In a previous post, I wrote about the minor discomfort that you might feel after receiving a deep massage, and what to expect over the three days after your massage session. But, that was assuming that you were going into the session healthy, you went to a well qualified practitioner, and received the right type of bodywork for you. Assuming all of that, a certain amount of soreness to the touch is normal in some cases, but many people have asked about remaining in pain, or in some cases, feeling worse after receiving massage. So, I thought I would write more on the subject of post-massage pain. Feeling bad after a massage can be frustrating and alarming, when you are already in pain, and you go to a practitioner for help, and something seems to go wrong. Truthfully, there can be many, many reasons why you didn’t feel better after the massage. Below are just a few things to review to help you troubleshoot what is going on. The main thing is to try and stay calm, and don’t jump to any conclusions about who is to blame. Perhaps it was something your massage therapist did or didn’t do, but it is also important to remember that it is possible that things have been leading up to this moment in time for you and your body for quite awhile, and this could be the result of a “perfect storm” sort of situation. Read on to find out when the problem could be your practitioner, and when it could be you. When It’s Your Practitioner A good massage therapist should always be addressing your injury or complaint, if it is within their scope of practice. It is up to the therapist to investigate what is hurting or concerning you, and get to the root cause by asking more questions, working the soft tissue, and helping to give you relief, even if your issue isn’t “cured” in one session. Each therapist will address your problem within the framework of their philosophical and educational background, and hopefully what they do is what your body needs to get better. But, at times, the technique a particular therapist uses may not be what will fix your problem. This isn’t necessarily anyone’s fault, it just means that you may need a different massage method. Many massage therapists are versatile enough to use a different method if you choose to go back for another session with them, but you may wish to do a little more research and find a different massage practitioner who does a modality known to address your problem. The Example: Let’s say you injured your back, and the resulting pain and tightness just won’t go away. If you don’t already go to a massage practitioner familiar with pain relief, then you may start out just going to a massage studio in your neighborhood, thinking that a therapist there will address your needs. Hopefully, everything went great, but if it didn’t, read on to troubleshoot some outcomes that could have happened, and how to resolve them. Outcome #1: While the therapist you see is very good at relaxation massage, she doesn’t do any deeper muscular work. You feel relaxed, but your back is still tight and painful. So, you leave there feeling that “massage didn’t help my problem.” What Happened: You needed a more corrective therapeutic massage, instead of a relaxation massage. What to do: If you liked and trusted your massage therapist and still believe she can help you, you can go back to her and ask her to address your pain again, either with a different method or with more time devoted to the specific pain. It is possible that another directed session on the problem area will take care of the problem. If you didn’t like your therapist, try to find a different one with the qualifications to work on you in the way that you need, whether you believe that to be deeper work or a different modality. Outcome #2: Your therapist worked deeply on the whole area of pain, but didn’t necessarily focus on any knots in the muscles. You leave the massage feeling neutral about how the massage went. It seemed like your therapist worked on the area, and you were hoping that it would feel better afterward. But, you go home and your muscles not only continue to feel tight -- they feel like they are getting tighter, and more painful as time goes by. You start thinking that your massage therapist did something horrible to you. What Happened: Most likely, your massage therapist either didn’t have enough session time to release your muscles thoroughly, or she didn’t work detailed enough on the actual knots (trigger points) that make your muscles tight. In order to release a tight muscle with massage, your therapist needs to spend time releasing the individual trigger points that make the whole muscle tight. There are key trigger points in each muscle that are in predictable places, and your therapist will be able to feel each knot and release it by working deep enough to access the trigger point without causing you severe pain or bruising. If they do not do that, then the generalized work they did over the top and around those trigger points can actually aggravate them into making the muscle cramp and spasm until the trigger point is released properly. What to Do: If your therapist was skilled but wasn’t able to spend enough time on the problem area, then you may wish to go back to her and ask for another session. Tell her everything you felt, and ask if she can just spend time working this area again to make sure it gets addressed. Sometimes when a client comes in who has a lot of pain complaints to address, there just isn’t time to address everything in one session. So, talk with your therapist to prioritize your issues, and let her work methodically on it until it is resolved. If you believe your therapist did not have the skill or knowledge to release your muscles, then looking for a different massage practitioner is in order. Look for someone who does pain relief massage, not just “deep tissue.” Know that the term “deep tissue” is a loose term used mostly to describe the amount of pressure, and can imply that you will be getting a more therapeutic massage. But, it does not necessarily mean that every therapist who does deep tissue will also be doing trigger point release, or any other modality that requires extra knowledge or skill beyond doing a good, deep, general relaxation massage. Because it can be difficult to find a new massage practitioner, you should feel free to ask questions when you call to make an appointment with a new massage therapist. Tell them about your problem and they should be able to give you an answer as to whether they feel like they can address your problem if you make an appointment with them. A practitioner who specializes in pain relief or corrective massage will understand the need to talk beforehand to make sure she can help you. Outcome #3: During the massage, your therapist was working very deeply into your muscles, and it was too painful. You thought the massage was supposed to feel like this, or you felt too embarrassed or uncertain to ask for less pressure. You did not feel a rush of blood circulation or overall good feelings after the painful spots were worked. In fact, you felt like your muscles (and your whole body) were fighting and getting tighter as she worked on you. You went home afterward and felt awful everywhere and bruised or extremely sore to the touch. The original pain did not go away. What Happened: Your therapist worked too deeply for your body to handle. What to Do: While this is not common, and not at all a response that you should just live with, it does happen. I would caution you to always tell your therapist if the pressure is too much for you. If you didn’t tell her she was hurting you, then she had no idea it hurt. But, if you told her it hurt, she should have lightened up the intensity. If you are severely bruised or in terrible pain after a massage, you should call your therapist and let her know what happened. If it was a massage establishment, call them and tell them what happened. You can ask for a refund, if not a massage with another practitioner there who might be able to treat you better. If you feel that you are very hurt because of this massage, you should always address it with the therapist. Going online and firing off a bad review won’t help your problem, and will only create hostility. Go immediately to the source and get it taken care of with the person who you feel made the error, or their direct supervisor. If you handle it in a calm and communicative way, you leave more options open in getting your problem resolved in a peaceful way. Always remember that bruising and pain are relative to each person, and if you didn’t tell her directly, your therapist might not have known there was anything wrong. In any of these cases, it may help to find a different practitioner. In order to find a massage therapist who will have a background in corrective massage work, I would recommend looking for someone who does Trigger Point Therapy, Myofascial Release, Pain Management, Neuromuscular Therapy, or Sports Massage, to name a few. When It’s You If none of those scenarios seemed to fit, then it may be you, not your massage therapist, who has inadvertently caused the pain. Sometimes, even when your therapist has done their job well, your body still has an unforeseen reaction. This can be because of your overall health and lifestyle -- and often people don’t realize anything was wrong with their lifestyle until receiving a massage and feeling disgusting afterward! Unfortunately, because the catalyst event was the massage they received, they think that the therapist did something to them to make them feel this way. But, in actuality, their body was not prepared to get a massage, any more than an out of shape person is prepared to run a marathon. In this case, massage is very much like exercise. If you sit all day, are highly stressed, eat poorly, smoke cigarettes, drink excessively, or never drink water, and you go out and run a mile, you will feel sick, tight, and sore afterward, right? The same thing happens when you get a massage. Massage circulates and pushes blood and fluid out of areas of your body that may not usually get as much circulation as they need. This is good, because it brings fresh blood and lymph to areas of pain and stagnation, but in doing that, it does create more work for your lymphatic system and kidneys, which process cellular waste. If your body wasn’t hydrated going into the massage, and relatively getting a good amount of circulation already, there is a big chance you will get off of the massage table feeling loopy, and go home feeling anything from tired, to nauseated, to prolonged muscle soreness. So, how can you fix this reaction? Look at your diet. Look at your activity and stress levels. Are you drinking enough water on a regular basis? Are you getting the right amount of daily movement? Be honest with yourself. Truthfully, your body may be crying out for better treatment in some way. A pain event is usually your body telling you (whether gently or intensely) that you need to do something differently. Massage will help you begin a change, and feel better over time, but only if you do the work at home as well. You can’t expect to go and get a massage and have all of your pain relieved in one hour, right? We all have to take care of our own bodies every day, and working with a good massage therapist can be integral to keeping you on track. But, if you have been ignoring and living with your pain for weeks, months, or years, just know that it will often take more than one bodywork session to completely resolve your problem. Hopefully this post has given you a place to start in your search for answers to your pain cycle. Here’s hoping that you find the right massage therapist for you, and feel supported in your journey to being pain-free!
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AuthorYour questions answered by Massage Therapy Instructor, Andrea Fleming, LMTI. Archives
March 2016
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