“No pain, No gain.”

“Pain is just weakness leaving the body”

“The pain you feel today will be the strength you feel tomorrow”

Take a digital stroll through the alleys of your local training gym or fitness-focused social media, and you will be inundated with a never ending supply of platitudes encouraging a disharmonious relationship with pain. Specifically in the wellness world, many will promote and parrot the narrative of massage needing to hurt to be effective. If you aren’t feeling it, it must not be working. Where does this story come from, how accurate is it, and who is benefiting from its repetition?

Furthermore, as bodyworkers, do we need to cause pain to ease pain?

Feeling the burn: lasting echoes of massage

Post-Massage Soreness and Malaise (PMSM) is an unpleasant result that can sometimes occur in the hours or days after receiving bodywork, presenting as pain, achy muscles, bruising, flu-symptoms, and fatigue. In my experience (personal and professional), PMSM mainly results when the therapist and/or client ignores the body’s signals and approaches care too aggressively. PMSM is not a necessary component of therapeutic massage.

My therapeutic method is to consciously minimize unnecessary discomfort both during the massage and after. We must challenge the common narrative of needing to feel “beat up” after a massage in order to receive remedial benefits.This is not, statistically or scientifically– as far as I understand– accurate. It’s also not really that enjoyable, for you or your therapist. Where does this narrative of necessary suffering come from?

Can we do deep, effective remedial work without causing pain? Yes.

Western ideology: more = better, stronger = more effective. What is lacking from this? Nuance. Subtlety. Complexity. Patience. The acknowledgement of our individuality and separation from industry. When it comes to caring for the body, our needs are often in direct opposition to capitalism and colonialism–systems that demand a streamlined, predictable path to “wellness” and productivity. We use mechanical rhetoric (“I dont have the bandwidth” or “we’re on the same frequency”) but we are not machines, and we cannot expect mirrored functioning to them. We are highly individual, unpredictable, and diverse in presentation.

Pain & Morality

It is not uncommon that clients will draw attention to their pain tolerance in a way that is dismissive or downright derogatory. “I need it light, I’m a wimp”… Or the other end of the spectrum, “do it as hard as you can, I can take it.” These stories are interesting because both are rooted in self-judgment more than helpful data that I can integrate into care for their body. Qualitative alternatives could look like, “I generally have a higher pain tolerance” or “I am very sensitive to pressure and get ticklish”. I am also very conscious of the psychology of this dynamic, and choose my words intentionally (“would you like light, medium, or deep pressure?”), avoiding associative rhetoric like “gentle” or “soft” or “strong” or “tough”.

Sometimes a number scale can be helpful for clients to give a more uninhibited analysis. Very often, what clients say drastically diverges from what their body reacts to and further communication must happen in the moment.

It seems people have a perception of what their body needs that is directly tied to what that means about them as a person. And their perception of what their therapist thinks will factor in tool. There is often the spirit of apology or justification: I promise you, any therapist worth their salt is not judging your pain threshold. We are neither impressed nor disappointed. Not only is this self-criticism not necessary, it also usually isn’t accurate. If I had a dollar for every person that told me to work as hard as I can, only to immediately seize up when I slowly introduce what I would consider just moderate pressure…

The point is, whatever pressure you need is okay, regardless of gender or job description or personality. Don’t ask us to hurt you. As Massage Therapists, with extensive anatomy/ kinesiology study, we are very aware of how to cause pain if we wanted to. Fortunately, that is not within our scope of practice, nor is it our goal! It might be helpful to question any therapist that seems to enjoy causing their clients pain. An effective therapist is adaptive and constantly considers the client’s experience and comfort.

But how will I know the massage is “working” if I don’t feel sore afterwards? Isn’t it just like exercising?

The Science of Pain

The comparison between massage and exercise is important! The soreness we feel and associate with exercise/training is called Delayed Onset Muscle Soreness (DOMS), and is the result of micro-tears in the muscle (sometimes an aspect of building new muscle, sometimes a sign that we might have pushed ourselves too much or too quickly). DOMS is similar to PMSM in that both are disrupting normal tissue function and both require the body to engage in a period of repair. They are also both widely accepted dominant narratives with flawed science and understanding. Neither are required experiences for your body!

While exercise and massage may be tangentially related, they are not the same thing. Vigorous exercise simply does not have the same physiological effects in the body as does vigorous massage (for a very simple and straightforward example, intense exercise temporarily increases heart rate, while moderate massage generally decreases heart rate). A massage is not a “workout,” even if it is similar in some ways. It is not necessary to have DOMS to experience the benefits of exercise or build muscle and it is not necessary to have PMSM to experience the benefits of massage.

Additionally, experiencing pain is not always adaptive and being able to grit through it does not mean something about you as a person, at least as far as massage is concerned. More is happening during a massage than basic technical manipulation: the entire nervous system is activated, we are experiencing close contact with another person–and we are in a space of physical and emotional vulnerability.

Where do ideas of the transformative nature of pain originate? The history of pain as a spiritual discipline is ancient, and very often intertwined with religion, class, and politics. The martyr is an integral archetype among many non-secular belief systems, bleeding into current ideas around “goodness” and worth. Sometimes it is even as simple as the recognition that pain is inevitable so we must rationalize it. As perfectly summed up by the dread pirate Wesley in Rob Reiner’s The Princess Bride, “Life is pain. Anyone who says differently is selling something”. If we are doomed to fate anyway, we might be tempted to shift the narrative so our pain actually means something. All well and good, we just want to make sure we aren’t adding more where it doesn’t need to be. And question anyone that might be benefiting from our pain.

Okay, but could some of that pain actually be the accumulation of toxins in my body?

“Detoxification” and Massage

This is an area where a healthy skepticism of the wellness industry–and an openness to consider your internal bias–is required. It is very likely that you have heard that massage helps the body by eliminating the harmful buildup of toxins and purges “stuck” waste products. This may have come from doctors, massage therapists, exercise instructors, spiritual guides, yoga practitioners, your neighbor, or your favorite friendly online influencer. I encourage some deeper investigation here:

Exactly which toxins are we talking about?

How exactly would we be moving these toxins safely through the body in a non-medical way?

Which natural elimination systems would we be bypassing in order to expel wastes?

Who is initiating this conversation around toxins and are they also “selling” you something?

Poisons are substances that irritate, damage, or impair tissue activity, and can originate from internal or external sources that are usually ingested.

Venoms are biological poisons that are injected into the body, usually from a bite or sting.

Toxins are a type of poison and come from living organisms (bacteria, cell degradation).

Toxicants are man-made, synthetic poisons (pesticides, industrial chemicals).

Toxins (in the body) look like ethyl alcohol (a necessary byproduct of internal chemical reactions), like carbon dioxide (released from metabolic processes), like A streptococcus (bacteria that causes strep throat). Toxicants (in the body) look like heavy metals (lead, cadmium), dyes (lower molecular weight xenobiotics), etc. Massage does not “remove” these toxins and toxicants– the body is already built to do that. If the body is unable to remove them, and medical intervention cannot, you will get very, very sick. And the symptoms and chemical levels would be clinically testable.

Poisons exist everywhere, man-made and natural. We would not be able to function if our bodies were not constantly detoxifying the potentially harmful substances made from inside our own systems as well as everything we come into contact with in our environments on a day-to-day basis. If any of the naturally detoxifying body systems were in jeopardy, like lead poisoning or liver failure, it would be extremely obvious and massage would probably be last on the to-do list (and deeply contraindicated!). Would you go to a Massage Therapist to address radiation poisoning or a fresh rattlesnake bite? Why not, if massage can “eliminate toxins”?

So,what if my systems aren’t necessarily in jeopardy but they aren’t in optimal condition either?

This is usually the space where wellness practitioners will build the bulk of their practices. Rightfully so, as there are many states between flourishing and catastrophe that can be influenced by outside applications. However, it is also a space with extensive room to be vague, free from accountability to results and filled with confirmation bias. We aren’t magic and also, “magic” can be perceived to happen when it comes to MT’s easing pain. Massage can flourish where other remedies fail–it can also be a therapeutic dud, or even cause further discomfort. Both realities can and do exist simultaneously.

One example of outdated belief: The lactic-acid boogeyman. Massage “flushing” lactic acid from the muscles is an oft-repeated myth stemming from early 20th-century science–in fact, our understanding about lactic acid (now recognized as the negatively-charged ion lactate) and the muscles has evolved significantly in the last few decades. Lactate is a brief source of energy and is naturally metabolized by the liver and kidneys, so you wouldn’t want to “flush” it out of the muscles, even if you could.

(The Cori Cycle, depicting the necessary movement and transformation of lactate between the muscles and liver)

Misinformation & Marketing : The True Pain Points

The wellness industry thrives on suffering. As if real, tangible pain wasn’t enough, there is a push to manufacture more, to convince consumers that they have an issue and then sell them the “cure” (see: the “problem” of cellulite). Massage enters the scene when therapists use faulty data, exoticism, and straight-up lies to push services and upsell products. As therapists, we recognize that stress and discomfort is ubiquitous in this age, and we must be extra careful to not exploit that fact in our work. We also don’t want to make any wild claims or promises in order to increase our bookings. If you see someone claiming to solve all your problems with massage, that is definitely an opportunity to pause and look deeper.

Great, now I feel even worse. What should I do?

A Real Pain in the Neck

Wading through societal pressure, shifting science, and mountains of misinformation–just to figure out what you are actually experiencing in your body– can be incredibly difficult. The first step is to slow down and engage critical thinking. Untangling other people’s embedded messaging takes practice and patience! Where did you learn that pain is inevitable in massage? Start here. Search for any cracks in that narrative or potential reasons for that perspective. If the therapeutic outcome was the same, would you choose a pain-free massage over a painful one? Would that change how you view yourself in any way? Why or why not?

Our relationship to pain is complex. It is likely that it will change over time, with different experiences and changing bodies. It might not always shift in a positive way. So one thing we can be sure of: we don’t want to add more if we don’t need to.

Interested in a pain-free massage? Book with Rela Noita.

Sources

Massage Therapy Modulates Inflammatory Mediators Following Sprint Exercise in Healthy Male Athletes NIH

“Detoxes” and “Cleanses”: What You Need To Know NIH

ORGAN SYSTEMS: DETOXIfication Texas A&M University

Elimination of persistent toxicants from the human body NIH

Is “Delayed Onset Muscle Soreness” a False Friend? The Potential Implication of the Fascial Connective Tissue in Post-Exercise Discomfort International Journal of Molecular Science

FAQs About Lymphatic Drainage Massage Cedars Sinai

Massage Therapy and the Body’s Organ Systems Cerebral Palsy Foundation

Is It Possible to Get Rid of Lactic Acid in Your Muscles? Healthline

Feeling the Burn? Don’t Blame Lactate London Bridge Sports Medicine Group