How To Get The Most Out Of A Massage


Kirsten Macnab |

By Paul Ingraham

Hands-on therapy has officially gone mainstream. Follow our instructions to maximise the benefits of your next session.

I was a massage therapist in Vancouver for 10 years and gave more than 10 000 rubdowns to every kind of client you could possibly imagine, from the body­builder twice my size who winced and pleaded for mercy to the doctor who was so calmly demanding that I needed a massage myself afterwards. Of course, every job has its share of characters, but I’ve always been surprised by the high rate of dissatisfaction with mas­sage among male clients. Men often made appointments for help with injuries, pain, performance, recovery, stress or depression, but all too often they ended up leaving with lighter wallets and unhappy endings instead of relief from the problems they came in with. With massage therapy now a multimillion-dollar industry and chains such as Sorbet opening more than 170 franchise locations across the country, it’s easy for consumers to get confused about what they really need. During my years in the business, I kept track of the most common client com­plaints about massage therapy. Now you can reap the benefits of my firsthand research and make sure your next (or first) mas­sage delivers everything you want.

PROBLEM 1

Finding a good therapist is difficult

Solution: A few hundred thousand massage therapists and massage school students are currently working and studying in South Africa, according to the Massage Therapy Association (MTA). Unfortunately, while practitioners are encouraged to register with the Allied Health Professions Council of South Africa (AHPCSA), many choose not to – and are able to avoid regulation.

To ensure a quality experience, look for TMT or CMT after the therapist’s name. This means he or she is licensed, registered or certified with an official body, although their requirements vary. Some organisations publish directories of their members – try searching for local providers in the MTA or AHPCSA’s databases. (Find them at mtasa.co.za and ahpcsa.co.za). Call prospective therapists and ask them about their training and style; any competent therapist will be more than happy to elaborate on his or her credentials and techniques.

In the past decade or so, chains such as Enmasse, Lis Spa, Rejuvenation Studio and Skin Sense have entered the market, offering convenience (walk-ins welcome, accessible locations) and often lower prices than a spa or independent therapist might charge. Like gyms, they even sell memberships. The downside is that they may have higher staff turnover, so ask plenty of questions before you book. You can also request a trial membership before committing to a multiple-visit package.

Man receiving a stone back massage in a spa

PROBLEM 2

I don’t know which of the health claims to believe

Solution: Keep your expectations reasonable. Massage feels great, so that’s a plus, but the specific biological benefits are still being studied, says psychologist Christopher Moyer, coeditor of Massage Therapy: Integrating Research and Practice. The plethora of styles complicates matters. (See our guide on the next page.) Here’s what we know and don’t know, so far: Massage boosts mood and eases stress. Of all the claims, this one is on the firmest scientific footing. “Studies show that massage can substantially reduce depression and anxiety,” says Moyer. But we still don’t know how that’s accomplished. The experts used to think massage lowered levels of the stress hormone cortisol and/or stimulated production of feel-good endorphins, but the research is inconclusive. Plus, there’s no consensus on just how often massage needs to be done to achieve this benefit.

Massage probably promotes circulation. Many studies seem to agree that it boosts blood­flow, but not enough research points to definite proof. In fact, Moyer contends that “any circulatory effects are probably no more beneficial than what a brisk walk would do for you.”

Massage does not detoxify the body. The idea that you can rid yourself of toxins through massage, sweating or a dietary cleanse has no basis in science. In fact, the latest research is showing that our bodies are full of microbes we need for good health. Even validation of the long-held belief that massage removes lactic acid from overworked muscles is waning.

Massage may or may not enhance exercise performance or muscle recovery. This is a shocker because so many therapists insist that it does and so many athletes swear by the results. But no clear scientific evidence confirms a word of it.

Massage seems to ease chronic pain from back problems. Whether it’s effective for other chronic pain is unknown. “Back pain in particular might benefit,” Moyer says, “but the science is mixed even for that.”

Massage may or may not help during rehab from injury. This is surprising, since massage is often prescribed; no definitive research supports a rehab advantage. The perception may stem from the mood boost.

So where does all this scientific controversy leave us? “I encourage people to try it and see,” says Moyer. “Massage is low-risk and generally pleasant, and it may well be effective.”

PROBLEM 3

There’s not enough (or too much!) pressure

Solution: This was the most common complaint I heard as a massage therapist; 75% of new clients said it. While a good therapist is adept at gauging the right pressure, a better one will check with you, especially when working in and around injured and sensitive tissue. To find and stay in your sweet spot, establish a 1-to-10 intensity scale with your therapist before the massage starts, with 1 being “very light” and 10 “very strong.” Estimate the massage level beforehand (“I feel like a 5 today”) and then tweak on the table (“better dial back to a 3 on that calf”).

A massage should never be painful. You only want it to hurt good – that strange, sweet ache that’s intense but not truly painful. Ignore all justifications for brutality, like “fascial release takes some force, but it’s worth it” or “a trigger point must be damaged to be deactivated.” No scientific evidence justifies the assertion that painful is helpful. In fact, adding pain to chronic pain can contribute to “central sen­sitisation,” a neuro­logical con­dition that leads to more pain with less provocation. If you’re really sore a day or two afterward, the therapist went too far.

PROBLEM 4

I won’t be able to afford regular rubdowns

Solution Good massage therapists are athletes. It’s a physical job that wears people down, and they don’t have long careers – about a decade on average. So expect to pay about R400 to R500 an hour for a professional massage. Spas tend be toward the top of that scale because they’re also selling atmosphere, and somebody has to pay for that koi pond. Conversely, massage chains tend to be at the lower end or even below that. To get the most for your buck, visit a clinic or independent therapist. If you’re lucky, your insurance might even pay for a massage or two. (Read your policy or check with the provider and your medical aid company for any conditions that may apply.)

Find Your Style: what to expect from the most com­mon types of massage

1. Swedish
The original; it’s best for almost everyone, especially first-timers.

2. Sports
Basically Swedish but with deeper, faster strokes for a more invigorating experience.

3. Deep Tissue
Essentially, “strong”; try it if other styles feel too gentle.

4. Relaxation
The light, soft strokes are great for stress relief.

5. Hot Stone
Warm rocks are placed on the body for an indulgent spa treat.

6. Trigger Point (or) Neuromuscular
For stubborn aches and pains, it targets stiff spots in muscles and “releases” them.

7. Myofascial Release
This stretching/pulling of connective tissue, or fascia, is often strong; best if you need help stretching or have chronic pain.

8. Medical
It emphasises the health benefits of massage and is more like physical therapy; used for injury rehab or support during illness.

9. Shiatsu
Japan’s house style is an intense hybrid of trigger-point work and acupressure.

10. Chair
It’s a quick, seated tension reliever to work out the kinks at the airport.

11. Reflexology
This foot massage has alleged benefits for organs. (Not for the ticklish!)

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