Massage Tips for Bad Backs
I am a practising massage therapist and allied medical student, qualified in four different types of bodywork, including Deep Tissue. I come from a Personal Training background and train as much as I can even though I suffer with chronic back pain.
I just wanted to share a few tips for people with back ache or sciatica that I use myself.
(1) BREATHING IS IMPORTANT
I ask my clients to slow their breathing down and listen to their own breath, which helps relax them before they the massage starts. Even when not having a massage, breathing slowly and deeply helps me combat pain. It doesn't take it away, but can reduce it or help me cope. The massage will be even more effective, if you are in this frame of mind. I have had the odd uptight person on my massage table and it is quite frankly a waste of time if you do not embrace the treatment.
Sometimes embracing your own pain helps, as crazy as it may sound. Pain is your bodies way of telling you there is something wrong. As unpleasant as it is, it actually saves our lives and prevents us from damaging ourselves even more. If you can put a positive spin on your pain and accept it, breathing through it may help. Any woman who has had a baby, especially more than one, will relate to this. Don't underestimate the strength of your own mind. Try not to feel like your body is against you even though it can feel that way sometimes.
(2) HEAT, HEAT AND MORE HEAT
If you have access to a sauna, heating up the muscles before massage softens them and makes the therapists job easier and relaxes you more. (Keep fluid intake up so you do not become de-hydrated). I used to have a sauna virtually every day after training and it was a great help. Now I don't do this due to my gym not having one, I can really feel the difference : ( I am going to change my gym for this reason.
(3) HOT STONES
I am qualified in Hot & Cold Stone massage (La Stone Therapy). I would suggest mixing deep tissue massage with hot stones if you can find a therapist who is happy to do this. While you have your lumbar spine massaged, two hot stones can be placed over the rhomboids (deep muscles between the shoulder blades) or on the trapezius (upper back, shoulders). This way you become even more relaxed and muscles are being warmed and softened while another area is being worked on, so when the therapist gets there, his/her job is easier and the result more effective for you.
(4) SPINAL LAYOUTS
Hot stones allow for spinal layouts. They can be arranged with a towel over them, which the client can lays on. Spinal muscles are relaxed this way, but it helps to add a hot stone under the back of the neck also, as tension in this area will effect muscles lower down. It feels amazing. Spinal lay outs that you see in photographs usually have stones placed on the back while the client is face down. This can be done, but it is not a proper spinal layout, which you lay on applying your own body weight.
(5) MASSAGE SAFETY
Stones can be used for deep tissue work by using the edges of them and the effect is 10 times more powerful than hand massage. I didn't believe this myself when I started my course but it really is true, hence why fluid intake is even more important with stone massage. Due to its strength, do not get off the table too quickly. Lay down for a while, get yourself together and move when you are ready. If you have a back problem, the therapist should offer to help you get off the table. If they do not, please ask for help, as you may feel a bit stiff from being in the same position for a long period of time. Never rush.
(6) BODY TEMPERATURE
Body temperature can drop when having a massage and I personally experience this often when someone works on me. It is important that your therapist has a way of keeping you warm if this happens. Its a horrid feeling and sometimes can make you feel vulnerable. I have suggested some clients bring warm socks as their feet get cold even under the towel. Being wrapped up and having two hands at the same time (compression strokes) pushing down on the muscles moving up the back over the blanket or towels, releases tension and can make you feel relaxed and warm again.
7) BACK MASSAGE
When doing a back massage, it is important that the therapist has the strength to work the deeper muscles of the core. The core includes muscles of the trunk in the front AND back. There is nothing worse than a feather light massage when you have real back issues. However, excessive pressure can stress you out to the point where you no longer trust the therapist and become less relaxed, even stressed. Some therapists delight in making you feel pain - I have no idea why, maybe they like to feel that they are the boss. If you find one like this, find a new one. If you can take the discomfort thats fine, but not all clients can and everyones pain threshold is different. A good therapist will make sure you are not distressed while applying the right amount of pressure. Attacking a muscle and going in like a bull in a china shop does not work. Warming the muscles gradually and applying more pressure in stages and getting really deep in a more considered way, retains trust between client and therapist and helps the client to let go of their pain.
8) DONT JUST WORK ONE AREA OF THE BACK
When I have worked on people with back pain, they sometimes only want work to be done on one area. The problem with this approach is, that tightness in one area often leads to tightness or tension in another, even if it is less severe. The muscle nearest the surface of the back that runs along each side of the spine (erector spinae) is a long muscle, so it would be pointless massaging half it. This muscle inserts in the back of the head, right at the top of the neck, so adding heat and massaging this area is very important also. Often massage brings to the attention of the client, areas of the back which needed work, which they were not previously aware of. You can commit more time to the worst areas obviously, but it does not pay to neglect other areas of the back.
Sciatica is better relieved with a cold stone or cold compress, rather than hot. Cold stones are marble and should be kept in the freezer. When applied to a hamstring (back of upper leg) or calf, this can offer great relief. Try a packet of frozen peas out of the freezer on your hamstring and see if it works for you. You can also try this on the glutes (bottom muscle) when the pain is bad. If you are having problems in the hamstring you can bend you leg up while on your front, making an angle of 90 degrees. The therapist can do a deep tissue stroke on your muscle with both fists side by side, while you lower your leg down and raise it back up again. Your muscle contracts against the therapists hands, while being massaged and you feel the pressure a lot more.
10) DON"T NEGLECT THE GLUTES (MUSCLES IN THE BOTTOM)
The muscles of the bottom or glutes of which there are 3 altogether, are often full of tension when having back ache, which isn't surprising considering its proximity to the lumbar spine. I have sciatica in my left leg and when my glutes are worked on, the tension is unbelievable. You can have a towel placed over the area and have compression applied if this areas in one you do not want touched directly. If you are happy to be massaged there then there are mores stroke options for the therapist, but either way, deep pressure can be applied. Press on your own glutes hard but carefully incase it causes you pain, making a circular motion with say 3 fingers in different areas and you may feel a lot of tension. My areas of tension are mainly by the hip and middle of the bottom and area by my tail bone.
11) BRINGING THE KNEES TO THE CHEST
The therapist can bring a knee or both knees to your chest, gently applying their body weight in order to relieve the back while you are on the table. This can offer great relief, but it needs to be done slowly and carefully.
12) THAI MASSAGE IS AMAZING BUT......
Thai massage is fab, no two ways about it, however, if you have a bad back I would refrain from letting anyone walk on it incase they walk directly on your spine. In fact, even if I didn't have a bad back I still wouldn't want to risk this, no matter how small the person was. I apply pressure with my foot on areas of the back avoiding the spine always and that can feel great. If you have sciatica having compression applied with the foot to your calf and particularly hamstrings while you lay on the floor can feel like bliss. I ask my boyfriend to put his foot on my hamstrings and press quite hard all the way up my leg into the glute and it was heaven, but he is also qualified in massage so he knows what he is doing.
Getting some books on massage can help you learn some techniques for yourself, but I would recommend doing a short course even if its only for a couple of days, as there are many situations where massage is not safe. Learning with a friend or partner can help you in the long run, as you need to work on someone to improve your skills and if they are willing to massage you then you do the same for them and swap.
Self massage can be beneficial and this is possible with the calves, glutes and hamstrings, but not really with the back unfortunately. Buy some cold-pressed oil (best quality) and warm it by putting it in a small bowl and placing that in a pan of boiling water. Get some old towels and cover the surface you are placing your body part on and practise some strokes. Find simple ones in your massage book and feel free to adapt them if need be.