Mainstream culture teaches us to ignore pain. In the 1980s, actress Jane Fonda popularized this notion in her workout videos, as she urged her viewers to push through the pain with the immortal words “no pain, no gain.” Additionally, there’s evidence to suggest that Americans are conditioned to associate pain as the price to pay for achieving success.1 Massage therapy, on the other hand, trains us to pay attention to pain. When we do, we have the opportunity to reduce, manage, or eliminate pain, and avoid injury and reach our health and wellness goals.

Get to Know Your Pain
Massage, by its very nature, is a gateway to body awareness. When your massage therapist presses on a ligament, muscle, or tendon, receptors are stimulated and you sense where you are being touched. Some areas may relax when pressed. Other areas may feel tender. In essence, when you’re receiving a massage, you can’t help but become body aware—unless you’ve fallen asleep (and it’s not a crime if you do).  

Focus Your Attention
As the massage continues, your therapist will zero in on your pain area. When that happens, your attention will be drawn to the spots that are tender. For instance, if your neck is bothering you, your massage therapist will search for the tender or tight areas in your cervical muscles. In a short period of time, your therapist will find the epicenter of your pain and delineate its borders (e.g., it’s tight underneath the base of your skull, but not a thumb-width below it.) Now, you are completely aware of your pain area and can start to evaluate whether massage is helping to reduce the pain.

Reduce Pain
Once the pain area is identified, your therapist will begin to work on reducing the pain through applying the appropriate pressure. Too much pressure may cause you to tense up, but just the right amount of pressure will evoke the hurts-so-good response. Depending on the issue, it’s not uncommon to feel immediate pain reduction during the massage. Other times, relief may occur right after you get off the table or a day or two after the massage.  

Monitor Pain
Experiencing pain reduction after a massage drives home the idea that paying attention to pain is a good thing. It’s a 180-degree shift from viewing pain as something to ignore or something to work through. If applied to everyday life, this perspective of paying attention to your pain—initiated and reinforced in a massage session—could actually help prevent injury. Frank Chen, MD, of the Sutter Health Palo Alto Medical Foundation, explains: “Pain usually indicates a problem or potential underlying injury. You need to pay attention to the warning signs your body provides.”2 Then, you can take action to avoid the injury (e.g., stop exercising when your knee hurts).

Pay Closer Attention
Not all musculoskeletal pain needs monitoring. Massage therapy can help you figure out which pain areas may need your attention. First, if you’re getting a massage specifically for pain reduction, then the areas associated with your pain issues should be on your self-monitoring radar. In addition, you may want to pay attention to areas of your body that weren’t tender until the therapist applied pressure. These areas may have been irritated before, but not enough that you noticed them. Outside the massage session, pay closer attention to pain that is recurrent, sudden and sharp, or results in a decreased range of motion or loss of strength.

Don’t Pay the Price
It’s time to rethink pain. When Jane Fonda said, “No pain, no gain,” she was specifically referring to the act of fatiguing muscles in order to stimulate maximum muscle growth. But the reality is that working through and ignoring certain types of pain can be costly. An ankle injury while trying to lose weight means no aerobic exercise, which in turn makes reaching that ideal weight more difficult. Massage can help you become aware of your musculoskeletal pain. Once aware, you can take action to reduce or eliminate the pain. In addition, you can apply the self-monitoring lesson from the massage session to everyday life in order to avoid potential injury. Here’s to less pain and more gain with your next massage!

When You’re Too Aware
Being aware of your pain is the first step to reducing or eliminating it. However, being too aware of your pain could cause anxiety. Anxiety is further increased if you catastrophize—think that things are only going to get worse. For example, aggravating an old injury and dwelling on the traumatic memory of being in acute pain for weeks is going to make you more anxious.  
If you find yourself hyperfocusing on your pain, you can learn to pull back by asking yourself these questions:
• How bad is the pain?
• Do I need to stop whatever I’m doing right now?
• Is it old or new pain?
• If old, how did it resolve before?
• If new, can I limit my attention to the times it seems to get worse?
Lastly, pat yourself on the back for a more balanced approach to self-monitoring.

Notes
1. David B. Morris, “Belief and Narrative,” The Scientist 19, Supplement 1 (March 28, 2005).
2. Frank S. Chen, “Prevention of Exercise and Sports-
Related Injury, Part 2,” accessed March 2016,
www.pamf.org/sports/chen/sportsinjury2.html.

Mark Liskey relies on his 23 years of massage experience to write about a wide range of topics. Find out more at www.markliskeymassage.com.