Is this going to hurt?

This is a frequent question I get from my clients. My joking response is usually “Don’t worry, it’s not going to hurt me at all!”

Over the years my treatments in this regard have changed drastically. Early in my career I was of the mind ‘no pain, no gain’ and I would put my clients through some fairly severe sessions. Looking back on it I realize that I didn’t necessarily get better results with that kind of therapy. Many people like that kind of treatment, but that doesn’t mean that’s the treatment that their body needs.

My current view is that it’s important to treat each client individually, and even different parts of the same body individually. Many clients don’t need or won’t respond to a heavy hand, and others need a firmer approach to make sure they can benefit from the therapy. What I find myself doing these days is varying between the types of strokes and techniques I use on each client and even varying during each session with a particular client.

In every case educating my clients is important. One thing I mention to everyone I work on is that the session shouldn’t feel like they are trying to endure some kind of torture. Many clients come in with the same mentality that I had early on in my career that the work has to hurt to get the effect. What I try to impress on them is that there is a very fine line between ‘good’ pain and ‘bad’ pain and making sure that we as a team stay in the ‘good’ pain range. Another aspect that I try to educate my clients with is that there will generally be a little soreness after the session. That soreness should only last 1 or 2 days at the longest. If it lasts longer than that I lighten the intensity so the client doesn’t have so much soreness after. On the other hand, if there is no soreness, then I know I can go a little deeper for that client to have a better therapeutic effect.

Stress reduction

Some of the effects on long-term elevated cortisol levels on the body

Some of the effects on long-term elevated cortisol levels on the body

The by product of our busy lifestyles is increased stress. When the body experiences a perceived threat there is a cascade of hormones that are designed for us to be able to protect ourselves. This is the famous sympathetic nervous system also known as the “fight or flight” response that is responsible for the human race surviving threats like saber tooth tigers and wooly mammoths in the early years. When there is a perceived threat the body releases these hormones to increase blood flow to the peripheral muscles, decrease blood flow to the central body, and increase heart and breathing rates. All of these actions prepare the body and mind to either do battle or beat feet, as the saying goes. The trouble is that the portion of the mind that is responsible for this cascade of hormones doesn’t distinguish between saber tooth tigers and the prospect of running short on money or being told that we have a terminal illness. And while a threat to physical safety may last only a short time, the threat of paying the rent or poor health can be carried much longer. As a result this continuous overwhelming cascade of hormones and neurotransmitters remain in our bodies and continue to have their effects. The chief hormone involved in this bodily function is cortisol, and when high levels are in the body for long time periods our bodies take a beating. An American Psychological Association survey in 2013 showed that 77% of the respondents reported regularly feeling physical symptoms related to stress. Another issue is that this way of life has become the norm for such a large percentage of the population that they don’t even recognize the effects anymore. People live in such a heightened state of sympathetic awareness that their bodies are being severely effected and they don’t even know.

Now for the good news. Not only does massage and bodywork decrease cortisol levels, it also increases serotonin and dopamine levels (two neurotransmitters related to the parasympathetic system, the “rest and digest” side of this interplay). An abstract for the study can be seen here Honestly these findings are somewhat controversial. The truth is that while it is well documented that massage and bodywork reduces stress, the scientific community isn’t exactly sure how it happens. In any case the goal is to take the patient out of the heightened sympathetic state and let them experience a heightened parasympathetic state. I’ve had numerous clients walk out of my office saying they feel almost drunk (I do insist that they sit a rest a few minutes before leaving when this is the case). The sensation is so foreign to these clients that they even feel like it’s an altered state of consciousness. And more good news, the increased hormones and heightened parasympathetic state are related to positive side effects. The body in this state is able to rest, blood is directed to the core organs, oxygen exchange is improved, and digestion is improved. Hence the slang term “rest and digest” for the parasympathetic system.