Massage pressure – the ugly pain

The good, the bad, and the ugly

Painful experiences on the massage table can be divided into three familiar categories: the good, the bad, and the ugly. Good pain is intense but somehow welcome, a paradoxical feeling, and probably what you mostly want out of therapy. Bad pain has no component of goodness in it, but is not necessarily incompatible with therapy. Ugly pain is particularly extreme and a bad idea in every way.

Good pain. In massage, there is such a thing as “good pain.” It arises from a sensory contradiction between the sensitivity caused by various types of muscle problems, and the instinctive sense that pressure is a source of relief from some of it — from trigger points (muscle knots) in particular. So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching. It is often described as a “sweet” ache. The best good pain may be such a relief that really the only bad thing about it is just that it is breathtakingly intense. The worst may be truly unpleasant: more like having to vomit to relieve a stomach ache!

Bad pain. Bad pain comes with no apparent benefits. If there is anything good about it, there is no way to tell from the sensation. Bad pains are usually sharp, burning or hot. Such pain is usually caused by excessive but harmless pressure. As bad as it feels, it probably won’t hurt you — maybe a little bruising — but there’s also a good chance that it won’t be therapeutic either. The big question about bad pain is whether or not it is ever justified.

Ugly pain. This is a type of pain in massage therapy that is, by my definition, never okay. Ugly pain is often caused by things that aren’t likely to offer even a delayed benefit, and may even be dangerous. Let’s look at ugly pain

Ugly pain

Let’s deal with the subject of ugly pain first, because it’s important to completely eliminate it from therapy. Once you’ve got a clearer idea of what kind of pain is totally unacceptable, it’s easier to wrap your head around the other kinds of pain. So, what kinds of situations involve “ugly” pain?

  • fingernail digging or skin tearing sensations, very common in “fascial release” therapy
  • nerve pinching or gland compression in one of the body’s “endangerment zones,” vulnerable spots where sensitive tissue is exposed
  • disturbing infected or inflamed tissue
  • truly excessive pressure or overstretch that is simply way over your personal pain threshold for that day, location or situation

“Ugly” pain is something inflicted only by careless, incompetent therapists. Ugly pain should simply never happen. Yet it does happen, and a shocking number of therapists will actually attempt to justify it or minimize the concern.

For instance, many poorly trained therapists do not know the endangerment sites, and will carelessly dig their thumbs into that hollow between your jaw and your ear, where there are exposed nerve bundles and salivary glands that can really smart when poked — and, no, they do not get the slightest benefit from being mangled. There are no trigger points there! Yet that therapist may well put out a “no pain, no gain” message or try to justify it as a crucial part of treating jaw tension, which is simply ridiculous. Jaw tension is treated by treating the jaw muscles, not the salivary glands!

Another alarmingly common example is the sensation of skin tearing, there is no likely therapeutic benefit to stretching the skin so hard that it feels like it is going to tear — and it is a completely different and uglier sensation than how fascial stretching can feel and should feel (more like a good massage).

There also seem to be therapists who believe that any painful sensation is simply part of the process, and if they poked you in the eye that would be “ocular release therapy.”

Ugly pain can be a sign of real dangers, one more obvious than the other:

  1. Direct injury.
  2. Sensory injury. A painful, alarming experience can actually dial up pain sensitivity — even long term.

Consequently, ugly pain in massage therapy is all too common and tragic. If you have a therapist you suspect of carelessly or deliberately inflicting ugly pain, just say no!

Excerpt taken from Paul Ingraham - http://saveyourself.ca/articles/pressure-question.php