No Pain, No Gain and Its Effects on Our Clients

By Marie-Christine Lochot , LMT
2015-10-7

No Pain, No Gain and Its Effects on Our Clients

By Marie-Christine Lochot , LMT
2015-10-7

The expression "no pain, no gain" got popular in the early 1980's when actress Jane Fonda started to produce workout videos. It expressed the belief that in order to get strong muscles, one must train hard and suffer over and over again. The myth has been refuted many times by doctors, physical therapists and various researchers, but it still persists. It is true that to increase muscle strength, the muscle must see some increase in stress. This should bring some discomfort, often compared to a burning sensation, but not pain. Pain during or following exercise is our body signaling that something is wrong, usually suggests an injury and warns us to stop. In "Good and Bad Pain for Athletes," Drs. Edward G Mc Farland and Andrew Cosgarea of the Department of Orthopaedic Surgery at Johns Hopkins said, "The muscles, tendons, ligaments, cartilage and bones of the body are living structures that react to the stress of exercise very slowly. If they see stress too fast, they cannot respond in time and begin to fail. Failure can be caused by too much stress too fast or by stress accumulated over time. When this occurs, each one of these tissues responds a little differently and begins to produce what we call bad pain."

This "no pain, no gain" motto has permeated different aspects of our lives, but also our massage therapy practices. As massage therapists, we have seen on our tables those athletes, professionals or weekends warriors, who push too hard, are in pain and want us to "fix it" so they can go back to their painful training. I remember seeing a client who was training for the New York Marathon. Her right achilles tendon had a "lump" the size of a marble. The tendon was obviously in some kind of distress. During her intake she did not mention it. I pointed out the lump and asked, "Does that hurt when you run?" Her answer was, "Just the first ten minutes. I push through it and then it feels better." Obviously, her endorphins were masking the pain. She completely ignored my warnings, ran the marathon in pain, could barely walk after it and ended up not being able to exercise for a few months.

There are also clients who ask us to work deeply because if they don't feel pain, they think that nothing is being accomplished or because it is what they are used to. In oncology massage, we often see clients who were going for deep massage before their cancer diagnosis. Despite the fact that they are going through grueling cancer treatments, they still want the deep techniques. It is very hard to tell them that they cannot, that it would be too much for their bodies. They don't believe that a gentle touch could feel good and help them. I had such a client a few months ago. I explained in length what I could do and not do, and why. She reluctantly agreed to it. Once the session was over she looked at me and said, "I feel really good. That gentle touch felt deep after all." And she kept coming back for more.

I believe that in massage therapy like in exercise, pain is not beneficial. Too often, pain is equated with discomfort, but they are far from being the same. Scott Lamp, Clinic Director of Southeastern Sports Massage wrote an article in the Massage Therapy Journal called "Working in the Optimal Therapy Zone." In that article, he said "...The Optimal Therapy Zone (OTZ) is that amount of pressure which, when applied to soft tissue with an appropriate massage therapy technique, provides optimal therapeutic results in the shortest period of time without causing undue discomfort. The OTZ is found where the pressure is enough to cause discomfort but not enough to produce voluntary or involuntary splinting of the area which is being worked..."

It is up to us, the professionals, to educate our clients so they understand the difference between discomfort and pain. That will allow them to be more in tune with their bodies when they receive a massage but also when they exercise. Let's also acknowledge that gentle touch has therapeutic effects and that deep work is not always necessary. In 2010, researchers at Cedars-Sinai Medical center in Los Angeles did a study on massage. Twenty nine healthy adults got a 45-minute session of deep-tissue Swedish massage and twenty four received a session of light massage. "Volunteers who had the light massage experienced greater increases in oxytocin, a hormone associated with contentment, than the Swedish massage group, and bigger decreases in adrenal corticotrophin hormone, which stimulates the adrenal glands to release cortisol."

"Our bodies communicate to us clearly and specifically, if we are willing to listen," said Shakti Gawain. So let's listen and help our clients do the same.