A Reader's Question: Are Massage Therapists Fat Friendly?

A reader asks:

Are most massage therapists fat-friendly? Is it more difficult to do work on a fat person, and is it as effective for the client?

Thanks, Alice!

That's a good question and I'm glad you asked. I'm going to ask some massage therapists and see what they have to say about it. I can't speak for "most" massage therapists. Strangely, I don't recall it coming up in conversation so I don't know what other massage therapists would say. However, speaking for myself, I welcome anyone and everyone that I'm capable of accommodating. It pains me when I occasionally hear someone say that they'd like to get a massage but they are reluctant because of their weight. I want people to feel that my office is one place where they can feel good about themselves and accepted just at they are.

Please note: This article was written in January, 2009. Since that time I have learned some things about how massage works and about how the nervous system works that I didn't know then. My answer would be different now. I am keeping the article as it was originally written. However, I now know that we don't need to be able to palpate the muscles in order to treat pain. In fact, massage works through the nervous system. Receptors in the skin respond to our touch, send impulses to the brain, and it is the brain that makes the muscles relax or turns down the volume on pain. It is not direct pressure on the muscle. Therefore, it doesn't matter how much adipose tissue lies between our hand on the surface of the skin and the muscles below. This is good news.


I still welcome clients of all shapes and sizes and if I am unable to accommodate them for any reason, I am happy to help them find a therapist who can.  - Updated 8/17/13 by Alice


It can present some challenges for the massage therapist and some of this depends on the type of massage that you are doing. If you are focusing on relaxation, there should not really be a problem since the work is more general rather than specific. However, if you are trying to work with a specific pain problem, can be more difficult for the therapist to palpate bony landmarks and to directly affect the muscles below. If the therapist knows their anatomy well, they can compensate for this diminished ability to feel the tissues by their understanding of anatomy. Further, since the nerves that serve the muscles also serve the skin directly over the muscles, we can have an effect on deeper tissues even if we cannot touch them directly. My personal experience is that if I focus, I can sometimes eventually palpate more than than I initially realized. So yes, can be more challenging but it is certainly possible.

As for the effectiveness, this is going to vary with the individual client and is hard to predict. My suggestion would be for a person to try it and see if they find it effective.

As long as my table can safely support a person, they are always welcome in my office. If my table could not support an interested client, I would find a therapist whose table could support them. I would hope that other therapists would feel the same. If they do not, then perhaps they should seek another profession.

Ask The Massage Therapist has moved to http://www.massage-stlouis.com
Please come and visit us there! You can follow us on Twitter at massagestl

Reader Question: A Broken Foot

A reader asks:

"I broke several bones in my foot a number of years ago. Most of the time it's just fine. However, once in a while, it aches, is stiff or causes mild pain when I walk.

Can massage therapy help?"

It very well might and is certainly worth a try. Since it's your foot, a place you can easily reach, you can probably do this on yourself.

Besides the bones in your foot having been broken, no doubt the trauma that caused it also strained the ligaments, tendons, and muscles in your foot, too.

Here's where knowing exactly the right stroke to use can really make a difference. While gliding strokes may feel good, they won't be very effective. What will probably work best in this case is lots of friction (rubbing strokes).

The foot is very bony. There are lots of ligaments holding the bones together and lots of tendons going to the toes and around the ankle. The muscles in the foot are small and a little hard to access. They are between the five long bones that lead to the toes and on the underside of the foot beneath the thick skin of the sole and the thick tendonous structure known as the plantar fascia.

I'll describe how you can treat the entire foot. If the ache or stiffness is confined to a particular area you can concentrate on that area.

Friction is a rubbing stroke whereby you rub the skin over the tissue underneath. You can do it with or without oil but if you use oil, use only a little so that you still get some friction. Take the pads of your fingers and rub back and forth. Say you are starting at the ankle. You would rub the area thoroughly. The pads of your fingers will glide over the skin just a little as your are gradually moving around from place to place, but your fingers are not gliding a lot over the skin. It is as if you are reaching through the skin and "scrubbing" the joints, ligaments, whatever, underneath. Do this thoroughly, work around all those bony nooks & crannies. It should create a little warmth. This is very good for the joints, tendons, and ligaments. Do this all over the foot or concentrate around the area of discomfort.

Getting at the muscles between the long bones is a little challenging, but you can take your fingertip and friction between the long bones of the foot located between the ankle and the toes. As I said before, imagine that you are trying to scrub between those bones.

The underside of the foot is also a little challenging because the structures we want to affect are beneath some very thick tissue. If you make a loose fist and use it to rub the area, you can penetrate the thick sole of the foot. Using your thumbs to press into this area and stroke the arch longitudinally is good, too.

Gently mobilizing the many joints of the foot can be helpful, too. Firmly grasp your foot in both your hands and gently move the foot so that the various joints are moved as much as is comfortable. This should not cause any pain.

This can be done regularly or occasionally when the foot is feeling fine as a preventive measure. If the foot is feeling achy, it can be done to try to relieve discomfort. If you know you are going to be in a situation that may cause discomfort, it can be done beforehand, during the stressful activity, and afterwards.

By the way, this treatment is also good for dancers, runners, and anyone who stands on their feet a lot.

I hope this helps!

How To Contact Us

If you have a comment or a question about massage therapy in general or about a point raised in a particular article, please leave your question or comment in the "Comments" section of that article or in the section "Ask Your Questions Here!"

However, if you need to contact me personally, send an email to:

askthemassagetherapist [at] gmail.com

Of course, I've spelled out the "at" symbol in an effort to foil the bots that roam the internet harvesting email addresses so they can spam them. Be sure to use the appropriate symbols for "at."

I look forward to hearing from you!

Thanks,

Alice

How Do I Ask A Question?

Jean asks, "How do I ask a question?" It's very easy.

I've created a section specifically for your questions titled "Ask Your Questions Here!" You can find that section easily by clicking on the label "Ask A Question" at the top right side of the screen. You'll be led to an entry inviting your questions and at the end of that entry you'll find some small print that starts with the words, "Posted by Alice Sanvito." It will give the time it was posted and, following that, it will say, "comments." If you click on that word "comments," it will take you to a page with a box where you can leave your question or comment. After you've written your question, you can select "publish your comment" or "preview." When you are satisfied with what you have written, select "publish." Your question will be forwarded to me and I'll respond as soon as I am able. Your response may come as its own article or entry, such as this one, or if it is a short response it may be posted in the comment section after your own comment.

Questions and comments about other articles may be posted in the comments following those articles. Every new entry is followed by a place where comments can be made. If your question or comment is specific to a particular entry, you can post your comment at the end of that entry. If you have more general questions or a topic you'd like to see covered, post it in the "Ask Your Questions Here!" section.

It's very easy. Thanks for asking!

Ask Your Questions Here!

Do you have a question about massage therapy?

If you have you never tried it but are curious and would like to know more, this is your opportunity to ask questions. Don't worry, your questions are not silly! If you are thinking of them, someone else is probably wondering the same thing, too. Do both of you a favor and go ahead and ask!

Are you an existing massage client who has questions? Please ask! I'd love to try to answer them.

Are you a beginning massage therapist who would like some input from an experienced therapist? We all start out with a lot of questions, from how to handle specific conditions to client/therapist relationships to getting those pesky oil stains out of the sheets. I've been practicing for seventeen years and would love to share the benefit of my training and experience with you.

Are you an experienced therapist who has some specific questions and would like another therapist's input? We never quit having questions and it's wonderful to have other experienced therapists to talk to. Get another experienced therapist's point of view.

Whoever you are, you are invited to submit any questions you may have. I'll do my best to answer them and be honest when I can't.

I look forward to hearing from you.