Is getting a massage a substitute for physiotherapy?

If you're emerging from 2020 with a long list of aches and pains, you aren't the only one. Not only has this year been intensely stressful - which can have physical manifestations - but there are many pandemic-specific reasons why you might have been placing your body under strain.

This year, many people found themselves working from home for the first time. Although some had the benefit of a dedicated home office, others worked in less-than-ergonomic set-ups. With gyms closed, some people began new exercise regimes and ended up getting injured. Others, forced to balance the needs of work and childcare, spent more time than usual running after their kids.

In one survey of 2,000 Brits, commissioned by Nurofen, 36% of respondents said they had experienced increased back pain during lockdown.

If you fall into that bracket, you might be left craving a massage. Classed as a 'personal care' service, massage therapists in the UK have been allowed to operate as normal throughout the year, apart from during the spring and November lockdowns. However, before you book, it's worth considering the nature of your complaint - would a massage be best, or would it be preferable to see a physiotherapist?

How to know you need a massage

If you're looking for relaxation, stress relief and general tension release, you're in safe hands with a massage therapist. The same applies if you're training hard and want to alleviate any niggles before they turn into serious injuries.

"If you are someone who is feeling tight and slightly achy without the presence of persistent pain then a massage therapist is the person you should see," says Jayden Arnold, head of physio at Ten Health and Fitness. "They are the experts at hands-on soft tissue release to help ease tight and sore muscles, and improve joint mobility. If there is pain or persistent dysfunction, however, it's better to see a physiotherapist initially. They can diagnose the issue and may then recommend massage as part of the treatment plan."

Reasons to seek a massage

"The main circumstances when it is beneficial to see a massage therapist are twofold," says Aisling O’Malley, Clinical Specialist Physiotherapist at London Bridge Hospital (part of HCA UK). "One when you are physically training - for, example, running a half marathon - and are aiming to promote recovery. The second is if you feel aches and pains from your day-to-day activities or work, as it can be a useful tool to help manage stress and body aches."

Nick Torry, a South East London-based massage therapist specialising in Raynor Naturopathic Massage, points out that massage can be useful for recurring tension or tightness. The most common complaints he sees are tight shoulders and sore backs - the latter of which is often related to unacknowledged problems in the hamstrings and hips.

"Physiotherapy is useful for the times when you have a discernable physical problem - you'd go to a physio and they'd give you an assessment," he says. "With a massage therapist, it could be physical, but it could also be mental, and it could just be that you want to relax. If you've got aches and pains that are being exacerbated regularly, a sports massage can help with that."

Finding the right type of massage for you

He adds that there are various different schools of massage, ranging from very focused sports massage to energetic approaches grounded in Eastern traditions. And while massage therapists aren't trained to diagnose injuries, they do provide a holistic, mind-body treatment.

"You won't necessarily come out of a physiotherapist with a greater sense of emotional or physical well-being," he says. "But you're highly likely to have benefited from a massage in some way, even if it's just in the sense of taking some time and space for yourself."

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How to know you need to see a physio

If you're experiencing new and persistent pain in your body, or you've sustained an injury, you should see a physiotherapist - whether privately or via referral from a GP.

"The first port of call is to take relative rest for one to two days and then start to move and use your body again," says O’Malley. "If you struggle to regain normal function, you should seek advice from a physiotherapist. Remember that a physiotherapist can advise you whether it is appropriate to see a specialist physician, seek imaging or seek alternative treatments such as massage or acupuncture."

The physiotherapist should be able to diagnose the issue, explain the mechanism of injury, and provide a rehab plan to help you fix the issue. Massage may also play a small role.

"A small component of physiotherapy is providing hands-on soft tissue release, to help with immediate improvement or pain or function," says Arnold. "But the overwhelming majority of work they will do is exercise- and rehabilitation-based. You should see a physiotherapist when you have any pain affecting the body and the way you live your life."

He thinks it's critical to seek a professional opinion on any injuries, just as you would see a dentist if you were having any problems with your teeth. Even when sports injuries seem minor, they can sometimes have lasting consequences that will need addressing further down the line.

"Don't be afraid that by going to see a physiotherapist, you will have to stop doing what you love," he says. "Whenever possible they will try to keep you doing as much of the exercise and activities you love while doing your rehabilitation, not telling you to totally stop and rest."