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Therapeutic massage therapists – also known as medical massage therapists, clinical massage therapists, neuromuscular massage therapists, and soft tissue specialists – are set apart from general massage therapists through the intention of their work.

Although relaxation, improved circulation, and stress reduction are all part of what we [massage therapists] do, the focus is less whole-body and much more site-specific.

Today we’ll be exploring how therapeutic massage therapists know:

  1. What to Work On
  2. Which Techniques to Use
  3. When to Move On

How Does a Therapeutic Massage Therapist Know What to Work On?

Most clinical therapists work closely with a variety of other healthcare professionals; this collaboration offers multiple educated perspectives and recommendations throughout a person’s treatment.

Independently, your therapist might:

  • Conduct a physical assessment
  • Test your range of motion in the area(s) of concern
  • Ask specific questions about what brought you to them
  • Ask what sensations you’ve experienced
  • Ask what your goals are for the session

All of these components are factored into where they feel they should start and the strategy they choose for your session.

If you were to come in for neck pain, we might start there yet end up in a completely different, considerably irrelevant (to the patient) area. We will explain to you why it is that we started at the base of your neck and ended the session towards the front of your knee so that you understand how your body functions.

How Does a Therapeutic Massage Therapist Know Which Techniques to Use?

There is no default formula for a therapeutic massage. Once the session begins and your therapist feels the tension in your body, they will modify their plan as they become better informed through their touch. 

Every medical massage therapist has their own way of designing their sessions based on their unique school experiences and continued education routes.

We all have a toolbox (our brain) that we add relevant tools (information) to so we can reach our needs and goals. Continued education renews old information and can offer a fresh view on how to use ‘old’ techniques in ‘new’ ways.

At the most basic level, we as therapists know in what direction each muscle fiber goes so applying the proper technique depends on what the goal is for the selected muscle(s).

For example, the muscles in your forearm generally run parallel to the underlying bones. If I intend to lengthen the tissues, I’d probably pull out my elongation tools—in other words, I would choose to use effleurage and myofascial release. If I intend to break up tense areas or underlying scar tissue, I would use multiple cross-fiber techniques, trigger point therapy, and percussion.

How Does a Therapeutic Massage Therapist Know When to Move On?

As soft tissue specialists, we should know that there is such a thing as ‘overkill.’

Overworking the tissues can cause more harm than good. Using excessive pressure can also cause more harm than good.

Time is an essential factor that we consider when deciding to move from one area to the next. In general, it is too much to spend over 5 minutes on the same spot or muscle.

Exhausting the muscle fibers can compromise the integrity of the tissues by causing an overabundance of microtears. These micro tears release a protein called ‘myoglobin’ which, in large amounts, can be potentially toxic to the kidneys.

Experience and education are what inform us while intuition is what guides us as therapists of all kinds.

Tuning in and recognizing the subtle shifting of tension by a few notable degrees signals to us that it is time to move on. There are related structures that, once worked on, may allow an additional release of the previously manipulated area.

Please note that not all massage therapist (clinical, medical, therapeutic, ect.)

Ultimately, we as clinical therapists know what to work on through:

  • Communication 
  • Initial and continued education
  • Experience working with common conditions
  • And our intuition

Medical or therapeutic massage pairs knowledge of common musculoskeletal conditions with a blending of techniques meant to restore range of motion and break down adhesions and knots. 

Our focus is truly on facilitating the body’s natural healing process through strategically placed techniques as we move over the body.

This blog was contributed by Lex Alvarado:

Lex Alvarado has over 14 years of experience working with patients, collaborating care to improve pain and posture.She is certified in Active Release Technique (ART) and neuromuscular massage (CNMT) and is a Board certified massage therapist (CAMTC). She is currently on the rehab. team at Irvine Spine and Wellness Center. When you are ready, contact us online or reach the team at 949-552-5535