What is the difference between the various types of massage?

Remedial massage, Deep tissue massage, Sports massage, Swedish massage, Myofascial release, Neuromuscular release, Soft tissue release, Trigger point massage, Lymphatic massage … the list seems endless. But what is the difference between the various types of massage?

When we were studying at the Northern Institute of Massage the then principal, Eddie Caldwell, would often be asked by new students what the difference was and if the Institute taught them. His answer was yes they ran courses for different types of massage but would add “do you know, at the end of the day it’s all skin rubbing”. Now this isn’t strictly true. There are differences, and they don’t just involve rubbing of the skin. But Mr Caldwell’s down-to-earth approach always manages to put things into perspective.

Massage, although an ancient art, is constantly being updated as variations in procedure or new therapeutic techniques are added to the toolbox. Unfortunately these new techniques are often padded out, inflated and given a new name in order to create a whole new therapy. It might be cynical to suggest that the reason for this is for marketing purposes or to sound more scientific and to distance themselves from the word ‘massage’. It’s hard not to think, when meeting such a therapist, ‘get over yourself you are a masseur!’

On the positive side, even if these techniques don’t justify the creation of a whole new therapeutic modality or proprietary brand, they can be useful tools to have at your disposal as a therapist.

Multiple types of massage can be used to treat a patient in the clinic. The skill is deciding what mix of techniques is best suited to an individual patient’s needs. A patient suffering from stress needs a different form of massage to someone with a frozen shoulder. These in turn requires a different treatment plan to an athlete who wants to improve performance. In some ways there are as many different types of massage as there are patients.

So, bearing this in mind, we can define the different types of massage recognising that each represents just one string to the therapist’s bow.

Remedial Massage

remedial : adjective
giving or intended as a remedy or cure. Example ‘remedial surgery’
Remedial masseurs are trained to recognise and treat musculoskeletal conditions such as back pain, stiff neck and shoulders, sciatica and knee injuries. A typical treatment may include massage, mobilisations, tractions, rehabilitation exercises/stretches, postural assessment and a mixture of the techniques described below used for therapeutic effect.

Swedish Massage

The classic massage. A straightforward, no frills but very effective massage for general aches and pains. Also an excellent stress buster. It usually incorporates the neck, shoulders, back and legs.  The term isn’t recognised in Sweden. Not surprisingly they just call it massage. The popularisation of this type of massage is often wrongly accredited to Peter Henry Ling, a Swedish gymnastics teacher in the 1800s. In actual fact, it was Dutch practitioner Johan Georg Mezger who which developed ‘Swedish massage’ as we know it today, and adopted  French names like ‘effleurage’ and ‘petrissage’ to denote the basic strokes that we perform.

Sports Massage

A form of massage geared towards amateur and professional sports people. One of the oldest recorded forms of massage dating from early martial arts in the far east to the ancient Greek and Roman games. Homer writes in the poem The Odyssey of Greek soldiers being rubbed with oils to aid their recovery and regain strength on return from battle.

Deep Tissue Massage

Deep tissue massage is a type of massage aimed at the deeper tissue structures of the muscle and fascia. The term is often used to distance the therapist from the lightweight ‘beauty therapy massage’. A bit unfair to beauty therapists many of whom can give a perfectly decent massage. Getting through the layers of muscle is more subtle than you might imagine and requires persistence and coaxing as well as firm pressure. Just digging in demonstrates inexperience or a lack of training. Many people like a deep massage as the pain produces large amounts of endorphins (the body’s own painkiller) that gives a natural high. However, overdoing it can cause the muscle to react badly causing more tightness than before.

Soft Tissue Release

Soft tissue release (or STR massage) is a technique of assisted stretching of muscle fibres, tendon and fascia. STR involves repeatedly and quickly stretching small areas of the soft tissue. Precise pressure is applied to part of the muscle which is then moved to achieve a very specific stretch. An interesting and popular form of therapy, especially useful if adhesions are present in the tissue.

Trigger Point Therapy

A trigger point (TrP) is a small area of muscle that is exquisitely painful and tender to pressure. When pressed it produces a recognisable and reproducible pattern of referred pain away from the site of the trigger point. We use TrP therapy to get rid of these nasty little blighters.

Neuromuscular Massage

As well as TrP release this also includes the very effective Muscle Energy Techniques (MET) and Positional Release. Neuromuscular techniques are a recommended and powerful skill set for any Remedial masseur.

Lymphatic Massage

A type of massage which encourages the natural drainage of the lymph, which carries waste products away from the tissues.

Myofascial Release

Fascia is a thin, tough, elastic type of connective tissue that wraps most structures within the human body, including muscle. Fascia supports and protects these structures. All types of massage will involve treating the fascia to some degree, it fact it would be hard not to! Myofascial techniques claim to isolate and release fascial tension by using gentle sustained pressure on the tissue.

Although it is a useful exercise to define the different types of massage, I have never understood a therapist defining or limiting themselves to a specific skill set. This would be like a carpenter limiting themselves to just using a hammer. As long as a therapist has taken the time to study and train in the therapy and as long as it is covered by their insurance and recognised by their professional body then there is no reason why a therapist shouldn’t expand their repertoire. The availability of high quality courses makes acquiring new skills and learning new types of massage a natural part of Continuous Professional Development.