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There’s no question that regular massage can benefit a triathlete—studies have shown massage can increase flexibility, speed recovery, and prevent injury. But the massage itself still poses questions—some too awkward to ask. Is a massage supposed to be this painful? When is the best time to schedule a massage? Should I wear underwear? What happens if I fart?
John Sanders and Robin Wooten, triathletes and owners of Next Level Massage Education, have heard them all (and more). Their answers to questions about massage from Triathlete readers:
What is the difference between a massage for relaxation and a sport massage?
A relaxation massage tends to be more superficial, non-specific, connective and flowing. A sports massage, on the other hand, is vigorous and involves the use of multiple modalities, which could include relaxing Swedish-type massage techniques. Sports massage is more stimulating and at times needs to match the intensity of the athlete. It can be sport-specific and should be added as part of an athlete’s regular training schedule.
The pressure isn’t deep enough, but I don’t want to insult my massage therapist. What should I do?
Communication between client and therapist is essential to provide the best therapeutic massage possible. A professional massage therapist should not be offended by a client who asks them for deeper work or to move a little left or right. If they do get offended, then find another therapist.
Is there such a thing as too much pressure, or should I take as much as I can stand?
Yes. A therapeutic massage can at times be intense, but, it should never be painful. A painful massage is counterproductive.
What should I do if I get ticklish during a massage?
Communicate with your therapist. The therapist will adjust their touch/technique to help diminish the sensation.
Why do I sometimes get a headache after a massage?
While uncommon, massage does effect vascular circulation which for some could elcit a headache. Also, excessive pressure on the sinus cavity from being face down in the face rest could bring on a headache. Anytime you feel excessive congestion, which is quite common, turn your head to the side to help you breathe. Communicate with your therapist if your face rest is uncomfortable because it’s angled too low or too high.
Is it normal to bruise once in a while after a session?
No, not from a sport maintenance massage. If the treatment consists of structural integration techniques, then yes, bruising may occur due to the intensity of this type of work.
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Does it make a massage more effective if I don’t wear underwear (or do wear underwear)?
If the athlete is in need of a relaxing massage, being completely undressed can allow the therapist to address all areas of tissue without the need of working through the sheet. This does not make the massage more effective, however. A professional, knowledgeable sports massage therapist can work through clothing or sheets and still be effective. If the client is more comfortable wearing underwear, then they should, as this will help them relax on the table and not worry about being exposed. If the athlete is going to be stretched extensively, then wearing underwear/shorts/sports bra can allow the massage therapist to be unencumbered by a sheet while draping their athlete. Communicate with your therapist prior to the session to determine what you should wear to meet your needs and wants.
I farted during a massage. I was so embarrassed, but I pretended like nothing happened. Should I have said something?
An “excuse me” would be nice! The last time this happened, I asked my client, “what else did you have with your broccoli last night?” We both laughed! In the massage world, this is called “a release.” It’s going to happen. And yes, there may be giggles.
Sometimes I fall asleep on the table. Does that make things difficult for the therapist?
No, not at all. As a matter of fact, it can be construed as an act of trust. When your client is so comfortable and trusting of you, they fall asleep on the table, this is considered a huge compliment—they have completely given themselves to their therapist. A client who talks during their entire massage session is not reaping the rewards of the complete healing process the therapist is attempting to provide.
As far as the triathlete, they can often be injured and/or completely stressed out due to a rigorous training schedule. Sometimes the athlete needs a break from therapeutic work and receive a relaxing put-me-to-sleep massage.
I like my massage therapist, but she’s very chatty. How do I let her know I’d rather not talk?
Communicate with them. Let them know you prefer a quiet session. Let the therapist know you are not trying to be rude by not answering or engaging in their conversation, you just want to completely be in the moment of your therapy session. Your therapist will understand, and if they don’t, find another therapist.
I’ve never had a massage before. Should I schedule one before my race next week?
Yes. However, it is very important you let your therapist know you have never received a session before and you do not want to receive an overly intense massage. Schedule the massage three days before your race, request moderate pressure, nothing specific, full body, with some stretching. And communicate! Do not allow them to go to deep or too intense. Be sure to schedule your post-race massage one or two days after your race.
Is there ever a circumstance or injury where massage could make things worse instead of better?
Yes, there are contraindications when a massage should not be performed: an acute injury, an opened wound, when an athlete is feverish, to name a few. First duty of a massage therapist is to cause no harm. If in doubt, communicate with your therapist.
How far out before a race should I schedule a massage?
Hopefully the athlete has incorporated maintenance and rehabilitative massage into their training calendar. Most receive pre-race massage three days before race day and post-race two days after. Two to three days beforehand allows an athlete’s body to receive moderate to intense massage therapy which should not inhibit performance, and, hopefully increase performance. All athletes’ bodies are different, so knowing your body will help you determine how close to race day you should receive bodywork.
I’m never sure about gratuities. How much should I tip?
Gratuity is an act of gratitude, it is never a requirement to tip. If you are a gracious receiver of an awesome massage 15-20% is a standard percentage. The ultimate gratuity is not gratuity, but re-booking the next massage.
Why does my therapist always tell me to drink lots of water after the massage is over?
There is an overused myth in the massage world which expresses massage therapy releases toxins. Massage therapists ask clients to drink plenty of water to help flush out these toxins. However, there is no clinical research to provide evidence that massage therapy releases toxins. That being said, massage therapy does generate heat. This heat can create a sensation of thirst, so, drinking water will help quench this thirst, plus, drinking water is good for the body.
There are a list of questions to ask your client before you begin massage therapy. These should always be asked before you consider beginning work. Depending on the client, this may take a very short amount of time, however, it’s important to understand exactly why we ask these questions, and why they’re so important.
Some clients may be quick to answer the routine questions, but there will be others who might find them a little trickier. Treat each client individually, and don’t assume an answer until you have it from them. Go through a short interview process with each one before asking them to lie down and beginning the treatment.
Remember to also employ active listening techniques and pay attention to their body language. We’ve put together a sample of some questions that you might ask a client before you begin treatment, so you can easily gauge the type of massage they’re looking for, and can treat them appropriately in regards to their past experience and potential injuries.
Have you been to a massage therapist before?
This question is a great first interview number, as it tells you a lot of information in one. Firstly, it tells you whether this is the first time they’re attempting to do something about their condition, or whether there’s a history of practise that has or hasn’t worked before.
This can cut your consultation time down significantly and allow you to find the best course of action quickly and efficiently. If they know techniques that have worked (or techniques that have failed to work) you can use your own expertise to determine where to progress from there.
Are you in pain? Where does it hurt, and how?
No matter your approach to this question, you should attempt to find out the source of their visit. Is it to relieve stress build-up, or is their condition more chronic? Determining their needs is a multi-step process, but you have to begin somewhere.
What is your profession?
You can learn a lot from a client by asking this question. If a client is complaining of lower back pain, it can stem from many situations. If they work all day moving large boxes around a storage warehouse, you might be able to cut down on a few of those possibilities and devise a way to both heal the injury and prevent it from happening again.
Get further into this question by asking how they perform any of the tasks that you feel might contribute, even if it’s as simple as how they sit on their office chair.
How are you affected by this injury?
Now that you know their basic working lifestyle and condition, find out what outcomes they’d like to achieve at the end of your sessions. People often come to massage therapists quite late into the proceedings, rather than preventatively or as soon as possible, so you may be helping people who are already experiencing a lot of disruption in their daily life from a common injury.
Have you tried anything else?
This ties in and has the same outcomes as our first question, but also lets you know if they’ve tried any other conventional (or non-conventional) remedies.
Do you have any other conditions?
This is a helpful question, however it’s important to remember that your client is not obligated to answer. Find out if there are any complicating factors at play, or anything that might put them at risk through certain techniques.
Ask them to go over their health form
Ask them a few questions regarding their completed health form, even if they’re fairly routine. This will allow them to feel as if you’re giving them a full rundown (which you are, but it’s also important to make people feeling safe and secure).
If there are any oddities within their form, ask them to explain them in greater detail. People sometimes are more willing to talk to a healthcare professional than they are to write out intimate details on a form, as it feels more personal and less committed. Don’t probe too deeply, and always respect your client’s wishes, but try to understand what’s going on.
Are you taking any medications that may be a contraindication to massage?
It’s vital to know whether your client is taking any medications that may affect their massage experience, or alter the type of massage that is appropriate for their needs. This includes medications such as anticoagulant medications (or blood thinners) such as Warfarin.
Do you have any allergies?
People often forget to mention things that may be obvious to you, so it’s important to still cover the basic questions before you begin treatment, such as if your client is allergic to something. The last thing you want is for your client to be breaking out in a rash because you’ve used an oil for their treatment that they’re allergic to. Always better to be safe than sorry!
Do you know about the process of massage therapy?
Ask them how much they understand about the treatment they’re about to receive. If they’ve been to a massage therapist before, explain what might make your process different. If not, explain the basics of how what you’re about to do is going to help them as an individual.
You don’t have to go over the entire history of massage, but tell them what you’re going to be concentrating on or what techniques you might be using for them to help.
Ask them to roleplay any specific pain issues
If your client is complaining of a repetitive pain, and it’s not debilitating enough that they’re unwilling to do it, ask them to quickly run through a movement cycle akin to what causes the pain. If it’s reaching for something, get them to pretend to reach for something, and so on. You’ll be able to tell when, where, and why they’re hurting (in most cases).
Ask a few personal questions, and make conversation
Finally, remember that massage is about relaxation, and about keeping your client in a position where they feel secure. They’re entrusting a lot to you, so try and be communicative and pleasant to put them at ease and make sure they enjoy their massage experience (and that they keep coming back to you for more!)
Discover Massage Australia offers a variety of courses recognised by the Massage Association of Australia covering deep tissue massage, remedial massage and spinal torsion, that can have you fully certified in as little as a week! Contact us today to chat about our upcoming course dates or check out our online massage course.
