Why I Always Recommend Massage

Massage is more than soothing music, aromatic oils, and a pleasant touch. It can be an entire treatment option for tight muscles plagued by pain.

I’m astonished by the amount of clients I have who struggle with their flexibility and had trainers in the past who have never recommended massage for their chronically tight muscles. These same people will stretch and stretch and stretch and see minimal benefit.

And why is this?

Put simply, chronically tight individuals often have adhesions in the muscles (AKA, muscle knots, AKA, trigger points).  These often develop as a result of inflammation, which muscle knot“in turn activates the body’s pain receptors and initiates a protective mechanism, increasing muscle tension and causing muscle spasm” (Clark et al., 2014, p. 205). This is often the result of overuse injuries; thus, when you overuse a particular set of muscles, especially without stretching or giving those muscles a break, injury is bound to happen. A knot is considered an injury, though not one contraindicated for massage.

As a case in point, I have a client, an older male, who is a hardcore runner. He is chronically tight in all the muscles you’d expect a runner to be tight in: hip flexors, hamstrings, even muscles in the shoulders and chest. While he has been doing a stretching program for quite some time before seeing me, it’s clear said stretching program has been unsuccessful in increasing his flexibility–and it’s due to tender nodules that have built up in these muscles, indicative by the many painful spots we found while trying self-myofascial release.

The picture above is an example of what these nodules look like close up. What massage aims to do is break those nodules up and return the tissue to normal. When the nodules have been broken down, it is then possible to stretch the tissue to increase its flexibility.

Otherwise, to stretch knotted tissue is akin to stretching a string with a knot in it–the more you pull the string, the tighter the knot becomes. You may be able to stretch the surrounding tissue, bringing momentary relief, but you cannot stretch the knot out, which is why massage is so important.

Of course, you can always implement self-myofascial release strategies, but if you have a myriad of nodules, which are tender to the touch, massage is excellent for relieving you of the burden of having to do it all yourself. Plus, some tender areas are incredibly difficult to reach with self-myofascial release, so it’s very helpful to have a masseuse tackle those areas for you. (This is why I recommended my runner client to a masseuse.)

***

The first time I ever received a massage was when I was in physical therapy for my hip. I had been struggling with lower back pain on my left side, and what finally cured me of it was deep tissue massage and several sessions of self-myofascial release. I have not had any issues with my back in about a year. My PT also released other tight areas, but due to the condition of my hip, massage is a temporary relief; however, it’s been the best treatment thus far.

I also recently received a massage strictly from a massage therapist; thus, you aren’t doomed to weekly sessions of physical therapy for muscles that are simply knotted and not necessarily injured in the form of tears and inflamed tendons. (By the way, you can find a link to my masseuse’s website in the menu above.)

I went to her based on a client’s recommendation, so I recommend you do your research and ask others who have received massages from masseuses in your area.  Massage, like all professions, has its bad apples. A masseuse, for example, herniated a disc in my psychiatrist’s neck. Another masseuse caused my stylist’s co-worker to miss work due to extreme pain in her neck following the massage.

Mine was amazing and released all of the tension in my hips. I’m due to see her shortly, but I’m fairing rather well. Prior to seeing her, the tension was nagging. Now, even though I know I’m a bit tight again, it’s not so nagging thanks to her work. Her massage has allowed me to actually work out my legs without worrying about the pinching sensation that I usually feel at the front of my left thigh, right near my groin. As for squatting with a barbell without having that issue, only time will tell.

Now if you have a medical condition, such as issues with your spine or joints, it is absolutely vital that you consult your doctor before getting massage, as massage can sometimes worsen certain condition. Granted, most massage therapists are very knowledgeable about what conditions they can and cannot work with; however, a doctor’s recommendation is always valuable.

Massage is generally contraindicated for some of these conditions, although a masseuse can work around some of them:

  1. Fractures
  2. Sprains
  3. Bursitis
  4. Osteoporosis
  5. Rheumatoid arthritis in the acute stages
  6. Osteoarthritis in the acute stages
  7. Herniations
  8. Acute muscle cramps
  9. Strains (any acute injuries, like bruising)
  10. Tendonitis in the acute stage
  11. Carpal tunnel syndrome

A more exhaustive list of indications and contraindications can be found in the link above.

References:

Clark, A. M., Lucett, S. C., & Sutton, B. G. (Eds.) (2014). NASM Essentials of Corrective Exercise Training. Burlington, MA: Jones & Bartlett Learning.

General Council for Massage Therapists. (2006). “MT1 Principles of Cautions and Contraindications.” Retrieved from http://www.gmct.org/Portals/0/documents/Massage_Therapists_MT1_Cautions_and_Contraindications.pdf

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