How I Choose Massage Techniques: Inside an RMT’s Treatment Approach

“Tight” is a useful starting description, but I want to know what it means for you.

Does your neck feel stiff when you turn it? Does your shoulder hurt during a press, while reaching behind you, or after several hours at a computer? Is the discomfort recent, or does it keep returning after the same activity?

I also want to know how you responded to previous treatment. If you felt better initially but were too sore to train two days later, that matters when planning the next session.

Depending on the concern, assessment may include active movement, resisted testing and hands-on examination of relevant tissues. Together, these findings help establish a starting point and identify something meaningful to reassess.

The goal needs to be specific enough that we can tell whether treatment is helping. An easier head turn or more comfortable reach gives us more useful information than simply finding another tender spot.

Sidelying is one of the positions I return to regularly when treating the shoulder and surrounding tissues.

With the upper arm supported, I can change its position, work around the shoulder blade and access relevant areas along the side of the rib cage. Depending on the assessment, that may include the rhomboids, trapezius or serratus anterior region.

It also allows me to combine hands-on contact with movement. I can assess how a particular position feels, adjust the treatment and then ask you to repeat the movement that was uncomfortable.

The choice is practical: which position gives us useful access while keeping you comfortable? Some clients do better on their back, others on their side, and a session may use several positions.

When appropriate, I incorporate Functional Range Release (FR) into this work. The treatment is directed towards the tissues and movement restrictions identified during assessment, with reassessment guiding what comes next.

The amount of pressure I use depends on the area, its sensitivity, your preferences and the purpose of the treatment.

For a familiar area of persistent muscular tension, slower, more focused work may be appropriate. For a newly irritated or particularly sensitive area, I may begin with broader contact, lighter pressure or a different position.

Your response helps determine whether that choice makes sense. Can you breathe comfortably? Are you bracing against the pressure? Does the contact reproduce familiar discomfort, or introduce something different?

I want that feedback while I am working. There is no advantage in discovering at the end that you spent twenty minutes silently enduring a technique.

For an overview of the individual methods, our guide to therapeutic massage techniques and their benefits explains several approaches used in the clinic. During an appointment, the important part is selecting and adapting them to the person on the table.

An isometric exercise involves producing muscular effort while holding a position without substantial joint movement. That might mean gently pressing into resistance while I help you maintain a particular arm position.

I sometimes introduce this after focused manual work so we can explore how the movement or effort feels at that point in the session.

For example, after treating a shoulder region, we may practise a controlled effort in a comfortable position, then reassess the original reach. This gives me information about your tolerance and gives you a chance to practise with guidance.

The effort, position and duration are selected individually. A sensitive shoulder and a shoulder being prepared for heavier training should not automatically receive the same exercise.

Manual work, movement and loading each have a role in the treatment plan. The appointment provides an opportunity to work out an appropriate starting point.

I like to introduce a relevant movement while we are working on the area.

If we have just treated your shoulder, that can be a useful time to practise a reach or shoulder-control exercise. If the concern involves your wrist, we can explore the relevant movement and make sure you understand what you are trying to do.

This creates room for questions. You can show me where you feel the effort, whether the movement is uncomfortable and whether the instructions actually make sense.

It also allows me to adjust an exercise before it becomes homework. A movement that looks straightforward when demonstrated may need a different position, smaller range or clearer cue when you try it.

I would rather leave you with a manageable exercise you understand than a long list you have to decipher later.

Additional tools need a clear purpose within the appointment.

I may use heat when it is appropriate and the client finds warmth helpful before hands-on work. I also consider red light therapy as an adjunct when pain or tissue irritation is part of the treatment picture.

These are separate treatment choices. Heat and red light therapy work differently, and the decision to use either depends on suitability, the treatment goal and the client’s preferences.

I explain why I am suggesting an adjunct and how it fits into the appointment. We still need to assess movement, adapt manual treatment and consider what happens between visits.

Our guide to red light therapy for pain management explores its potential benefits and the limitations of the evidence in more detail.

Reassessment brings us back to the reason you booked.

If turning your head was uncomfortable, we check that movement again. If reaching overhead was the problem, we revisit the reach. Where appropriate, I may also repeat a resisted test or compare how much effort a movement requires.

I am interested in several things: comfort, range, control and whether the movement feels easier or more reliable to you.

An immediate change is useful information, but I also want to know what happens later. How did you feel that evening? Were ordinary activities easier the next day? Did the original symptoms return with a particular task?

That follow-up helps shape the next decision. We may continue with an approach, change the amount of treatment, adjust home care or discuss another provider’s assessment.

Repeating the same session indefinitely without reviewing its value is not the aim.

Your treatment priorities can change even when the original complaint has the same name.

One appointment may focus on a sensitive area and comfortable movement. Later, we may spend more time on loading, movement practice or preparing for the demands of work and training.

Your schedule matters too. A session before a physically demanding weekend may need a different approach from one during a quieter recovery period.

This flexibility is part of our integrative care approach: choosing appropriate tools, explaining their purpose and adapting care to the person’s response.

Looking for more ways to support your recovery and wellness?
Explore these evidence-based articles from Excelsior Integrative on therapies that complement remedial massage, from red light therapy to targeted rehabilitation strategies and relaxation massage techniques.