What to expect from a massage treatment

If anyone learnt anything from the Covid-19 pandemic and its associated lockdowns and restrictions, is that nobody really knows what sports massage is. At first we were clearly lumped into the "spas and massage parlours" category, which caused a lot of eye-rolling, indignation, and thrust professional associations into the spotlight for their lobbying efforts as they tried to clarify what exactly the role of a sports massage therapist is.


Even if you are familiar with sports massage, sometimes interchangeably referred to as deep tissue massage, there can be a wide variety of approaches between therapists. Even in my own career as a massage therapist, I have worked with clients with widely varying needs and expectations, in a variety of different settings.


It is understandable if you are nervous or unsure about what to expect during your treatment; a massage will usually involve removing some amount of clothing (more on that below), involves close contact by someone who may still be a stranger to you, and often will involve some degree of physical discomfort - any or all of which has the potential to leave you feeling vulnerable and exposed. Any specific issues or concerns should be brought up with your therapist, who should be doing everything they can to make you feel safe.


Every therapist will have a slightly different way of working, and even I will sometimes do things slightly differently depending on your needs and the clinic set-up, but as a general rule, here is what you can expect:


Intake form and case history


Before putting hands on you, I will ask you to fill out an intake form - which asks for some personal details (such as your name and contact number), some general health questions (such as whether you suffer from asthma or diabetes), some more specific health and injury questions (such as whether you have had any surgeries, or whether you could be pregnant), and some lifestyle questions (such as what sports you practise, if any, and whether you smoke). I have included only those questions which I believe are relevant to me providing a safe and effective service.


At the time of booking, you may have volunteered - or I may have asked - some questions about your reason for visiting me. This is useful to me in order to prepare ahead of your treatment, but it will still be important for me to go through a more thorough case history in your first session - this is why your first appointment will be scheduled for at least 15 minutes longer, and will cost slightly more. In those 15 minutes - sometimes more - I will ask about the specific issue you have come to see me about. I might ask you a lot of questions, and make you do some movements, and not give you any answers - this is because I am trying to gather as much information as possible without making snap judgements which could influence my treatment approach. I might write notes as we go, or I might listen and absorb the information.


Hands-on work

before we begin: clothing


The question on everyone's mind: do you have to take your clothes off for a massage?


The short answer is that it is entirely up to you. It is my job to help you feel better in your body, and respecting your personal boundaries is integral to that. Whether I feel I could give a better massage with more exposed skin is irrelevant if that experience leaves you feeling tense and anxious. I have plenty of techniques that can be just as effective without direct skin contact.


Most of my clients will remove all clothing except for their underpants, so that is what I am most used to working with. Women sometimes choose to keep bras on and simply unclasp at the back. Of course, if we are only working on either the top or bottom half of the body, clients sometimes keep the other half clothed, but this isn't always comfortable for them (for example, lying on your front in jeans could be uncomfortable due to the stiching and zipper or buttons; or keeping a shirt on may result in it being overly creased). Again, I will work with whatever is comfortable for you, so please don't hesitate to ask any questions ahead of time or to communicate any concerns to me.


while you are on the table: draping


Whether you choose to remove clothing or not, I will use the same draping techniques I would use if you weren't wearing clothes: body parts I am not working on will remain covered, and I do not reach under the towel to make contact with any areas that are covered. With your consent, I may tuck towels into waistbands or hems; this allows me to secure the towel in place, and to protect any of your clothing from massage oil/wax, but I understand this can at times feel invasive. As always, if you are not comfortable with any suggestions I make, or if you become uncomfortable with anything I do, you are always welcome to tell me.


while you are on the table: pain and discomfort


Perhaps the second most common question or belief regarding sports massage: will it hurt?


The answer is less straightforward, and does partly come down to a question of where we consider the line to be between pain and discomfort (another blog post on that someday, perhaps).


My aim is to avoid causing you pain during your treatment. I don't want to work at at intensity that causes you to grit your teeth, hold your breath, scrunch your face up, clench your fists, curl your toes, or do anything else that amounts to creating more tension in the body. On both a physical and a psychological/emotional level, this is not useful, no matter how effective the massage technique is.


On the other hand, it is almost inevitable that some parts of your treatment may be physically uncomfortable. This is because tense, tight tissues can feel tender to touch, almost like a bruise. If a trigger point forms (usually what people may refer to as a "knot") it can be extremely tender when pressure is applied, and may cause referred pain in other areas of the body (for example, many trigger points in the neck and shoulders cause referred pain down the arm, or up into the jaw and forehead). I would be lying if I said you wouldn't experience some of this discomfort. My aim, if I find one of these trigger points, is to keep my pressure at an intensity that doesn't cause you pain beyond a 7 out of 10 - the sort of pain that may require some mindful, deep breathing, but shouldn't feel traumatic. The pain should start to ease within 10 seconds or so, but whether it has or hasn't, I won't spend much longer on that point.


The reality is that sometimes I will find one of these spots unexpectedly, and it may take me a second or two to adjust the pressure, so you may have moments of more intense pain than I would like you to experience. That's why it is important you communicate with me about the intensity of the pain or of the sensations you are experiencing.


Occasionally, these trigger points are associated with emotional experiences; there are many schools of thought as to what exactly causes this, but I myself have experienced this phenomenon when receiving treatment on an area. Crying is a common response, and not one to be ashamed of. Other feelings may come up too, and you may or may not be ready to face them; if you are not comfortable with any emotions you are experiencing during your massage treatment, it is important you tell me to stop what I am doing that is causing this. I am not a trained psychologist or counsellor, and as such may not be in a position to provide the emotional support you may need at that time.


So my short(er) answer to the question "Will a massage hurt" is: some parts may be uncomfortable, but should always be tolerable, and shouldn't be the most memorable aspect of the experience.


while you are on the table: oil and wax


I generally use Songbird vegan massage wax (usually the sports massage blend though all varieties have similar ingredients). Occasionally I will use coconut oil or, less frequently, a homemade blend (a favourite included cocoa butter and castor oil, for a silky consistency that still allowed me to control my pressure and pace).


If you have an allergy or sensitivity to any oils or other ingredients, please do let me know. I can always adapt to a different massage medium if you have one you prefer, or I can use techniques that don't require any oil or wax at all.


By tucking towels into your clothing where appropriate, I try to avoid any wax or oil coming into contact with your clothes (but should it come to it, I do find that the Songbird wax blends wash out of clothing very well). However, if possible, I would always recommend wearing clothing that you don't mind getting some oil or wax on, just in case.


while you are on the table: techniques used


I don't use a set routine in my massage treatments, so every treatment could be a little bit different. Techniques I use may include: compression (pressure) through the towel; direct and indirect fascial techniques on the skin without wax or oil; a variety of traditional massage strokes with wax or oil, using hands or forearms; steady pressure on a trigger point using hands or elbows; gentle joint mobilisation; and both passive and active stretching.


My favourite instruments are my hands, but there are some benefits to instruments, so occasionally I will use a gua sha tool or suction cups to augment the work my hands do.


Home-care advice


An important and often overlooked part of a massage treatment is teaching you some self-care practices that will help the benefits of your treatment last longer. As such, I will reserve some time at the end of our session to show you some techniques, which may include: self-massage using a foam roller or trigger point ball; mindfulness and breathing practices; static and dynamic stretches; and activation exercises to strengthen less active muscles.


These suggestions will not comprise a comprehensive training or rehab programme; the aim is to give you 2-3 simple, immediately actionable suggestions that can slot into your existing routine, to prevent recurrence of issues you are having (though of course, if you need a more comprehensive training routine, that's something I can help you establish in a course of movement coaching sessions).


My aim, in everything I do, is to empower you to make the decisions that best serve you and your body; the suggestions I give are intended to be a starting point, from which we can establish what is and isn't working, and refine both the next hands-on session and your day-to-day movement habits. Over time, we will both learn what your body - or a particular issue - responds to best, and you will be better placed to understand warning signs and address small niggles before they become bigger issues. That's why the home-care element is something I take seriously.


Follow-up sessions


If it's your first time seeing me, the first treatment after a prolonged break, or we are working on a new issue, it's generally recommended that we schedule in a session a week for at least 2-3 weeks (though that initial phase can be longer for more chronic or complex issues), then gradually start leaving longer gaps between sessions.


As everyone's body, lifestyle, and goals for treatment are different, it is hard to recommend an exact number of sessions or timeframe for "full recovery" (even defining a full recovery will very greatly from person to person, and from issue to issue!). Many injuries or chronic pain issues will flare up from time to time - changes in weather, stress levels, or a change in activity levels, to name but a few factors, can all cause an old sensation to resurface - so it is not unrealistic to plan to touch base at least once every few months as maintenance, or when there is a change in circumstances.


TL;DR


Ultimately - from start to finish - we will work together to devise the best treatment and maintenance plan for you! I welcome any questions so please don't hesitate to reach out.

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