Welcome to a new series highlighting ubiquitous myths in manual therapy which damage the industry and more importantly, mislead you. Hopefully, this can serve as a guide to finding the right therapist for you.

Let’s make a start…

“If it hurts, it must doing some good…”

I’ve heard this many times. It is not true and there is simply no good scientific reason to think so.

Why do we think this?

We tend to think that something mechanical has to happen to our muscles to fix the problem and make us feel better. So accepting pain must be either

1. The ‘thing’ that needs to happen hurts when it’s happening

‘Jam your elbow in my bum cheek to do the thing, which hurts and that’s ok’

Or

2. The amount of pressure required to achieve the ‘thing’ will hurt

‘Jam your elbow in my bum cheek really hard because you need to get to the bit to do the thing, and that’s ok’

The first problem is that you cannot physically change a muscle, fascia, ligament or tendon by rubbing, poking or pulling because they are super strong. Manual therapy cannot make make bits of you longer, softer, released, activated or whatever else the poxy pseudoscientific training course said it could. We’re made of stronger stuff. No-one’s changing your meat.

The more fundamental problem however, is that muscle aches and stiffness have a lot more to do with your central nervous system than it does with your actual meat. The tissue is not the issue. The experience of a sore and irritating ‘knot’, or a tight muscle is very real, but as far as finding a biologically plausible, physical thing that researchers agree on – not even close. And no, a therapist cannot feel them, research shows this to be hopelessly unreliable.

No pain, no gain. Wrong, stupid!

Know pain, know gain. Better.

Pain science tells us that when we’re hurting, especially long term, the nervous system tends to dial up pain – actually makes it hurt more. It’s like an alarm system, on high alert. It just makes no sense to aggravate an already heightened nervous system. Our primal response is fight, flight or fright, this makes us tense, guarded and can dial up our pain experience. However, think about a gentle breath, sinking onto a couch, being supported in a safe environment, trusting, and deeply relaxing. This is the language the sympathetic nervous system understands and it does, dial down pain.

Personally, I love a massage with enough pressure for a satisfying ache, like a pleasing stretch or the scratching of an itch, calming the body and being kind to it. I feel loose, relaxed and without pain. If you love a painful massage, go right ahead. When it comes to you and your goals, I’m here to help out, or get out of the way. I’m just trying to tell you it doesn’t need to hurt and that the pain does definitely not mean it’s doing good.

Summary

Research the literature on physiology, pain science and neuroscience and I highly doubt you will find a plausible, evidence-based or clinically significant justification for a painful massage.

If there was, I’d be doing it.