A Good Massage Therapist Should Know When Not to Treat You

I love what I do.

As a massage therapist, there is tremendous satisfaction in working with clients experiencing muscular tension, discomfort and movement limitations that fall within my scope of practice.

Sometimes the changes a client reports after a therapeutic massage are remarkable.

They may tell me their pain has significantly decreased. They may notice that an area feels considerably less restricted. Or a movement that was difficult before the session may suddenly feel much easier.

Those moments are rewarding.

But being a responsible massage therapist isn't only about knowing when and how to treat.

Sometimes it is about knowing when not to treat.

And sometimes the most important thing I can tell a client is: “This is something you need to discuss with your doctor.”

When Therapeutic Massage Made a Significant Difference for One Client

I once had a client come to AmaniTouch because of significant pain around her right shoulder.

Her movement was severely restricted.

When she tried to raise her right arm, she could barely bring it above horizontal without experiencing pain.

After discussing what she was experiencing, I provided a therapeutic massage focused on the shoulder and surrounding muscular structures.

I worked through the muscles around the affected area and also incorporated work involving the latissimus dorsi.

By the end of the session, something had changed.

She raised her arm again.

This time, she was able to lift it considerably higher and told me she could do so without the pain she had experienced before the massage.

She was extremely happy. And I was happy for her.

These are the moments that give me tremendous intrinsic satisfaction as a massage therapist. Seeing a client leave feeling and moving differently from when they arrived reminds me why I enjoy this work.

The client was so pleased with her experience that she later referred her cousin to me.

But her cousin's situation was completely different.

“She Helped Me, So Maybe She Can Help You”

Referrals are one of the greatest compliments a client can give a therapist.

But they can also create an interesting expectation.

If one person experiences significant relief after a massage, a family member or friend may naturally think: “Maybe the massage therapist can fix my problem too.”

That was essentially what happened here.

Her cousin came to AmaniTouch expecting me to help her.

But when she explained what she was experiencing, I immediately realized that we were dealing with a very different situation.

She described tingling in both feet that travelled upward in a sock-like pattern.

She also described tingling in her fingertips that travelled upward through her hands and toward her elbows.

She had come for massage.

But after listening to her and completing my assessment, I had to have a very different conversation with her.

“This Is Above My Pay Grade”

I was straightforward.

I told her: “Thank you for coming to see me. I can identify areas of muscular tension in your back, calves and other areas of your body, but the reason you came to see me today is above my pay grade. You should be speaking with your family doctor, not me.”

There were muscular areas I could have massaged.

But simply because I could find muscular tension did not mean massage was the appropriate answer to the symptoms that had brought her to the clinic.

And I wasn't going to pretend otherwise.

The pattern of symptoms she described was enough for me to recognize that her primary concern required medical evaluation rather than an attempt by me to solve it through massage.

So I referred her back to her family doctor.

Massage Therapy Has a Scope

This is something I believe clients should understand.

Massage and therapeutic bodywork can play an important role in helping people with muscular tension, discomfort, mobility concerns and other issues that fall within a massage therapist's scope of practice.

But massage cannot replace your physician.

A massage therapist should not feel obligated to accept every problem simply because a client walked through the door asking for treatment.

Sometimes we need to say: Yes, this is something I can work with.

Sometimes: I can work with part of what you're experiencing, but another healthcare professional should also be involved.

And occasionally: No. This needs medical evaluation before massage should be considered.

Knowing the difference is part of being a responsible practitioner.

What Happened After I Referred Her?

She listened to my recommendation.

She went to see her family doctor.

Her doctor ordered further testing and took responsibility for investigating and managing the symptoms that had originally brought her to me.

That's where those symptoms belonged.

But here's the interesting part.

She came back to AmaniTouch.

Not for me to take over what her physician was managing.

She returned for the massage services that were appropriate for me to provide.

And she became a regular client. In fact, she began coming to me weekly.

That experience reinforced something important for me:

Being honest about what you cannot treat doesn't necessarily cost you a client. Sometimes it is exactly what earns their trust.

You Don't Build Trust by Pretending You Can Fix Everything

It would have been very easy to massage the areas where I found tension and allow the client to believe I was addressing the reason for the tingling.

But that would not have been honest.

My responsibility isn't to prove that massage is the answer to everything.

My responsibility is to provide the best care I can within my scope of practice and recognize when someone's needs go beyond it.

That distinction matters even more when a client comes to a therapist because somebody they trust had a very successful experience.

One client's outcome does not mean another client's symptoms have the same cause.

And it certainly doesn't mean the same treatment is appropriate.

Knowing When to Refer Is Part of the Treatment Decision

Good therapeutic care begins before the massage starts.

It begins by listening.

Why is the client here? What are they experiencing? What are they expecting the massage to accomplish?

Does what they're describing reasonably fall within the therapist's scope?

And is there anything about their presentation that suggests they should speak with a physician or another appropriate healthcare professional?

Sometimes the correct treatment decision is not to begin treatment at all.

That isn't failure.

That's professional judgment.

Massage Is Helpful. But It Cannot Take the Place of Your Doctor.

I believe strongly in therapeutic massage. I have seen clients report meaningful changes in pain, muscular tension and ease of movement after their sessions.

Those experiences are part of why I love my work.

But believing in massage does not require pretending that massage can address every health concern.

Your family doctor and other healthcare professionals have roles that a massage therapist cannot—and should not—attempt to replace.

And a massage therapist has a responsibility to recognize that boundary.

At AmaniTouch, if I believe what you are describing falls outside my scope of practice, I will tell you.

I would rather refer you to the appropriate healthcare professional than provide a massage for something that requires medical attention.

Because sometimes providing good care means knowing what to do.

And sometimes it means knowing when to stop and refer.

Not Sure Whether Massage Is Appropriate for What You're Experiencing?

AmaniTouch offers a complimentary 15-minute Pain Assessment where we can discuss your concerns and determine whether one of our massage services may be appropriate for your goals.

When something appears to require medical evaluation instead, we'll tell you.

Book a Complimentary 15-Minute Pain Assessment