Should My Massage Hurt?

Should My Massage Hurt? 

It's "no pain, no gain," right?  


Catherine Nelson, LMT, CST, CKTS 


Years ago, when I began working with athletes, I began to notice a pattern. Unlike the other patients I worked with, athletes almost never said a word if the work was too deep. They would return for their next appointment with bruises, little improvement, or worse, loss of improvement.  


Athletes are used to pushing their bodies past the point of comfort, and in training, that does result in stronger muscles and better performance.  


But when it comes to massage therapy, suffering through the wrong kind of pain slows the recovery process, damages tissues, and can seriously set back any kind of progress.  


The old adage, "no pain, no gain," really has no place in massage therapy. 


Resource: Should My Massage Hurt? (Video) 


Bad Pain vs Good Pain 


Pain can give us a lot of information about whatever we're experiencing, and it's especially helpful in bodywork.  


Discomfort vs Pain 


There will be many occasions in which your massage or bodywork may cause discomfort. Discomfort is not the same thing as pain.  


Discomfort can occur when muscles and tissue not normally touched are being worked on, when a joint range of motion is being challenged, or when injured tissue is being manipulated.  


Discomfort also occurs when you're not fully comfortable lying on the table (this often happens in the face-down position), and some modifications to your position would allow your body to more fully relax.  


And it can also occur when you have a fairly high level of generalized pain all over your body, either from inflammation, a nervous-system disorder, or something similar.  


It is possible for discomfort to reach a level of true pain, in which case, the pressure and/or technique will need to be modified or adjusted. However, in general, a sensation of discomfort is not the same as one of pain, and is not cause for concern in the same way.  


If you find the discomfort you may experience to be intolerable, speak with your therapist about it. Perhaps another therapeutic approach is more practical for your care, perhaps modifications to your position on the table need to be made, or perhaps you'd be better served by a different therapist who has a different style.  


During massage and bodywork, bad pain is a cause for concern.  



-Hold your breath 

-Grit your teeth 

-Just get through it 


If ever the work soars past discomfort and into pain, that's a problem.  


If that pain is the kind that causes you to have to hold your breath, grit your teeth, and just get through it, it's too much.  


It's the wrong kind of pain.  




-Hurts so good 

-Fall into it 

-Stay a while 


This is the kind of pain that sets off the pain alert in your brain but at the same time makes you think, "but don't stop." It's a strange sensation that is probably best described as "hurts so good." 


This good kind of pain never causes you to have to hold your breath or grit your teeth. It's enjoyable and something you can relax into.  


This is an acceptable kind of pain. 



Tissue Damage 


Most people are aware that movement, and especially exercise, causes tissue damage. When you work out, your muscle fibers are torn, and when they rebuild themselves, they're stronger. This is how muscles get bigger.  


This kind of damage is an acceptable, even desirable kind of damage. It is different than the kind of damage caused during an injury. There are other differences, but in short, the exercise damage is much less severe than damage caused during an injury.  


You may not know tissue damage occurs during massage and bodywork treatments as well. When the work is performed properly, small damage is caused, very similar to the kind caused during exercise. We call this "therapeutic damage."  


When the work is performed improperly and inexpertly, injury-type damage will occur. The muscles and soft tissue will actually be injured.  


This is why your pain response is so important. With injury damage, you will experience pain--the bad kind of pain.  


Most people receive massage therapy to help them recover, lessen pain, and rejuvenate their soft tissue. None of this can occur if the tissue is damaged, and in fact will cause setbacks. So instead of getting better and making progress, you'll be delayed and have to heal from a worse or new injury. 



Speak Up 


If you are seeing a skilled, knowledgeable, and talented therapist, he/she will know to watch for signs the work is too deep. But at the end of the day, nobody can read your mind. So, it is important for you to speak up when the pain reaches the bad-pain level.  


If you're with the right therapist, your therapist will not be mad that you said something. On the contrary, he will be grateful for the information. It will allow him to modify the work to be much more beneficial to you in that moment.  


If your therapist does not receive this feedback well, that's a big red flag, and it might be time for you to consider finding a therapist who better fits your treatment goals.  


Your therapist is your partner in the treatment process. In order for her to do her best work, she will need you to give her good, helpful information about how you're feeling. This is how she best creates her treatment plan for you. And during the work, she does need to know if something causes pain.  


It is your responsibility to speak up. Never hesitate to do so. 




Not all discomfort is pain, and not all pain is bad. But if you ever experience the bad kind of pain during a massage session, you really do need to let your therapist know in the moment so he can modify the pressure and/or the technique.  


If you suffer through the bad pain, you're likely to experience a setback in your treatment progress, because too much damage has been caused to the soft tissue in that area. This will result in what is essentially an injury that will need time to recover. Massage therapy can be used strategically to accelerate the healing process, so why would you suffer through a setback?  


Speak up for yourself in the moment. If you don't feel like you can give this kind of information to your therapist, you definitely need to find a new one. If you do say something and it doesn't go well with your therapist, you need to find a new one. A professional, knowledgeable therapist will be glad to have this information, and will make the necessary adjustments.  


That old saying, "no pain, no gain," can be applied to many areas of our lives. Massage therapy is not one of them. If you've been receiving care with this mindset, now you know why that bad kind of pain is so harmful to you, and why it's important to say something to your therapist when you experience pain during treatment.  





Catherine Nelson, LMT, CST, CKTS, is a long-time massage therapist with a long and varied background in Western medicine. She specializes in CranioSacral Therapy for PTSD and anxiety, medical massage therapy for injury rehabilitation, and sports massage therapy for all phases of training and competition. She can be reached directly at  




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