Bridging Eastern and Western Perspectives on Massage

 People have developed many different ways of understanding the body, health, and the effects of massage. Western healthcare encompasses a range of approaches, from conventional biomedical medicine focused on anatomy, physiology, and measurable processes to complementary and integrative practices that consider physical, psychological, and whole-person well-being.

Eastern medical traditions are equally diverse. Traditional Chinese Medicine, for example, describes health partly through the balance and movement of qi (or chi), often translated as “energy.” Other traditions, including Ayurveda and various Japanese and Korean healing practices, have developed their own concepts and approaches. These systems should not be treated as interchangeable, but they share an interest in balance, function, and the relationship between different aspects of the body.

The language and models used by these traditions are different. Western biomedical approaches tend to describe massage through mechanisms such as muscle relaxation, nervous-system responses, pain perception, and changes in circulation. Traditional Eastern approaches may describe similar experiences in terms of restoring balance or supporting the flow of qi. These descriptions are not necessarily scientific equivalents, but they can provide different ways of understanding the same subjective experience.

For example, someone receiving massage might experience warmth, tingling, reduced tension, greater ease of movement, or a sense of lightness. A Western physiological explanation might consider changes in muscle tone, sensory nerve activity, circulation, or relaxation. Within a traditional Chinese framework, the same experience might be described as improved movement of qi. The experience itself is real; the interpretation depends on the framework being used.

The lymphatic system offers another example of how physiological and traditional perspectives can be discussed side by side. From a biomedical perspective, lymph moves through the body through muscle activity, breathing, and pressure changes rather than through a central pump like the heart. Movement and certain forms of massage may assist lymphatic fluid movement. Traditional practices may interpret sensations of reduced heaviness or improved bodily flow through concepts of balance and circulation of qi. These are different explanatory frameworks rather than direct translations of one another.

Ultimately, neither Eastern nor Western traditions represent a single, uniform way of thinking. Both contain diverse schools of thought, evolving practices, and different interpretations of the body. Modern research can investigate measurable physiological effects of massage, while traditional systems offer their own historical frameworks for understanding health and bodily experience.

Approaching the subject with curiosity allows room for both perspectives while recognizing an important distinction: a traditional explanation does not automatically become a scientific explanation, and a physiological explanation does not necessarily capture every aspect of how a person experiences their body. Massage can be understood through multiple lenses, and people may find different frameworks meaningful while still distinguishing established evidence from traditional belief.

Gluteal Work

A good massage begins with communication.

If English is your second language, or if your massage therapist uses terminology that you do not understand, please let them know. Your therapist should be willing to explain what they mean and make sure you are comfortable with what is being discussed before proceeding.

You should never feel embarrassed about asking a question. In fact, asking questions is one of the best ways to make sure you have a positive massage experience.

If something does not feel right during your session, speak up while you are still in the treatment room. Your therapist cannot correct something they do not know is bothering you.

For example:

• The pressure is too light: Tell your therapist when you first notice that you would prefer more pressure.
• The pressure is too intense: Let your therapist know immediately. More pressure is not necessarily better.
• You are uncomfortable with gluteal work: Tell your therapist before or during the session. Your therapist can explain why the area may be relevant to your treatment and can work around it if you prefer.
• You do not want oil in your hair: Ask your therapist to cover your hair, skip the scalp, or work on your scalp with clean, oil-free hands.
• You do not understand the term “draping”: Draping refers to the sheet and/or blanket used to maintain your privacy and modesty during a massage. Proper draping is a standard part of professional massage practice.
• You do not understand the word “emollient”: An emollient is simply a product such as massage oil, lotion, cream, or gel that helps the therapist work smoothly over the skin.
• You do not feel comfortable with your therapist: You have the right to stop the session. A professional therapist will understand that sometimes a client and therapist simply are not a good fit.

Your comfort and sense of safety should always be taken seriously.

Why Might Your Therapist Work on Your Glutes?

This is particularly important if you are seeking massage for lower-back discomfort.

Many people are surprised when a massage therapist recommends working on the gluteal muscles. Some clients may initially wonder, “Why are you working there? My back is what hurts.”

The answer is that the body does not always hurt exactly where the source of muscular tension or restriction is located.

The gluteal muscles are large, powerful muscles that connect functionally with the pelvis, hips, and lower extremities. They also work closely with the muscles and connective tissues surrounding the lower back and pelvis.

For that reason, a therapist may determine that addressing the gluteal region is an appropriate part of a massage intended to address muscular tension associated with the lower back and hips.

The area near the upper portion of the gluteal muscles is also close to the sacroiliac (SI) region, where the sacrum and pelvis meet. A massage therapist may work with the surrounding muscles and soft tissues in this region when appropriate.

This does not mean that every person with lower-back pain needs gluteal massage. Your therapist should consider your individual circumstances, obtain your consent, and explain what they are doing.

You Are Always in Control

Gluteal massage is a legitimate component of professional massage therapy and is included in the training of massage therapists. However, professional does not mean that you have to agree to every technique.

If your therapist recommends gluteal work, it is perfectly reasonable to ask:

“Why are you working there?”

A good therapist should be able to explain the clinical or therapeutic reasoning in language you understand.

You can also say:

“I'm comfortable with that.”

Or:

“I'd rather you skip that area.”

Both are perfectly acceptable.

The purpose of explaining the connection between the lower back, pelvis, hips, and gluteal muscles is not to pressure anyone into receiving gluteal work. It is to help clients understand why a therapist may recommend addressing an area that does not initially seem connected to their complaint.

Sometimes, treating the area around the problem can be just as important as treating the area where you feel the discomfort.

Speak Up During Your Massage

Please do not wait until the massage is over to mention something that could have been corrected during the session.

If you want more pressure, less pressure, a different technique, another position, more draping, less oil, or for an area to be skipped, say something.

Your therapist's job is not to guess what you are thinking. Your job is not to silently tolerate something that makes you uncomfortable.

Massage therapy works best as a partnership between the client and therapist.

The goal is simple: you should leave feeling that your time, comfort, privacy, and individual needs were respected.

My Least Favorite Massage - Prenatal Massage

One of the questions I am asked most often is, “What is your favorite massage to perform?”

I enjoy working with the various modalities in which I have been trained, and I am comfortable adapting my techniques to different clients and needs. However, if I am being completely honest, there is one type of massage I have never particularly enjoyed performing: prenatal massage.

Over the years, I have performed many prenatal massages, and despite having plenty of experience with them, they have never become a favorite of mine. My preference has remained the same throughout my career.

Why Prenatal Massage Is Challenging for Me

The primary reason is the side-lying position that is commonly used during prenatal massage.

Many expectant clients seek massage because they are experiencing discomfort in the back, neck, hips, or other areas affected by the physical changes of pregnancy. As a massage therapist, I personally prefer working on the back when a client can comfortably lie prone, because it gives me broad access to the entire posterior body and allows me to use the body mechanics that feel most natural to me.

Side-lying changes that considerably.

With the client positioned on one side, I am working with a different orientation of the spine and can only address portions of the back at a time. The same is true when performing scalp massage. I genuinely enjoy scalp work, but side-lying makes it difficult to access both sides of the head equally.

Then there are the body mechanics.

My technique is very dependent on positioning myself correctly around the massage table. With side-lying work, I find myself applying oil from different angles, rotating my arms and shoulders differently, and working with my hands and wrists in positions that simply do not feel natural to me.

In other words, my ergonomics feel completely different.

And after nearly three decades in this profession, I know what good body mechanics feel like for me. Prenatal massage takes me well outside of that comfort zone.

It's a Personal Preference

Some of the places where I have worked did not require every therapist to perform prenatal massage, while others expected all therapists to provide it as part of their regular services.

When given a choice, I have always preferred other forms of massage.

In fact, if you gave me the option of performing five Deep Tissue massages in one day or one 60-minute prenatal massage, I would choose the five Deep Tissue sessions without hesitation.

I would even rather perform a two-hour massage than a 50-minute prenatal session.

That is how strong my preference is.

This does not mean that prenatal massage is unimportant or that I do not appreciate the value it can provide to expectant clients. Pregnancy can place considerable physical demands on the body, and appropriately performed prenatal massage can be a wonderful way for an expectant mother to receive relaxation and comfort.

It simply means that prenatal massage and I have never been the perfect professional match.

Every massage therapist develops techniques, modalities, and treatment environments that suit their individual strengths and preferences. After all these years, I have learned what I enjoy doing, what I do well, and what I would happily leave to another therapist who genuinely loves prenatal work.

And I have a tremendous amount of respect for the therapists who do.

Health Care Provider

 💜💜💜 I am a CAMTC certificate holder.  I'm now considered a healthcare provider. 💜💜💜

Please Reschedule When You Are Sick

I strongly believe that massage therapy should be postponed when you are actively ill.

If you are coughing, sneezing, sniffling, experiencing significant congestion, have a sore throat, are repeatedly clearing your throat or lungs, have recently vomited because of an illness, or are experiencing other symptoms of a contagious respiratory or gastrointestinal infection, please stay home and reschedule your appointment.

Massage is a close-contact profession. During a typical session, a massage therapist may spend an extended period of time in close proximity to a client's face, respiratory system, and body. For that reason, coming to an appointment while actively sick creates an unnecessary risk of exposing the therapist and potentially other clients.

Why Massage Should Be Postponed When You Are Sick

There are several important reasons to reschedule a massage when you are experiencing an acute illness:

Contagious illness:
Massage requires close physical contact, making it possible for respiratory and other infections to spread between clients and therapists.

Your body needs time to recover:
When you are fighting an infection, rest and recovery should take priority. Massage is not a treatment for an acute infection, and receiving one while you are sick may leave you feeling more fatigued or uncomfortable.

Fever and acute illness:
Massage is generally not appropriate when someone has a fever or is experiencing an acute infectious illness. Your therapist may decline or postpone treatment if you arrive with symptoms of illness.

Protecting other people:
Your massage therapist has other clients, coworkers, and family members who can also be affected if an illness is spread through the workplace.

Please Do Not “Push Through” Your Symptoms

I understand that people sometimes hesitate to cancel an appointment because they do not want to lose their appointment time, pay a cancellation fee, or inconvenience their therapist.

Please understand that rescheduling because you are sick is not an inconvenience.

I would much rather have you contact me and say, “I'm not feeling well. I need to reschedule,” than have you arrive at the appointment coughing and sneezing and try to push through the session.

If you are unsure whether you are well enough to receive a massage, contact the establishment or therapist before your appointment and discuss the situation.

“I'm Almost Better” Still Matters

One of the most common situations is the client who says, “I'm basically over it. I just have this cough.”

If you are still experiencing significant respiratory symptoms, particularly frequent coughing, sneezing, congestion, or repeated throat or lung clearing, please consider yourself not yet ready for a close-contact service.

The fact that you are feeling better does not necessarily mean that you are no longer capable of spreading an infection. Follow current public-health guidance for the particular illness you have, and when in doubt, err on the side of protecting others.

Why This Matters to Me Personally

I take illness precautions seriously because I also have responsibilities outside of my massage practice. I provide care for an elderly family member, and an infection that might be relatively minor for one person can have much more serious consequences for another.

That means I cannot look at an obviously sick client and think, “It's probably nothing.”

If I become ill, it can affect not only my ability to work but also the people I care for and the clients I am scheduled to see.

When you come to a massage appointment while actively sick, you are not making a decision that affects only yourself. You are potentially exposing the therapist, other clients, coworkers, and their families.

Please, Stay Home

If you are actively coughing, sneezing, unusually congested, repeatedly clearing your throat or lungs, experiencing significant throat discomfort, or recovering from an illness that may still be contagious, please reschedule your massage.

Give yourself time to recover. Give your therapist the opportunity to remain healthy. And give the next client the same consideration you would want someone else to give you.

Massage can wait. Your health, and the health of the people around you, comes first.