Massage Therapy Frequently Asked Questions

Are clients given homework or exercise to supplement their massage therapy?

In order to be effective, the work performed by massage therapists must be supplementary to the stretching and exercise that clients perform on their own. Because clients only see their massage therapists a couple times a week at best, they must ultimately be responsible for the condition of their own bodies. Sandra told us, “I make it clear to my clients that we are a team and that I am not a bandage or a magician. They must participate in their own healing and ultimately they have more vested in getting well.”

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Homework always involves the practice of injury avoidance, or taking care not to put undue strain on a part of the body recovering from injury. The client is also usually expected to perform routine gentle stretching exercises that focus on the injured area. Clients may either work alone or with a personal trainer doing light resistance training to strengthen the tendons, ligaments, muscles, and fascia around an injured area, as well as the area directly affected by injury.

How do alternative modalities differ from medically accepted modalities of massage?

Certain types of massage are included in the Complimentary and Alternative Medicine (CAM) grouping. CAM is used as a short form term that describes anything that is employed for the purpose of improving human health but that is, as of yet, not supported by the practitioners of western medicine. Included in the CAM grouping would be Qigong, Ayurevedic Massage, Stone Massage, Acupressure, and various other modalities referred to as energy techniques. It is important to note that many of the less conventional types of massage are hugely popular, and are backed by the testimonials of many thousands of people who attest to their effectiveness. Not all of these alternative forms of massage therapy exist on the periphery; in fact, some are held in very high esteem among many people in the therapeutic massage community. Even massage therapists who have chosen to make use of medically recognized modalities in their practice, and members of the medical community who are open to the idea of a holistic approach to human health, have recognized the benefits of many modalities classified as complimentary and alternative.

The decision to embrace less conventional modalities doesn’t have to be exclusive. Many massage therapists incorporate both medically accepted and complimentary and alternative modalities into their practice so as to be able to meet the needs of a variety of different clients.

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How do massage therapists choose which modalities they will incorporate into their practice?

Many forms of massage are recognized by the medical and rehabilitation therapy communities as being extremely beneficial and as having tangible results that can be proven by western scientific methods. These medically recognized modalities include myofascial alignment, deep tissue massage, and neuromuscular massage. These medically proven techniques are the one’s most often employed for accident victims and as part of rehabilitation therapy. Veteran massage therapist, Sandra Bennett, explained how her personal career goals influenced her decision to study more conventional and medically accepted forms of massage, “My initial vision was to work with the medical community and therefore I didn’t spend a lot of time learning energy techniques; not that these cannot be healing, but the doctors with whom I relate are scientists who generally need hard evidence.”

Because many modalities are culturally derived, the psychological affect of one of these culturally derived massages can be profound for clients who either come from or relate to a certain cultural background. When choosing a culturally derived modality to incorporate into practice, it is important to consider the client base in the area in which one intends to practice. This is largely why Sandra Bennett, whose massage practice is established in Hawaii, incorporates the traditional Hawaiian art of Lomi Lomi massage. To this point Sandra said, “The modalities one chooses are also dependent on the clientele one wishes to work with. Someone who does primarily relaxation massage will be a big disappointment to someone who wants specific healing in a particular area; and someone medically focused will disappoint the client looking for relaxation.” She went on to ask rhetorically of aspiring massage students, “Are you interested in geriatrics, pregnancy massage, medical, relaxation, hotel work, spiritual or somatic work. It’s all based on a personal vision.”

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What are the different modalities or methods of massage therapy?

There are 80 different recognized modalities or methods of massage that a massage therapist can choose to specialize in. Some of the more ancient modalities, many of which are still practiced today, have a cultural heritage and are geographically derived. These modalities are often taken up as a preferred method by massage therapists who were brought up in a certain part of the world, or who where otherwise indoctrinated into a certain culture. This is true whether it is east Indian culture as is the case with Ayurevedic massage, European as is the case with Russian or Swedish massage, Chinese as is the case with Acupressure, or Polynesian as is the case with Lomi Lomi. Each modality is recognized either within its cultural community or universally among all cultures as having benefits. Some are known to be more effective when used for specific reasons like injury rehabilitation and are accepted by the practitioners of conventional western medicine. Some ancient Asian and native practices, as well as some that were developed in more recent years, don’t have the same medically recognized distinction. The following abridged list represents some of the more commonly employed modalities of massage, both those that are recognized as being medically effective and those that are considered alternative or complimentary.

Acupressure is an ancient Chinese modality that combines acupuncture with massage. Acupressure massage therapists use their knowledge of pressure points on the body, applying pressure to these specific areas as part of the healing process.
Anma is also a form of traditional Chinese massage developed by nomadic people who established mobile massage practices that served royalty, military officers, and the societal elite. It involves the less subtle techniques of kneading and deep tissue massage.
Ayurevedic Massage often involves two therapists working in concert using hot herbal oils. This modality is East Indian in origin and is often coupled with yoga and meditation as part of the holistic healing process.
Balinese Massage, rooted in Bali, incorporates hot stones and heated oils to improve the flow of oxygen and blood throughout the body. It is gentle in nature so has the benefit of helping clients’ achieve a state of relaxation.
Barefoot Deep Tissue Massage incorporates the use of the heels, sesamoid, and arches of the massage therapist’s feet to apply tension, compression, and transverse friction in a deep tissue massage. It is most successful on large muscle groups like the thighs and back as it allows for greater force to be applied without the single-pointed pressure that thumbs and elbows would exert.
Bowen Therapy is an Australian modality that seeks to restore lymphatic flow without prolonged contact with the muscles. It does this by using a hand movement that rolls over muscles, ligaments, and tendons without over-working the troubled area.
Breema combines Thai massage and partner yoga, and seeks to create strong mind-body awareness. It is subtler than some other forms of physical yoga in that it doesn’t require extreme exertion or muscular contortion. It incorporates the nine principles of Breema: body comfort, no extra, firmness and gentleness, full participation, mutual support, no judgment, single moment/single activity, no hurry/no pause, and no force.
Champissage is a form of alternative east Indian massage that focuses on the head, neck, and face with the intent of clearing blocks that exist in the energy channels of the body known as chakras. It has been used to address everything from stress to hair loss.
Deep Tissue Massage is often used on athletes or other people who are subject to consistent and intense physical exertion. It is often recommended for people recovering from injury. This modality seeks to relieve tension and pain in the muscles and fascia through deep penetrating massage.
Esalen Massage involves gentle rocking movements coupled with energy balance, passive joint exercises, and deep structural work with the intent of addressing muscular issues and joint problems.
Hilot Massage is of Philippine origin and is often used as a less expensive alternative to conventional medicine in rural Philippines. It combines massage and other traditional healing techniques, and is used for everything from correcting musculoskeletal issues to inducing labor.
Lomi Lomi is traditionally Hawaiian, but has been seen in other island nations like Tahiti and Samoa. It incorporates the use of all possible parts of the body including knees, elbows, and feet, as well as tools made from stones and sticks. It is used to facilitate relaxation, and even as a way to aid in digestion.
Medical Massage includes many forms of medically supported techniques including cartoid sinus massage and decongestive therapy, which can be used as part of traditional approaches to treating breast cancer and many other common ailments of varying severity.
Meso-American Massage is a form of soft tissue and structural massage that has been retained as part of the American indigenous cultural heritage. The specifics of this healing art are traditionally handed down by word of mouth as part of oral tradition.
Myofascial Release makes use of stretching, shear compression, multidirectional tension, and skin rolling to loosen up fascia and muscles so as to eliminate pain and restore full range of motion. This modality is very commonly used for injury rehabilitation.
Neuromuscular Massage involves concentrated massage focused on a specific trigger point in the body. It is used to address pain, stiffness, muscle spasms and related immobility in parts of the body linked to a problematic trigger point.
Postural Integration is a form of alternative bodywork that incorporates deep tissue massage, breathing exercises, bodily movements and body awareness, along with emotional expression. Postural Integration has been coupled with various forms of psychological therapy in an approach that promotes wellness holistically.
Raynor Massage is a deep tissue approach that focuses on the abdomen with the intent of removing blocks in the natural flow of chi throughout the body, along with the release of pent up emotions.
Reflexology is an alternative approach that is centered on the idea that all parts of the body are linked to specific corresponding points on the hands, feet, and ears. This form of massage seeks to improve circulation, relieve tension, and promote normal function of the entire body through massage performed on the hands and feet.
Russian Massage approaches massage therapy in a dynamic, variant, and cyclical way by beginning with a slow and gentle massage, then moving on to a deep and vigorous massage, then finally returning to a slow and gentle massage to complete the session.
Shiatsu translates from Japanese as “finger pressure”. This ancient modality focuses on the acupuncture/acupressure points throughout the body using thumbs, fingers, and palms of the hand.
Stone Massage uses sanitized and heated stones placed both under the client and on the client’s back along the spine. This stone placement is done in conjunction with massage performed using heated oil and stones held in the massage therapist’s hands.
Structural Integration incorporates slow and deep massage techniques coupled with a reeducation process that teaches the client how to properly align body form in the course of daily movement. The goal of this modality is to restore natural length, alignment, and balance to the body’s myofascial system.
Swedish Massage makes use of five specific massage strokes: gliding, kneading, rhythmic tapping, cross-fiber friction, and vibration. This modality has been proven effective in treating pain, stiffness of joints, and even osteoarthritis.
Sports Massage was originally designed for the unique physical needs of athletes and incorporates Swedish massage and trigger point techniques to address specific problem areas. It is particularly effective when used in the recovery of sports related injuries.
Thai Massage involves placing the recipient of the massage in positions similar to those of hatha or physical yoga. Its focus is on both stretching and acupressure, and is considered a form of assisted yoga.
Traditional Chinese Massage is based on the principals of traditional Chinese medicine. There are two schools: Tui na, which involves stretching, pushing, and kneading muscles; and Zhi ha, which involves pressure applied to acupressure points.
Trager Approach incorporates gentle and rhythmic massage intended to bring about deep relaxation, increased mobility, and optimal physical performance. This modality also seeks to reeducate the recipient’s neuromuscular system so as to bring change to reflex responses.
Trigger Point Therapy involves the deactivation of photomicrographed and electronically measured trigger points in the body that can cause pain elsewhere in the body. An example of this is apparent when considering the existence of trigger points located in the back, neck, and shoulders, which when tense can be the cause of headaches.
Visceral Manipulation is a Mayan massage that is still used throughout Latin America. It is a modality that specifically targets the abdomen as the means by which to address overall physical health.
Watsu combines hydrotherapy with Shiatsu massage in which both the massage therapist and client are in a waist-to-chest-deep pool of water. The client is guided through a series of movements intended to activate energy channels, or chi, that runs through the body.

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