Massage Pressure – The Good

More about this whole “good pain” business

Good pain is an interesting subject because it’s a contradiction that somehow manages to make perfect sense when you experience it.

And it comes from inside of people. Therapists have not imposed the idea of good pain on patients the way that they have imposed many other common therapy ideas. Even massage newbies recognize the sensory paradox clearly. It’s always quite interesting to listen to an inexperienced patient discovering good pain …

Oooh, wow … oh, that’s sensitive … but it’s good … but it’s definitely pain … but it’s definitely good …

typical patient discovering “good pain”

The contradiction between the good and bad parts of pain can be very strong. Good pain may involve an undeniably nasty or gross or sickening competent, a truly unpleasant quality, and yet still be accompanied by a distinct sense of relief, like an itch being scratched.

So, how can a painful pain be so good? What’s going on? It’s all about trigger points. The secret to pain’s goodness — like so much else about massage therapy — probably mostly lies in the nature of trigger points, or muscle knots. They are an “itch” that we cannot easily “scratch” on our own. In particular, we try to stretch them out, and it usually doesn’t work all that well. They are probably 80% of the reason why a good massage is both intense … and an intense relief.

Trigger points are fairly well-defined physiologically. We know what they are, and we know where they live. They are essentially a miniature spasm, a small patch of a muscle tissue that is super-clenched. They are common, and responsible for most of the garden variety aches and pains of humanity, ranging from mild to crippling. And we know that they can, sometimes, be relieved simply by “ironing them out” with skillful thumbs.

When you press on a trigger point, it’s going to feel painful because it’s a swampy little patch of muscle in metabolic overdrive, its sensory nerve endings bathed in junk molecules. But it’s also going to feel like a relief to have any of that problem taken away! As discussed above, relief from trigger points may occur simply through crushing and destroying the cellular machinery of it. But there are numerous other possible mechanisms, such as a tiny, localized stretching of the spasm — a miniature version of what you do when you stretch out a big leg muscle to ease a charlie horse. Another likely mechanism is that the pressure squishes stagnant tissue fluids out of the spot, allowing them to be replaced by fresh circulation.

Referred pain spreads the goodness. Undoubtedly another reason that massage pain can be good is the phenomenon of referred sensation. If you stimulate internal tissues anywhere in the body, muscle or otherwise, the brain really has trouble telling quite where the sensation is coming from. The net effect of this is that, when you press hard enough on your muscles, particularly on sensitive trigger points, the pain is often experienced throughout a much wider area.

There are many important clinical implications of this interesting neurology, but as far as the good pain thing goes, it basically just makes trigger point release feel bigger, more important. Press on a small spot … feel it down your entire arm. Wow! Impressive! Even though it’s just a thumb on a trigger point, it feels as though that “itch” is being scratched throughout an entire region. Referred pain essentially amplifies the good pain effect — or the bad pain effect, if the pressure is too intense!


Excerpt taken from Paul Ingraham -