Clients are often asked if they want a “Swedish” or “deep tissue.” These terms, however, can misinform them about what massage therapy actually provides.
Recently, a client asked me what is the difference between “Swedish” and “deep tissue” since she often gets asked about that when she books an appointment at a spa. She wasn’t the first client to ask me about that; at least a dozen have asked me the same question for more than five years. There isn’t a straight answer to this because I am uncertain about how massage therapy is boiled down to two modalities for clients to choose.
There is very little reliable information online about the origin of the term Swedish massage, but I think there may be a few old books on massage therapy that provide such documentation. A quick search on PubMed mostly yields on how effective Swedish massage is for a condition when it is pitted with another modality. The most reliable source I could find so far is from an acupuncture and massage college in Miami, Florida, that goes into details (with pictures) about the origins of Swedish massage. I’m not sure how reliable this source is, but it is a start.
As science reveals more about pain, the answer is leaning towards more shades of gray than a clear ‘yes’ or ‘no’.
At first, I would say “yes,” but only temporarily. I cannot say with total certainty that massage will get rid of your back pain—or any kind of musculoskeletal or neuropathic pain—because pain is much more than just a biological phenomenon. Most of the time, clients get some relief that lasts from two days to two weeks. A few do not get better after one or two sessions within a month, and a lucky few get lasting relief for more than a year after a few sessions over three to six months.
Because pain itself stems from so many factors, it is almost impossible to pinpoint a single cause of persistent pain. A single type of treatment is even less possible. Even the most recent systematic review from Cochrane in 2015 “have little confidence” in massage therapy for low back pain. (1)
Clients and patients who seek massage therapy for pain or stress relief often carry a story with them. This story often contains a weave of prior experiences, expectations, emotions, and metaphors that shape their thoughts and actions, leading up to why they came to see us. Sometimes, they do not share that story with us because they probably do not expect to engage with massage therapists in such a way.
Patients pay and clinicians “fix.” That is the current expectation from both parties.
Of course, this doesn’t mean that
massage therapists is cosplaying a psychologist or a similar mental
health professional—and nor should they cross the professional
boundary! Simply, this means that we should show genuine care and
empathy to our clients’ and patients’ condition, not just going
through the script and motions to “get through” the session.
Sports massage principles are not that different than other types of massages for non-athletic populations, given the current evidence about what sports massage could and could not do. The main idea behind sports massage is to help the person return to performing at their sport or task as best as possible within a certain time frame.
While that certainly can be applied to athletes of various levels (e.g. high school, elite, recreational), we can definitely apply the principles to non-athletes, just with a different way of communicating and addressing the issue at hand. A real estate agent, for example, who often drives long hours throughout the week to see clients and inspect properties, might likely get low back pain from sitting a lot in the car. If the pain gets severe enough to warrant medical attention, he/she might seek massage therapy as a way alleviate to symptoms so he/she can get back to work again.
While this sometimes does not address the underlying issue for low back pain (or any type of pain), massage therapy can be the starting line for many cases—within our scope of practice.
Some athletes love to receive a massage as much as chowing down on their favorite post-training meal as part of their recovery. Even some massage and physical therapists recommend athletes should get a massage before or after a training or competition. But just how effective is it for performance and recovery? Does sports massage have to be painful or could it be as relaxing as a traditional Swedish? Let’s see what current evidence says.