For example, if you say “I have pain in my forearms”, they should be able to find the spot to work in order to ease the tension just by feeling it.
I'm not sure whether that's a good heuristic. A good therapist will be able to feel where things tense up, flinch and a bunch of other factors but pain is in the realm of qualia that normally can't directly be felt in another person.
I would not rule out that there's one school of people who can feel pain, but that's not an ability that you should expect even among people with highly trained perceptions. Knowing about how a patient perceives their own body is valuable information for a therapist. Asking questions about it is a good sign.
Apart from information gathering, there's a school of thought that recommends asking patients for their experience to build patient agency.
I agree that asking questions is a good sign, but I still stand by the basic point I was trying to make. Often the place the pain is felt and the knot of tension causing the pain are not colocated. A good massage therapist should understand the human body well enough to figure out what's wrong from a combination of palpating and communicating, rather than solely working the place where you tell them you have pain.
When it comes to chattiness, I think it makes a lot of sense to voice your preferences to the therapist. Different clients have different preferences.
At the moment I'm getting messages in my workplace. The message therapist did a lot of talking in the first session and then did nearly none at all in the second and third, likely because they got the impression that I'm not into talking a lot.
A good message therapist is flexible about the amount of talking they do.
Written for Daniel Kokotajlo's unofficial blog post day! I didn't very effort here, so sorry that it's pretty rambly and full of personal anecdotes. I hope it's still at least somewhat helpful!
Recently several people have asked me how to go about finding a good massage therapist. I had thought about writing a post on this for a while but didn’t realize there was an actual audience! I guess there is! I have chronic problems with muscle tension and have been to about fifteen different massage therapists, so I hopefully have some wisdom to share.
My basic advice is to use Yelp (or equivalent, e.g. Google reviews). I expect this to work significantly better on average than recommendations from friends, because your preferences and body are likely different enough from theirs. However, recommendations from friends can be worth a shot too.
I will note up front that I have never had a massage therapist try to sexualize the massage. People seem disproportionately concerned about this when getting a massage for the first time, but I really don’t think it’s that common.
The first question to answer is: What are your goals? Why do you want to get a massage? Do you have a particular pain that bothers you, such as an old injury or a bad knee, or is it more that you just feel generally tense? Are you looking for temporary pain relief or someone who will work with you for a long time to address the underlying problem? Are you not looking for pain relief at all but just a nice relaxing experience? These are all important things to know going in.
The main measure of whether you should keep seeing a massage therapist is whether you think they’re good. This will obviously be a subjective judgment, and may change over time (e.g. if you thought someone had the potential to give you long-term relief, but after a few sessions that hasn’t materialized.)
A big thing I look for when seeing a new massage therapist is whether they can read my body without my having to give them verbal information. This is particularly important for me since I’m really hesitant to speak up when I’m in pain (a good massage therapist should notice the flinch reaction in the surrounding muscles and ease off automatically), but I think it’s also a good litmus test in general. For example, if you say “I have pain in my forearms”, they should be able to find the spot to work in order to ease the tension just by feeling it.
I have a weird reflex in my right leg, and the way a new massage therapist responds to that is significant evidence for me. One woman nerded out about it, felt around, and told me that all the nerves in some area were bunched together weirdly. This was a good outcome, and I went to her regularly for a while. Another woman saw the reflex, asked me if I was doing it on purpose, then kinda freaked and told me to see a neurologist. I did not see her again.
There are a whole heck of a lot of different ways to give a massage. I’ve had people walk on me, yank on my limbs, press and hold ‘trigger points’, cover me in Tiger Balm, rub me with hot rocks, have me tense and release my muscles, go chop chop on my shoulders, and even spend half of the session giving me a lesson on how to walk with better posture instead of massaging me. Massage space is deep and wide.
Massage therapists will often give a list of different types of massage they’re trained in, with names like “shiatsu”, “traditional Thai”, “myofascial release”, “trigger point therapy”, “Swedish”, and probably lots more. I’m gonna be honest with you: I have no idea what most of this stuff means. As such, I find that the best way to figure out what a person’s deal is is to just try them out for one session.
I’ve found that I generally prefer “deep tissue massage therapy”, which (vaguely) is targeted at getting to the root of chronic issues. This can be very intense, to the point where I feel flu-y or have trouble walking for a day or two afterwards. I like this intensity because I value the long-term benefits, such as going longer between bouts of crippling shin splints. However, if you don’t have such chronic problems, your calculus may be different.
How important is ambience to you? There are all sorts of things to consider, like whether you get to choose the music, whether the table is heated, the lighting, the amount of ambient noise, maybe even the neighborhood. (My favorite massage therapist usually asks me what music I want, but I’m too much of a wet noodle to tell her my preferences so sometimes she plays, like, pop punk, and I don’t find it very relaxing.)
Like with styles, there’s a huge amount of variation in ambience. Some people work out of spas, some out of physical therapy offices, some out of basements. One of my favorite massage places doesn’t have private rooms, just curtains separating the different spaces. You can hear the other clients as well as the traffic outside, and everyone listens to the same music. I don’t mind this because the place has plenty of other good attributes, but others may feel differently.
If having a lot of control over your environment is important to you, you might want to look into massage therapists who do house calls!
Chatting
This one is a big deal for me. I find it really annoying when my massage therapist is chatty, because I don’t like small talk in general, and because often when this happens it’s just the massage therapist complaining about their girlfriend or ex-wife. (Three out of the five male massage therapists I’ve seen were chatty, compared to only one out of ten females. Small sample size, obviously.) I just want to lie inert and silent and be massaged! Other people, such as my mom, don’t mind the chatting, so this wouldn’t be a major factor for them.
Exchange of information
On the other hand, I really value it when, after or during my massage, the massage therapist tells me something about my body that I didn’t already know. Epistemics are kind of a lost cause here (basically every massage therapist I’ve talked to has given me some kind of pseudoscience explanation of how massage works, many of them mutually contradictory), so I mostly just go on whether the information is practically useful. Examples of useful information I’ve gotten are tips on how to improve my posture, and specific stretches I can do to ease particularly tight muscles and tendons.
Language barrier
There are a lot of great Thai (and various other Asian) massage therapists, usually women. They generally work in coalitions rather than as freelancers (for lack of better terminology), and, not-unrelatedly, not everyone at these places is always good enough at English to handle basic customer service. I don’t mind this at all because I don’t talk to my massage therapists anyway, and they’re really nice to me and give good massages. However, if clear two-way communication is important to you, you might want to make a point of finding someone with whom you share a language of fluency. (If you speak Thai, well then, lucky you!)
Convenience has several aspects: location, booking procedure, and availability. I personally prefer places that are easy to walk or bike to, which allow booking online (by text is fine too, once you’ve built a relationship), and that have lots of availability.
If you’re optimizing for lots of availability, I recommend finding one of those more coalition-type places, since they often have quite a few appointments open at any given time. If you’re optimizing for proximity, house calls often come at no extra cost!
Some people – I think particularly women – strongly prefer to have a massage therapist of their same gender. This is perfectly reasonable and should be easy to filter for. (I also have a nonbinary massage therapist who I love).
Massages are just pretty expensive. As far as I can tell, the baseline massage cost scales with cost of living in an area – by which I mostly mean that massages are about twice as expensive in the Bay Area as they are back home in Wisconsin. However, not all massages are the same amount of expensive. I keep mentioning those coalitions of Thai women – these often offer great massages that are relatively affordable. If money is no object for you and/or you’re just really desperate for pain relief (I’ve been there), I’ve found that the most long-term effective massage therapy is generally more expensive.
You might be looking for random other things in a massage, such as aromatherapy packages, pedicures, or couples massage. Not everywhere offers these things, so make sure you check for them before booking an appointment.
And if you’re tight on money and can’t see a massage therapist regularly, I’ve heard a lot of people recommend self-massage using trigger point massage therapy. This works better if you have the book and some tools, but all of those linked products together add up to less than the cost of an hour of professional massage (in the Bay Area).
Thanks for reading, and let me know if you have questions!