The term “massage therapy” covers a very diverse group of modalities and techniques. In all of them, therapists press, rub, stretch and otherwise manipulate the muscles and other soft tissues of the body, often varying pressure and movement. They most often use their hands and fingers, but may use their forearm, elbows, or feet. Their intent is to encourage the soft tissues to relax, allowing an increased delivery of blood and oxygen to the massaged areas, warming them, expelling metabolic wastes like lactic acid, allowing the muscle to relax and return to a normal resting state. Therapists usually try to provide an environment that is as calm and soothing.

At the first appointment, your therapist will discuss your symptoms, medical history, the results you and/or your health care provider desire, and other factors such as your work, daily activities and stress level. She will likely perform some evaluations through touch. If she finds nothing that would make a massage inadvisable, she will proceed with the massage.

At any time, you can bring up questions or concerns.

For your treatment, you will be in a private room. You disrobe to your level of comfort and lie face down with your face in the headrest and under the top sheet on the massage table. Only the parts of your body that the therapist is working on will be exposed. Usually there will be soft music (or music of your choosing) and dim lighting to set a relaxing mood. Oil or cream is used to help reduce friction on the skin. Your therapist may use other aids such as ice, heat, aromatherapy, tools, or machines. She may also provide recommendations for self-care such as drinking more water, soaking in Epsom Salts, practicing better body mechanics, isolated stretches, and developing an awareness of your body.

Other than just relaxing, there is really nothing more that you need to do. Just relax! Your therapist will gently move you when needed or ask you to adjust your position. If your assistance is required, your therapist will request your assistance and provide ample instruction.

Sanitation.

All linens are changed between clients and clean linens put on the table. The massage table is cleaned between clients, including any other equipment a client may come in contact with. The therapist’s hands will be washed immediately before coming into the massage room, and immediately after finishing your massage.

Your confidentiality.

Your information is private and belongs to you the client. Your therapist will not discuss the details of your session with others, nor will she mention your name, unless otherwise authorized to do so by you. Confidentiality may also refer to coincidental meetings in a public forum. Your therapist will not acknowledge you in public unless you approach and greet her first to avoid putting you in the uncomfortable position of having to explain to someone how you know her.

What areas will be massaged?

Your therapist will address this issue in your initial interview. You may inform your therapist at that time of the areas you want or do not want massaged. The only consistent area a professional, ethical massage therapist will NOT massage is the genitals. You may feel nervousness your first couple of sessions. It is important that you try to relax and enjoy the experience. It is also likely that as you continue receiving massage, the nervousness will subside. However, at any time you feel uncomfortable, speak up and the therapist will be more than happy to make adjustments.

Massage may cause discomfort, but should not be painful.

The question many people ask is, “Does massage hurt?” This depends on the pressure used while performing the strokes. A light massage is very effective and may not hurt. However, other forms of massage get into the depth and layers of muscles causing some discomfort. Generally, if your muscles are tight or sore you will feel some discomfort. If it hurts, it should be a “good hurt”. Your therapist will ask you to breathe through it and may ask you determine on a scale of 1-10 the level of discomfort you’re experiencing ~ (1 = you barely feel it and 10 = “stop now!”).

Everyone’s threshold of pain is different and your therapist will continually work with you on this. If at any time the pain moves from discomfort to unbearable pain, let your therapist know if she has not already sensed your level of discomfort and adjusted her pressure. If the pain persists, your therapist will stop the session and/or cease massage in that area.

Massage is much more therapeutic and effective when your body is not actively resisting. If the pressure is too deep, your muscles will instinctively respond with an “armoring” defense mechanism against the intrusive pressure. For that same reason, try not to voluntarily contract a particular muscle as it is being work on it. Unless your therapist asks you to contract a particular muscle in order to implement a particular technique, this is often counterproductive and will deter relaxation.

Is talking allowed?

It is your massage session and for your enjoyment. You may talk as little or as much as you want. The key to a good massage is relaxation and comfort. Some clients fall asleep, while others are more comfortable interacting with the therapist. Your therapist will always make you feel as though she is working with you, never on you. To work with only your physical body would be to neglect your emotional feelings. Expect your therapist to only initiate conversation to determine how comfortable you are and to make the necessary adjustments to enhance your experience.

Your feedback.

Your feedback is the cornerstone of your bodywork. This is very important. Please do not feel that you will hurt your therapist’s feelings. Your therapist is more empowered and more capable when she knows your feedback. Please let your therapist know before the session has started if specific areas are tense or ache, and for approximately how long. If your therapist is applying pressure to the deltoid (shoulder) and there is a referred pain felt simultaneously in the neck, or there is a burning or cold sensation, do not hesitate to vocalize these feelings. You may need some extra time in these areas. This is key to getting the most out of your treatment. Your therapist wants to deliver a massage that is tailored to your needs and worthy of your time and money.

How often should you get a massage?

In a perfect world, we would all get massaged daily! Generally speaking, most people should get a massage every four to six weeks. However, that may vary widely depending on lifestyle. If you are very active or under a significant amount of stress in your job or your personal life, then you probably need to receive massage more often. Both stress and injury are cumulative! Neither goes away with the passage of time.

Anytime is a great time to receive a massage. Don’t wait until you are injured or extremely overwhelmed by stress. Stress is a normal part of our life, it’s how you react that’s crucial. Massage is a great way to reduce stress.

Individuals in chronic pain and/or experiencing high levels of stress (neither requiring medical intervention): two times per week for at least three weeks until pain and/or stress has reduced by at least 75%.

Individuals with nagging aches and pains due to daily life: weekly sessions until stress level has reduced by at least 75% ~ typically about eight weeks.

Individuals who need to relax for general health and maintenance: once or twice a month.

Budget is also a concern. However, massage should be considered preventive health care. Relaxation and stress relief as a result of massage can help you to avoid a number of stress related health concerns (e.g. high blood pressure, headaches, etc.).

After the massage…

Your therapist will instruct you to relax and take your time. If you sit up too quickly, you may feel dizzy. This may be due to positional hypotension. We’ve all felt this at one time or another. You may become so comfortable…or even fall asleep while on the table that you actually need an extra hand to help you up without expending a lot of energy. How you feel after your massage depends on what you want to achieve. Most people feel very relaxed. Some experience freedom from chronic aches and pains and increased joint range of motion.

You may be sore the next day, much like having worked out at the gym…especially so if it is your first massage and your body is not accustomed to soft tissue manipulation. This is nothing to be alarmed about. To help relieve some of this discomfort, your therapist will encourage you to drink plenty of water to rehydrate the muscles, enhance muscle recovery, and eliminate toxins released during the massage.  You may also be encouraged to take a long soak in a tub with Epsom Salts. The salts help pull out the lactic acid and waste products that have been flushed out of the muscles and helps to get it out of your body. Within a day or two the discomfort will be gone and you will begin to notice a significant difference in the degree of tension in your muscles. Other than that, the only agenda you should have after a massage is relaxing and taking it easy. Participation in extraneous activity is discouraged for at least thirty minutes to an hour after receiving a massage.

Contraindications.

Massage therapy appears to have few serious risks if appropriate cautions are followed. A very small number of serious injuries have been reported, and they appear to have occurred mostly because cautions were not followed or a massage was given by a person who was not properly qualified and licensed to do so.

Health care providers recommend that patients not have massage therapy if they have one or more of the following conditions:

Deep vein thrombosis (a blood clot in a deep vein, usually in the legs)

A bleeding disorder or taking blood-thinning drugs

Damaged blood vessels

Weakened bones from osteoporosis, recent fracture, or cancer

A fever

An open or healing wound

A tumor

Damaged nerves

An infection or acute inflammation

Inflammation from radiation treatment

If you have one or more of the following conditions, be sure to consult your health care provider before having massage:

Pregnancy

Cancer

Fragile skin, as from diabetes or a healing scar

Heart problems

Dermatomyositis, a connective tissue disease

A history of physical abuse

Side effects of massage may include:

Temporary pain or discomfort (much like having worked out)

Bruising

Swelling

A sensitivity or allergy to massage oils/creams

Massage can still be used in some instances should you suffer from any of the above conditions, just not in the specific area affected.

Massage therapy should not be used to replace your regular medical care or to delay seeing a doctor about a medical problem. A massage therapist does not diagnose illness, disease, or any other physical or mental disorders. A massage therapist does not prescribe medical treatment or pharmaceuticals, nor does a massage therapist perform any spinal manipulations.