Every serious athlete needs a skilled RMT. We all learned this lesson the hard way, through trial and error, or the easy way: thanks, coach/mentor/experienced friend. RMTs (Registered Massage Therapist) are a lot like plumbers. You don’t really think of them until you desperately need one.
Some of us find a skilled RMT through sheer luck. We book a session with the closest clinic, luck out booking with a randomly great therapist, and continue training relatively pain-free. Others luckily get referred to “that guy” or “that woman” – the secret expert in your area for your particular fitness addiction (who might be tough as heck to book). Others (like me) once bounced from clinic to clinic due to mediocre sessions or convenience, or circumstance. This is counter-productive, to say the least.
Once I applied a more focused criteria of researching and hiring a new therapist, I quickly found an excellent RMT who fulfilled everything that I have outlined below. I recently moved, and I need to find a new RMT in my area, so I found writing this up really beneficial.
Before you begin, ask yourself: what do you want in an RMT? The answers will differ from athlete to athlete. Make a list as you read this post, and add any additional points that reflect personal preferences or needs based on your endeavours. I’ve compiled a few essentials that I’ve considered over the years I’ve spent competitively ultra-running.
However, I should stress that seeking massage therapy is for muscle and tendon pain that has not presented as serious injury (swelling and bruising). When in doubt, a physiotherapist or an MD can help differentiate the difference, and they can then refer you to massage therapy once they have ruled out serious injury.
First, the obvious considerations: are they licensed and accredited? Does the facility have a phone number, a receptionist, and more than one room? Do they have a website, Facebook or other social media? Can you book on-line? Are all the RMTs listed with individual contact information? Do they offer weekend and after-hours therapy? For me, these relative no-brainers made it easy to rule out the occasional option lacking some of these necessary considerations.
Secondly, if you are a woman, would you prefer a female RMT? If you are a man, do you feel weird about a male RMT? You shouldn’t (I’m a guy and I prefer male RMTs). In my anecdotal experience, male RMTs have dished out a more intensive myofascial release, possibly because men are conditioned to endure and dish out more pain. However, I have a high pain tolerance, and I am also aware that enduring more pain on the table means a quicker recovery on the asphalt. Not everyone prefers quick injury turnaround. Some athletes prefer a graduated comeback. Regardless, seek a clinic with a fair gender balance and trust that if licensed and accredited, they are legally bound to provide expert care.
Carefully communicate your pain tolerances to a new RMT and make sure you are they are asking the right questions about pain. If I tell my RMT to “go hard” when they hone in on an adhesion, I know it is going to hurt. Not everyone is going to want this in one session, so make sure your RMT is dialed in to your pain threshold. For example, I might grunt with pain at some point, but I don’t want the therapy to stop. This may be your “stop” zone. There is no correct or incorrect pain level. For me, I need an RMT who will do what it takes to get me running again ASAP.
When you first call or contact, try to do some research about what is bothering you. It is so much better to start an hour of registered massage therapy with massage, rather than clumsily trying to explain what is often a common problem treatable with massage. Even just “*body part* pain” can often allow them, with a few expert taps and squeezes, diagnose and treat your injury. And this is also a mark of a skilled RMT: fast diagnosis. Sometimes it is difficult to localize pain – this is normal. Try to foam roll or use a self-massage tool to find the source of trouble. Is it knee pain, or is it an IT adhesion? Is it Achilles pain, or is it a soleus adhesion? Is it heel pain, or is it plantar fasciitis? Running forums are great for this. If you’re not sure where to start on-line, find your favourite running magazine. It will probably have a free forum to browse and join.
Next, does the facility offer any other therapy? Are there physiotherapists and intra-muscular stimulation (IMS) practitioners practicing there? Do any of the therapists have multiple degrees? Is there a gym, a hot tub, ice baths (for teaching and recovery)? A change room? A treadmill? Showers? A water cooler? Self-therapy tools for purchase, practice or recommendation? Personally, I am fine with a session and an easy bike ride home, but to each their own. I once went to a clinic that had RMTS, physiotherapists, and IMT practitioners, with a hot tub, two treadmills, and a huge therapeutic gym. They were dialled.
I also expect to be taught during my sessions. How/why did my injury occur? Was it an accident or do I need to focus on an asymmetry in my physiology? Am I over training? What is actually happening in the muscles, tendon(s) and bone structure? How soon can I train again? What exercises can I start doing to fend off further or tertiary injuries? A skilled RMT will talk about their job, and their job is you!
On a personal note, I also need an athlete or former athlete to treat me. I need someone who can empathize with the hours I put in, the dedication, the devotion, the pain, the grit, the incredible punishment I put into my body 28-29 days a month. This person might work an extra hour that day if you email with a suddenly tight hamstring, or what feels like a tear in your hip. They might sacrifice a lunch if you bring them a smoothie and you tip them a bottle of wine (it is not crazy to tip or ‘bribe’ your RMT – as in any service-oriented profession, quid pro quo is the status quo!).
Do not immediately reject RMTs new to the profession or younger therapists in their 20s. One of the best RMTs I ever had was in my old neighbourhood: a young man in his early 20s who was fresh out of school, and it was obvious he’d studied hard and also excelled: he rattled off the names of obscure muscles, tendons, and bones like he was Henry Gray come back to life. He was also an accomplished athlete himself at the peak of his own fitness, so he really understood how important it was for me to return to training immediately.
Everything here I discovered through trial and error, basically by treating muscle injury on a case-by-case basis and booking last-minute sessions with randomly available RMTs in my area or near work. The most important lesson overall is to build a working relationship with the same person each time. This makes treatment far more efficient, as they become familiar with your history of injury and are able to pinpoint treatment quickly with the best working knowledge of your physiology.
Finally, establish a regimen of maintenance therapy (once or twice monthly bookings) so that injury does not arise, you are also less likely to delay treatment.
Guest Blog Post:Roy Kok (Long-distance runner)
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