So you’re in pain or dealing with an injury and you want the help of someone in the bodywork field to sort you out. How do you choose the BEST person for you?
This can be a daunting decision, with thousands of choices that often looks similar on paper (or the web).
If you’re NOT in pain, then my opinion is simple: see whoever you want! Do what feels good. See the person you like the most.
When you’re in pain, however, there are a few critical distinctions to make and important points to consider if you want help actually getting out of pain AND finding the root cause so it doesn’t come back.
How to choose a body worker for pain relief:First of all, here are some very basic things to consider:
- MANY (I would say the majority of) manual therapists – massage therapists and other body worker practitioners – are not necessarily trained to help people eliminate pain.
- Having said that, there certainly ARE capable manual therapists and body work practitioners out there who have been trained to relieve pain at its source, and this post is designed to help you find THOSE people and learn how to differentiate between your average massage therapist or someone you would go to for relaxation vs. someone who can help you get and STAY out of pain.
First off, let’s weed out the therapists who probably CAN’T help you:
Before I list these, I want to be clear I’m not knocking these therapists or discounting their work – I think there’s room for ALL of us and room for every modality. I just think it’s important for all of us (clients and practitioners alike) to know who we are seeing and WHY, with an honest look at scope of practice. I was a massage therapist for a year (8 long years ago!) and in that time I never helped my clients eliminate their pain for good. I wasn’t trained to do that and I went through a very comprehensive training that included myofascial massage, orthorpedic massage as well as the typical deep tissue, swedish etc.
Here are the modalities and people I would NOT consider seeing if you are looking for pain relief:
- Your corner massage chain or generic massage therapist.
- This includes therapists whose work consists mostly of Swedish, deep tissue or very general whole body massage.
Here are the practitioners and modalities you might consider, CAREFULLY: (and use my interview questions to make a wise decision here!)
- Massage therapists or massage businesses who list “sports massage” or something like this as an option (often an “upgrade” that you pay extra for). A lot of the time these therapists are allowed to say they practice “sports massage” when they had a few hours of training for “athletes” while they were in massage school. This does NOT mean (in my opinion) that they know how to find the root cause of pain. MAYBE THEY DO. Some people have had extra training that gives them the authority to make this claim with confidence. This is where I want to encourage you to interview people, because you never really know from the average website bio (see below for questions to ask and what to look for when interviewing practitioners).
- Manual therapists who say they do “myofascial massage.” Like I said above, I was trained in myofascial massage but NONE of that training included teaching us how to find the ROOT cause of pain. Generally speaking, THIS IS SIMPLY A MASSAGE MODALITY or technique. It does NOT mean this person will be able to release your fascia (it takes a very skilled person to do this with their hands. They absolutely ARE out there and if you can find one of these that’s AWESOME!)
- All other modalities that do not (necessarily) include training to find the root cause of pain, from energy work to deep body work – reiki, craniosacral therapy, shiatsu, trigger point therapy, thai massage, reflexology etc. I like to speak from personal experience and personally, I haven’t directly experienced eliminating physical pain with any energy technique. Maybe I’m not open minded enough. That said, I have friends who have and I believe them. The mind is extremely powerful! If you believe in energy work and believe your practitioner is saving your ass, then they probably will! I definitely believe in energy being stored in the body, as well as emotions, trauma etc. My personal preference is to access that energy in a very physical way. So – if energy work is your jam, carry on! As for some of the other ones I listed above, it’s for the same reasons as the above two that I list these: most of the time the training for these modalities does not include how to find the root cause of pain. This doesn’t mean there aren’t some really skilled practitioners out there who specialize in shiatsu, Thai massage or trigger point therapy that can help eliminate pain. So once again – please refer to the interview questions to help you determine if one of these practitioners is right for you.
- ALL other body work modalities fall into this category of being potentially supportive (if you interview them and like their answers): Alexander technique, Feldenkrais, Bowen, chiropractic, Trager and Rolfing, or Structural Integration, ART, Mashing, Rossiter etc (I’m sure there are many more).
- Just because someone was trained in something potentially helpful does NOT mean they are GOOD! Your job is to find out if they are, and their job is to make sure you know it when you call or walk into their office.
Questions to ask when interviewing a practitioner:
The very FIRST thing I urge you to ask any professional before you see them is
“How does your work address pain at its SOURCE?”
Their answer will tell you a LOT, and here’s what you need to consider when listening to what they say in reply:
Do they sound confident when telling you HOW they find and address pain at its source, or do you get the sense they’re giving a canned answer that broadly endorses their work as something anyone and everyone should try? I’m probably more confident than a lot of people, but I actually guarantee 50-100% relief of pain and/or increase in range of motion for new clients if they walk in my door with pain or immobility. It’s rare I don’t get results like that so I’m confident giving that kind of guarantee. If the person you’re talking to doesn’t sound confident in their abilities to give you a RESULT, I would move on.
One of the biggest markers of someone I would trust to help you when you’re in pain is an answer that includes telling you WHERE THE PAIN IS ISN’T THE PROBLEM.
Does their answer give you the feeling they know how to find the root cause, or does it sound like they only look at the pain itself? This is the MOST important distinction to make!
If you’re talking to a massage therapist and you’re experiencing back pain of any kind and they tell you they’re going to dig into and release (or attempt to “relax”) your back muscles…BE VERY WARY! Going into the back muscles and forcing them to chill out often has a result that includes feeling good for about 12-24 hours but then…either the pain comes back OR it can get a LOT worse.
This is because the root cause wasn’t found and addressed, and the muscles that are trying to PROTECT your spine have been loosened…and may freak out by going into spasm. This can include your glutes, low back muscles, erector spinae and upper traps.
Similarly, if you have pain in your feet or shoulders and they want to focus their attention on your feet or shoulders – MOVE ON!
“Can you help me figure out what habits I have that might be causing this pain?”
Many manual therapists don’t necessarily do this, because often they’re working on you in a spa-like setting where you’re face down on a table and conversation like that isn’t really possible.
Unless you’re using a practitioner that has you WALK, sit, stand, perform movement tests (and retests during the session) specific to your pain and watches your every move…they will be missing some of the most critical information that can help you!
For this reason, if you’re going to choose someone who works with their hands and puts you on a table without clothes – I would DEFINITELY make a point to ask them if they do any kind of pre and post massage testing or assessments that can help them AND you gauge actual results and the habits that may be causing the physical issues.
“Do you look for or test muscle inhibition or weakness?”
This is typically NOT in the domain of most manual or massage therapists and practitioners. However, it’s an important topic and I would advise that you at least find a practitioner who can skillfully ANSWER this for you!
That means they know how important this is and if they do suspect something like this is going on for you, hopefully they can refer you to someone in their network that can help with that particular issue. If they give you a blank stare or don’t know how to answer this question with intelligence – I would move on.
A skilled chiropractor will know how to perform muscle and nerve activation tests, and if you can find one I recommend going even if it’s just for this information alone.
It has been my personal experience, however, even with highly trained and very intelligent chiropractors (whom I LOVE) often after performing these tests and informing me (or my clients) of muscle inhibition or weakness when asked “Ok, so what do I DO about this? How do I correct it?” the answer does not satisfy me. I highly respect the work of Perry Nickelston of Stop Chasing Pain. If you can find a chiropractor or therapist trained by him or with a similar background you will probably be in GREAT hands! I intend to take his course this year or next.
Do you work with fascia, and if so what is your approach?
It might sound convenient for me to bring this up, but I don’t talk about fascia because that’s the field I’m in; I am in the field of fascia and fascial release because I believe it is THE cutting edge place to be for mapping new understandings of the body, pain, pain relief, injury recovery and prevention.
I’m ecstatic to see so many people embracing fascia work these days, and there are a LOT of professionals who work with bodies that include this all-important tissue in their field: from chiropractors and personal trainers to osteopaths, massage therapists and more.
Obviously, I highly recommend finding someone who works with the fascial system when addressing pain.
Here are a few key points to consider about fascia work specifically:
- If you’re going to a massage therapist who does myofascial massage – this doesn’t necessarily mean they’re good, nor does it mean they know how to find the cause of your pain or even release your fascia. If they’re highly trained and skilled at this work they will probably not use ANY oil or cream. They might use a very small amount of cocoa butter or NOTHING BUT THEIR BARE HANDS (this is ideal). Fascia needs to be “grabbed” and dragged across its own layers if it’s going to be changed. Better yet…
- Find a practitioner who pins or compresses your fascia with weight and asks for MOVEMENT on your part. Find someone who does this and ask them the first 3 interview questions, and if you’re satisfied with their answers – you will likely have found someone really really good.
This is an often overlooked aspect of choosing a practitioner, but I think it’s maybe the MOST important of all:
Choose someone you TRUST.
This might sound hokey but I think it’s absolutely critical.
If you’re in pain, don’t go to just anyone! If your gut sense is you can’t trust this person with your body…LISTEN TO THAT. Use your gut wisely here.
Take 5 minuets to talk to people or look over their website and get a proper FEEL for the person and their work before trusting them with your body.
Extra bonus for those of you who actually READ my posts! 😉
Look for someone willing to experiment with you! Confidence doesn’t mean arrogance. Confidence doesn’t mean they have ALL the answers. To me, a confident person is willing to admit when they don’t know something, and if they don’t know something it’s a chance to LEARN. If you find someone who is willing to get curious WITH you, think outside the box (even THEIR box), try new things and be open to learning WITH you…this is someone I would grab onto and never let go of.
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