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This is a guide for people who are trying to find a good medical massage therapist, mainly for help with chronic pain or injury rehabilitation. My recommendations are based on a lot of expertise and direct experience. Do you want a GOOD massage therapist? I constantly hear from readers who have been dissatisfied with therapeutic massage, and the most common question I get by far is:. I have been asked a thousand times if I can recommend a therapist in Europe, Asia, India, Africa, Australia … whole continents where I know only a few people, and only thanks to email and Facebook and Twitter.
And so, unfortunately, the question is mostly impossible to answer. Even right here in Vancouver I barely know any therapists that well. Massage therapy is like pizza: From to , I systematically asked patients why they left previous massage therapists. The experiment continues in correspondence with readers today. I have heard it all. But I have also heard a litany of basic problems with customer service. Well, these are some worst practices in massage therapy.
This is a random sampling from recent conversations, all about therapy with well-trained therapists, all with great credentials and aspirations to give people medically useful treatments. Where the only massage to be had comes from an old hippy bodyworker who speaks passionately about reflexology and wants know what colour the pressure makes you think of?
I knew I was in trouble the moment I walked into her office: Unfortunately, I stayed — perhaps out of morbid curiosity. Cheesy, loud new age music, of course. Violently strong pressures, and total disregard for my requests to ease up. Rapid, erratic changes in technique, intensity and location — one moment she was wrenching my neck, the next slapping my back, and a few seconds later she was driving her elbow into my kidneys.
And so on and on. It felt more like an assault than a massage. She actually shoved the heel of her hand into my eye socket, apparently by accident — I wonder what she actually intended to do?
At the end, great insult was added to injury: A young woman with a long history of completely unreasonable chronic tension headaches sought treatment from three of my colleagues — three unusually well-trained Registered Massage Therapists. Any BC-RMT could walk into virtually any jurisdiction in America and be — by far — the best-trained massage therapist available to that population. My client had seen three of these elite therapists before coming to visit me, but had not gotten any relief whatsoever.
She enjoyed the massages, but unfortunately did not find them therapeutically useful. And I immediately found what I was looking for: What happened next is what makes it a good story. My client said in amazement emphasis definitely hers:. And no one has ever pressed on that spot before. Could this possibly be? I asked her to confirm this in detail, because I found it so strange.
Looking for and treating suboccipital trigger points is one the most elementary things I can imagine a massage therapist doing for a client with chronic tension headaches. And yet three other fancy RMTs had not only missed it, but apparently had not even looked for it — an inexplicable oversight. And much, much more. Finding a good therapist can be an expensive multi-month project, with hundreds of dollars spent on relationships that go nowhere.
But the consolation prize is great: When you start with a new therapist, ask for what you want, and watch what happens. In particular, be picky about pressure. Ask for more or less as needed throughout the treatment. Find out what the certification standards are in your state or province. Does your government regulate massage therapy? What does it take for the massage therapists in your region to become massage therapists? Now that you know what the standards are, use them, and favour the therapists who are well-trained and certified.
Credentials really do not guarantee anything, but they are better than nothing. It may be a false front, but it usually indicates a therapist who has promising aspirations to professionalism.
For instance, it strongly suggests that they are more interested in working with physicians than against them. The odds of finding good trigger point therapy are definitely higher in such offices. Practically everyone needs a therapist who is familiar with the concept of trigger points muscle knots. You can check on this before you even book an appointment: Janet Travell and David Simons.
Tell them you are looking for a therapist with specific skills. Be an assertive consumer, and just politely ask, as easy as asking for their rate: Everyone can benefit from reducing dependence on health care professionals. So, study trigger point therapy yourself , learn what works for you — a good idea in any case — and then find a therapist who is happy to take direction and learn with you.
This subject — finding and training good help for muscle pain — is covered in much more detail in my trigger points tutorial. If you catch your massage therapist pushing any of these ideas, watch out!
Their clinical significance is extraordinary. Although the idea of trigger points has spread far and wide in the last twenty years, it has spread more like religion than science, and mostly among massage therapists.
They are still relatively obscure and controversial. Many doctors and physical therapists have scarcely even heard of them. The one kind of therapist that seems most likely be able to help — massage therapists, professionals who work directly with muscle tissue every day — are often unprepared for challenging cases, or even basic ones , as with the headache story I told earlier in the article.
Massage therapists have many common failings when it comes to trigger points, above and beyond the more general problems with their profession:. And so, myths and bogus treatment concepts have always been rampant in the world of trigger point therapy. Trigger point therapy does not come standard in massage therapy offices — it is a specialization without standards or regulation. It is not reasonable to expect all massage therapists to understand how to treat serious trigger points properly.
Most massage therapists are unprepared to treat anything worse than mild-to-moderate cases of isolated trigger point pain. In another common and disappointing scenario, massage therapy is focused … but focused on the wrong tissue. It was a nagging, sickening pain, like a toothache in her deltoid muscle. What made her case a bit unusual was that she really had given physical therapy and massage therapy a good chance to work. She had seen a massage therapist and a physiotherapist concurrently and frequently for 12 weeks.
But she had gotten exactly no relief. I cautiously quizzed her about exactly what kind of therapy she had received. She almost certainly had shoulder trigger points! The pattern for each muscle is distinctive, almost a fingerprint. Her therapists had never checked a likely cause of this particular pattern of symptoms — which happens to be the infraspinatus muscle on the back of the shoulder blade, several centimetres away from the symptoms. Every massage therapist should know this.
Just one properly directed massage. She sure was happy! A therapist may have to spend a fair bit of time looking for sensory relationships like this, and it can be tricky even if when single trigger point really is the only problem.
But the point is that any good therapist will be trying to do that. I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine. I have had my share of injuries and pain challenges as a runner and ultimate player.
My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications , or my blog, Writerly. You might run into me on Facebook or Twitter. Do you have an hair-raising story to tell about massage therapy? This gentleman asked to stay anonymous, but he was very eager for me to share his story. I asked he could try to help a stubborn old should injury that was always paining me.
The session was 15 minutes and he knew my medical history. He knew it because I almost left the session. I had the sense that he was fixated on no pain, no gain. I stuck it out. I almost puked after the session and felt a malaise that lasted for 24 hours. For 3 nights I could not sleep. My shoulder was wicked sore … just like when it was injured prior to the assessments for surgery and the cortisone and physio treatments.
I took pain relievers that had no effect.
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