One of the questions I get asked regularly by patients is what remedial massage actually is, followed by how it is different from another type of massage. Even patients who have had remedial massages before are still unsure about it all. And it becomes even more blurry when you have had remedial massage treatments from different therapists and every one of them may have been different, maybe even with the same therapist.

The following is my contribution to shed some light on the matter.

One Goal, Many Modalities

First of all, remedial massage uses a wide range of massage techniques, all very different in style and application. To name just a few:
  • Deep tissue
  • Trigger point
  • Myofascial release
  • Manual lymphatic drainage
  • CRAC stretching
  • Heat and cold therapy
  • And many more

These are all techniques in their own right and are used in remedial massage. So which one will you get when you book in a remedial massage treatment? Will the practitioner select the one she is most comfortable with? Although different practitioners have different preferences and experiences, there is a certain method to the madness, which brings us a step closer to what remedial massage is.

Deciding Treatment Factors

Although all remedial massage therapists in Australia are trained in the above modalities, what kind of treatment you get is determined by a number of factors that the therapist takes into consideration, such as:
  • The condition you present with and anything you can tell about it (e.g. where the pain is)
  • Your medical history
  • Physical examination results, e.g. range of motion or specific tests for certain conditions
  • The therapist’s own assessment upon palpation of the affected areas
  • Information from other health practitioners, e.g. a chiropractor or physiotherapist
  • Any other factors that may have an effect, e.g. sleep patterns or posture

It is the intention and clinical reasoning that sets remedial massage apart.

With all the gathered information about your specific case the therapist then uses clinical reasoning to determine the best treatment approach. This usually includes the type(s) of massage, location, duration, frequency, etc. In most cases the overall goal will be to provide relief for the condition you have presented with and how to treat it effectively in the long run.
Remedial means: something that works as a remedy or a cure. The main focus of remedial massage is to alleviate a given condition, e.g. a faulty posture, a frozen shoulder or tension headaches. To achieve this, the therapist uses any treatment approach available to her. E.g. a faulty posture may best be corrected with deep tissue and stretching, a frozen shoulder may best benefit from myofascial release and heat/cold therapy, and tension headaches may require trigger point and manual lymphatic drainage.

Clinical Reasoning

Clinical reasoning is the difference between what we call a technician and a physician. A technician has learned a range of techniques and can skilfully apply them. A physician can do that as well, but is guided by her analysis of the underlying condition and her experience in choosing the best treatment approach.
Getting a massage treatment from a massage ‘technician’ is not a bad thing at all, don’t get me wrong. If overall relaxation is your goal (think spa massage), then that is probably your best bet. However, if you do have a condition or muscular pain that needs addressing, then consulting a physician (in this case a remedial massage therapist) should be your first step. He/she will be able to help you identify the issue at hand, explain to you what and why things are happening the way they are, and suggest a comprehensive treatment plan that will get you pain free.

Remedial vs Relaxation Massage

The following table highlights the main differences between a traditional relaxation massage (technical approach) and remedial massage (the physician approach):
Relaxation Massage Remedial Massage
Area General application More to very specific
Depth More superficial More deeper work
Techniques Relaxing massage techniques Numerous and diverse techniques
Lubricants Generally uses oil Less oil, plus creams, lotions and gels
Positions Usually lying down or facing up Multiple positions depending on treatment
Goal Usually stress relief, general health and wellbeing Relief of pain, tightness or a specific condition
Relaxation Factor Relaxation throughout and after the massage, you may even fall asleep Usually not very relaxing during the massage, but all the more relief afterwards; highly unlikely to fall asleep

Treatment Comparison

A relaxation massage treatment may look something like this:
Upon your arrival you will be asked if there are any specific areas you want to get treated or if there is an area you want to have excluded, e.g. abdomen or feet. You will have already specified the duration with your booking, and when it is your turn you will be asked to undress to your underwear and lie face-down on the table. The practitioner may then ask you what pressure you like and then begin the massage sequence. When the sequence is over you will be given time to dress, which concludes the massage.
And here is an example of what a remedial massage treatment may look like:
When you get to the practice for your first treatment you will need to fill out a form with your personal details and your medical history (injuries, operations, medication, allergies, etc). This is followed by an interview with the therapist, where you will talk about your condition/pain/tightness and more in-depth medical history. The therapist will then review any other documentation you may have with you (e.g. x-rays, letters from other health practitioners) and if necessary perform a number of physical examinations to understand your condition better. Once this is done the therapist will suggest a treatment. After you have given your consent the therapist will explain to you the position she wants to start with (e.g. side-lying on the table or seated in a chair) and what you will need to undress (e.g. you can leave your pants on if only the shoulder is treated). The therapist will then execute the treatment plan, adjust accordingly if necessary while always getting your consent, and she may get you to take on a different position. When the treatment is finished the practitioner will let you get dressed again, then maybe repeat some parts of the physical examination to detect any changes. Afterwards, the therapist will most likely talk to you about the overall treatment plan and what you can do in-between treatments to get better.
It is also likely that a remedial massage therapist has gained additional modalities and treatment forms, which give her a deeper understanding in those areas. E.g. there are numerous additional courses available for lymphatic drainage or oncology massage that will help tailor the treatments better for these conditions. If you are unsure always talk to your practitioner about her expertise.

Conclusion

Remedial massage is a collective term that covers a number of different massage styles and techniques. What makes it unique is the application of these techniques based on clinical reasoning, with the (long-term) goal of improving a patient’s condition, tightness or pain. Although remedial massage is still massage, it is the intention that sets it apart. A remedial massage treatment resembles more what you would expect from a visit to your local physiotherapist or chiropractor and has not much in common with the relaxation massage at your local spa.