Remediate or rehabilitate: What is remedial massage?

I was recently Googling to ensure my remedial massage website – David Hall Massage Therapy – was still ranking highly and I noticed a question in a “People also ask …” section.

It was: “What is the difference between massage and remedial massage?” I suspect the answer I saw came from a different type of physical therapist who has some massage skills but is not specifically trained and qualified in remedial massage.

The answer was that “While deep tissue massage is a whole-body treatment, remedial massage focuses on parts of that body that require rehabilitation. Remedial massage first starts with a review of the muscles, ligaments, tendons and posture.”

Here’s why that answer is wrong.

Firstly, look at the dictionary meanings of rehabilitation/rehabilitate and remedial/remediate.

Rehabilitate: The action of restoring someone to health or normal life through training and therapy after imprisonment, addiction, or illness/injury.

Remediate: Provide a remedy for; redress or make right.

For example, the main role of physiotherapists is REHABILITATION and recovery after surgery, injury, disease/illness, or other trauma. Most physios tend to only give short sessions and only focus on those areas.

They also usually prescribe a range of home exercises to help restore range of movement in muscles, joints and other soft tissue that have been cut, torn or weakened through surgery, injury and/or illness. Physios normally require regular repeat visits to monitor your progress, sometimes over several months.

The main role of remedial massage therapists is to REMEDIATE common or longer-term problem/pain areas of muscles and joints, including headaches and migraines. This is distinct from treatments immediately after those acute pains caused by surgery, injury or illness.

Remedial massage also helps people prepare for (days in advance) and recover from sporting, fitness or other recreational activities, eg the sore muscles after triathlons, fun runs or Defence fitness assessments.

Some common examples of remedial massage treatment would be for lower back pain, hip pain, neck and shoulder pain, leg and knee pain, sciatica, tennis/golfer’s elbow, headaches, migraines, carpal tunnel, plantar fasciitis, bursitis, tendinitis, vertebral disc pain, muscle or joint strains or sprains, or just generally tight or aching muscles or joints anywhere.

The Google answer is correct in saying remedial massage starts with a review (assessment) of the muscles, ligaments, tendons and posture – as does physiotherapy.

But unlike physiotherapy which mainly just “focuses on parts of that body that requires rehabilitation” (the Google answer), most experienced and competent remedial massage therapists take an holistic/big picture approach that also considers a range of factors elsewhere in the body that may be causing or contributing to the client’s pain areas.

For example, common pain in the lower BACK often stems from tightness or issues with the hip flexors in the FRONT of the hips. Or it could be that tightness in the Pec (chest) muscles where the client has felt no pain is also a significant factor.

So, if any physical therapist doesn’t also address those areas for any type of lower back pain (from any source), you may only get temporary relief at best.

(I explain that a lot more in other articles on my website).

By just focusing treatment on the lower back, the therapist could easily prolong or make the problem worse. The pain you feels is inflammation and by just working in that area, particularly deep into the affected tissue, it could increase the inflammation. (In some cases, eg with physios after surgery, it may be necessary to work deep to prevent build-up of scar tissue.)

It also does not consider all the other muscles and soft tissue that compensate following surgery, injury or illness – or even just with common everyday pain, like a sore lower back or neck and shoulders. Often these areas become sore through the compensatory effects and require thorough remedial massage.

Ignoring those compensatory factors may delay the healing process from the original injury or other problem area to the point where the pain becomes “chronic” if it is still there after three or four months. Chronic pain is a chemical self-generating process and does not rely on the status of the original injury. Chronic pain often then requires medical/pharmaceutical intervention, sometimes with highly addictive opiates.

The Google answer also mentioned deep tissue massage. In my opinion, that is where the therapist works deep into the soft tissue (muscles, etc) to increase blood flow, help release tight fascia and stretch or help tone the tissue.

Remedial massage is deep tissue massage, but deep tissue massage is not necessarily remedial. If a massage therapist, for example, only applies deep tissue on the back of the body and does nothing on the front, it may give some relief but is not likely to remediate a problem. Much common back pain stems from muscles in the front of the body.

Similarly with right v left, up v down and in v out (eg inhaling and exhaling muscles, and inside and outside of leg).

Taking an holistic/big picture approach is why a competent remedial massage therapist can often fix or make a significant difference to someone’s pain areas in just one session, whereas a physiotherapist may require six or more treatments to help restore movement or function after things like surgery, torn muscles, etc.

So, unless your pain is in the specific areas caused by surgery, injury (eg a torn muscle or ligament) or other trauma or illness, seeing a competent remedial massage therapist will provide your most cost and clinically effective REMEDY.

And while on the subject of different types of massage….

Some clients ask for sports massage when what they need is remedial massage.

Sports massage, in its truest context, is about 5-15 minutes of on-site pre- or post-competition massage and stretching, focussing on muscle groups primarily used in those sports.

However, a qualified sports therapist should already be a qualified remedial therapist because they may also need to be aware of and deal with potential injuries or know who best to refer to.

A sports massage therapist is also likely to have studied muscle testing and exercise therapy as a specific subject area; learning many muscle and joint movement tests and assessment techniques and how to prescribe exercises. These are similar to what physios use.

Most remedial massage therapists include at least some muscle stretches as part of the massage and give advice on various exercises.

So why do GPs only ever give formal referrals to physios or other allied health professionals when they should be referring clients with a range of common muscle and joint pain issues to remedial massage therapists?

That is a medico-political issue and, unfortunately for the patient, has nothing to do with prescribing the best or more appropriate care. Suffice it to say in this article that massage therapists are controlled via Government regulation of their courses, training organisations and industry associations (with education, standards, curriculum, ethics, etc). Natural therapies like remedial massage are considered “alternative.”

Doctors and allied health professionals – considered “mainstream” or “contemporary” – are registered with the Australian Health Practitioner’s Regulation Agency (AHPRA). So, their hierarchy, and the industry sector that ultimately pulls their strings and sets the agenda, do not directly control massage therapists.

Some better-informed GPs may suggest their patients get a remedial massage, but it is more off the record and not a formal referral.

Next time you’re in pain and need to REMEDIATE muscle or joint issues or headaches that weren’t a direct immediate result of surgery, injury or illness, think REMEDIAL MASSAGE.

(My observations above are based on 31 years massage experience and knowledge, and comments made to me by thousands of clients who have tried other physical therapists).

David Hall ©

TOWNSVILLE REMEDIAL MASSAGE THERAPIST

Townsville massage therapist based in Mount Louisa and specialising in Remedial Massage for all types of muscle and/or joint aches and pains, headaches and migraines and preparation for and recovery from sporting, exercise and fitness activities including Defence fitness tests. I guarantee the best value for money remedial massage in Townsville. CALL NOW on (07) 4774 6973 or 0438 774 819 to book an appointment.