Thursday, December 15, 2016

How to Receive a Therapeutic Massage

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How to Receive Therapeutic Massage


Finding a Therapist and Making the Appointment...


·        I don’t know about you but I like to do research on who’s available before I make an appointment for a doctor or therapist. My research usually includes the person’s experience, education and expertise as well as getting a sense of what kind of person it is, what is he or she like, so I can make an educated guess about, Will we connect? Will I be supported in my goals?

·        It is nice to actually speak with the therapist before you decide to make an appointment. If you reach the person’s email or text, receptionist or appointment service, you may want to arrange a time to chat by phone for ten minutes before you commit to making an appointment. This time hearing the person’s voice and communication style helps you figure out if this person is competent for the things you need, and compatible for you as a therapist.

·        If you have concerns about massage in general, express these in your initial contact and be certain your concerns have been addressed before you commit to an appointment. For example if you would prefer to not remove your clothing, many therapists are happy to work on your muscles and joints through clothing (wear loose or stretchy clothing not jeans). If you want to bring another person to sit in the room with you, many therapists are happy to accommodate that. If you want the doors left open, window shades left open, or if you want the session outdoors, some therapists will accommodate that.

·        I don’t know about you but I want to go to doctors and therapists who know more about my body than I know. I want someone who knows what to suggest even if I don’t know to ask. I want someone who knows when to follow my directions and to challenge me when my directions would not lead to my improving. You can get a sense of the therapist’s approach in a short phone call. Then, when the therapist needs to say, “Actually, the directions you are giving me would not benefit you,” how do they say it? Are they condescending? Superior? Bossy? Or do they say it in a way that increases our trust and connection, and my safety?


Arriving for the Session...


·        It is important you feel safe and connected with the therapist before beginning. Small talk helps people to gauge each other. How is the handshake? How is the eye contact? Is the person’s voice soothing or harsh? If you don’t feel safe and connected, it is better to break the appointment. You don’t want to be laying on the table dreading every minute, and neither does the therapist want to be in that situation.  

·        It is important to spend the first minutes of your time discussing your hopes for today’s massage. The massage “time” begins as soon as you begin this discussion. You may think you want to talk as little as possible, to get onto the table as quickly as possible so you can have a few more minutes of massage. That is understandable. Your hopes and goals, actually, will be better achieved if you spend some of your time in dialogue at the beginning. Between 3 and 9 minutes of your session time is normal. You will actually end up with better results when some of the time is talking before the hands-on bodywork.

·        Before beginning it is important you discuss:

o   what parts of your body are tense, where you have muscle or joint aches or pains.

o   how long these areas have been tense.

o   the activities of daily living (ADLs) that have been inhibited by these aches. For example if your shoulder is hurting this may inhibit your ability to lift your arm to brush your hair.

o   what you have tried, what has worked, what has not worked and what you have not tried.

o   reasons you left other therapists.

o   sharing your expectations and hopes for today’s session: When it is over, how will you know your time has been well spent?

·        It is nicer for you, to pay at the beginning of the session, or before arriving. When you are very relaxed after the session, your brain is in an easy state, that you won’t feel like writing checks, counting money, navigating a paper calendar, reading any printed words, looking at a smartphone or going online for payment or scheduling. This effect after a bodywork session lasts a few hours, so it is good to arrange your day so that you don’t immediately go back to work after your session. Instead you might schedule a walk outdoors or a gentle hike.

Beginning the Massage, Before you Relax...


·        if the pressure you are feeling makes you clench your jaw in order to “take it,” it is too much pressure and is counterproductive to relaxing. Say, “I would be able to relax better if the pressure was slightly less.”

·        Don’t worry about hurting the therapist’s feelings by asking him to adjust the massage so you can relax better. Since your relaxation is the whole point of your massage, the therapist wants to know if something he is doing is not the best way to relax you. 

·        The therapist will also be watching how you are breathing, whether you are clenching your hands, toes or eyes, and other cues and clues that tell him quickly if you are tensing up or relaxing. You may find you are about to say something and already he changed, before you said it. This is not because he is a mind-reader. He is a body-reader. Often the cues and clues occur several seconds before you become consciously aware of a discomfort. Still, there are times the therapist has not noticed and then it is your turn to say something.

·        If you are face up you may leave your eyes open if you like. When I am receiving a massage I usually close my eyes. When my eyes are open, and I see the therapist’s face, I revert to polite customs and etiquette, including boundary space. Seeing someone touching me or looking at my body or face seems unusual in this sense and it can hinder my relaxation. This is why I close my eyes. It helps me  relax more. Still some people prefer to keep eyes open and that is fine.

·        If the music hinders your relaxing, please give a suggestion like turning the volume up or down, skipping the song, asking for a different type of music, or turning the music off. All these options are fine for the therapist. 


As You Relax...


·        As you relax your abdomen and pelvis it is natural to pass gas. Don’t hold back as this holds your muscles tight. This is normal and massage therapists hear it all the time.

·        Some people like to express their appreciation for the massage with immediate feedback. One way to do this is verbally, for example saying, That’s working. Some people express this by humming, oohing and aahing in a way that expresses positive approval. Your therapist won’t take your sounds “the wrong way,” it is perfectly appropriate. Think of a child receiving a massage from her mother—the child would ooh and ahh and hum. Think of eating something that tastes really good—yum. Therapists have heard these sounds dozens of times. It’s taken as a compliment, and tells the therapist you approve, which helps him tailor the session to your body.

·        You should know that the purpose of a therapeutic massage is not to create this pleasure. The pleasure is a side-effect. The purpose of a therapeutic massage is that your muscles relax. Muscles can relax without any “ahh”-worthy pleasure. Also, you can receive a very pleasurable massage that does not relax your muscles. For example if you go to a dayspa or resort, the therapist’s intention is usually more about creating the “ahh”-worthy pleasure, than the muscles relaxing therapeutically. Therapeutic massage has a different intention than a luxury-pampering massage. Still, therapeutic massage often feels pleasurable even though that is not the therapist’s primary intention.

·        Some people like to talk during a session, about things that don’t relate to the session. This distracts you, and distracts your therapist. Your therapist will not be able to give you the best session you deserve, if you distract him. Many of us in our culture feel uncomfortable with silence, but massage is a time where silence can be comfortable.

·        Talking during the session, about the sensations you have from the massage, is helpful. Does the pressure recreate a feeling you had before? Tell your therapist. Describe how it feels to “relax into” the pressure. Your commenting on these things helps the therapist to adjust to you. Your saying them out loud helps you to relax your muscles today, and gives you more influence over your muscle tension later, when you are back in your life.




·        Before the middle of the session the therapist might ask you if you feel this is working. Are you getting what you wanted to get from today’s session? Asking this early in the session allows him to adjust his process so that you can get the most from your session.

·        The therapist has the right to ask you questions about your body, at any time during the session. Therapeutic massage is not a luxury pampering service where the customer is queen for a day. It is more like a doctor who needs to know how your body is responding, in order to tailor the therapy to your body. The therapist may ask questions like, is this the spot you told me about or can you guide me until I am exactly on it? Can you feel it changing? When I do this, does that feel better or worse? Can you  lift your arm? Would you lift your head for a second?


Nearing the End of the Table Time


·        Sleep is different from relaxation. If the therapist notices you are sleeping he may ask you a question. You may be surprised and for a moment, you may feel irritated that you were awakened. He is doing this for your benefit. Therapy is about your relationship with yourself. You have a relationship with your body. This relationship develops, while you are present with your body. In fact that is how bodywork works. It helps you be present with your body, so you can embrace even the parts that bother you. The therapist is doing you a therapeutic favor by bringing your presence back to your body. 

·        The therapist may let you know when the time is approaching, so that if you have any additional issues there is time to at least address them if not complete them.


After the Session


·        The therapist manages the time so that you have at least two minutes after the session, for you to say how the session worked from your perspective. It is important you are vertical for this discussion. Standing is best so you can feel how you balance on your feet differently.

·        After the session, before you leave, you may discuss whether you would like another session, and when that would be.

·        How long will it take to change this condition? Half of that answer depends on you. For example, if you have golfer’s elbow, and you continue to golf the same way, the therapy sessions may only prevent you from worsening, but not actually improve your situation. In this situation, you still “need” the sessions to prevent you from worsening. Therapy is a partnership. If you would like any suggestions about what you can be doing on your own, between sessions, that will speed up your resolution, ask your therapist. He probably has some good ideas. For the therapist to know how many sessions it will take, he needs to get an idea of how much you will be doing for yourself during the time between. He won’t know this after the first session, so his estimates will be more like guesses until he sees how much weekly progress is occurring. It is normal to have five, ten or more sessions to fully resolve a tension pattern. Certain tension patterns are deeply reinforced over decades, so that you may take a year or more to fully resolve them. Tension is not a physical change in the muscle tissue, but a pattern in the brain. Tension is when the brain sends voltage to the muscle. If your brain can fully embrace the tension as it is brought to your attention, it is possible to change a decades-long pattern in one session. Possible, but not common. Certain conditions, like tendinitis, are actually tissue change in the tendon, and take a more predictable time frame. A newly-formed tendinitis can fully resolve in one month if you are also doing the ice-cup homework the therapist gives.



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