You don’t need to, in the majority of cases these injuries are self limiting and will remedy in a week or two.
What can I do?
Keep active and don’t load the area for a few days to lower the inflammation. Once the area stops hurting you can load it again.
What happens if it still hurts after a week or 2?
Again the reason is probably that you keep loading the area and it is not having the chance to get out of its inflammatory stage. Reduce the load or adapt adapt any behaviours to stop irritating the area.
It’s still hurting and it’s been over 3 months now?
Well we are now in the chronic definition of an injury/pathology. This means that there may very well be sensitisation of the area and all interventions are going to be less effective. It may be worth going to see your doctor who can refer you to a specialist.
Yes it can!!! There is evidence to say that massage can reduce pain in the short term of an acute injury.
So why isn’t it funded by the NHS and why isn’t everyone getting massages?
Well it’s unlikely a massage has any causal effect that will remedy your injury.
But you said it was effective??!!
I said it was effective, not efficacious. The difference is that insulin can be proven to be efficacious as it is provable to observe a direct cause of insulin changing glucose into glycogen in the blood. That is to say we have a causal link from the drug to an effect. In the case of massage we have a correlation of less pain in the short term compared to no treatment.
But this is effective! I mean it works, it’s observed and is empirically demonstrated!
We must widen our scope to other interventions and their effects, acupuncture, laser therapy, craniotherapy are all effective for relieving pain and can be extremely convincing for those that have experienced them.
The case of laser therapy is a good one as we can “sham” the effect. This means we have a control study with an arbitrary wavelength of light and compare it to a group of people exposed to the supposed “efficacious” wavelength of light.
The patients and experimenters are blinded (not literally) and we see no significant effects between both groups although both groups have a similar pain relieving effect.
So your saying I shouldn’t get a massage?
Why not get a massage! indeed why not get any treatment I’ve described above, it is likely you will lessen the pain in the short term and considering in most acute injuries they are self limiting and will remedy in a couple of weeks you can save yourself some pain.
I suggest you think of the cost, is it worth £35 for a 30 minute sports massage to relieve the symptoms of pain until your body can remedy itself, this is a choice for the individual.
I’m in pain, should I get a massage?
The is very little evidence that massage will reduce your pain symptoms, you really don’t need to get a massage.
Is a massage good for your body?
There is no evidence to suggest it has any benefit other then making you feel good (in the case that you enjoy being massaged)
I’m in pain though what can I do?!!
If you have recently had pain symptoms in the majority of cases you have irritated something and it is best to reduce the load until it can heal itself, this does not mean you have to rest, keep as active as you have been but try alternating your exercise or adapt your behaviour to let the inflammation go down and then go back to reloading it.
But I’ve been in pain for over 3 months its driving me crazy!!!!
Im really really sorry but massage is not going to help you. You have my deepest sympathies as chronic pain seems to be a terrible and persistent issue. There is evidence that exercise can have a mild effect on the reduction of symptoms.
What exercises should I do?
Anything you enjoy doing, there are no specific exercises that will help you more significantly better then others. If the activity causes you pain, reduce the level at which you are participating or adapt the way you do it to reduce your symptoms.
My osteopath/chiropractor/personal trainer/physiotherapy has told me to do these specific exercises to remedy my pain. Should I continue doing them?
Yes, go nuts. They will likely help you if they are active exercises that requires you to activate your muscles. If they are passive exercises like stretching, mobilisation or massage then they are probably not evidence based practitioners. This does not mean that they are wrong!!! There are instances where well controlled studies cannot be funded or even possible to attain evidence for a variety of modalities, its a sticky subject. If you feel benefit from anything you are prescribed then keep doing them.
Wow you’re amazingly honest and brilliant!
In my experience this question is best indicated by the client. In our clinic, we usually start by suggesting a 1-10 pain scale and the pressure should be about at about 7. If the pressure is too much, then the muscle will tend to contract and any further pressure will be ineffective.
From a therapists point of view the muscle, by the end of the session, will be palpably softer and the experience of the client should describe the sensation as a "good pain". The experience of applying pressure should be like sinking into the muscle, this is achieved most effectively by slow and continuous pressure. A faster paced massage can feel lovely however it should always have some measure of slow and deliberate pressure to sink deeper into the tissues.
Should a massage hurt?
A massage will have more immediate resolution of pain symptoms if the pressure applied is strong enough to hurt the client, this is due to a "reversion to the mean". Once the massage is over, the sensation of relief will give the client a sensation of a reduction of symptoms.
I consider this a potentially useful use of massage to relieve symptoms however in our clinic we don't follow this method as on occasion the massage can cause painful symptoms that weren't there before the client came for treatment.
As a massage therapist of nine years I obviously believe in the power of touch. I have seen it, I feel it and I spread it. It can be one of the most powerful tools of communication between people. But how powerful is it for babies and pregnant women?
It was in 1979 Columbia, with high infant mortality rates from premature births and a lack of incubators arose a new model of care called Kangaroo care. It was an idea that arose out of desperation, but to this day is inspired and quite obviously natural instinct. Essentially premature babies were worn in a sling skin to skin for 24 hours a day by their mother, father, sister, brother, grandmother, neighbour whoever was able to and close to them in their life. The results were astounding as they found “skin-to-skin holding stabilizes heart and respiratory rates, improves oxygen saturation rates, better regulates an infant's body temperature, and conserves a baby's calories”. This groundbreaking model of care set the field for more research. How could being skin to skin be that powerful and how far does it go?
Now, after you birth your baby every hospital across the country should promote skin to skin straight away with the mother, father or other birth partner. For me the most important outcome I have seen and experienced from skin to skin is it’s natural ability to suppress pain. Before I had children I didn’t really know how this was possible and I was very skeptical. It wasn’t until the birth of my second that I realised the impact it would have on me.
During my labour, I was practising hypnobirthing and the one thing that kept me rooted, on course and not afraid was my husband’s hand being constantly on me. I kid you not, the minute he took his hand away I felt a rush of pain go through my body. Lucky for him it was only a four hour labour! I was completely mind-blown and so was he. But then it went further and our second born was going to open my mind completely. From the get go he wanted to be on me, skin to skin, day and night; far from the western approach we read about. This was completely new to me as our first wasn’t like this. I had to explore co-sleeping in depth as he had to be in bed with me or he just cried, he breastfed really well and loved it and he just always wanted to be in a sling on me with his head on my chest. Fast forward to now and he is nearly two yet he still LOVES skin to skin. If he is teething, falls over or is poorly he just sticks his hand in my top and he stops crying immediately. He had a surgery when he was thirteen months old and when he came out and the anaesthetic was wearing off all I had to do to calm him was put him on the boob with his little hand stroking my chest and he fell asleep for two hours, on the boob, content as anything and woke up like nothing had happened. Unreal eh?
But enough about babies let’s explore how this can help you when you are pregnant. Firstly, when you feel your baby feels. That is really important to remember. So if you go and get a pregnancy massage, reflexology, your nails done whatever it is you like that includes some kind of contact you enjoy...your baby is feeling those feel good hormones too. Jackpot! When my clients get a pregnancy massage it is different to a regular massage. The techniques used aren’t that different but it’s the way the woman is reacting. Your body is under a lot of stress physically and emotionally, hormonal changes and just going through something you may not have experienced before so a massage during this time can tick loads of boxes.
Positive touch through a massage can be so uniquely powerful as it can give you both emotional and physical healing. Ever heard of emotional release? Yes it can give you that. Ever heard of back pain? Tick. Ever heard of fluid retention? Yes it can make that better. The list is really endless. Now, what’s even better is if you can anchor those feelings right there and then to your birth through hypnobirthing. If you listen to particular music or scripts and get a pregnancy massage at the same time, BOOM...job done. You will plant these wonderful oxytocin filled feelings into your subconscious so when you go into labour you can simply press play, listen to the music you had on during your massage and get your partner to then massage you. Labour pains? No thank you!
So what are my top tips for maximising your use of skin to skin? If you are pregnant it could be your way of relaxing, it could be a chance for you and your partner to bond and for him/her to help you, it is helping you relax emotionally and physically and you are passing all that oxytocin oxygen rich goodness to your baby. Once baby arrives put them on you, embrace them being on you skin to skin and just enjoy it. Plant yourself on the sofa, do some necessary healing and time out and just be in the moment.
Some positive touch could be all you and your baby need to make a life changing difference and pave the way for generatations to come.
Bold statement but a proper deep tissue massage is hard to come by. As someone who has been doing deep tissue almost every day for the past 8.5 years I like to think Alex and I know a bit about it. Deep tissue massage for the therapist is great because we learn the 'no hands technique' so you can work using your elbows, knuckles and forearms without damaging our thumbs from overuse. Particular good for me as I have flexible thumbs so try not to use mine too much and my mum has arthritis so that's always something I am vigilant of. When you come across a knot or trigger point your elbow is the tool. It is so simple! We find the knot and lean on it with our elbows until we feel it go down; can be slight or a lot. You then use effleurage around the area to create a good blood flow and give the muscle a bit of a rest before you go in again. Three times is probably your maximum before you move onto another muscle. However, you can go back to it once the muscle has had a rest and I find this is even more effective as the muscle has time to relax and recuperate before you give it another round. It usually means we can feel more as well because of that muscle relaxation. You continue doing this for the whole body...
So why is it a rarity? I don't know if it's different massage schools or techniques but whenever I book a deep tissue massage every therapist is so different it baffles me. Some are too fast, some use their thumbs too much so it just hurts my surface muscle and doesn't get into the deep muscles, some don't find the knots we have just talked about during consultation...the list is endless.
The key things I look for, and you should, when getting a deep tissue massage is that the therapist has the right qualifications (make sure they actually have done a deep tissue massage course as some just say they do it), that they use the no hands technique effectively, they listen to you during the consultation and they are slow slow slow with their technique. A fast technique just equals fast mind and body. It is not going to effectively treat the muscles, hence the name deep tissue massage. The technique MUST be slow and controlled in order to effectively treat the deeper muscles otherwise they just 'hide' as you are slightly straining.
These are our top tips now go out and find that fab therapist :)
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