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  • Writer's pictureKirby Clark, MMT

Pain Management & Self-Care

Updated: Dec 19, 2023

When it comes to managing pain and discomfort in the physical body, what you do outside of the massage room is ten times as important as the work you and your therapist do during your appointments. That may sound like a cop out or sign of indifference to your experience as a client. But think about it, you’re on the table for one hour a month (sometimes more, sometimes less)- that’s 1/730 hours or 0.14% of the month. Only so much can be accomplished in that one hour, the other 729 hours are outside of your therapist’s influence. Pain management and self-care practices are of paramount importance to compliment the work accomplished on the massage table. The following is a list of my favorite tried and true self care practices to really stretch the benefits of and ensure you get the most out of your massage sessions.

Hot Epsom Salt Baths If you’ve read previous blog posts or have ever paid attention to the suggestions, I make in a post-massage assessment, you may have (correctly) suspected that Hot Epsom Salt Baths are my all-time favorite self-care practice. BAR NONE! Epsom salts contain magnesium, which is important to muscle and nerve function, but that’s more of a supplementary bonus to the bath in my opinion. The heat from the bath is an incredible way to relax your muscles and increase circulation throughout the body. There are so many wonderful physiological effects to heated thermotherapy, especially when it is applied to the entire body like in an immersion bath. PLEASE go back and read my blog post about How To Take A Proper Epsom Salt Bath for more information on the subject and treat yourself to 45 minutes of bliss!

Ice The application of ice is the other end of the thermotherapy spectrum. While subjectively less enjoyable than the Hot Baths, Ice can do so much in relieving pain and reducing inflammation by causing vasoconstriction in the circulatory system (the opposite effect of heat). Dependent on each individual’s case, ice applications may be more appropriate than heat treatments (in cases of acute/recent injuries/traumas). But in most cases, by the time a massage therapist intervenes the condition has progressed from the acute phase into a chronic condition. In this context, in most cases, contrast treatments where you alternate cold and hot therapy is appropriate and effective in pain management. I recommend a standard of 20 minutes of ice applications at a time, followed by either a 40–45-minute hot bath or 20 minutes of a heat application, following up with another 20 minutes of ice and so on and so forth. I’ll also close by making a point in reminding you that ice is a critical part in treating headaches. Keep your body as cold as you can stand from the neck up (while also keeping your feet as warm as you can comfortably stand). The vasoconstriction that will take place in your neck and facial muscles will reduce the intensity of the headache.

Stretches While I cannot speak in depth or too intelligently on this subject, I can and will speak with great confidence that stretching can make all the difference with the benefits you are seeking from massage therapy. This is because posture is responsible for a great amount of discomfort and disfunction in the body. If you can stretch the body back into better posture, you can eventually get the body to remember and essentially re-train your body to return to normal form and therefore normal function. I incorporate assisted and resisted into my bodywork when appropriate (mostly with tight piriformis or sciatic/hip conditions). The alternating stretch and release “confuses” the muscle to eventually release the tension it is holding. In a later post, I plan on addressing how people train their bodies to hold onto tension- it’s abusive, self-abusive! Instead start training your body to let go of that stress in order to remember what it once was. It takes the muscles about 20 seconds of holding a stretch in order for the stretch to be effective. Without getting too technical, when you stretch- the muscle sends signals to your brain to resist and guard against the stretch. Holding a stretch, will reduce the signals your muscles send to your brain and the muscle will relax further into the stretch.

Postural Changes In the same vein of thinking, simple postural changes you can make in your regular day-to-day life can literally change your body and your relationship with your body. This can be as simple as remembering to roll your shoulders back while you work, making sure your legs aren’t medially rotated inward or laterally rotated outward, or switching up which shoulder you carry a bag on. Low-effort changes can result in high-impact gains for your body. Why would you suffer through pain and discomfort when making easy, simple, low-effort changes in your daily routine and posture can pay off so well? Are you kidding me? One of my favorite ways to subliminally train your body to make these changes is tapping. I’ve just recently started tapping again (in massage classes we did a tapping exercise at the start of every tai-chi and shiatsu class) on stiff muscles whenever I notice I’m holding them out of correct posture. Tapping is also great while you work or while stuck in traffic or at a stoplight, it grounds you to your body which can relax you physically and will eventually train your body to relax if you consistently tap when you notice your tension.

Breathing So often when we are in pain, or when we are anticipating pain, we tend to hold our breath or breathe quickly and shallowly. I think this has a lot to do with how frightening pain can be. Intense, unknown pain is terrifying. I know, I’ve been there. If you can breathe deeply and slowly, you will supply your body with the oxygen necessary to repair and maintain healthy muscles. The best way to breathe is inhaling through your nostrils into your bellybutton (until you feel your abdomen and naval expand), then exhale through pursed lips (imagine you’re blowing out candles on a birthday cake). Ideally your exhale will last at least twice as long as your inhale. This will enrich your blood with precious oxygen, calm your mind, and ground you to your body. This is also important to keep in mind while you’re on a massage table. (There is no situation I can fathom in which you should hold your breath or cease breathing.)

Medication/Supplements/Patches Maybe I’ll be rebuked for taking this stance, but when a physician prescribes you medication, you had better just take it! I know, I know- you “don’t like pills”, and would rather seek “natural”, “holistic” treatments for your ails. I get it, it’s very fashionable these days to be anti-medication. There are some very understandable and valid reasons for this particular mindset. So many of my colleagues got into massage therapy specifically in a rejection to modern medication. But I think this does disservice to physicians and disservice to complimentary therapists. Alternative medicine and modern medicine do not always work at cross purposes. I’ve had so many clients come in complaining of terrible pain, and when I ask them if they take any medication they answer is usually, “no, I don’t like to take pills.” As if there is some shame or something inherently wrong in taking a prescribed medication. Perhaps I’m going off on a tangent, but this has to be addressed in the massage community- the therapists can be just as ignorant as the clients sometimes. The fact is there are limits to what massage therapy can do, and there are massive benefits to modern medicine. Switching gears, I sometimes recommend supplements when appropriate, but always while insisting “you should consult with your physician before buying or taking anything I recommend”. A physician outranks your massage therapist, people! I’m also an advocate for lidocaine or icy/hot patches when necessary.

Health/Medical Attention Continuing my previous point, when all else fails- and certainly in emergencies, SEEK THE MEDICAL ATTENTION OF A PHYSICIAN!!! If your regular massage appointment simply doesn’t help that much, seek health/medical attention outside of your massage therapist. Chiropractic care can work so well in tandem with massage therapy. A chiropractor helped me through the worst pain of my life. Chiropractors aren’t for everyone, but (similarly to massage) it’s worth reconsidering if your hesitation involves a negative prior experience or negative word-of-mouth stories. While I have not yet had the pleasure of experiencing acupuncture, I’m not opposed to recommend those services either. When a condition stagnates and remains the same or worsens even after massage therapy, you should seek additional health care. But above all else, if your condition is severe enough to be debilitating- please, please, please get medical attention from your primary care physician.

In Good Health,

Kirby Clark, MMT

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