On the Table: When Should You Speak Up?

On the Table is an ongoing series where I try to address concerns from the client perspective. Have a question? Comment below!

Being on the massage table creates an interesting dynamic: one of you is vulnerable and horizontal, and the other is fully dressed and mobile. We call this a power differential. If the therapist is careless, the power differential can swing to the point where the client feels like they are not “allowed” to give feedback about their treatment. When you are in the process of finding a therapist, you should feel like your treatment plan is a partnership. And with any healthy relationship, communication is key!

There seems to be a lot of confusion about how much communication is appropriate during a massage. When it comes right down to it, this is YOUR massage, and you should never feel like you are enduring (or suffering!) in any way. Granted, this is often easier said than done.

The “I don’t want to tell you how to do your job” trap

GUILTY. I am a well seasoned massage therapist AND educator, but if I’m not in my classroom, I am THE WORST at speaking up if I’m uncomfortable during a massage. Why? Because I don’t want to be the person who tells someone else how to do their job. But you know what? That’s something I really need to get over, because as the therapist, I REALLY REALLY APPRECIATE getting feedback. Am I pinching you? Working an area too long? Using too much pressure? Do you hate the music? Are you cold? Tell me! I am in the business of making you feel great and forget the world for an hour- if you’re focused on wishing something was different, I am more than happy to change it, and then make notes in your file so that your next massage is even better. Similarly, if your therapist is really wandering off from the treatment you discussed prior to you getting on the table, be sure to check in- it’s possible they found some unexpected issues, or it could be that they’re just daydreaming about what to eat for dinner. Snap them out of it!

The “no pain, no gain” trap

I’ve heard many variations of “you can work as hard as you need to!” or “that therapist had her elbow dug into (x-muscle) and it really sucked for 3 days but dang I felt better after that!” Well, yes, we all feel better after a bruise heals! I will be addressing the issue of “deep tissue” later on this blog, but for now I will simply state that there is little benefit to working tissue to within an inch of it’s life*. Let me put it this way: if your neighbor barged into your house and started bossing you around and taking things, you would probably be a little defensive, right? Maybe grab a baseball bat? But now let’s say your neighbor knocks politely on the door at a reasonable hour, and has a freshly baked pie and a bottle of wine. You’d totally let her in and invite her to watch Project Runway with you. Same thing with your tissue- if it feels like it’s being “attacked”, it’s going to guard, and no amount of deep breathing will make this a beneficial massage- damage is damage. On the other hand, if the tissue is given a chance to warm up and let the therapist in, it is much more responsive to the work. If it feels like you’re being hurt, please say something.

The “massage therapists just KNOW, right?” trap

My personal rule of thumb is to always work to the depth where the tissue pushes back at me, and that tends to usually be about the right pressure. But that doesn’t mean it’s the right pressure for everyone. I also try to be aware of non-verbal cues, but at the end of the day I must confess that I am just not psychic. I can try to make some really educated guesses, but ultimately I need your feedback. Was I just working a trigger point that exactly mimicked the headache you’ve had for 3 days? Did you think that the work we did on your hip flexors really helped your low back release? Or maybe you just really really love scalp massage. If I didn’t ask (and I should be asking!) and you feel like you need to tell me something, go for it.

The “well, this is how it’s always been” trap

In the mid 90’s, I worked next to a coffee shop. And being the 90’s, I frequented said coffee shop. A grande mocha was my usual drink, and it got to the point where the baristas (who were wonderful!) would see me walking up the block toward the shop, and they would have my drink ready for me before I even walked up to the counter. This was lovely! Except, that is, for the days I wasn’t in the mood for a mocha, or wanted to try something new. A lot of my clients come in with recurring issues, and we often do the same (or similar) treatment plan every time. I try really hard to never assume you will be the exact same person you were the last week/month/6 months ago I saw you. Maybe today you really just need to de-stress instead of working on your foot issues, or maybe your low back pain has resolved but you have a headache. That’s great! I’m going into the treatment with a clean slate; if you want to carry on as always, cool. If you need something new or different than usual, I’m happy to switch it up!

 

As I said at the beginning of this post, your massage should be a team approach. Therapists get into this business because we want to help people- YOU! So please, yes, feel free to speak up during your massage- it’s very helpful!**

*one tiny exception is with some myofascial techniques where the intention IS to cause a little bit of an inflammatory response, but it should just be riding that line of “this kind of sucks”.

**That is, unless, you are asleep, which is a really great compliment to your therapist!

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