Welcome to the Ask a Massage Therapist section of HandsOfSolace.com. Before you continue to the questions, I'd like to remind you of a few important items:
The answers to the questions that follow, as well as all of the information on this website, are my opinions. They are based on my experience and research, but still opinion. I am a massage therapist, and cannot diagnose, prevent, or cure any illnesses you may have.
The information provided on this site is for educational purposes only. It is not intended to diagnose, prevent, treat, or cure any disease.
The information has not been evaluated by the FDA.
You should always consult with your doctor before using this advice or undertaking any changes to your diet or exercise program.
This disclaimer may be updated anytime and is presumed to be a part of any past or future postings.
Please feel free to email me any questions you have about massage, and I'll be happy to try to answer them.
This depends on what type of massage you are receiving. The most traditional types of massage usually use oil or lotion, and it is assumed that the client will remove most or all of his or her clothing. For these (Swedish, Deep Tissue, Esalan), you can wear whatever you'd like. If you wear makeup to your massage, realize you will likely have to reapply it afterwards, especially mascara and foundation as these will often be wiped off on the face cradle cover. Some other kinds of massage and bodywork, including Shiatsu, Reiki, and Reflexology have the client leave most or all of his or her clothing on. For these types of sessions you will want to wear very comfortable clothing that you can easily lie down in. For Shiatsu or Thai Massage, you will need to wear clothing that stretches easily.
However, the amount of clothing removed in a session is always up to the client. If you would prefer to leave all of your clothes on for your session let your therapist know ahead of time. They will be able to adapt their work to the situation, or refer to you someone else who can help you better. The more items you remove the easier it is for your therapist to access your muscles, but it must be balanced with your comfort throughout the massage session.
For any massage where you take your clothes off, you will always be covered by a sheet or towel. Your therapist will uncover only the body part to be worked on, and you should always feel safe and comfortable.
A massage license is required by many states in order for a person to practice massage. Illinois is one of these states. Having a massage license means your practitioner completed the amount of education required (300 to 1,000 depending on the state) by the state to be deemed competent and safe. They likely also completed a written exam, and in some states a hands-on exam. In states where it is required, having a license means your practitioner is legally allowed to practice massage. It also means that your state has laws in place protecting you as a consumer, and that there is some sort of regulatory board where you can report unethical or illegal behavior.
Certification is a higher-level process, either with more detail or more specificity than the licensing process. Examples of this include taking a national exam to be Nationally Certified in Therapeutic Massage and Bodywork, or taking continuing education classes to be certified in things like pregnancy massage or manual lymph drainage. These require further education, study, and usually some sort of exam to receive a passing grade by the certifying body.
A note on what I said earlier: reporting unethical or illegal behavior. As a consumer, you deserve respect as well as a practitioner who upholds the ethics and laws of their profession and locality. If you feel this is not happening, you have several options. If possible, you could try speaking to your massage therapist directly to see if there is a miscommunication or a lack of understanding on the massage therapist's part. Otherwise, contact your state's regulatory board if your state has massage therapy licensing laws. Contact the police. Contact the professional organization your massage therapist belongs to. This is usually the American Massage Therapy Association, the Association of Massage and Bodywork Professionals, or the International Massage Association. These organizations provide liability insurance as well as requiring members to uphold a code of ethics. Unless your therapist has liability insurance through some other source, they should belong to one of these or a similar organization.
The licensing debate is a big topic in the massage therapy world right now, but what it means to you as a consumer is this:
-if you're in a state that requires it, seek out a licensed massage therapist
-if you're looking for specialty work, seek out a therapist certified in it
-look for a therapist who is committed to continuing education. Licensing, professional organizations and many certifications require it, and it shows their enthusiasm for what they do.
-look for a therapist who belongs to a professional organization, as it shows they have liability insurance and they should have a commitment to ethical behavior.
Many massage therapists are in this profession because they like people, and they think that bodies are amazing. Your massage therapist should show you and your body respect and courtesy. If not, find a new massage therapist! Massage can help you feel more comfortable with your body, and people often report being able to touch their own scars more easily after a massage therapist works on them. Your massage therapist is there to help you and support you, not judge you. They know that any true appreciation for the body includes all facets. This means your massage therapist isn't too worried if you forgot to shave your legs or if your stomach makes gurgly noises during the session. At the same time, if there are places you'd rather not have touched, make sure to tell your massage therapist before the session starts.
There are two reasons to cancel your appointment in this situation. The first is that getting a massage while you are sick will likely make you feel worse. Laying down with that increase in circulation, usually this just increases your current symptoms. The second is out of respect for your massage therapist. Please cancel so you don't pass on your cold to your massage therapist (and any other clients he or she may be seeing that day)! Your massage therapist is there to help you in your healing process, sharing your cold is not going to help you get well!
A study originally published the the Archives of Surgery 2007 titled "Acute Postoperative Pain Management Using Massage as an Adjuvant Therapy: A Randomized Trial," showed that the group of postoperative people who received 20 minutes of relaxation massage of the back had "a significantly greater short-term improvement...in decreasing pain intensity, pain unpleasantness and anxiety. In the long term, patients in the massage group experienced a faster rate of decrease in pain intensity and unpleasantness." (Massage Magazine, March 2008)
Your postoperative massage can have many different goals: relaxation, pain reduction, and decreasing anxiety are some of the first things to consider. As your condition progresses, your therapist can use a variety of techniques to:
-help reduce any swelling you're experiencing
-work on superficial or deep scar tissue to improve the pliability, flexibility, and appearance of scars
-release muscular tissue that may be holding a joint or scar in place, which will increase your range of motion and decrease your sense of guarding or holding a joint.
Massage has post-surgical benefits for operations ranging from cesarean sections, hip or knee replacements, liposuction, or pretty much any situation where your body is going to be modified, left with scarring, or you are going under anesthesia.
This is related to the question of whether or not it's ok to talk during a massage session, so I'm going to use some of that same answer here. The short answer is yes, tell your massage therapist.
Tell your therapist if you are experiencing pain, or you would like more or less pressure in an area. Remember that every therapist has a different style, some may use only lighter pressure, and some only deep pressure. But if you are unhappy with the massage, speak up! Your massage therapist is a professional, and although the promotion of health is the major focus of our job, we're also in the customer service field. If they have a specific reason for using one style over another, they should be able to explain it to you in a way that makes sense. If you're still not happy, it's ok to look for a new massage therapist.
With that said, also keep in mind that the "no pain, no gain" theory to wellness may not be fully accurate. There are techniques, including myofascial release, lymphatic drainage, CranioSacral Therapy, and reiki, among others, that can feel very light as the practitioner is working, but have a significant impact on body systems and tissues, including deep tissues. During the session you may not feel very much, and you certainly won't have the endorphin release of the more painful types of massage. But the benefits can be just as positive and dramatic.
The amount of conversation during a massage session should be up to you. Many massage therapists have their own standards for how much talking happens during a massage session. Some believe there should be no conversation in order to create deep relaxation, and indeed, by being quiet and just listening to the experience of your body, you may find yourself drifting into a meditative state. Some therapists are naturally chatty, and feel that people are more relaxed if things feel more "normal." These therapists often use conversation as a way to distract the client from pain or nervousness that may arise during the session, and this can also be effective. Probably the most common situation is some conversation at the beginning of the massage, naturally quieting down as the client gets more relaxed and comfortable. So don't feel like you need to engage your massage therapist in conversation, it's perfectly ok for you to just lay back and relax.
There are some kinds of massage where the therapist will ask you questions about what your experiencing, or questions about previous injuries or pain based on what he or she finds during the session. The therapist is not trying to keep you from falling asleep, the questions help make sure that your massage is as effective as possible. Some types of massage even require a bit of active participation on your part, and your massage therapist will explain that to you as well.
And there are times when you should definitely talk to your therapist, even if you are in a quiet session. If anything is making you uncomfortable: a technique, the temperature or light level in the room, the way you are being draped. Tell your therapist if you are experiencing pain, or you would like more or less pressure in an area. Remember that every therapist has a different style, some may use only lighter pressure, and some only deep pressure. But if you are unhappy with the massage, speak up! Your massage therapist is a professional, and although the promotion of health is the major focus of our job, we're also in the customer service field. If they have a specific reason for using one style over another, they should be able to explain it to you in a way that makes sense. If you're still not happy, it's ok to look for a new massage therapist. It's also important to tell your massage therapist if you remember something that you forgot to tell them during the intake process. Sometimes you remember those things for a reason, so mention it when you think of it.
This is a very common question, beaten only by "Do you do deep tissue massage?" Unfortunately, "deep tissue massage" is a phrase that has no single definition. Not just clients, but even the massage community is feeling confused about what this technique entails. (For an interesting discussion on this topic within the massage community, see the "From the Editor's Desk" blog at Massage Magazine.)
Things that can fall under the category of "deep tissue massage:"
1. Strong pressure (sometimes with very little warm up of superficial tissues), feeling pain or a "good hurt" sensation during the session (No pain, no gain), with a bruised sensation post-session
2. Neuromuscular massage techniques, including trigger point therapy
3. Deep strokes, including muscle stripping and friction
4. Working on only specific areas during a session, rather than a full body massage
5. Work with a therapeutic goal beyond relaxation
6. Using gentle modalities to affect a release of deep muscle adhesions
Spas and individual practitioners may charge extra for "deep tissue massage," sometimes citing the greater stress placed on the practitioner's body, the higher skill level presumably required, or to recoup expenses for continuing education.
I believe that at this point, deep tissue massage is defined by the person currently speaking of it. When you schedule a massage, ask your therapist what their definition of Deep Tissue is. If it's not the type of massage you're looking for, ask for something else (or find a different therapist). It doesn't matter exactly what it's called, it just needs to help you achieve your goals for the massage session. For example, I do address deep tissue structures and scar tissues during my sessions, and much of my work includes therapeutic goals other than relaxation. But I do not perform the work with pressure that feels deep or painful to my client (most of the time). Am I performing Deep Tissue Massage? Sure, but it wouldn't match up with many of the definitions out there.