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5 massage techniques/strategies I've abandoned

My new book is out! It’s called Massage Is Weird: https://massagesloth.com/book/
I’ve been in this business for ten years (well, almost), and there are some massage techniques and strategies that I’ve stopped using. In this video I talk about 5 of them, along with the practices I’ve used to replace them. If you’d like to skip ahead, click the time codes below.

0:45 1) Aggressive massage and stretching of the neck. This is something commonly taught in massage school, but I’ve seen no good justification for it over my years of practice. In fact, I’ve seen a lot of sore necks and headaches (including my own!) that could have been avoided if the massage therapist had chosen a more moderate approach. Neck range of motion isn’t something that can be changed in a single session, so I tend to respect it as I work. I find that gentle myofascial release, staying within that ROM, can reduce the frequency of neck cricks and headaches, without all of the pain the next day.

5:29 2) Using trigger point therapy first. These days, I keep neuromuscular therapy (NMT) in my back pocket as another useful tool, rather than as the first line of defense against every type of pain. It’s definitely a useful discipline to learn about—the referral patterns of pain and the clues they give you about the relevant muscles are invaluable. I just no longer consider prolonged/repeated ischemic compression to be worth the immediate discomfort or next-day soreness. That said, I will work directly with trigger points if other approaches fail, and with clients who have found such work useful in the past, as long as they tolerate it well.

7:43 3) Postural assessment and correction. My days of giving my clients a posture complex are over. The scientific literature on posture indicates that there are a wide variety of spinal configurations (exaggerated kyphosis or lordosis, scoliosis of varying degrees) that can be symptom-free. Indeed, even “ideal” postures can co-exist with substantial pain. In cases where slumped posture and pain co-exist, the answer doesn’t seem to be posture correction, but rather an increase in activity, and increase in the variety of activities, and interventions such as massage. While the posture may remain the same, the pain is likely to decrease over time. Please note that there is merit in attempts to prevent progression of scoliosis, and of kyphosis associated with aging. This is associated with better outcomes over time.

11:29 4) Psoas massage as a first-line strategy. Don’t get me wrong, I love abdominal work. I just no longer consider it worth the time and potential discomfort to work directly with psoas every time a client has low back pain. These days, I’ll work broadly with related structures (QL, the posterior and lateral hips, tensor fasciae latae, and iliacus), and I find that I’m able to help with low back and hip pain in most cases. The idea that we need to “deactivate trigger points” or “strip out adhesions” is based on conjecture, and I would be very surprised if it held up to close scrutiny. That said, some clients respond well to psoas work, or have had success with it in the past. For these clients, I’ll happily offer broad, slow contact.

13:42 5) Overloading my clients with stretching and self-massage advice. These days, I’ll offer a single stretch at a time, erring on the side of giving them too little. This gives them a chance to actually incorporate them into their lives and benefit from them, and it lets me see whether they’re the kind of client who even wants homework! If not, I simply allow massage to do its work.

Thanks for watching (and reading all this)! Let me know if there are any massage practices you’ve abandoned in the comments, and if you disagree with any of mine. Let’s talk about it.

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24 Replies to “5 massage techniques/strategies I've abandoned”

  1. I'm in my first year as an LMT and this video really helps. I haven't used trigger point religiously since my internship, I found it takes to much time & doesn't have the same calming affect as regular massage. I've also been trying to work on my aggressiveness in general, I get excited someone has areas they are allowing me to work on but I'm learning to take a step back and make sure I'm helping not hurting.

  3. So good, thank you for all this …. I am re learning these things since beginning massaging. Love listening to you explaining things.

  5. Amin. brother! I don't give homework at all now, I do refer to physio often. Cause they are equipped better. Plus, if you read McGill you will learn that you should not stretch for back pain (something we never learnt in school). I don't do Special tests. AROM and PROM are often enough. I don't use oil much, no kneading and petrissage ))))) 90% is myofascial release which works awesome!

  6. What a relief to hear you say you don't often work psoas! Thank you! Fellow therapists have looked askance at me when I've admitted to not working psoas for back pain. I hated receiving it while in massage school and decided then and there I wouldn't subject my clients to it. Feels way too vulnerable and active stretching more effective.

  7. I’ve been a practicing LMT for 13 years and I agree with everything you said. Good advice all the way around.

  8. Yes, bad posture can cause pain in your body. Search The Egoscue Method. Or Pete Egoscue.

  10. This is my first week back at work after a 7 month hiatus from giving bodywork. I found your message in this video to be very comforting. Thank you. I have been watching your videos since I begin practicing in 2015. You are one of the most influential and important teachers in my massage education. I deeply appreciate your work; thank you for making it accessible.

  11. I agree whole heartedly with neck flexion. I just learned this technique this week, and everyone has said it is not needed with how much we already flex our necks daily.

  13. What kind of school did you go to? Massage therapist are not supposed to do anything “aggressive” and at least in Florida, are not supposed to manipulate bone, do an assessment of ROM that falls into the scope of practice of Physical therapy, chiropractors or osteopaths.

  14. I've been a massage therapist for 19 years.
    I stumbled on your channel and now have binge watched you for 2 days (between clients)
    So many things that you say really speak to me.
    I have even thought that somewhere in my training that I just missed something. I have abandon a lot of the techniques you discuss here because they just didn't feel right for me. I try to explain to clients that it isn't necessarily a "knot". I find it interesting how many therapists I have seen that thing that things that are bones are a "knot" The fact that clients shouldn't feel like I have beaten them when they leave my room.
    Thanks so much for putting so many of my thoughts into words for all of us to see.
    Keep up the good work.

  15. Hi Ian, could you please share with us what books you recomend to read like a Bible for the massage? Thank you

  17. Thanks. This was very helpful.
    We need to always be careful, because we are not doctors, but we can help assist people in their healing.

  18. Excellent video. I totally understand what you say about use of trigger points. While, I love that work and having a natural ability to come across those areas, direct constant pressure isn't always the answer. I am a solid 3 years in, and only this month have I started to have any variation of pain in my hands and wrists. Issue is that a lot of deep pressure and deep tissue clients have been coming in, saying they can "take the abuse". No, just let me get to your attachments and manipulate around your tighter tps!

  21. What I do with my clients is, before performing a neck stretch, that standing up they show me their maximum extension of the neck (without overstrain)
    And I always use a towel to perform this procedure (I have noticed that using a towel the procedure can be more tender)
    I believe that in order for the person to reach a greater stretch of the neck, the person must perform activities such as yoga, which is something gradual and that is the person who manages the stretch and the time.
    Am I right if I do it that way??
    Sorry my English 🙏 I'm not a native speaker

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