Mindfulness can be described as the practice of deliberate connection with the sensory abilities of the body. It is a quieting of the “thinking mind” and has been shown to have a significant range of health benefits. Mindfulness practice is something that can be easily integrated into your massage practice and in this article we will explore how this can be done and why as a remedial massage or myotherapist you should consider this in your practice.

Massage effects – is it all mechanical?

In a previous Bright Health Training blog we looked at the effects of massage on chronic lower back pain. Specifically, we reviewed the result of a 300 participant study that compared relaxation massage with remedial (or structural) massage and a control group. The findings where that both forms of massage produced significant improvements clinically, in function and pain. In fact relaxation massage showed slightly better results overall and of the two forms still showed significant improvements in a 12 month follow up. So the question has to be asked, are the effects of massage all about mechanical changes to the body?

It is now clear that lengthening fascia through manual manipulation is basically impossible and any changes in tissue length in a clinical session will quickly change back to its original length after a treatment. So what are the possible mechanisms for improving pain syndromes such as chronic non-specific lower back pain? Well it is most likely that it is in fact neurological not mechanical. And the fact that relaxation massage is as good or better than remedial massage to relieve pain supports this idea.

So news flash! Massage therapists, when we think about improving pain and function, we need to start thinking more about the brain and the nervous system, whilst still keeping in mind biomechanical function.

What Are the Benefits of Mindfulness?

Mindfulness has been identified as one effective way to improve a significant number of different areas of health. Some of the most significant include improvements in mental health, immune function, stress and pain. Recent developments in the understanding of pain and how chronic pain develops have been exploring many of the psychological factors involved. It has been discovered that catastrophizing and injury and negative emotions associated with an injury play a large part in developing chronic pain syndromes, even after tissue healing is complete. In one landmark study from Perth, it was shown that catastrophizing is linked to a lack of mindfulness.

Why is catastrophizing important to recognise? Catastrophizing pain has been shown to be linked to the development of chronic pain. The reason for this is that with catastrophizing, there have been significant changes noted in the way that the brain processes pain, and this can lead to the development of chronic pain syndromes.

So mindfulness can be a way to train your brain into reducing the sensation of pain and reducing the effects of the pain experience. It is very likely the case that the effects of mindfulness training will go some way to explaining the pain reduction experienced during repeated relaxation massage treatments.

The final point to note regarding mindfulness and pain, is that mindfulness has been shown to literally change the way your brain is structured and used. And for someone with pain or without pain, mindfulness training has been shown to develop “sensory” thinking (focusing on the feelings and sensations of the body) and reduce cognitive thinking (focusing on the constant flow of thoughts).

How Can Mindfulness be Integrated with Massage?

So how can we integrate mindfulness training with massage therapy? There are multiple ways that this can be done, with everything from guided relaxation and meditation through to movement therapies. Here we will give you one formula that you can use with your clients.

Firstly this will work best with a relaxation style of treatment, so if you are performing deeper style techniques it might be best to do the more intense techniques first and then follow with mindfulness practice.

Step 1. While you are treating, ask your client to spend some time focusing on their breathing. Don’t get too concerned about breathing a certain way, but encourage relaxed abdominal breathing. It is much more important that the client is simply concentrating on the sensation of breathing.

Step 2. Instruct your client to let any thoughts that distract their mind to simply pass and then draw their attention back to their breathing. Get them to do this for about 5 minutes.

Step 3. Ask the client to focus on the sensation of the massage, in the same manner that they did previously, when thoughts distract them, just acknowledge the thought and then draw their attention back to the feeling of the massage. What this will be doing is developing the connections in the brain relating to body sensations, whilst reducing activity in the areas of the brain related to thought.

Step 4. When working through any areas that the client experiences are painful or uncomfortable, ask the client to actively relax and focus on a sensation of healing, releasing or calming. One of the best ways to do this is to ensure that they don’t allow muscular guarding to occur or elevate their relaxed breathing.

Step 5. Ask the client to be conscious of any thoughts that arise that might be judgemental about pain, function or injury. Again, tell the client to not “correct” their thinking, just make a note of it and return their focus to the sensation of the massage and relaxation.

Mindfulness is different from therapeutic approaches that might seek to “correct” thinking or behaviour, instead it is a training method to improve the brain’s connection to the sensations of the body. We now know that chronic pain is more about the brain’s perception of what is occurring in the body, specifically it develops an inaccurate assessment of what is occurring in the body, which is often based around fear, social stress and catastrophizing a problem. By using mindfulness training, any thinking is reduced and instead a stronger connection between brain and body is developed.

Where Can I Find Out More About Mindfulness?

Mindfulness training takes on many forms but here are some great links that I recommend you look at if you are wanting to get more information about using mindfulness and other brain training techniques in massage and myotherapy practice.

http://www.actmindfully.com.au/ Acceptance and Commitment Therapy website with courses for both clients and therapists.

http://www.bettermovement.org/ Feldenkrais and Rolfer Todd Hargroves’ site which has his book and information about mindful movement, an excellent resource for therapists or for someone to watch.

http://www.greglehman.ca/ Physiotherapist and Chiropractor Greg Lehmann has free online books and courses available to practitioners that are wanting to learn more about pain and the brain.

Good luck and please keep in “mind” that the benefits of your massage and treatments are not always about how hard your pressure is!