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Therapeutic Modalities Explained: The Low Down on the Mumbo Jumbo

Shiatsu? Myofascial release? Neuromuscular therapy? Just what does all that mean anyway? Common therapeutic modalities explained below!

Clinical massage - Clinical massage involved evidence-based techniques used to treat injuries, pain, and to increase range of motion. It is performed to reach a specific therapeutic outcome. Clinical massage usually does not involve massaging the full body, but only the areas needed to be worked in order to achieve the desired result. For example, a client presenting with sciatic nerve pain would receive bodywork that focuses on the muscles that are causing that pain, and therefore would not have unnecessary body parts, such as the arms, worked on during that session. Of course, clinical massage can be incorporated into a full body session, however that requires the client to schedule a session that is long enough to massage the full body in addition to allowing sufficient time for the clinical work in order for a successful end result to be achieved.

Craniosacral therapy - Craniosacral therapy (CST) is gentle manipulations of the skull and other parts of the skeletal system, intended to harmonize the flow and natural rhythm of the central nervous system, known as primary respiration.

Deep tissue - Deep tissue utilizes techniques that work deeply into the muscle tissue. This can potentially mean deep pressure is used, but deep tissue can be achieved through sustained gentle pressure, as well as techniques used to encourage the nervous system to allow the muscles to relax. The muscles are warmed up and worked into gradually, to provide pain relief and a greater range of motion.

Hot Stone Massage/Hot Stone Therapy - Hot lava stones are used to massage the muscles, heat seeping in to allow for deeper muscle relaxation than through massage strokes alone. Swedish massage techniques are typically incorporated with the use of the heated stones.

Lomilomi - Lomilomi is a traditional Hawaiian massage modality, rich with Hawaiian history and spirituality. The techniques involve palms, fingers, forearms, elbows, knuckles, even knees, feet, and sometimes sticks and stones. The practitioner performs a very flowy routine that is much like dancing and involves full body movement.

Lymphatic drainage - Often referred to as Manual Lymphatic Drainage (MLD) or Lymphatic Drainage Therapy (LDT), this technique is used to move fluids through the lymphatic system to allow the lymph nodes to move excess fluid out of the body naturally. It is used whenever the lymphatic system is malfunctioning or certain areas of the body have excess fluid that is not moving out well enough on its own. This technique uses extremely gentle pressure to stimulate the lymphatic system.

Myofascial release - Myofascial release is a gentle technique that involves using pressure sustained on myofascial restrictions to reinstate the flow of viscous fluid and release the fascia to provide pain relief. Fascia is a delicate tissue that surrounds every muscle and organ, and there is a layer of fascia that envelopes the entire body as one large piece. Fascia moves easily due to the viscous fluid that exists between the layers. Surgery and injuries can result in restrictions in the fascia, as well as repetitive motion injuries, etc.. Scarring, twists, and catches in the fascia can create a large amount of pressure on sensitive areas, causing pain that the cause of cannot be seen in medical imaging tests. Tight muscles sometimes are restricted by fascia and cannot be fully released until the surrounding layer of fascia is also released. Myofascial release is not technically massage, but still falls under the manipulation of soft tissues and is performed by massage practitioners.

Neuromuscular Therapy - A term used to label therapeutic massage services, that starkly differentiate from the relaxation-focused massage services that you more commonly find in a spa setting. Neuromuscular therapy focuses on resolving more involved pathological pain issues, both chronic and acute, and is also often utilized to gain and maintain increased range of motion and mobility.

​Trigger Point Therapy - This involves locating trigger points in the muscles and using sustained pressure to release the trigger point. A trigger point is a small point in a muscle in which striated muscle fibers are bunched up together, and have been known to cause a lot of pain and discomfort. The pain often refers to other areas away from the trigger point itself, which is why the problem is often not where the pain is.

Orthopedic massage - Orthopedic massage is not a single technique, but a comprehensive system that involves assessment, manipulation and movement of soft tissues in order to restore structural balance to relieve pain, and rehabilitate and prevent muscular dysfunction.

Prenatal massage - Prenatal massage is performed on pregnant women in any stage of pregnancy. It is calming and soothing for both mother and baby, and can help with pregnancy discomforts, such as lower back pain, that are common in pregnancy. Most strokes used during a prenatal massage are long, slow strokes for relaxation. Pillows are often used to prop the expecting mother into a comfortable position.

Reflexology - Reflexology is not massage, but a technique that involves placing pressure on certain points in the hands and feet to affect areas of the body elsewhere, such as the liver, or neck, for example. According the reflexology theory, all areas of the body can be treated by stimulating these particular points in the hands and feet.

Shiatsu - Shiatsu uses the same points in the body, called tsubo points, that are used in acupuncture. The intended results are basically the same, the difference being that in Shiatsu no needles are used, and instead the practitioner uses their fingers to apply light pressure and stimulate the points, encouraging a healthy energy flow along the body's Meridians (energy pathways as defined by Traditional Chinese Medicine).

Sports massage - Sports massage is a modality primarily for injury treatment and prevention for athletes. The therapist will use techniques specific to the sport or activity the client participates in, or for the injury involved. Sports massages are also often performed prior to a major sporting event to prepare the athletes body. More intense work should be done a few days prior to the event to give the athletes body time to adjust. Sports massage is also done for maintenance to prevent future injuries and problems, due to the repeated movements and continuous heavy use of muscles that athletes to deal with.

Swedish massage - Swedish massage is what is typically performed in a standard spa setting or massage clinic. It is a general-purpose modality, typically used for relaxation and stress relief, as well as relief of mild levels of tension in the muscles. Swedish massage involves long, slow strokes (effleurage), kneading (petrissage), friction, stretching, and tapping. Swedish is a good "starter massage" for those who are new to massage therapy.

Thai massage - Traditional Thai massage is performed with the client fully clothed (in flexible clothing, such as gym clothes), on a mat on the floor. It is quite different than the massage most people are used to receiving on a massage table while undressed. No lotion or oil is used, because the technique involves a lot of stretching and static pressure. It is somewhat like passive yoga for the recipient. There are some practitioners who will perform "Thai on the table" in which they alter their methods to have the client on the table instead of the floor. It is also quite simple for someone who is trained in Thai massage to incorporate some of the techniques in a table massage if deemed to be beneficial to the clients needs.

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