Discouraged - difficulties with deeper massage.

[Skittles]

Hey everyone. Hoping for some guidance here.

I live in Vancouver, Canada. Though I am not a Registered Massage Therapist, I did complete a Certified Body Worker program at an accredited massage school and learnt a variety of different massage modalities, plus some esthetics. I graduated six months ago and have been massaging professionally in a health spa for about four months now, so I'm still relatively fresh to the industry.

Now that I am finally working (and making real money as opposed to my practicum), I find that I'm having a lot more trouble satisfying clients that are looking for deeper/firm pressure massage. I've noticed that a lot of the people who have voiced these concerns happen to be much leaner, petite women. As a guy, I find it a bit more challenging to work with these clients because my arms/hands are simply too large to apply the kind of precision that I'm accustomed to with larger clients. I was taught by my instructors to be conservative with my thumbs, so I generally use a lot of palmar, ulnar border, elbow, and knuckle work.

After an experience with a particularly nasty client, I've lost a lot of my confidence applying deeper pressure in general. It has bled into my performance with other clients as well. I get a lot of anxiety going into treatments and have to really discipline myself to stay positive about my place in this industry. I find that I am really good at performing general relaxation massage (light/medium pressure) but whenever I see somebody that wants deeper pressure (40-50%+ of clients usually), I get nervous.

I'm not entirely sure what I'm looking for. Tutorials, maybe? Encouragement? Either way I'm feeling mighty low.

 

[GET THEM OUT OF AZ]

Discouraged - difficulties with deeper massage.

The most constructive thing that I can suggest to you without being able to see or feel your massage is to find someone you know well and trust who CAN experience your massage to give you very specific feedback and suggestions for what you could do to improve. The best place to find someone if you can't think of anyone off hand is your school. Either a former instructor or a classmate will hopefully be more than willing to help you out. Otherwise, a co-worker (and fellow therapist) might be able to do this as well.

Books and videos will also help you, though not as much, and you can (almost) never go wrong with taking continuing education classes. Maybe when I have more time (dinner's in the oven and waiting to be taken out : ) I can come up with some actual technique ideas for you.

 

[theoneandonlycharlotte]

Discouraged - difficulties with deeper massage.

I would appreciate any technique ideas you could offer. Thank you so much.

I'm planning a trip to my old school to maybe pick up some pointers or suggestions from my teachers. I'm hoping they'll be able to provide some insight into what I am doing wrong or what I could be doing differently. Might branch out to coworkers as well if I can find somebody. I've been poking around YouTube for technique suggestions, but it's hard to translate a lot of what you see into reality because you usually don't ever get a good look at what they're specifically doing. I'll keep at it though...

 

[Pompal 09.]

Discouraged - difficulties with deeper massage.

Hey everyone. Hoping for some guidance here.

I live in Vancouver, Canada. Though I am not a Registered Massage Therapist, I did complete a Certified Body Worker program at an accredited massage school and learnt a variety of different massage modalities, plus some esthetics. I graduated six months ago and have been massaging professionally in a health spa for about four months now, so I'm still relatively fresh to the industry.

Now that I am finally working (and making real money as opposed to my practicum), I find that I'm having a lot more trouble satisfying clients that are looking for deeper/firm pressure massage. I've noticed that a lot of the people who have voiced these concerns happen to be much leaner, petite women. As a guy, I find it a bit more challenging to work with these clients because my arms/hands are simply too large to apply the kind of precision that I'm accustomed to with larger clients. I was taught by my instructors to be conservative with my thumbs, so I generally use a lot of palmar, ulnar border, elbow, and knuckle work.

After an experience with a particularly nasty client, I've lost a lot of my confidence applying deeper pressure in general. It has bled into my performance with other clients as well. I get a lot of anxiety going into treatments and have to really discipline myself to stay positive about my place in this industry. I find that I am really good at performing general relaxation massage (light/medium pressure) but whenever I see somebody that wants deeper pressure (40-50%+ of clients usually), I get nervous.

I'm not entirely sure what I'm looking for. Tutorials, maybe? Encouragement? Either way I'm feeling mighty low.

Studying technical videos is okay, but you should really get work from MTs that do a lot of deeper, more specific work. It is possible that you simply don't know how to do the kinds of work these clients are requesting. For example, I know people that searched for YEARS before they found an MT who could do good, deep, specific anterior neck work. Clients that have had a lot of massages will tend to have higher expectations than those who have not. If you experience the work of a very successful MT who does mainly deep, specific work, you can learn a LOT from the experience and possibly better understand some of the tutorials you watch. Every time I get a massage, I learn something new, or that I did/didn't like, or am reminded of something that I learned but haven't used in a while. Receiving massage is critical to improving as a massage professional.

That said, I have also noticed that many "leaner, petite women" often request extremely aggressive work. Many of the ones I have worked with had little muscle tissue to work with and seemed to think that massage had to hurt in order to be beneficial. I was able to re-educate some of them, while others moved on to try other MTs.

Over time, I found greater success in working with them when I helped them reframe what it was they thought they were requesting. To do so, I had to spend a few extra minutes on the client intake discussion - time that turned out to be very well spent! If you try adapting some of the following ideas to fit how you do your client intakes, you may find it easier to satisfay these clients:

1) Sit them down for the conversation, make eye contact frequently, and take notes. Be the conscientious professional.

2) Ask them if there is anything they have previously experienced in prior massages that they didn't care for. Pay attention and take notes. They will often also mention things they really liked.

3) Tell them something like this: "Since this is my first time working with you, I will be a little cautious about how I apply pressure until I better understand how your body responds. Because of how I work, sometimes it may not feel like I am using as much pressure as I actually am... I try to minimize discomfort, even during deep work. Even so, I will check in with you from time to time. Let me know right away if you feel discomfort - it will help me understand your tissue response and adjust accordingly." - That will help shift their expectations a little, and they may respond in some way.

4) If they ask for "deep tissue" (or whatever), ask them something like this: "Do you mean deep-to-the-bone and very painful? Or do you mean a reasonably deep pressure firm enough to feel that your tissues were touched?" - Most will prefer the latter option, and may become more comfortable with the idea that it can be "deep" without being excruciating.

5) If they indicate a preference for very painful work, ask if they have a specific reason why. I have received many different answers, many of which were related to medical issues (fibromyalgia, sensory deficits, etc.) for which that kind of deep pressure is contraindicated. As an ethical professional, you will need to educate them about the dangers of what they have requested as applicable, and ask them to permit you to try an alternate approach that is safer and more likely to provide a positive result. If it isn't due to a medical issue, you can also educate them about how aggressively painful work often triggers tissue contraction and bracing, increasing the chances of tissue damage, post-massage soreness and bruising.

6) Reiterate the fact that you tend to be more cautious about how you apply pressure until you better understand how their tissues respond to the work you do. This includes how they feel immediately following the massage, later that day, and over the next few days. There is a learning curve every time you start working with someone, but it won't take long for you to understand how to best work with their body.

7) If this is NOT the first time you have worked with one of these clients, simply start by telling them you have been thinking about your last session(s) with them, and feel like you need to better understand their needs and preferences. (Those are two separate lists, BTW.) Then transition into discussing the above points with them.

Don't give up.

 

[Sumsie]

Discouraged - difficulties with deeper massage.

Read and re-read Jason's post...
I have "learned" some of my most effective techniques by receiving quality massages.

You are certainly ready for some continuing education - actual workshops not videos. Each one you take will give you more technique and confidence.

As a small lean woman myself, I frequently am VERY dissatisfied both with pressure and technique. My thought is that the therapist - especially with male therapists - seems to be afraid of hurting me. I get the same complaints from other women my size - they end up being my best clients because I am not afraid... I KNOW what it feels like and know the type of pressure that they are looking for.
And of course it IS technique -
so many therapists don't seem to know what they are doing at all - lack of training, lack of experience, lack of confidence, and ALWAYS these therapists tell me that they never get massage themselves. They (and you) really need to feel what they are doing, and feel what a GOOD massage can be.

And, on the other hand, often large people are more sensitive and prefer lighter pressure.

 

[Todd A]

Discouraged - difficulties with deeper massage.

You may want to check out Sean Riehl's Deep Tissue dvds, especially the one on the torso. http://www.deeptissue.com

 

[Risika]

Discouraged - difficulties with deeper massage.

As a guy, I find it a bit more challenging to work with these clients because my arms/hands are simply too large to apply the kind of precision that I'm accustomed to with larger clients. I was taught by my instructors to be conservative with my thumbs, so I generally use a lot of palmar, ulnar border, elbow, and knuckle work.

After an experience with a particularly nasty client, I've lost a lot of my confidence applying deeper pressure in general.

My husband is also an MT. He has very large hands. He has found that due to his size, where many instructors taught to be conservative with the thumbs, it was not as much of an issue with him, since he had a certain amount of strength that average MT does not have and was able to apply that pressure in a way that did not harm him. I say, consider using your thumbs and see if this works better for you. You can use your thumbs without ruining your digits. Just be aware of what and how you are doing it.

Also, know that each massage is different, due to the size and shape of our work surfaces that the good Lord gave us. If you have large hands, your massage may be a broader based massage than someone who has tiny hands. I am known for my very pointy elbows. I just had a client a month or so ago tell me that if anyone ever attacks me, I should use my elbows to hit them. His secondary comment was, I wouldn't want to be hit by those! *chuckles* The are people who want deep pressure with an intense object like one of my elbows. Those who don't will prefer some other portion of my hands. Not all of our body types are going to reasonate with all clients. It is important to remember that there will be times you need to refer out.

If you keep finding that you are having difficulty with a particular type of client or body style, it will give you a better way to screen them before taking them into your practice. Likewise, as Jason mentioned, you can work to re-establish the way they expect massage to feel. Let them know up front that the combination of your tools and their body type, means they should expect something a little different than what they may have experienced in the past. If they are not open to this, refer them out. You'll be much happier in the long run.

Keep up the good work and welcome to the forums!

 

[afanof_art]

Discouraged - difficulties with deeper massage.

I have trouble massaging very small women too because it 'feels' as if I am hurting them. Like they have no meat and I'm digging into bone. They assure me it doesn't hurt, but when you are running across those knots in their rhomboids and it feels like a cattle-guard with every bump, bump, bump... well, it makes me hesitate to go deep. I have found that a small circular friction with my thumbs is what they like best to give them a deeper feel to the massage without freaking me out as well. And placing a bolster under their shoulder as I work there, also helps. And hot stones. They love the feel of the stone around the border of their scapula so I use hot stones with every massage, but more so, in these cases.

 

[ChristianR]

Discouraged - difficulties with deeper massage.

A huge thank you to all of you for the encouragement and the resources.

I think a big part of it right now is confidence. I'm going to try and get together with a coworker this afternoon and try to give her a massage. Might be a good way to get some tips/pointers and to see if I can practice some new techniques with her. She's going to give me a massage in a few days as well, so it'll be a good way to reflect.

So I suppose at this point it's all about practice and research. I'm going to keep an eye out for workshops and see if I can find some online sources as well.

But ultimately I want to give everyone a huge thank you for the guidance.

 

[Little Glenn]

Discouraged - difficulties with deeper massage.

Jason hit the confidence pointers on the head. I skipped over that part a little bit but definitely let us know how things go!

 

[GenderS]

Discouraged - difficulties with deeper massage.

Here's a list of some old threads that may be useful. I don't have time to go through each to make sure they are pertinent to your particular situation, but maybe one will be useful.

• Learning "deep tissue"
• Deep Tissue - Anterior Legs
• Deep Swedish vs Deep Tissue (sports)
• Deep tissue/muscle therapy
• DEEP TISSUE ISSUE!
• Deep Tissue-Full Body Sequence Please!!
• Going too deep?!?
• Techniques for hip flexors and rotators?
• Deep Tissue Techniques
• HELP! Deep Tissue Issue lol
• Deep Tissue, not Deep Swedish
• Deep Tissue vs Deep Pressure
• Deep Tissue vs. Deep Swedish
• Deep Tissue Massage

 

[billgates27]

Discouraged - difficulties with deeper massage.

Jason made some great suggestions, I've also found that there are a lot of clients out there who have only experienced massage that hurt, so that's what they expect so it is necessary to sit down with them and explain. Besides all the other great comments, I just wanted to add that for a satisfying deep tissue isn't quite the same as just applying hard pressure and rubbing around. A good understanding of kinesiology and direction of muscle fibers is important in order to be able to apply the massage work effectively and in a way that satisfies the client. Without knowledge in those areas, you can dig around all you want but it won't help the client and although they may like the discomfort or pain, they don't get any benefit from the work.

Another route to think about is that if you are having a difficult time with deep tissue, who says that's what you have to offer? You mentioned you do really great light/medium work-- why not have the spa where you work only book you the clients who want a relaxing session? Relaxation work can become your specialty, and there are plenty of clients who just want that type of work. It's one thing if you really want to learn deep tissue work, but you don't have to learn it in order to have a satisfying career.

 

[Shaylon G]

Discouraged - difficulties with deeper massage.

Another route to think about is that if you are having a difficult time with deep tissue, who says that's what you have to offer? You mentioned you do really great light/medium work-- why not have the spa where you work only book you the clients who want a relaxing session? Relaxation work can become your specialty, and there are plenty of clients who just want that type of work. It's one thing if you really want to learn deep tissue work, but you don't have to learn it in order to have a satisfying career.

t023

 

[Hugh]

Discouraged - difficulties with deeper massage.

Hi People
I will first like to apologise for coming in on his topic ,i am a first time user and can not find where to post my query
My question is i have had 3 clients with no previous reaction to oil where i have given them deep massage on same area for 30-40 mins
on one area could this cause a rash nd is it to long to work on one muscle
Thanking you in advance and again sorry 4 coming in on this conversation but really need help
Regrds
Mike

 

[marybeth!]

Discouraged - difficulties with deeper massage.

Hello...I am new to this forum. Just beginning in my field as well. I can see I have come to the right place for support, guidance and information.
I have enjoyed reading all the comments here. I agree that receiving a massage allows you to 'feel' what you like and don't like...passing on what you do like and those techniques to your own clients.We learn through touch.
Also loved Jason's post (thank you)...I too have had clients thinking the only way to receive the benefits of massage is to 'hurt' from deep pressure. I am going to use his advice and pose those questions to them.
http://www.massagebodybenefits.com

 

[Rasiklal]

Discouraged - difficulties with deeper massage.

Hi People
I will first like to apologise for coming in on his topic ,i am a first time user and can not find where to post my query
My question is i have had 3 clients with no previous reaction to oil where i have given them deep massage on same area for 30-40 mins
on one area could this cause a rash nd is it to long to work on one muscle
Thanking you in advance and again sorry 4 coming in on this conversation but really need help
Regrds
Mike

It is possible that working one area for so long could abrade the skin, resulting in a friction rash. I have one client for who effleurage is guaranteed to cause rashes, so I use other methods.

As for working an area for 30-40 minutes... if you mean the exact same spot, then there is a good chance of overworking the tissue and causing some kind of damage. If you mean many little spots close to one another, there is less risk of this... again, depending on your approach.

Depending on the client's situation, spending that much time on one small area may not be the best approach. I know of one MT who worked 30-40 minutes on part of a client's low back, and immediately after the massage that client's back went into such severe spasm that he had to be transported to the hospital via ambulance and kept overnight on strong muscle relaxers. What other factors were involved, I don't know, but it is a fact that he walked in for a massage and rolled out to the hospital on a gurney.

To me, "deep" work really calls for a greater level of practitioner knowledge and sophistication. As the therapists, we are the ones responsible for the outcome of the session, so we must exercise control of what we do to influence that outcome while attempting to enable our clients to permit a positive outcome.

 

[brenda]

Discouraged - difficulties with deeper massage.

Thank you Jason for your reply
Really appreciate it

 

[ZsaZsa Galore]

Discouraged - difficulties with deeper massage.

I read someone's comment on FaceBook the other day and really liked it. It went something like this:

Deep tissue massage rarely comes from the hands. It comes from the feet/ankles.

It's very true. And, when you think about it this way, it may help those who are having difficulties, to get deeper with less effort.

 

[Katie B]

Discouraged - difficulties with deeper massage.

I read someone's comment on FaceBook the other day and really liked it. It went something like this:

Deep tissue massage rarely comes from the hands. It comes from the feet/ankles.

It's very true. And, when you think about it this way, it may help those who are having difficulties, to get deeper with less effort.

Excellent point!!

I was just telling my podiatrist that I think one of the reasons my plantar fascitis is taking FOREVER to go away is that even though I've stopped running I am still using my feet as that is where the pressure comes from in my massages.

Angie

 

[Pompal 09.]

Discouraged - difficulties with deeper massage.

Excellent suggestions, especially from Jason.

I make it a habit to get a massage a few time per month for a few important reasons:

1) good for my health
2) I learn something new from each treatment
3) if I'm I'm instructing patients I treat to come back to me for treatments I want put myself in the patients shoes

Whenever I get a "pain junkie" on the table I always break into a story about how when I was an athlete the best massage therapists weren't the one's that laid into me. I then go on a rant of how it's simply not therapeutic giving such heavier preassure. If the client is not satisfied that's fine it least they know my perogative as a therapists.

I know I probably break a golden rule when it comes to NOT asking a client feedback as to how the preassure is. I rarely do. I think it's more important to read the tissue. I think when you starting asking too much feedback in might come off as lacking confidence.