Why I Don’t Start Every Massage Where You Hurt

When something hurts, it makes sense to point directly at that spot and say, “This is where I need you to work.” However, that area does need some attention, it may be a referral pain pattern. I don’t believe a therapeutic massage should automatically begin and end wherever someone points. When someone comes to me with low back discomfort, neck tension, tight hips, or another muscular complaint, I want to understand the bigger picture first. Where you feel discomfort is important information. It just isn’t the only information I want.

I Want to Know What the Problem Is Interrupting

One of the most useful things you can tell me isn’t an anatomical term. It is what you are having trouble doing. Maybe sitting through your workday has become uncomfortable. Maybe turning your head while driving feels restricted. Maybe getting up after sitting for a long time is when you notice your back the most. Maybe you feel fine during normal daily activities but notice tension after hiking, running, lifting, or working a long shift. Those details give me context. My role as a massage therapist is not to diagnose why something hurts. My job is to listen to what you are experiencing, understand your goals, work within my scope of practice, and customize the massage accordingly.

The Painful Spot Is Part of the Conversation, Not the Whole Conversation

If you tell me your low back feels tight, I am going to listen. If you tell me your shoulders have been bothering you all week, I am going to listen to that too. What I don’t want to do is make an immediate assumption about what caused it. Pain and discomfort can have many possible explanations, and determining the medical cause of pain is outside the scope of massage therapy. This distinction matters. I can work with the muscular tension and movement concerns that are appropriate for massage without telling you that one particular muscle, posture, or habit is definitely the “root cause” of your problem. Your Daily Routine Gives Me Useful Information. Two people can point to the same part of their back and have completely different days. One may spend eight hours at a computer. Another may work a hospital shift that involves standing, walking, bending, and assisting patients. Another may have spent the weekend hiking around Colorado Springs. Someone else may be a parent moving between work, driving, carrying children, and everything else the day requires. That doesn’t mean I can determine the cause of someone’s discomfort simply from their occupation or activities. It does mean that understanding what your body is being asked to do every day gives me useful context for the session.

I Also Want to Know What You Want From the Appointment

“Make this stop hurting” is completely understandable. I still like to dig a little deeper. What would improvement allow you to do? Could you like sitting to feel more comfortable? Are you trying to return to an activity? Do you want less muscular tension after work? Are you looking for relaxation as well as focused therapeutic work? Are you preparing for an event or recovering after one? Your answer helps give the session a purpose. That purpose can be more useful than simply deciding that a certain area needs the deepest pressure possible.

More Pressure Isn’t Automatically Better

This is another assumption worth addressing. Therapeutic massage does not have to become a contest between the therapist and your pain tolerance. I use Ashiatsu because it allows me to apply broad, controlled pressure, but the amount and type of pressure still need to make sense for the person receiving it. I want feedback during a session. If something feels too intense, tell me. If a position is uncomfortable, tell me. If an area feels different from what you expected, tell me. Good communication doesn’t interfere with the treatment. It helps me adapt it.

Sometimes the Plan Changes During the Session

A massage appointment isn’t something I want to put on autopilot. The information you give me before we begin creates a starting point. Your feedback during the massage provides more information. That means the session may need to be adjusted. The goal isn’t to complete a predetermined checklist of muscles. The goal is to provide an individualized massage that makes sense for your needs, comfort, and goals that day.

There Are Also Times When Massage Shouldn’t Be the First Answer

Not every painful area belongs on a massage table first. New or severe symptoms, significant injury, unexplained weakness or numbness, changes in bowel or bladder function, fever associated with back pain, or other concerning symptoms can warrant medical evaluation. The same principle applies when something simply doesn’t seem appropriate for massage. Being a therapeutic massage therapist also means recognizing the limits of massage therapy. I would rather tell someone that their symptoms should be evaluated appropriately than pretend massage is the answer to everything.

You Don’t Need to Figure Out the Anatomy Before Your Appointment

This may be the most important takeaway. You don’t need to walk into my office knowing the name of the muscle that feels tight. You don’t need to diagnose yourself. You don’t need to decide whether your piriformis, quadratus lumborum, hip flexors, fascia, posture, or anything else you read about online is responsible. Tell me what you actually know.

Where do you feel it?

When do you notice it? Doing what movements, sitting stationary?

What makes it more noticeable?

What are you struggling to do comfortably?

What have you already tried?

What would you like to get out of your session?

That is useful information.

Why My Sessions Start With a Conversation

At Inspire Movements Massage Therapy, I don’t want your session to be determined solely by the body part you selected when you booked. I want to understand the person attached to it. That is why communication and individualized treatment are such important parts of how I work. Sometimes the area you point to will receive considerable attention. Sometimes the conversation gives us a reason to approach the session differently. Sometimes what you tell me means massage may not be the appropriate first step. You don’t need to arrive knowing the answer. That is what the conversation is for.

About Jessica Deardorff, LMT

Jessica Deardorff is the owner of Inspire Movements Massage Therapy in Colorado Springs, Colorado. She has practiced massage therapy since 2016 and holds an active Colorado massage therapist license, MT.0021143.

Her areas of focus include low back pain, sciatica support, headaches and migraines, mobility-focused massage, therapeutic Ashiatsu, and cupping therapy.

Jessica’s approach centers on individualized therapeutic massage, communication, and understanding what each client wants to accomplish rather than applying the same routine to every person.

Sources and Further Reading

For general information about back pain symptoms and when medical evaluation may be appropriate:

MedlinePlus – Back Pain: When You See the Doctor

MedlinePlus – Low Back Pain – Acute

Educational disclaimer: This article provides general educational information and does not diagnose injuries, pain conditions, or other medical conditions. Massage therapy may not be appropriate for every situation. New, severe, unexplained, or worsening symptoms should be evaluated by an appropriate healthcare professional.