go right back to the craziness of daily life – leave time to go get a refreshing beverage and watch everyone else be in a hurry for a few minutes.
Why does a massage therapist ask about my medical history?
There are certain medical conditions for which massage is contra-indicated (untreated high blood pressure would be one example). The medical information you provide helps the massage therapist refrain from doing the rare thing that might cause you harm. It also provides some lifestyle and daily activity information that can help the therapist chose the most effective technique to relieve whatever complaints you may have.
What is not included in a therapeutic massage?
A medical diagnosis, career advice and sex.
Do I tip?
I discourage tipping in my private practice because I believe my service should cost exactly what I say it costs. If you receive a massage at a gym, spa, or hotel your therapist is probably being underpaid and a generous gratuity (around 20%) is always appreciated.
When should I not get a massage?
There are certain conditions that are contraindications for massage. Following are some of the major ones:
- Any type of infectious disease
- Systemic infections
- Severe cold
- Fracture, bleeding, burns or other acute injury
- Liver and kidney diseases
- Blood clot
- Pregnancy-induced diabetes, toxemia, preeclampsia/eclampsia
- High blood pressure (unless under control with medication)
- Heart disease
- Open skin lesions or sores (therapist may work around them if localized)
Always alert your massage therapist about any changes in your medical condition. They can work with you to address many conditions and will err on the side of caution when treating you.