Just the right touch: how to get the most from a massage

Friday, September 29th 2000, 12:00 am
By: News On 6

Now that doctors are prescribing it, HMOs are paying for it, and all your friends are doing it, you've decided to get your first massage.

Will it be Swedish, neuromuscular or Shiatsu? For your back, your alignment or your headaches? At a spa, private office or the chiropractor's? For 30 minutes, 60 or 90?

All these decisions are enough to make you tense!

Relax. Here's a guide to the types of massage available in the area, for whom they're best suited, how to find the therapist with the magic fingers and what to expect when you're on the table.

Light massage

Swedish: The most common massage method in the United States uses gentle stroking and kneading. The therapist often uses oil. A good method for relaxing and improving circulation.

Deep massage

Deep tissue: Direct, slow pressure addresses chronically tense muscles, such as backs strained by desk-bound posture. Ideal for people who work high-stress jobs or exercise strenuously.

Neuromuscular or trigger-point therapy: The therapist concentrates finger pressure on specific muscles. Prescribed as relief for spasms and pain.

Myofascial release: Manipulates the weblike tissues (fascia) that surround and connect the muscles (myo). It's a medium-deep massage for people stiff from lack of exercise or too much exercise, such as the couch potato who can barely move after a yard-work marathon.

Sports: Incorporates both Swedish and deep-tissue massage but is geared specifically toward athletes who regularly stress the same muscle groups. Good before or after competitions or workouts.

Rolfing: Aims to bring the body's individual parts into alignment through a standard 10 sessions, resulting in freer movement. Good for dancers or for people whose skeletal alignment is off-kilter, for example, from broken bones or scoliosis.

Acupressure/Shiatsu: Similar Oriental methods that use finger pressure (as opposed to stroking or kneading) on the muscle to release tension and balance the flow of chi, or energy, through the muscles and organs. Often used with acupuncture and herbs. Good for people open to alternative therapies.

Reflexology: Practitioners believe zones of the ears, hands and feet are microcosms of the body, and that pressure on the relevant area can address problems that correspond elsewhere. A good choice for modest people (no need to get naked), as well as for elderly patients whose bones may be too fragile for traditional deep massage.

CranioSacral therapy: Focuses on the skull, neck and spine, and incorporates both manipulation of soft tissues and membranes as well as energy work (see below). Recommended for people experiencing noggin maladies such as headaches and sinus infections.

Energy work massage

THERAPEUTIC TOUCH/REIKI: Practitioners of these methods don't touch the skin, but pass their hands a few inches over it, making it ideal for premature babies, people who are terminally ill and cancer patients. It is based on the idea that the body's electromagnetic field, or aura, radiates from the body's surface.

The method is gaining acceptance in medicine, massage therapist Brigitte Bowman says, with people like hospice nurses practicing it as a healing technique. Unlike other types of massage, energy work doesn't require licensing by the state.

Specialty massage

PRENATAL: Relieves lower-back pain and other discomfort associated with pregnancy. The therapist's office will be outfitted with a special table to accommodate the mother's belly.

INFANT: Practitioners generally teach parents the techniques for massaging their baby as a bonding experience.

HOT ROCKS: In this popular spa treatment, warm stones are placed strategically on the body. The heat component makes it good for arthritic patients.

CHAIR: The client drapes himself or herself over a specially designed chair. Good for an instant relief, such as on-the-job.

More than a massage

AROMATHERAPY: The therapist massages with essential oils of herbs whose properties address specific problems; for example, lavender to soothe and calm.

HERBAL WRAP: Post-massage, the client is wrapped in heated herb-infused towels.

PARAFFIN HAND BATH: Hands are covered in warm paraffin and wrapped in mitts for 10 to 15 minutes to smooth and relax them.

Finding a masseuse

Massage therapists work out of private offices, spas, hair salons, chiropractors' offices, cruise ships, even stores such as Whole Foods Market. But like physicians and hairdressers, the best one often is found through a friend's recommendation.

Several associations' Web sites list members by region. Two to try: www.amtamassage.org and www.abmp.com. The Yellow Pages is another option, although sexually oriented masseuses are difficult to distinguish from the others.

At a minimum, therapists must be registered to work in the state of Texas. (Check the rosters at the Health Department's Web site to confirm a therapist's registration: www.tdh.state.tx.us/hcqs/plc/massage.htm.)

Specialty check

When you've found a therapist, ask what additional training the person has had and what his or her speciality is. Trust your instincts. Does the therapist make you feel comfortable? Are your personalities complementary? You will be spending intimate time together, so personal factors rate higher than if, say, you were interviewing mechanics.

What to expect

WHEN YOU ARRIVE: The therapist should ask you about any medication you're taking and recent health problems, such as broken bones, heart disease and chronic headaches.

CLOTHING: Nudity is the general rule, but the therapist will drape the parts he or she isn't working. If you're uncomfortable with the full monty, though, it's perfectly acceptable to wear underwear or a bathing suit. (A therapist shouldn't touch breasts or genitals during the massage.) Other types of massage, such as trigger-point or reflexology, don't necessarily require disrobing.

INSTRUCTIONS: Tell the therapist what areas you'd like given special attention. Also feel free to tell the person to adjust the intensity of his or her touch, if necessary.

TIME: A half-hour massage usually means the neck, back and shoulders, unless the client requests otherwise. For an hour or 90-minute session, expect a full-body massage.

FEES: The average rate for a one-hour massage is $50 to $60. A 10 to 20 percent tip is optional.

So, ask!

Question: Should it hurt?

Answer: A little, if it's deep-tissue massage. "There is some discomfort, but it should never be painful," Ms. Bowman says. On a 1 to 10 scale (1 = light pressure and 10 = passing-out pain), she aims for 4, 5 or 6 – the "hurts so good" range.

Question: When should I schedule a massage?

Answer: Any time is fine, although post-workout is better than pre-workout. If you have a particularly stressful event planned, schedule a massage the day before; the full benefits of massage are felt 12 to 24 hours later, Ms. Bowman says.

Question: What should I do before and after my massage?

Answer: Don't eat a big meal immediately before your appointment; afterward drink 8 to 12 ounces of water to help flush toxins released during the massage.

SOURCES: The American Holistic Health Association Complete Guide to Alternative Medicine; massage therapist Brigitte Bowman; Sterling Mansoori, owner of Sterling Health Center in Addison