5 Tips for Reducing Burnout in Massage Therapy

Caregiver burnout can result from job stress and can impact both physical and mental health and potentially your massage practice. These tips can help!

Burnout, an issue generally stemming from job-related stress, especially affects massage therapists and people in other health care professions. It is not something to ignore or let pass, as it can be accompanied by serious mental health issues like depression, isolation, and trauma. There’s no need to make drastic changes, but by shifting your focus at times and listening to your emotional and mental state, you can achieve more life balance and reduce the daily burnout you feel.

Aim for More Balance

Work-life balance means different things to different people–some might balance out their business by spending more time with a partner and children, while others might introduce a new hobby or learn a new skill to feel more balanced. One 2003 study, for example, demonstrated positive improvement in caregivers who began making music recreationally.

If you’ve been working nonstop, even a short vacation could create more harmony between your career and your personal life. When a vacation simply isn’t feasible, reconsider the hours you’re putting in at work. Evaluate whether they’re serving you well as a practitioner but also as a human who needs time to rest and recharge. If more and more evenings or weekends have become occupied with work, it might be time to reprioritize.

Boost Your Self-Care

Studies show health care workers are notorious for neglecting self-care. If your practice feels particularly rushed or hectic, you might benefit from allocating more time for your own care and well-being. Treating yourself to a spa day might not always be realistic, but simple activities like staying hydrated, stretching, taking short walks, or journaling, however briefly, can effectively help ease burnout.

Mindfulness activities have particularly positive effects on burnout and are a sustainable way of preventing burnout and incorporating a self-care routine. Meditation, mindful movement, and walking meditation do not require any props or extra preparation. What’s more, they can be done anywhere. If you’re new to meditation, try downloading a free app to facilitate the process.

Try New Things

An immense field, bodywork offers numerous professional opportunities that only require a few continuing education hours or workshops. If your practice starts to feel less fulfilling, consider looking into an adjunct endeavor.

After years of practicing Swedish massage, for example, you might be interested in incorporating a therapeutic rock treatment. Or perhaps circumstances in your personal life are drawing you toward mindfulness-based approaches or energy work, such as Jin Shin Do and reiki. If your office setting allows for it, you might consider purchasing a spa tub and offering some types of hydrotherapy.

Acquiring new skills can breathe new life into your massage therapy practice, attract and help you retain clients, and introduce you to different bodywork modalities. Your new approach might allow you to be more creative and attentive to your own needs, and you can feel good about having taken the time for discovery and self-improvement.

Switch Up Your Marketing Strategy

By marketing differently you can reach new audiences, learn new skills, and boost your practice in a way that fits you better. Advertise your services in a local gym, for instance, and brush up on what you know about sports massage to attract a new type of clientele. Alternatively, connect with your local hospice organization to offer your services. Even if your involvement is strictly voluntary, you might make connections that result in more clients.

You might also consider branching out in marketing through new types of social media. While unlikely to become your go-to strategy, image-based platforms like Instagram and Pinterest create a unique branding opportunity. Invest a bit of time into researching these avenues, following bodywork and health accounts, and posting some images of your office space, for starters.

Seek Your Own Therapy

Massage therapists are always advised to receive massage regularly, both to experience others’ techniques and for the same benefits their clients receive: lowered stress and anxiety, reduced muscle tension and fatigue, and increased serotonin and dopamine levels (to help counteract depression). Of all people, massage therapists know the many ways bodywork can improve multiple aspects of life, and they are uniquely positioned to receive various types of bodywork because of professional connections.

If you’re experiencing burnout in your business, emotional state, physical well-being, or mental health, you can begin addressing these areas by receiving massage treatment. In many cases, caregiver burnout or compassion fatigue should also be regarded as a serious issue worth addressing with a mental health professional.

Avoid the temptation to immediately dismiss burnout as a phase you will naturally work through. Though this may be the case, feelings associated with burnout may also be deeply seated in grief, trauma, or depression. Either way, consulting with a psychotherapist can help you identify the roots of those emotions and a path for moving forward.

Health care providers are particularly susceptible to caregiver burnout because of the extraordinary amount of time and attention they put into meeting others’ needs and a tendency to neglect their own. But burnout is not a death sentence for your career or livelihood. Once you pay attention to the exhaustion you are feeling, you can address it and begin moving past it.

Massage Therapy to Alleviate Symptoms of Juvenile Arthritis

Juvenile arthritis, of which there are many subtypes, can cause pain and discomfort and impact quality of life. Learn how bodywork treatments can help.

Juvenile arthritis refers to the range of autoimmune or inflammatory conditions affecting children and adolescents under the age of 16. Currently, nearly 300,000 children in the United States experience some disease under the umbrella of juvenile arthritis, including juvenile lupus, Kawasaki disease, fibromyalgia, idiopathic arthritis, and others. As more information about these issues surfaces, evidence continues to support use of alternative therapies, such as massage, to address symptoms and improve quality of life for people affected.

Symptoms and Effects of Juvenile Arthritis

Depending on the diagnosis, different forms of juvenile arthritis (JA) might affect the joints, muscles, organs, connective tissue, and skin. JA can be very difficult to diagnose—there is no single exam or blood test that can reveal which type a person has. A doctor will likely recommend a specific test depending on a child’s symptoms.

Each of the various rheumatic conditions associated with JA will exhibit in different ways. Juvenile idiopathic arthritis (JIA), the most common form, is called idiopathic because it has no known cause or predictable onset. Symptoms resemble those of arthritis often affecting older individuals: joint inflammation, changes in bone structure, and discomfort or pain.

JIA may be accompanied by eye inflammation (oligoarticular JIA), psoriasis on the skin surrounding the joints (juvenile psoriatic arthritis), fever and rash (systemic JIA), or other issues that indicate different forms of JA. Like JIA, Kawasaki disease involves inflammation of the joints but is also characterized by inflammation of the blood vessels and may lead to heart conditions. Lupus, though not common in children and adolescents, can affect skin, lungs, blood vessels, joints, brain, and kidneys, potentially wreaking havoc on nearly every organ system in the body.

No matter the way arthritis manifests, or the symptoms experienced, it can significantly impact a child’s adolescent years and the later life, as well as the lives of the child’s family and loved ones. Affected children may be more likely to miss school and decrease participation in sports or physical activities, which can compound problems since inactivity has been shown to worsen arthritis symptoms. They may also experience psychological and social issues such as depression, low self-esteem, or negatively impacted peer relationships.

Treatment Options for Children with Juvenile Arthritis

There is no known cure for JA, but remission is possible with early detection and proactive treatment methods. Researchers recommend as much exercise as the child’s ability allows, regular stretching, proper nutrition, physical therapy, and occupational therapies. In extreme cases, splints, orthotics, and surgery can help correct growth differences caused by JA.

Complementary therapies, including massage and other types of bodywork, have been proven effective for children and adolescents. In fact, arthritic people of any age can benefit from bodywork, as long as symptoms are not acute and do not present complications that preclude touch therapy.

Massage and Bodywork Therapies for JA

Children who received massage for just 15 minutes per day showed improvements in decreased pain related to arthritis. They also experienced lower stress and anxiety as a result of massage. In this study, parents administered the massage, so the therapy was cost-effective and efficient for families. A professional massage may be more thorough and comprehensive.

A bodywork practitioner may choose almost any modality to address JA, though most therapies are not indicated for direct local application. In other words, the therapist is not likely to massage the knuckles if a child has arthritis affecting the hands but will use a modality that supports the lymphatic and immune systems for greater overall comfort and joint decompression.

Various types of hydrotherapy, including both heat and cold therapy, can help alleviate pain and discomfort caused by arthritis. Hot compresses and ice packs can be applied directly to arthritic areas of the body, or individual body parts may be submerged in a contrast bath (alternately in hot and cold water) to relieve pain and reduce inflammation.

Contraindications of Massage for JA

Massage or bodywork focusing on the specific area afflicted by arthritis can potentially increase pain or exacerbate symptoms during flare-ups and is not recommended. Individuals who have types of JA that affect the skin or cause irritation and inflammation should consider consulting their doctor before proceeding with bodywork treatments.

Beyond easing the pain and direct symptoms of JA, touch therapy and other forms of bodywork also offer benefit by increasing levels of serotonin and dopamine–the chemicals that improve mood. Youth receiving massage for JA may experience greater happiness and quality of life as a result, and peer relationships and co-occurring mental health issues may improve.


  1. Beck, M. F. (2011). Theory & practice of therapeutic massage (5th ed.), 119. Clifton Park, NY: Milady.
  2. Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., & Kuhn, C. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal of Neuroscience, 115(10), 1397-1413. Retrieved from http://www.tandfonline.com/doi/abs/10.1080/00207450590956459
  3. Field, T., Hernandez-Reif, M., Seligmen, S., Krasnegor, J., Sunshine, W., Rivas-Chacon, R., … & Kuhn, C. (1997). Juvenile rheumatoid arthritis: benefits from massage therapy. Journal of pediatric Psychology, 22(5), 607-617. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/9383925?dopt=Abstract
  4. Moore, F. B. (1964). Manual of hydrotherapy and massage, 48, 50, 53. Boise, ID: Pacific Press Publishing Association.
  5. Juvenile idiopathic arthritis treatment. (2017). Arthritis Foundation. Retrieved from http://www.arthritis.org/about-arthritis/types/juvenile-idiopathic-arthritis-jia/treatment.php
  6. Schanberg, L. E., Anthony, K. K., Gil, K. M., & Maurin, E. C. (2003). Daily pain and symptoms in children with polyarticular arthritis. Arthritis & Rheumatology, 48(5), 1390-1397. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/art.10986/full
  7. What is juvenile arthritis? (2017). Arthritis Foundation. Retrieved from http://www.arthritis.org/about-arthritis/types/juvenile-arthritis
  8. Werner, R. (2009). A massage therapist’s guide to pathology (4th ed.), 145-147. Philadelphia, PA: Lippincott Williams & Wilkins.

Ways to Celebrate EveryBody Deserves a Massage Week

At Massagetique, we believe in the importance of sharing the benefits of massage with the community. EveryBody Deserves a Massage week encourages massage therapists and bodyworkers across the country to come together and do just that. This recognition week was founded by Associated Bodywork & Massage Professionals (ABMP) in 1995 to help promote the importance of massage and bodywork within local communities.

Join the Massagetique team and others in recognizing EveryBody Deserves a Massage Week from July 16-22. We encourage you to share the benefits of massage with those around you during this week and take steps to make massage more accessible to everyone in your community.

You might do this by:

  • Teaching a class on massage
  • Giving a lecture about different types of massage
  • Hosting an event to demonstrate massage techniques that can be practiced at home as self-care
  • Volunteering your services or offering discounts
  • Creating a contest
  • Creating and sharing informational flyers. 

The Massagetique team has created images you can share on social media and elsewhere to help promote EveryBody Deserves a Massage Week. Feel free to save, download, and/or print the images below and use them in your marketing materials (click on an image to download the file).

Additionally, here are educational articles about massage you can share on your blog, social media platforms, or other outlets throughout the week:

Throughout the week, Massagetique will share massage resources on our website and social media platforms and highlight ways massage can promote wellness and help treat health conditions. Let us know how you intend to celebrate EveryBody Deserves a Massage Week in the comments below. Share with us on Facebook, Twitter, or Instagram using the hashtag #EveryBodyDeservesMassage.

Inside Out: What Emotional Trauma Does to the Body

The body can be impacted greatly by emotional trauma, and vice versa. Learn how the effects of PTSD can be counteracted for mind-body wellness.

A good bodywork practitioner knows that health issues and pain are not just physical and mental health issues are not just psychological. For optimal health, the body and brain work in tandem to function properly and keep each other running smoothly. When we come into contact with something that endangers either side of that process, all systems are affected and must be treated to re-establish total body and mind wellness. For effective treatment, it helps to understand what happens in both body and mind when a traumatic incident occurs.

Enduring the Fight-or-Flight Response

When we’re met with a stressor–anything we perceive as a threat–our brains must choose to fight or flight? Sometimes we make this decision and move on so instantaneously we’re hardly able to register something was a threat. Other times this conundrum, known as the alarm phase, is so sustained the body has to make adjustments to accommodate it.

In this survival mode, the brain signals the body to use all energy and resources to resist the threat. Heart rate increases, cells use more energy, and there are changes in circulation. If this process lasts longer than a few hours and the threat is still present, the body can begin to shut down all reserves in order to protect itself.

The alarm phase of stress response teaches the brain to recognize and overcome similar threats in the future. But during a particularly stressful event—one categorized as trauma in the brain that could lead to posttraumatic stress—the brain might get stuck, logging its extreme trauma response as a default rather than one to file away. Next time it is presented with a threat, even if the threat is relatively harmless, the brain might use the same response. This is one possible indication of posttraumatic stress (PTSD).

Survival mode is not meant to be the body’s standard response, however. Such a reaction takes a toll on the nervous system and can lead to subsequent health issues. There is also evidence the brain may be damaged during these periods of intense stress response.

When Stress Becomes Trauma

In extreme circumstances, when a stressor lingers, is physically harmful, or causes an intense emotional reaction, the brain and body are likely to register it as trauma. After such an incident, one may experience posttraumatic stress, which can manifest in many ways:

  • Sleeplessness or insomnia
  • Depression
  • Mood issues, irritability, or anger problems
  • Flashbacks or nightmares
  • Anxiety

Though these effects are considered largely psychological, each can have physical consequences. This means that while you may have addressed an issue like whiplash after a car accident by seeing a chiropractor and massage therapist, ensuing depression may disturb digestion and contribute to health problems.

The Physical Toll of Untreated Trauma

Some mental health aspects of PTSD affect the body in more abstract ways, while others have a more direct correlation with physical health. For example, when PTSD leads to altered eating habits, including binge eating or skipping meals, physical ailments can range from fatigue and malnutrition to cardiac issues.

Depression, which can occur on its own or as an aspect of posttraumatic stress, may manifest in feelings of loneliness or a tendency toward isolation. An individual with depression may find it difficult or impossible to leave the house or interact with strangers. As a result, they might not be motivated to seek health care, potentially prolonging illness.

Compromised mental health has been linked to general aches and malaise, acute pain, inflammatory issues, and more. When psychological issues are present, the immune system is more likely to fail, increasing the possibility of illness. If the source of trauma caused substantial physical injury, the body may be slow to heal or prone to infection if PTSD symptoms are complicating the recovery process.

Approaching the Treatment of PTSD

The far-reaching effects of mental health issues related to PTSD have helped psychotherapists and bodywork professionals alike understand more about the ways one can heal after trauma. More comprehensive treatment methods are being developed to help manage all aspects of PTSD.

The days of thinking about stress, anxiety, trauma, depression, and other mental health issues only as psychiatric diagnoses have passed. After all, we know the brain controls everything about how we function–whether it’s picking up a fork, catching a ball, or fleeing from a potential threat. When something happens to disrupt this healthy brain activity, the psychological damage has the potential to adversely affect not only thoughts and mental state, but also physical health.

The more we learn about the physical nature of PTSD and trauma symptoms, the sooner we can continue to promote whole-body, person-centered healing techniques that address issues beyond the psychological.

The more we learn about the physical nature of PTSD and trauma symptoms, the sooner we can continue to promote whole-body, person-centered healing techniques that address issues beyond the psychological. Massage therapy has been shown to decrease stress and release feel-good chemicals like serotonin and cortisol, counteracting the adverse effects of almost any mental health issue. Massage and bodywork are not meant to replace psychotherapy, but they can be effective complementary therapies. If you are experiencing PTSD or related mental health issues, consider seeking bodywork in addition to ongoing psychotherapeutic care.


  1. Bremner, J. D. (2002). Does stress damage the brain?: Understanding trauma-related disorders from a mind-body perspective. New York, NY: WW Norton & Company.
  2. Dryden, T., & Fitch, P. (2007). Recovering body and soul from post-traumatic stress disorder. Massage Therapy Journal, 133-19. Retrieved from https://www.amtamassage.org/articles/3/MTJ/detail/1817
  3. Fehrs, L. (2013, August 1). Muscle memory, trauma and massage therapy. Institute for Integrative Health Care. Retrieved from http://www.integrativehealthcare.org/mt/archives/2013/08/muscle-memory-trauma-and-massage-therapy.html
  4. Gatchel, R. J. (2004). Comorbidity of chronic pain and mental health disorders: the biopsychosocial perspective. American Psychologist, 59(8), 795. Retrieved from http://psycnet.apa.org/journals/amp/59/8/795/
  5. Meeks, J. A. and Byrami, S. (2016). A systematic review of complimentary therapies to treat symptoms of post-traumatic stress: Disorder in the aftermath of domestic abuse. Senior Honors Projects. 243. Retrieved from http://commons.lib.jmu.edu/honors201019/243
  6. Premkumar, K. (2012). Anatomy and physiology: The massage connection (3rd ed.), 328, 351-353. Philadelphia, PA: Lippincott Williams & Wilkins.

Massage and Bodywork for the Alzheimer’s Patient

Massage and bodywork can have a positive impact on many individuals who have been diagnosed with Alzheimer’s and may also serve as self-care for caregivers.

Chances are you know someone who has Alzheimer’s or another form of dementia. You may have even served as a caregiver in some capacity for a loved one with dementia. Currently, about 5.1 million Americans live with an Alzheimer’s diagnosis. But with as many as four family caregivers looking after each person with the disease, it impacts more than just those who have been diagnosed.

The longer Alzheimer’s progresses, the more likely it is to affect one’s overall health and relationships with others. And while bodywork, like any other treatment currently available, is unlikely to reverse the course of Alzheimer’s or help a patient regain memory, it has the potential to significantly improve quality of life for anyone living with the disease.

How Does Alzheimer’s Affect the Body?

Alzheimer’s disease, or AD, is characterized by plaques and tangles of proteins on brain cells. These plaques cause cells to die and parts of the brain to atrophy. Cells become unable to communicate with each other, and this results in a loss of brain function. A person with AD is unable to process new information and access memories because the part of the brain associated with each of these tasks, the hippocampus, shrinks.

Initially, effects of AD may seem relatively innocent: minor lapses in short-term memory, brief periods of disorientation, and difficulty retaining new information. During these early stages, people with Alzheimer’s may be alert and emotionally positive. Later AD symptoms can be more severe and may include deeper confusion about events, changes in character and mood, more serious memory loss, and distrust of one’s family and caregiving team.

But while the most prevalent issues associated with Alzheimer’s are related to memory and brain function, cognitive degeneration can also have profound physical effects, including compromised ability to speak, swallow, and walk. People with AD who get disoriented or lost may be more likely to fall, and it is not uncommon for patients to have difficulty performing daily tasks such as bathing, dressing, and eating.

How Can Bodywork Treatments Help Alzheimer’s Patients?

Most bodywork modalities are supportive for AD, depending on the client’s comfort level. Massage has been shown to improve overall quality of life, lessen agitation, contribute to better sense of orientation, and lead to more positive social interaction for those with AD.

Certain modalities have been shown to specifically target various symptoms of Alzheimer’s:

  • Therapeutic touch reduces agitated behavior such as pacing, wandering, and vocalization.
  • Similar to therapeutic touch, slow-stroke massage can reduce physical signs of agitation and ease AD patients who are resistant to care.
  • Reiki treatments can help reduce anxiety and depression in those with AD and dementia while also promoting relaxation and improving overall well-being.
  • Craniosacral therapy can reduce inflammation in the brain, which may help people with chronic migraines and poor sleep. In a TEDx Talk in 2016, Michael Morgan, LMT, CST-D asserts that a combination of craniosacral therapy, exercise, and modified diet may help AD patients regain memories and even reverse the effects of Alzheimer’s. More research is needed to verify these benefits, however.
  • Multisensory treatment approaches like music and art therapies are not direct types of bodywork, but they can improve overall cognitive state and reduce anxiety and depression related to AD.
  • Other alternative therapies, such as light and dance therapies, can help AD patients able to participate by easing stress, anxiety, irritability, and emotional issues related to the disease.

In a more abstract way, massage and bodywork place an emphasis on person-centered treatment, which addresses all needs and contributes to more comprehensive care. When a person receives more than the standard attention to a specific issue, and when they are seen as a person instead of simply as a patient, greater healing can take place, and overall well-being is likely to improve.

It is worth noting that caregivers for those with AD—especially those who are family members or friends—can experience extreme stress and depression related to the time and emotional investment that goes into patient care. Anyone serving in this role may also benefit from receiving massage or another type of bodywork as self-care to relieve stress and symptoms of depression.

Contraindications for Massage as Treatment for Alzheimer’s

Some people with advanced AD may become agitated, hostile, or irritable, which can impact the extent to which they find massage treatments enjoyable or helpful. Other clients may not be able to communicate clearly because of verbal impairments associated with AD, which can impede the therapist’s ability to fully address their needs. Additionally, because many AD patients are elderly, they may have co-occurring health conditions that preclude massage as an effective treatment for any aspect of AD. As always, it is best to consult with a primary care provider before seeking any type of bodywork as support for someone with Alzheimer’s.

As the population of the United States ages, more and more people are predicted to start experiencing Alzheimer’s symptoms, which tend to start around age 65 and progress rapidly. Research continues to emerge regarding cures, preventative measures, and ways to improve quality of life for those with Alzheimer’s-related memory impairment. While many treatments and solutions are being explored, the massage and bodywork fields continue to offer promising results.


  1. About Alzheimer’s disease: Statistics. (2016, January 28). Alzheimer’s Foundation of America. Retrieved from https://www.alzfdn.org/AboutAlzheimers/statistics.html
  2. Allison, N. (1999). The illustrated encyclopedia of body-mind disciplines, 106, 356. New York City, NY: Rosen Publishing Group.
  3. Hawranik, P., Johnston, P., & Deatrich, J. (2008). Therapeutic touch and agitation in individuals with Alzheimer’s disease. Western journal of nursing research, 30(4), 417-434. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/0193945907305126
  4. Kontos, P. C. (2005). Embodied selfhood in Alzheimer’s disease: Rethinking person-centred care. Dementia, 4(4), 553-570. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/1471301205058311
  5. Miesler, D. (2003). Massage and the Alzheimer’s patient. Massage Bodywork Magazine, December/January 2000. Retrieved from http://www.massagetherapy.com/articles/index.php/article_id/275/Massage-and-the-Alzheimer%92s-Patient
  6. Morgan, M. (2016). 2 deaths, 1 disease. TEDx Talk. Retrieved from https://www.youtube.com/watch?v=5YSh4oR8xc0
  7. Ozdemir, L., & Akdemir, N. (2009). Effects of multisensory stimulation on cognition, depression and anxiety levels of mildly-affected Alzheimer’s patients. Journal of the neurological sciences, 283(1), 211-213. Retrieved from http://www.sciencedirect.com/science/article/pii/S0022510X09004390
  8. Rowe, M., & Alfred, D. (1999). The effectiveness of slow-stroke massage. Journal of Gerontological Nursing, 25(6), 22-34. Retrieved from http://www.healio.com/nursing/journals/jgn/1999-6-25-6/%7B80dc9bd2-e52d-4c1f-aadb-c37e2eaf6376%7D/the-effectiveness-of-slow-stroke-massage
  9. Salach, M. D. (2006). The effects of reiki, a complementary alternative medicine, on depression and anxiety in the Alzheimer’s and dementia population (doctoral dissertation, San Francisco State University). Retrieved from http://bodynsoulsynergy.com.au/PDF/ReikiPDF07.pdf
  10. Werner, R. (2009). A massage therapist’s guide to pathology (4th ed.), 223-226. Philadelphia, PA: Lippincott Williams & Wilkins.
  11. What is Alzheimer’s? (2017). Alzheimer’s Association. Retrieved from http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp#symptoms
  12. Woods, D. L., & Dimond, M. (2002). The effect of therapeutic touch on agitated behavior and cortisol in persons with Alzheimer’s disease. Biological research for nursing, 4(2), 104-114. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/1099800402238331

Using Bodywork to Manage and Treat Posttraumatic Stress

Massage can help treat mental health concerns as well as physical issues. Those experiencing PTSD, for example, may benefit greatly from massage therapy.

Any traumatic incident has the potential to cause both mental and physical harm. The extent of damage often depends on the incident. After a fall, for instance, someone may have a fairly quick psychological recovery but experience lower back pain for decades. A car accident may also have lasting effects, from flashbacks to recurring migraines that last years after the accident. Other trauma, such as childhood bullying, may not have direct physical implications but lead to long-lasting posttraumatic stress (PTSD). Even in cases such as these, the experience alone, and the later impact of PTSD, can often result in co-occurring physical health issues and pain.

Many types of bodywork work not only to treat the physical symptoms resulting from PTSD, but also to address the underlying psychological issues present as a result of a traumatic event. Massage alone has been proven to decrease cortisol levels, which are especially associated with high stress, depression, immune conditions, and the aftereffects of abuse. Receiving massage can also increase serotonin and dopamine—the “feel-good” chemicals often inhibited by mental health issues such as depression and PTSD.

If you have been diagnosed with PTSD or you have experienced trauma, you may benefit from incorporating bodywork into your healing process, after consulting with a psychotherapist and your primary care provider. In addition to massage therapy, any of the following bodywork modalities may be helpful as you work to overcome trauma and PTSD:

Craniosacral Therapy for PTSD

A therapist trained in craniosacral therapy might use this method to ease physical stress from trauma when tension continues to be held in the neck and head muscles. Craniosacral therapy is a gentle method that focuses on the skull and neck to disperse the buildup of cerebrospinal fluid. This treatment can be especially beneficial for the relief of headaches or migraines, but it can target pain anywhere in the body. By alleviating pressure on the spinal cord, craniosacral therapy can also improve brain function, lower stress, and may even help decrease emotional difficulties.

Aromatherapy after Trauma

Scents can trigger intense emotional reactions—both positive and negative—and for many people, they also have the power to instantly alter mood and attitude. Aromatherapy, used either in conjunction with touch massage or on its own, may reduce anxiety and many other symptoms of PTSD. A 2016 review of studies performed on the use of complementary therapies to treat posttraumatic stress found that lavender and chamomile essential oils, in particular, promote calmness and relaxation. One study revealed lavender could decrease side effects of PTSD such as sleep problems, depression, anxiety, agitation, and somatic ailments. These plants may be used in tea or in essential oil form, either in a topical solution with a carrier of coconut oil or in a diffuser.

Unlocking the Unconscious with the Rosen Method

“The mind is very literal, while the body speaks the emotional truth,” writes Marion Rosen in her book Rosen Method Bodywork. “Through our bodies we can become aware of, and undo, a learning process that is detrimental to our health and well-being.” Focusing on both breath and movement in addition to healing touch, the Rosen Method recognizes the body-mind connection and is often used in conjunction with psychotherapy. A combination of psychodynamic short-term therapy and Rosen Method Bodywork can be extremely effective for improving overall quality of life, relationships with partners, and general health and well-being in individuals who have experienced mental health issues and chronic pain, according to a 2007 study.

Jin Shin Do Mind-Body Techniques and Trauma

Jin Shin Do therapy unites Chinese medicine and Western psychology by bringing together concepts of energy pathways in the body and emotion-related tension. The more tension we hold—whether it results from daily stress, pain, trauma, depression, or any number of other factors—the more the body’s internal energy flow is suppressed. We may harbor muscular tension related to an emotional experience, even months or years after the event. The Jin Shin Do modality can help by facilitating increased relaxation, body awareness and a “letting go” of built-up psychological and physical “armor” from the past. Treatment involves activating pressure points on the body while using simple verbal cues or very basic talk therapy to stimulate a healing mind-body response.

EMDR as Bodywork

While not strictly classified as a bodywork modality, eye movement desensitization and reprocessing (EMDR) applies a somatic or physiological approach to healing through traditional psychotherapy. EMDR works to detach emotional responses and triggers from traumatic memories by using rapid eye movement. The client follows the practitioner’s fingers or moving dots on a light bar while thinking about a painful memory attached to their current distress or PTSD. After repeating this process several times, the memory is likely to carry less emotion and often begins to be seen as fact rather than trauma. EMDR is still being researched, and while this approach may not work for everyone, those interested in approaching trauma from a physiological approach may find EMDR treatment helpful. A trained and licensed psychotherapist must administer EMDR. Additionally, EMDR is not a contact therapy and should not incorporate massage or other touch.

The above modalities are not recommended for acute physical pain or severe emotional distress. Most are recommended for use as complementary approaches, in combination with traditional healing massage, psychotherapy, or both. Some people who have experienced extreme physical trauma, such as military combat, sexual assault, or domestic violence, may find it difficult at first to receive touch as a form of therapy. Before considering massage or other bodywork for the treatment of PTSD, it is a good idea to to consult with your doctor and psychotherapist.


  1. Allison, N. (1999). The illustrated encyclopedia of body-mind disciplines, 94-95, 169, 188-190. New York City, NY: Rosen Publishing Group.
  2. Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., & Kuhn, C. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal of Neuroscience, 115(10), 1397-1413. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16162447
  3. Meeks, J. A. and Byrami, S. (2016). A systematic review of complimentary therapies to treat symptoms of post-traumatic stress: Disorder in the aftermath of domestic abuse. Senior Honors Projects. 243. Retrieved from http://commons.lib.jmu.edu/honors201019/243
  4. Rosen, M. (2003). Rosen method bodywork: Accessing the unconscious through touch, 27. Berkeley, CA: North Atlantic Books.
  5. Ventegodt, S., Thegler, S., Andreasen, T., Struve, F., Enevoldsen, L., Bassaine, L., & Merrick, J. (2007). Clinical holistic medicine (mindful, short-term psychodynamic psychotherapy complemented with bodywork) in the treatment of experienced physical illness and chronic pain. The Scientific World Journal, 7, 310-316. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17334622

Protocols of Palpation: Basic Methodology to Guide Your Practice

Palpation techniques, which allow massage practitioners to perform a baseline assessment of a client’s body, make up the cornerstone of any massage therapy practice. Though specific palpation techniques may differ depending on the therapist and on the client’s areas of concern, all typically rely on the extreme sensitivity of a therapist’s hands to analyze tissue and begin development of a personalized treatment plan.

Therapists usually begin treatment with palpation in order to identify soreness and tightness of muscles, skeletal alignment, spasms, trigger points on the body, fibrosis, and more.

After beginning a bodywork session with palpation, a therapist may repeat it throughout the session to ensure the therapeutic approach is always in line with the concerns presented during the initial evaluation. Throughout the course of treatment, the therapist will likely continue palpation to monitor changes occurring in the tissue as a result of the manipulation during massage sessions.

Almost any bodily structure can be palpated—skin, tissues just below the surface of the skin, lymph nodes, tendons, joints, bone, deep tissue, ligaments, and more. Through palpation a therapist is likely to be able to identify almost any abnormality or malady that may be present.

What Is the PALPATE Approach?

In order to use palpation techniques effectively a therapist must have developed a thorough knowledge of anatomy and physiology and must also be attentive, both objectively and subjectively, to the qualities of a body. Again, actual palpation methods will likely differ somewhat between therapists, but some standard procedures have evolved. In 2013, a research team detailed a seven-step approach to palpation that uses the acronym PALPATE:

  • Position: Make sure the client is comfortably positioned.
  • Anatomy: Visualize a 3-D anatomic model.
  • Level: Determine the appropriate depth of tissue contact.
  • Purpose: Set a clear intention for initiating the healing process.
  • Ascertain: Keep a relative point of reference while initiating motion.
  • Tweaking: Continue perpetual exploration of the tissue while fine-tuning the previous steps.
  • Evaluate: Adjust techniques according to findings from palpation.

This method can help practitioners prepare for and demonstrate the most basic and universal way to initiate palpation with a client. It does not address specific techniques a therapist may use or aid in the specific analysis of tissue.

When it comes to developing a comprehensive screening for pathology in the body, tissue abnormalities, and conditions of the body’s structure, some therapists agree the process calls for some intuition. Dr. Leon Chaitow, an osteopath and naturopath who teaches around the world, warns, however, that the label of “intuition” would be mistaken.

Skilled therapists will be able to recognize both normality and deviations from it, according to Chaitow, and they may need to act whether or not they are able to fully articulate an abstract understanding of something that does not “feel right.” Rather than calling this intuition, Chaitow says skilled people demonstrate know-how as they become able to perform more complex forms of bodywork, even those they may not necessarily be able to describe.

STAR Palpation for Assessing Bodily Abnormalities

Four principles are used to help massage therapists evaluate somatic dysfunction. Chaitow refers to these as STAR palpation, and others have called it the TART method (substituting “tenderness” for “sensitivity”). Regardless of the acronym, the general principles remain the same:

  • Sensitivity: Soft tissue dysfunction will almost always present in tenderness or pain.
  • Tissue texture change: The therapist might feel that tissues are hot, cold, tense, swollen, or fibrous.
  • Asymmetry: The tissue may vary between sides of the body. Asymmetry on its own may not necessarily be cause for concern, but a massage therapist will use their best judgment in each situation to determine whether it is normal or abnormal.
  • Range of motion: Movement is restricted and/or muscles are very tight, inhibiting normal motion.

When these indicators occur alone, they might point to a type of pathology, discomfort, or dysfunction in the body, but a combination of two or three factors are usually enough to confirm a problem. After an initial assessment, the therapist can use this information to determine more about why a problem exists and develop a treatment plan.

The most important element in diagnosing a potential issue and beginning to treat it, however, is communication with the client. A therapist cannot begin to provide adequate treatment without understanding a client’s level of pain or discomfort during palpation, history of injury or illness, and any habits possibly affecting areas of the body that are presenting problems.

Though palpation methods may be taught, the true skill and art of palpation is learned through experience. Over time, a good bodywork practitioner will generally be able to detect subtleties in texture, density, moisture, and temperature variations in target tissue. Chaitow says experts “have the ability to observe, recognize, interpret, judge, decide, and act appropriately in a split second – not based on planned decision-making, but more on a foundation of sound knowledge and practiced skills.”


  1. Aubin, A., Gagnon, K., & Morin, C. (2013, February 18). The seven-step palpation method: A proposal to improve palpation skills. International Journal of Osteopathic Medicine, 17, 66-72. Retrieved from http://www.journalofosteopathicmedicine.com/article/S1746-0689(13)00048-5/pdf
  2. Beck, M. F. (2011). Theory & practice of therapeutic massage (5th ed.), 646-652. Clifton Park, NY: Milady.
  3. Chaitow, L. & Fritz, S. (2006). A massage therapist’s guide to understanding, locating and treating myofascial trigger points, 70. London: Churchill Livingstone.
  4. Chaitow, L. (2013). Muscle energy techniques (4th ed.), 305. London: Churchill Livingstone.
  5. Chaitow, L. (2017). Palpation skills in clinical practice? Massage Today, 1(17): 13. Retrieved from http://www.massagetoday.com/digital/index.php?i=644&r=t#13

Can Massage Therapy Be Used to Treat Lupus?

Massage therapy should never be used as a primary lupus treatment, but it can help relieve symptoms, when a doctor approves its use, in many people with lupus.

Lupus, a chronic condition, can be extremely painful and unpredictable and have a significant impact on a person’s quality of life. However, it is possible to live well with the condition while taking steps to prevent flare-ups. National Lupus Awareness Month, recognized in May, is a time to educate people about lupus and empower those living with it.

The role of a healthy immune system is to fight off foreign bacteria and viruses in order to protect us from threatening germs and diseases. But if the immune system misfires, it can create an attack on itself. This often results in extreme inflammation and possible organ damage. This condition is called lupus erythematosus, or just lupus.

There is currently no known cure for lupus. However, many medications and lifestyle changes can ease symptoms and improve quality of life for those living with the disease. Depending on the severity of symptoms and consequences of a flare-up, treatment may range from over-the-counter anti-inflammatory medications to surgery, if internal organs are affected.

Using Massage to Treat Clients with Lupus

On the surface, massage therapy may seem like an appropriate treatment for lupus because it routinely relieves pain, promotes relaxation, and improves mobility. But acute lupus symptoms can cause lesions or so much pain that a person experiencing them cannot bear touch. Lupus first affects the body’s tissue and causes blood vessel inflammation. Pain can present anywhere from the top layers of the skin to deep in the joints. For some, the thought of massage for someone in pain as a result of lupus can seem daunting, or downright repelling.

Massage should never be used as a complete treatment for lupus or a replacement for other medical care. Additionally, some massage techniques can promote fluid circulation within the body that may actually exacerbate some issues related to lupus attacks. Deep tissue massage, for example, is almost never indicated with someone who has lupus, especially during or immediately following the flare-up. It is essential to receive approval from one’s medical team before pursuing massage as part of a lupus treatment plan.

Benefits of Massage for Lupus

Since massage cannot serve as immediate or acute care for someone with lupus, its effects–though no less beneficial–are largely secondary. Bodywork is best used to address co-occurring mental health problems or health issues that do not directly result from a lupus attack.

For instance, an individual with lupus may experience depression or stress related to their diagnosis or as a side effect of some medications. Depression can lead to poor sleep, fatigue, and even generalized aches and pain. Massage has been proven to not only treat the effects of depression, including fatigue and soreness, but also increase serotonin levels. Receiving bodywork regularly may mean a person with lupus can experience relief from depressive symptoms while also addressing the root chemical imbalance linked to depression.

Another common outcome of lupus is frequent headaches. People with lupus may get headaches more frequently, and headaches may coincide with full lupus flare-ups. Many studies have shown massage therapy, particularly the Trager approach and craniosacral therapy, can reduce the number and intensity of chronic tension headaches experienced by some individuals.

Tips for Using Massage in a Lupus Treatment Plan

The risks of massage therapy for people with lupus are far lower during remission. It is generally safe to receive bodywork at this time, after receiving approval from a primary care provider.

To ensure wellness and use massage to its full advantage in your health plan, consider the following:

  • Learn as much as possible from your health care team. The more you know about your health history and current condition, the more you can tell your massage practitioner.
  • Communicate, communicate, communicate. Let your physician know when you begin massage treatments, and convey as much information as possible to your massage therapist about your experience with lupus. This includes current symptoms, past surgeries (if applicable), current medications, and any other illnesses you may have.
  • Don’t be shy about stating your needs. A massage therapist can only accommodate you if you are transparent about your comfort level. Perhaps you would prefer to receive massage while clothed or seated in a chair, for instance. A good bodywork professional will accommodate you and help you feel at ease.
  • Set a goal or intention for your sessions, and share this goal with your massage therapist. Improving mobility, decreasing stress, and getting more sleep are all examples of worthy goals that can be addressed in massage treatments.
  • Continue to talk to your massage therapist about your expectations. Check in after and between sessions about how the therapy is working and whether it can be adjusted to better suit your needs.

There are many types of bodywork that, when used carefully, can serve individuals who have lupus. If you’re considering massage treatment for yourself or a loved one who has lupus, always consult with a physician before scheduling an appointment. With this approval, massage practitioners may use bodywork at the client’s comfort level, so long as it remains safe to do so and no direct risks are present.


  1. Beck, M. F. (2011). Theory & practice of therapeutic massage (5th ed.), 144. Clifton Park, NY: Milady.
  2. Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., & Kuhn, C. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal of Neuroscience, 115(10). Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16162447
  3. Kirkbride, G. (2015, September 24). Massage therapy and lupus. Hospital for Special Surgery. Retrieved from https://www.hss.edu/conditions_massage-therapy-lupus.asp
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  5. Massage & lupus (2012, February 15). American Massage Therapy Association. Retrieved from https://www.amtamassage.org/articles/3/MTJ/detail/2538
  6. Paige-Graeber, S. (n.d.). Lupus and massage. Retrieved from http://www.lupusny.org/about-lupus/fight-lupus-body-and-mind/lupus-and-massage
  7. Paz, Z. (2017). Lupus. American College of Rheumatology. Retrieved from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Lupus
  8. Quinn, C., Chandler, C., & Moraska, A. (2002). Massage therapy and frequency of chronic tension headaches. American Journal of Public Health, 92(10):1657-61. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447303
  9. Mooventhan, A., & Nivethitha, L. (2014). Effects of acupuncture and massage on pain, quality of sleep and health related quality of life in patient with systemic lupus erythematosus. Journal of Ayurveda & Integrative Medicine, 5(3): 186–189. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204291
  10. Werner, R. (2009). A massage therapist’s guide to pathology (4th ed.), 13-17. Philadelphia, PA: Lippincott Williams & Wilkins.

Massage Therapy: Alternative Treatment for Migraine Headaches?

Migraine headaches, a common ailment, can be severe and debilitating. Research shows massage therapy may be a promising alternative to migraine medication.

Migraines, the third most common illness worldwide, affect 1 in every 4 American households, accounting for over 1 million emergency room visits each year. More than 1 billion people across the globe struggle with migraines. Of those who experience migraines, 90% experience migraines so debilitating that they are unable to work during their episodes.

The Difference between Migraines and Headaches

Because sinus headaches and migraines have similar symptoms, it’s easy to confuse the two. In fact, many people who think they have recurring sinus headaches but haven’t yet consulted with a doctor are in fact nearly always (90% of the time) experiencing migraines.

Migraine symptoms, which include forehead pain and pressure, facial pressure near the sinuses, and a runny or stuffy nose, mimic those occurring with sinus headaches. However, sinus headaches cause certain symptoms that migraines don’t, such as fever, nasal pus, and bad breath.

Those experiencing either set of symptoms may find it helpful to speak to a physician. A professional diagnosis can take the guesswork out of migraines and lead to targeted relief.

Causes, Triggers, and Warning Signs

Those with a family history of migraines are more likely to get them, especially during their 30s. Women have a 300% higher chance of getting migraines, and this is believed to be the result of hormonal changes such as such as estrogen fluctuations.

Migraines often occur before or during a menstrual period, when estrogen naturally drops. Pregnant or menopausal individuals may experience migraines as a result of changing hormone levels. People who get migraines and are receiving hormone replacement therapies or taking oral contraceptives may experience migraines that are worse than usual—though they may also notice a reduction in symptoms.

People who take vasodilators (like nitroglycerin, for example) can also experience migraines that are worse than usual. Many individuals find that weather/humidity changes and physical exercise (including sex) trigger their migraines. Work and family stress, changes in sleep patterns (including jet lag), and strong scents trigger migraines in many individuals. Some people who experience migraines find that caffeine and alcohol, especially wine, trigger headaches. Other triggers may include processed and salty foods and food additives like aspartame and MSG.

People with migraines often experience changes in mood that can range widely, from euphoria to depression. People may also report thirst, food cravings, constipation, and an increased need to urinate as predecessors to migraines. They may feel stiffness in their necks and experience frequent bouts of yawning.

Another symptom sometimes preceding or accompanying migraines is an aura—a flash of light, shapes, or bright spots, or temporary loss of vision. Numbness or weakness on one side of the body, trouble speaking, auditory hallucinations, and spasms may also occur.

Is Massage Therapy a Good Alternative to Migraine Medication?

While migraine symptoms are usually treated with medication, some individuals do not respond well to migraine medication or experience side effects or other concerns that lead them to avoid pharmacological treatment. Massage is one potential alternative treatment available to help treat migraine symptoms.

Though further research is still needed, one study showed favorable results for migraine sufferers who participated in a trial where they received weekly massage. These individuals experienced less frequent migraines and slept better after receiving massage therapy.

Massage for medical conditions generally falls into one of two categories.

  • Massage as a complementary therapy: Many physicians recommend massage therapists to patients who want to address stress, anxiety, insomnia, flexibility, and pain issues, among other concerns, without additional drugs/surgery. These doctors value massage therapy as an “add-on” treatment with few to no side effects that can be beneficial to nearly any person, from preterm babies to elderly patients.
  • Massage as an alternative treatment: A growing number of doctors are beginning to recognize massage therapy as a medical treatment in its own right. For example, the American College of Physicians now recommends massage therapy as a first-line treatment for lower back pain. This organization—and many practicing physicians—recommend massage as an alternative to opioid painkillers and pharmaceutical sleep aids, which have been shown to cause any number of potentially harmful side effects in some individuals.

When reviewing the use of massage therapy as an alternative to pharmaceuticals, a team from Norway’s Akershus University Hospital found treatments like massage therapy, chiropractic spinal manipulation, and physiotherapy to potentially be just as effective as drugs for migraine relief. They studied the effects of medications like topiramate (an anti-seizure drug) and propranolol (a beta-blocker used for cardiac patients) on migraine patients and highlighted the importance of non-pharmacological interventions.

Can Massage Prevent Stress that Triggers Migraines?

A research team at New Zealand’s University of Auckland Department of Psychology conducted a 13-week study on people with migraine headaches (some of whom received massage therapy). This team observed their study participants’ cortisol levels, heart rates, and anxiety levels before and after massage therapy sessions.

Cortisol, the body’s primary stress hormone, signals the body to release more sugars in times of stress to provide quick energy for fight-or-flight reactions. It tells the brain to use more sugars in order to think fast and react to danger and gets the body ready to heal itself from injuries. Cortisol can save lives in crisis situations, but it can also have a negative impact on everyday life.

The research team found that people who received massage therapy slept better and had fewer migraines than those who didn’t get this treatment. They also noticed reductions in migraine patients’ cortisol levels, anxiety levels, and heart rates after massage therapy. Thus, massage therapy shows promise as a treatment for migraine headaches.

Can Massage Treat Insomnia that Triggers Migraines?

A study on sleep interventions for a group of 69 men in critical care for heart problems found that patients who received massage slept an average of 1 hour longer per night than those who received relaxation tapes or standard care.

Another research team studied a group of 57 women with breast cancer. The study participants who received massage therapy as a complementary treatment to standard medical care reported better quality of sleep than those who only received standard treatments. These scholars pointed out massage therapy’s usefulness for promoting health and helping patients sleep better without drugs.

To enjoy greater pain relief and better sleep, consider asking your doctor if massage therapy is the right complementary or alternative migraine treatment for you.


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  8. Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. (2017, April 4). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American college of physicians. Annals of Internal Medicine. doi: 10.7326/M16-2367
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