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My thoughts on Massage. My thoughts on Massage.

10-10-2009 , 05:57 PM
I decided to start this thread to have an easy containment area for all questions/thoughts related to massage. As some of you are aware, I am a Licensed Massage Therapist based in Los Angeles. The best I can figure to do this is in an Q&A format, as these are common quesitons I see in this forum and in general, so here goes nothing:

General:

What is massage?
In one sentence, the intent massage is to relieve a certain tension.

But:

What is massage NOT?

First and foremost, it is NOT medicine. Please please please do not expect us to be some sort of miracle worker that will fix all sorts of crazy ailments. While a bit of Sciatic problem is okay, severe and chronic Sciatic problems may be a neuromuscular problem that is too far out of our reach. Many of us who are responisible will refer you out.

How many forms of massage are there, and what are they?
There are hundreds of forms of massage. I will state what I think are appropriate for people who are dealing in athletics.

The 900-lb gorillas:
Rolfing: An intense form of body work that attempts to restructure the hard tissue (bones) by forcing the soft tissue (muscles and fascia) by using deep specific strokes. The final result is a body that is more in balance with gravity, more flexibility, proprioception, and posture.

Trager: A movement-based form of working using gentle rocking, swinging, and bouncing to help break poor movement patterns caused from prior injuries and other influences.

The 500-lb gorillas:
ART: A form of massage created by Art Riggs, an Advanced Certified Rolfer, that focuses on athletes. This does assist in streching muscles, releasing knots, and adjusting movement patterns. Such as helping the knee move on a proper hinge.

Hellerwork: Hellerwork is another very intense form of body work, similar to Rolfing, but mixes in elements of Trager as well. I have a bit of a problem with Hellerwork as it seems that it deals a bit more in spirituality than I am comfortable with.

The 300-lb gorillas:
Deep Tissue: Deep tissue is a broad area of work, usually focusing strictly on taking out knots. Results vary from massuer to massuer. Some are able to restructure, stretch muscles and fascia, and create specific sessions for each client. Some also will use many of the techniques found on Athletic and ART.

Oscillation/movement therapy/jostling, et.al.: This is a full session that is a highly watered-down version of Trager. Many Trager Level 1 and 2 Trager workers use these sorts of terms to describe their work. However, I would not suggest going to someone who specifically does this work often.

Athletic: Athletic is a sort of a "best-of" mixing deep tissue, oscillation/movement therapy, Swedish (soft to deep long strokes to "flush out" excess fluids and recently broken up fascia), and assisted active dynamic stretching. Some will also use joint decompressions and moblizations (rapid movement, sometimes referred to oscillations or vibrations).

The session:

Okay, great, how do I find someone that knows what they are doing?
Let's start up by not going to spas and other factories. I prefer it if someone goes to an inependant practitioner. I am not implying anyone with a job is a moron, as I also work out of some places, but from my own thinking and many others, we don't have enough time to really assess what you need, as we have to worry more about turn-around than anything.

The first place I would look is at and MMA studio. These therapists are top-notch and are used to dealing with injuries and recovery, as it is very hard to get into a place like this. You may also look into other fighting studios and dance studios. If all else fails, find a yoga studio or even look on google or yelp.

Okay, I have a business card, now what?

When you call him or her, you may want to do a quick test to see if they are as smart as you hope. Rather than saying: "Hi, I am having problems with my hip flexors," say, "Hi, I am having problems with my Sartorius and Rectus Femoris." If you get a "duh," then you are dealing with a moron.

I prefer a girl to touch me because I might catch teh geys, but I don't think she is able to give me enough pressure, and maybe she isn't as knowledgeable as a guy.
This is a HUGE myth, and even though I may want to promote it as much as possible because I am a guy, I'm not going to.

I have had 120lb girls terminate me, and I have had 250lb guys soft touch me. Men are not inherently more intelligent than women at this profession. Women are not inately more caring than men. A good therapist is going to have knowledge and know how to use proper amounts of pressure for each thing they are doing. For example, if I am attempting to stretch your sub-dermal fascia, I would not pile-drive you, since this fascia is going to be more superficial than your lung.

How much should all this cost?
I can't speak on this too much. I have my price and disdain people who charge too little, to be honest. I will say that if you live in a capitolist country, you should know you get what you pay for. So if you pay $65 you can't complain, but if you are paying $200, you are probably getting ripped off. I will note that I know Rolfers charge around $200 per session, but they are gods as far I know, so you are likely not getting the lemon smashed in your face.

With that said, I would say $85 to $150 is fair, but I degress.

How much should I tip?

This is another touchy subject. I don't take tips and I make that clear when I quote the price. However, many therapists to take tips, and that is fine. I don't know how much is apropriate.

Got my therapist, what is going to happen?
Each therapist has his or her own preferences, so I will say you must find someone you are comfortable with first. Even if they do excellent work, if you walk out with the heeby-jeebies, then this is probably not your person. I will describe my session.

-I am not picky about music. If you want massage music, great. Rap is fine, I really don't care.

-Many therapists will ask you to be quiet and relax. I don't understand this concept at all, because I could've swore the relaxing is my job. If you feel like talking my head off about your stupid gf, fine.

But... why can't I get advice?
This is far out of our practice. We are not legally able to give you advice on anything. Practicing psychology is a psychologist's job.

OMFG, I got this odd blotch on me!!!
Although I know that it is a basal carcinoma, I am not allowed to tell you, because that is diagnosis. See a doctor, please.

I found a chiropractor, and he told me that I should stop doing what I am doing for a while because it will mess up his work.
Uh. No.

First of all, why would I really tell you this. The point of massage is to make sure your day-to-day activities are done with ease. An effective therapist will be able to work around what you are doing and make the proper adjustments.

How many sessions do I need for X problem?
I can't know this without touching you or seeing your specific problem. This goes on many factors:

-How bad is the problem?
-How much pain can you take?
-How often are you going to see me?

And estimate?
Four sessions max, and more for maintenance if that is what you want.

LOLLOLOLOL!!! That tickles!!!!
Great. Laugh.

i feel like crying or cussing you out! I can't help it, I'm not a baby or a jack-ass, I swear!!!!
Laughing, cussing, crying, whatever, can be a natural response to the changes going on in your body. The mind and body are closely connected, and at times, what is going on in your muscles are caused by something emotional. We call this emotional release, and there is nothing to be ashamed of, if that is what you are going to do, it may be a life-changing experience.
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10-10-2009 , 05:58 PM
I want a massage
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10-10-2009 , 06:04 PM
how many handies you give out?
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10-10-2009 , 06:13 PM
i has some weird king of spotty rash kinda deal (like poision ivy) on my right knee and some on my left too. I think i got it from kneeling on the gym floor between sets, not from blowing my friends in the weeds as i was wearing pants that night lol.


how much is my masseuse going to hate me if i don't have this cleared up in 7 days when i go to get a massage?


i'm using caldoryl to clear it up, i really have no idea what it is or where it came from.
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10-10-2009 , 06:13 PM
To be clear, I will not accept anyone from this site as that is a clear violation of TandC. However, if you have a problem that you are uncomfortable posting here, feel free to use PM.
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10-10-2009 , 06:17 PM
Quote:
Originally Posted by willie
i has some weird king of spotty rash kinda deal (like poision ivy) on my right knee and some on my left too. I think i got it from kneeling on the gym floor between sets, not from blowing my friends in the weeds as i was wearing pants that night lol.


how much is my masseuse going to hate me if i don't have this cleared up in 7 days when i go to get a massage?


i'm using caldoryl to clear it up, i really have no idea what it is or where it came from.
We see all sorts of nasty things. She should be able to work around it. If you explain to her it isn't contagious, which it shouldn't be at that time, she may be willing to work on it.
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10-10-2009 , 06:55 PM
Cool thread dave. Lots of good info. I've had 2 massages to date, and they were amazing. Deep tissue stuff as I carry alot of stress in my back, so lots of knots to be worked out. Hurt like hell, but when it was all done, I wanted to kiss my therapist. Who was a man. And not particularly a handsome one.
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10-10-2009 , 08:04 PM
dave well written. i've prob. had like 200 massages in my life as i love them. the current guy i have who does "nueromuscular" and ART i believe is far more painful than anything before. what do you think of thai massage?
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10-10-2009 , 08:22 PM
Great post Dave.

I've got a lot of massages over the years. I can confirm that the 120 lb girl is very capable of doing a fabulous job. I've had a few different ones that have been excellent.
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10-10-2009 , 09:22 PM
Quote:
Originally Posted by theBruiser500
what do you think of thai massage?
Thai is highly controversal in my profession. There are 2 main forms: Northern and Southern (these are the generic names. I don't know the Thai names). Northern and Southern use the same moves but Northern is more sensitive. Southern practitioners have been known to break bones. Thai, by definition, is assisted yoga, or as one friend put it, "Yoga for lazy people." For the most part, we look down on it. My opinion is that it is not specific enough for fitness use, and there are too many wasted moves. However, I don't fully disrespect it, as it serves it's purpose. But I believe that someone educated in massage would be disappointed. I do think it is fine for people who only want to relax, and for those who are very inflexible, but there are better modalities for that. To note, most places in LA charge $40 and is the "in" thing. People who never went to a traditional school and are from families that passed down the technique are superior.
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10-10-2009 , 09:27 PM
Bruiser, how do you like neuromuscular? Do which style is being done on you?
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10-10-2009 , 10:25 PM
daveT, what do you think about shiatsu? And do you feel unilaterally this or that way about it, or think there's some good and some bad?
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10-10-2009 , 10:43 PM
Quote:
Originally Posted by daveT
To be clear, I will not accept anyone from this site as that is a clear violation of TandC. However, if you have a problem that you are uncomfortable posting here, feel free to use PM.
By accept someone, do you mean accept payment for services rendered? That would absolutely not be a violation of T&C IMO. If you're worried about advertising, that shows that you are honest, which is good - but you obviously know what you're talking about (both from a massage standpoint and training), so I think it would be absolutely fine if someone wanted to become your client based on your work in the forum.

Smiley, care to chime in?
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10-10-2009 , 11:17 PM
Quote:
Originally Posted by daveT
Thai is highly controversal in my profession. There are 2 main forms: Northern and Southern (these are the generic names. I don't know the Thai names). Northern and Southern use the same moves but Northern is more sensitive. Southern practitioners have been known to break bones. Thai, by definition, is assisted yoga, or as one friend put it, "Yoga for lazy people." For the most part, we look down on it. My opinion is that it is not specific enough for fitness use, and there are too many wasted moves. However, I don't fully disrespect it, as it serves it's purpose. But I believe that someone educated in massage would be disappointed. I do think it is fine for people who only want to relax, and for those who are very inflexible, but there are better modalities for that. To note, most places in LA charge $40 and is the "in" thing. People who never went to a traditional school and are from families that passed down the technique are superior.
hey i went to thailand and they had so many massage parlours everywhere and it was $4 for an hour so it was pretty amazing. in nepal i got a massage a random barbaershop where i just needed a shave, in china there was a lot of places for massage, in australia there was a lot of street massage, etc. Yet in Bolivia there are no places that offer massage. in a big city there are literally one or two places that do it and it was awful. $13 for half an hour (very expensive) and they just used a ton of oil and were terrible. i feel like in the US masage isn't even that big, all the massage places are on an appointment basis and hidden away.

do you have any thoughts on this and massage as it relates to culture? like in asia it seems to be a huge part of culture. here not so much, and in south america it is just non existent.
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10-10-2009 , 11:23 PM
Quote:
Originally Posted by daveT
Bruiser, how do you like neuromuscular? Do which style is being done on you?
He told me he does neuromusclar and I don't know that the means, and some ART and some techniques he has developed as he has been doing massages for over a decade. IMO he is legit and he busts out all sorts of scientific names for muscles on me that i have no idea what he is talking about. It's hard to say how effective it is cause i have postural problems like a forward head and forward shouldrs that i've had all my life so they aren't going to go away right away. and how much is the improement due to massage, and how much to my weight work and mobility work?

My leg has a habit of turning outward so we worked on my external rotators and after the massage my leg was fixed, but then the next day it turned out again... Anyway, I think he is great but think massage can only do so much : )
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10-10-2009 , 11:24 PM
Quote:
Originally Posted by kyleb
By accept someone, do you mean accept payment for services rendered? That would absolutely not be a violation of T&C IMO. If you're worried about advertising, that shows that you are honest, which is good - but you obviously know what you're talking about (both from a massage standpoint and training), so I think it would be absolutely fine if someone wanted to become your client based on your work in the forum.

Smiley, care to chime in?
Yea I really can't see how you could ever get in trouble (or anyone even know).

Obviously this thread has a ton of good content already. If someone wants to PM you and book a session go ahead. Having them come back on 2p2 and give you a glowing testimonial would probably be inappropriate imo though.
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10-10-2009 , 11:31 PM
have you ever banged womenz after you gives them massages?
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10-11-2009 , 01:30 AM
Good thread.

I've gotten a couple of massages before and while I enjoyed them I kinda have mixed feelings about them. Last time I went I had a decent amount of knots and it hurt at times but I didn't instantly feel "better" after or even the next day. I was pretty sore. What are some of the negative consequences to walking around day to day with knots and other things that massages help relieve?

Also I've only ever gotten massages one at a time with months/years between the next one. Would it be better to have a massage every week and would I start feeling more of the benefits? Assume someone who's healthy, in shape and lifts weights 3-4 times a week.
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10-11-2009 , 04:15 PM
These are all excellent questions that are going to recieve very long answers. I won't be able to answer then until Tuesday.
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10-11-2009 , 07:29 PM
Where does SMR rate on the effectiveness scale? As in, I foam roll pretty religiously about 10-15minutes a day and often sit around with my elbows dug into my vastus medialis and rectus femoris etc. Assuming I have the option of getting good massages (I don't right now), how much better would they be? Do you ever tell your patients to foam roll on their own?
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10-11-2009 , 08:56 PM
Would like to get your thoughts on tens machines. As for personal use. As mentioned, have alot of shoulder, back stress which leads to headaches. Would be nice to have regular trips for a massage, but just not possible. Is this worthwhile to purchase for muscular stress? Dumb? Waste of money? Would be happy if it simply loosened up the shoulders some, or alleviated a bit of the pain from the constant knotting.
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10-13-2009 , 01:44 PM
Quote:
Originally Posted by theBruiser500
hey i went to thailand and they had so many massage parlours everywhere and it was $4 for an hour so it was pretty amazing. in nepal i got a massage a random barbaershop where i just needed a shave, in china there was a lot of places for massage, in australia there was a lot of street massage, etc. Yet in Bolivia there are no places that offer massage. in a big city there are literally one or two places that do it and it was awful. $13 for half an hour (very expensive) and they just used a ton of oil and were terrible. i feel like in the US masage isn't even that big, all the massage places are on an appointment basis and hidden away.

do you have any thoughts on this and massage as it relates to culture? like in asia it seems to be a huge part of culture. here not so much, and in south america it is just non existent.
Very good question, and yes, massage is absolutely tied in with culture. To understand this, I will have to give a brief history,

All eastern massage and traditional medicine is derived from the concept of Ayurveda, which originated in India. This truth is strongly objected by Chinese culture in general. Ayurveda loosely translates to "study of life," and that involved spiritual as well as physical. Fun fact: On of the earliest treatises of Ayurveda was written by a one Chakara (get it? Chakra?).

India was one of the great conquerors of the known world, and with it, spread the concepts of Buddhism, Ayurveda, and of coarse medicine and masszge. In massage, and in Ayurvedic medicine in general, it was believed that we are able to manipulate the energy fields contained in our body. Even Yoga is based on stretching and sqeezing these energy fields, commonly called meridians. Meditation is also based on manipulating the energy that makes up our body.

So, with the spread of Indian ideas derives various forms of energy manipulation, such as using "hot and cold" foods, medicines, needles, and what-have-you. This is a very important part of the history of most, if not all, Asian cultures, as evidenced in using massage, toungue diagnosis, and pulse reading. But each culture changed it for what was available locally, tradition, and beliefs. For example, the plants found in the Northern China are gong to be very different from plants used in Southern China. Accupuncture originated in Central China.

Many of the massages that use Ayurvedic concetpts are Shiatsu, Anma, Thai, Indonesian spiritual healing, and the list goes on, but they all have a common beleif of manipulating the various energies within the body, normally expressed as meridians, Chi, Ki, chakras, triple heater, etc.

In Western Europe, massage has a very different history. It was very common back in Grecian and Roman times, but was repeatedly banned due to sexual misconduct (nothing changes...), so it was pushed into the underground and basically considered the work of the devil.

Enter in the time of Bolivia. For starters, many of the great civilizations of South and Central America were collapsed or on the verge of collapse. This was helped considerably by the strongly Christian European conquerors, who famously spread diseases by using disease blankets as gifts, and what-have-you.

As the old saying goes: To destroy a race is to destroy it's language. I am sure if the conquerors had the means to destroy the Mayan pyramids they would have done that as well. However, they did call the culture Satanic and commenced to destroy all written materials on the religion, math, science, and culture. Now mind, that the same things that were illegal in Europe was probably now banned in Bolivia, and that would most certainly include massage.

I do believe that there are certain needs every human has after the basics are taken care of. This would be knowledge and some way of explaining the world. The second is human caring and healing, if through touch, love, and healing. Surely, many South Americans were well advanced in many ways, evidenced by skulls that has had brain surgery.

Finally, in the late 1800s, Massage started hitting the mainstream again, say thanks to two doctors who created the strokes of Swedish, and massage techniques created by doctors is the norm that continued. By this time, our medicine was well Westernized, and of course the concepts of energy was essentially tossed out of massage.

Massage finally had a major break-through in WW1 whan the field nurses would use massage to attempt to recover and relax hurt soldiers. They created a manual manipulation called the Lymphatic Pump, and this technique increased the survival rate of the victims. Step in Ida P Rolf, who attempted to prove that by stretching and manipulating fascia and muscles, people would inherently perform better. Milton Trager created his approach to body work but went to medical school so that his work would have more respect. By combining the concepts of Lymphatic Pumping (which spawned a technique called lymphatic drainage), Rolfing, Trager, and add in some rehab, we end up with physical therapy.
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10-13-2009 , 01:58 PM
Quote:
Originally Posted by Blarg
daveT, what do you think about shiatsu? And do you feel unilaterally this or that way about it, or think there's some good and some bad?
Shiatsu is basically Accupuncture without the needles. It also involves using passive stretching.

Circa 1920, Japan required all massage therapists to pass a Western Medical Board exam to continue practicing. The problem what that all massuers in that day were blind (a tradition still held in South Korea). So the meridians were giving names that corresponded with various parts of the viscera. This proved enough to pass the Board, so Shiatsu was born.

I am a skeptic of using meridians. To say that by putting finger pressure on my temple is going to cure a urinary bladder stone is going a bit too far for me.

A friend and I had a talk about Shiatsu and Thai, as they are derived from the same place (see post above), and his biggest issue, as he had taken Thai, is that the definition of "energy" is too broad. The meridians are different in each Thai and Shiatsu. The way they deal with meridians is different as well. For example, in Thai, they bang and use foot or palm pressures to move energy. In Shiatsu, they look for "stagnations," too much energy called jitsu, or too little energy jin.

So, another comparison of Thai and Shiatsu is that they both use assisted passive stretching. While this may be fine for people that are very very tight, and let's be honest, it is sort of relaxing, it is far inferior to using assisted active stretching, which involves using the client lightly flex.

So, in my practice, I have basically tossed out Shiatsu completely. I did, for a short period, experiment with how to deal with areas that may be jin and jitsu, but I find they are not as effective as classic deep tissue techniques.

With all that bashing, I will admit that I loooove having Shiatsu performed on me, as it is the only form of massage that I feel relaxed afterward.
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10-13-2009 , 02:27 PM
Quote:
Originally Posted by straightaway
Good thread.

I've gotten a couple of massages before and while I enjoyed them I kinda have mixed feelings about them. Last time I went I had a decent amount of knots and it hurt at times but I didn't instantly feel "better" after or even the next day. I was pretty sore.
This is a perfectly natural response to deep work. The average is about 3 days of soreness. Deep work causes a few things to happen:

-We are breaking up adhesions, which are collogen deposits from early injuries, ranging from minor tears on up.

-We are also forcing the muscles to move and stretch. While at first, you may not feel a major difference, the spindle nerve endings (nerve endings on the ends of your muscles that tell you not to over-stretch) are going nuts.


Quote:
What are some of the negative consequences to walking around day to day with knots and other things that massages help relieve?
Knot is a terribly generic word that describes many things.

- The most basic knot is a build-up of collagen and other connective tissue to heal an injury. Our bodies have no way of breaking down and absorbing collagen so once it's there it is stuck. This could be a minor problem (let's be honest, people go their entire lives without a massage), but in the case of a major injury such as a ripped tendon, dislocation, or other trauma, the build-up may be so severe that if it is not manually broken apart, one may need surgery to have the connective tissue taken out.

-Another kind of knot is that the muscle fibers are stuck in spasm and are no longer moving. A goal of working on someone is to un-stuck these fibers so that they move again. Once the muscle is moving again, the strength is returned, and peeople report feeling lighter and stronger.

-Finally, although this may not be a knot-related problem is that muscles create holding patterns and after many years, shrink. This is strongly evidenced in women who constantly wear high-heels. Their calves are so shrunken that there is no way they are able to dorsi-flex the foot. Another visible feature is in older people: they tend to become more fetal in form, especially in the torso, as the pecs are now shrunken from bad posture, and the back muscles no longer have the strength hold them up-right.

Quote:
Also I've only ever gotten massages one at a time with months/years between the next one. Would it be better to have a massage every week and would I start feeling more of the benefits? Assume someone who's healthy, in shape and lifts weights 3-4 times a week.
Going more often is definitely prefered. I don't really create a "plan" for anyone. I honestly attempt to work well enough that I shouldn't have to see my clients for the same problem every week. Once again, we aren't doctors, so we really can't make these sorts of suggestions. With that said, I will make suggestions in stretching or whatever else to be sure they can maintain themselves.
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10-13-2009 , 02:39 PM
Quote:
Originally Posted by SmileyEH
Where does SMR rate on the effectiveness scale? As in, I foam roll pretty religiously about 10-15minutes a day and often sit around with my elbows dug into my vastus medialis and rectus femoris etc. Assuming I have the option of getting good massages (I don't right now), how much better would they be? Do you ever tell your patients to foam roll on their own?
The most common wish all us pros have is to administer a great self-massage, but we all fail miserably at it. For one, we can't get the proper angles, and two, we don't like administering pain to ourselves.

What I suggest for any client is based on what they are willing to go for. Yes, I have suggest foam-rolling as an option, and I have also suggest one of these contraptions, called a back buddy:



For working on the knots in the back. It does a wonderful job of really getting under the shoulder blade and hitting "that spot." *

If you want to be able to mimick what we are doing to you, and you are not in the mood to buy stuff, I suggest doing a good stretching program to my clients. Especially common is a good bit of hand-stretches and I will also teach people who to decompress their own joints, but that is about all I can show that will be effective. Stretching is the main thing for me, because that helps keep the fascia and muscles loose.

As far as working on your own quads there isn't much I could suggest, and yes getting a "real" massage is far superior.

*While searching for an image to the back buddy, I found one place charging $175, that is waaaaaaay to much. Should be closer to $40.

If you all would like, I could post good hand exercises and a self-lymphatic drainage technique as well.
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