Your Foot + Plantar Fasciitis

Pain in the heel when you take your first few steps in the morning - it can be dull or stabbing pain, but it subsides after walking around for a few minutes. Does this sound familiar? It’s the hallmark symptom of plantar fasciitis, and about 10% of us will experience this pain at some point in our lifetimes.

What the heck is a plantar fascia?

The plantar fascia, also known as the plantar aponeurosis, is a triangular band of connective tissue on the sole of your foot. It attaches at the calcaneus (your heel bone) to the metatarsophalangeal joints (where the base of the toes meet the foot, think toe knuckles). The plantar fascia protects the foot’s deeper structures, supports the longitudinal arch, provides an attachment point for muscles, and helps distribute load through the foot when you’re walking, running, jumping, etc. Whether or not you’re aware of it, the plantar fascia is a structural rock star!

Why does my heel hurt?

The cause of plantar fasciitis is thought to be collagen degeneration at the calcaneal attachment, meaning the tissue just isn’t as robust as it once was. Repetitive microtears to the plantar fascia can exceed the body’s ability to heal itself. Risk factors for developing plantar fasciitis include activities like distance running, age, and having low - or high - arches.

The body will generally heal itself when it comes to plantar fasciitis - although that process can take anywhere from six to eighteen months. The good news is that recovery is easier the sooner you get treatment! First line interventions include stretching the foot and calf, strengthening the intrinsic muscles of the foot, wearing thick soled shoes with a wide toe box, and - you may have seen this one coming - massage.

Because the plantar fascia is relatively superficial, it’s among the easiest structures of the foot to massage. And real talk, who doesn’t love a skilled foot massage? We like to think holistically in massage, so in addition to the entire foot we’ll want to consider any muscles that attach around the heel - that means your calf is going to get some love as well.

Any other advice?

And here’s our Mantis PSA on foot health - whatever shoe you like to wear, make sure it’s big enough for your precious feet! Toes need to spread, and your foot needs to pronate AND supinate as part of the gait cycle. One more tip: toe spacers can be a wonderful, inexpensive tool for engaging those intrinsic foot muscles. Throw them on when you’ll be walking around the house, thirty minutes to an hour should be plenty.

If you’re struggling with plantar fasciitis, don’t delay. We can help, and your feet will thank you.

Myofascial Release

Myofascial release: this is a big topic for a tiny blog post, so get ready! First, let’s revisit fascia. Fascia is a matrex of connective tissue that supports most of the body’s structures. Depending on the location and function, fascia can be thin and elastic or dense and fibrous. Superficial fascia supports the deep and superficial adipose layers under the skin, and provides a matrix for the lymphatic vessels. Visceral fascia suspends and wraps the internal organs in their respective cavities. Deep fascia separates individual muscles and also groups muscles into larger compartments, like the calf and the thigh. What a wonder is our fascia!

What is MFR?

Myofascial release is an umbrella term for any massage technique that considers not only a muscle but also the fascial compartment(s). A lot of modalities fall under this umbrella. Trigger point therapy is a myofascial technique, as are structural integration approaches like Rolfing or Anatomy Trains. Even foam rolling is a form of self myofascial release. Why? Imagine foam rolling your hamstrings (or grab your roller and try it out, we’ll wait). As you roll down the back of your leg, starting from the bottom of the pelvis to the back of your knee, you’re affecting your hamstrings and also the superficial and deep fascial tissue of the upper leg compartment. Now imagine a massage therapist gliding their forearm or loose fist down your hamstrings, as we are likely to do in a session addressing the legs. It’s not unlike the experience of foam rolling. Put that way, it sounds like all massage incorporates myofascia release.

Some myofascial modalities make use of long, slow contact around an area of tension or restriction - this is the stuff of John Barnes, one of the practitioners who helped catapult the term “myofascial release” to the industry buzzword it is today. The Anatomy Trains approach of Thomas Myers incorporates pin and stretch into the technique. An example: your therapist might compress (pin) a tender spot while you slowly mobilize and lengthen (stretch) the affected body part. Fascial stretch therapy stretches not only isolated muscles but myofascial continuities in the body, and unlike the slow approach of Barnes, this work is fast and energizing. Myofascial techniques can feel deep and pinpoint, like in trigger point therapy, or light and broad.

The myofascial techniques of Barnes or structural integration are performed without any lubricant, with the therapist compressing an area of restriction and then gliding against it in a shearing motion. Trigger point therapists, on the other hand, might use some lubricant to avoid aggravating the skin.

A note on release:

The mechanism of myofascial release is still theoretical, but we’re probably not “releasing” anything, not literally. A massage therapist or foam roller is no match for your body’s structural integrity - and that’s a good thing! Imagine trying to walk if your plantar fascia kept releasing with each step. When an area of sensitivity or restriction is moving freely and without pain, it can feel like something has released. That’s what we mean here.

Products We Use at Mantis!

What products does Mantis use?

We stock Biotone and Sacred Earth products at Mantis. The creams are both hypoallergenic, fragrance free, nut free, gluten free and cruelty free. Sacred Earth is vegan and has a slightly thicker consistency. Our therapists develop their own preferences, but clients usually don’t notice a difference between the two creams. For oil, we use a Biotone massage oil which is also vegan - although it is not nut free. All options are fast absorbing and kind to sensitive skin. Do let your therapist know if you have a preference on massage lubricant, or if you prefer no lubricant at all!

We’ve also had clients bring in their own lotions to use during appointments due to allergies so that’s always an option if our usual products don’t quite work for you.

Essential oils and Tiger Balm - oh my!

Your therapist may incorporate additional topicals into your session - with your okay. Peppermint essential oil can be cooling and locally analgesic when applied to skin, like a natural BioFreeze. It’s also helpful for opening the sinuses if you’re congested after lying prone in the face cradle (or from Texas pollen). Tiger Balm is a thick salve, made with menthol, camphor, and capsicum extract. It feels both warming and cooling at the same time. Peppermint oil and Tiger Balm are only applied to a targeted, painful area. We wouldn’t use them over your entire body.

Massage + Sciatica

Let’s celebrate your sciatic nerve!

The sciatic nerve is the longest and widest single nerve in your body. Originating in your lumbar spine, with nerve roots from L4-S3, your sciatic nerve runs through the hip and all the way down your leg. Around the back of your knee, the sciatic splits into its terminal branches: the tibial nerve, which innervates the back of your calf, and the common fibular nerve, which innervates the outside of your lower leg. We may only think about our sciatic nerve in regards to that burning pins and needles sensation known as sciatica. But without a sciatic nerve, you’d have no motor control over your hamstrings or calves, and you literally wouldn’t be able to feel your feet! And you actually have two sciatic nerves - one for each leg. So the next time you enjoy a barefoot walk on a sandy beach, thank your sciatic nerves for their faithful service.

But can you please talk about sciatica now?

Sure thing. Sciatica is a shooting pain and/or numbness from the low back/hip and into the back of the leg. Some lucky individuals feel the pain all the way into the heel of their feet, although it most commonly stops somewhere in the thigh. There are myriad causes for sciatica, and they generally involve something compressing the nerve: a herniated disc; a tightened piriformis muscle (this is called piriformis syndrome); pregnancy and tumors. Risk factors include type 2 diabetes, sitting or bending for prolonged periods, nicotine use, and current or previous injury to your low back. And while about 40% of Americans will experience sciatica, the good news is symptoms usually resolve within a few weeks to months.

Will massage help sciatica?

You bet! Massage is a wonderful salve for sciatica. Your therapist will want to know where exactly you’re having pain or discomfort, and they may also massage areas where you don’t have any symptoms. Think back to those sciatic nerve roots in your lumbar. Not everyone with sciatica is also experiencing low back pain, but decompressing the lumbar spine sure can help ease the sensation. They will also likely do a detailed treatment to your hip. If you’ve never had your glutes massaged before, trust us on this. Remember that piriformis muscle we mentioned earlier? It connects your sacrum to your femur and your sciatic nerve runs either through or behind it. Relaxing that tissue can go a long way in providing sciatica relief. Your therapist might also include some stretches to the hip and leg as well! After your session, you should notice a dramatic reduction in your symptoms - sometimes they’re even gone completely.

Remember, your sciatic nerve is working hard for you, and sometimes it needs a little love. If sciatica has got you down, we’re here to support you while your body heals itself.

Let's talk modalities: Swedish Massage!

We’re taking it back to basics this month with the massage modality that started it all (in the western hemisphere, anyway). That’s right, it’s time to talk about Swedish massage! Developed by European physicians in the early 1800’s, many subsequent modalities assume familiarity with Swedish techniques.

So what is it?

Swedish massage consists of three primary strokes: effleurage (long, gliding strokes down the length of the muscle); petrissage (kneading and lifting muscle); and tapotement (percussive vibration, think burping a baby). Another component of Swedish massage that doesn’t get a fancy French name is joint mobilization (when your therapist gently rotates your neck, or shoulder girdle). This type of massage uses cream or oil as a lubricant, and the client is undressed and draped. It’s also super relaxing, and pairs well with frou frou elements like soft music, essential oils, and an eye cover. If you want a calming massage to zen out to, Swedish just might be the thing!

What are the benefits?

In a nutshell, stress relief and relaxation is where Swedish massage shines. Of course, there are myriad benefits that come with reduced stress: temporarily decreased pain and blood pressure, better sleep, and improved sense of well being. The holistic, generalized techniques of Swedish massage also make it a great place to start if you’re new to bodywork. Not sure what to ask for? You can’t go wrong with the basics.

Who is Swedish massage not for?

Determining the right modality will come down to individual preference, to a certain extent. However, Swedish massage can lack the specificity that you’d find in, say, a trigger point massage. If you’ve got this one spot in your upper back between your shoulder blades that just won’t stop hurting - Swedish might not be the approach. Remember, though, that we’re focused on our client’s goals, and not the dictates of any one modality. We blend and borrow different techniques all the time! Your therapist might do some deep tissue work on your upper back and shoulders, and Swedish for your arms and lower body. It’s always best to start with how you’re feeling and what your goals are - we can take it from there.

Your Massage FAQ's

We get a lot of questions - and we love it! Client curiosity helps us build rapport, establishes trust and keeps us on our toes. We thought we’d address some of our most commonly asked questions here.

What are the benefits of massage therapy?

Goodness, do you have all day? We’ll try to keep this brief: reduced pain, improved range of motion, better sleep, an overall sense of well-being, and reduced stress are all known benefits of massage!

Did you go to school for massage/are you licensed to do this?

Yes! Texas requires 500 hours of education from a licensed massage school. The curriculum covers things like anatomy and physiology, pathology, ethics, and of course - lots of massage techniques. There is also a formalized internship process where we see clients to hone our skills, but do not receive any payment (because we’re not licensed yet). We then have to pass a background check and a licensing exam. After those hurdles are cleared, we can officially begin our careers as Licensed Massage Therapists! But we’re not done - licenses are up for renewal every two years, for which we complete continuing education. You never stop learning in this field.

How should I prepare for a massage?

Massage, in general, is come-as-you are. Make sure you’ve had enough to eat and drink before your session - low blood sugar and dehydration aren’t conducive for massage. Sunburns are also no fun, so use sunscreen if you plan to be outdoors in the days leading up to your session (plus you’re reducing your risk for skin cancer!). If you have any communicable skin conditions (athlete’s foot, poison ivy, etc) be prepared to keep that body part covered. Finally, come clean to your session. While we’re generally not squeamish around bodies, maybe don’t run a 5k if you won’t have time to shower before coming in.

One more note: If you have an infectious illness, or have had a fever in the past 24 hours, please reschedule. That’s just basic public health stuff.

What are the different types of massage, and which one is best for me?

The two most common modalities are Swedish (flowing and relaxing) and deep tissue (targeted and therapeutic). If you’d like a deeper dive, we have posts on sports massage, prenatal massage, manual lymphatic drainage, Thai and ashiatsu, and cupping. And while it can be helpful to know the different modalities, what’s most important are your goals for the massage. Clients come in for myriad reasons: relaxation, chronic pain, muscle soreness, “just because” - or all of the above. For example, maybe you want to unwind during your session and leave feeling refreshed, but you’ve also been on your feet a lot and the dogs are barking. Your therapist might focus on relaxation for much of the session and incorporate some deep tissue on your feet. Maybe your low back and hips feel tight and you can’t turn your neck to one side - how about some stretching in the hips, and myofascial release in the neck and shoulders? We can pull from multiple modalities to customize a session around your goals.

What are muscle knots and why do I have them?

This is another one we’ve covered before! In short: while there’s not a literal knot in your muscle fibers, it can certainly feel like there is. We call them myofascial trigger points: those localized, irritable spots that might even refer pain elsewhere in the body. How they got there in the first place can be related to muscle weakness, repetitive use, keeping a static posture for much of the day. Whatever the cause, we know that massage helps.

Can I get a massage while menstruating?

Yes! In fact, massage can help with some common symptoms: back pain, fatigue, abdominal cramping. You can let us know if you’re having symptoms related to your period, we’re not shy.

And there you have it, six of our most frequently asked questions. What questions do you have about massage? Maybe this post will need a sequel!

Massage & Health Insurance

Fun fact: the state of Texas considers massage therapy a health care service “if the massage therapy is for therapeutic purposes.” Some redundancy in the language, but there you have it: massage is health care. So does that mean your health insurance will pay for it? You might be pleased to know that oftentimes the answer to that is yes!

If you have an HSA or FSA through your insurance or employer, you’ll want to find out if massage is an approved expenditure. If it is, you can just pay with your HSA/FSA debit card at check out. Easy peasy.

Another option is to see if your insurance will reimburse you for your massages. We can provide a super bill with the receipt, session notes and CPT code which you will share with your insurance provider. Sometimes, they will also ask for a diagnostic code. Diagnosis is outside our scope of practice as massage therapists, but providing a clinical reason (such as pain, limited range of motion, or stress relief) for the massage is usually sufficient. Your insurance may also want a doctor’s note prescribing massage. While no one loves an extra hoop to jump through, telling your health care provider what you would tell us - chronic pain, tension, and/or restriction - and then asking for a referral for massage generally does the trick.

What can I do if my insurance/HSA/FSA doesn’t pay for massage?

We strive to keep our prices affordable to our clients - while also providing a living wage for our therapists. If you’re new to Mantis, let us explain a little bit about our pricing. We have two tiers: a standard rate and advanced rate. Therapists working in either tier are equally skilled at Swedish and deep tissue massage; advanced therapists also offer a more specialized skill set (if you’re not sure who to book with, read our therapist bios or give us a call). Keep in mind as well that Mantis is a tipless studio - you never have to calculate an additional percentage for your therapist, they’ve already been fairly compensated for the session.

If you’re wanting to prioritize bodywork without going broke, we’re here to help! We have a loyalty rewards program that automatically discounts every sixth massage, and we offer discounted packages year round. It’s also worthwhile to get on our mailing list, so we can send you the occasional coupon just for being awesome, and also let you know about our promotional e-gift cards - Black Friday is kind of a big deal, iykyk. Note that HSAs and FSAs generally won’t pay for our e-gift cards or packages, but you still rack up loyalty rewards!

Finally, let your therapist know what your therapeutic goals are. We can be proactive about offering self care practices at home, and suggesting a massage routine that strikes a balance for your needs and your budget!

How to Prepare for a Massage!

People come in for their first massage at all walks of life. From college athletes to middle age desk workers or retirees enjoying their golden years, it’s never too late (or too early) to try a massage. Sometimes people just aren’t sure what to expect, and so they put off making the appointment. We understand feeling apprehensive over the unknown, but also - wouldn’t it feel good to have those achy muscles massaged by a professional already? Let this be your guide to how to receive a professional massage: what you should know, and how to prepare.

The day of your first massage, make sure you’ve had enough to eat and drink. It’s very hard to enjoy a massage while dehydrated or hangry, and we want you to get the most out of your session. It’s also a good idea to use the restroom right before your session starts. Massage stimulates your parasympathetic nervous system (the rest and digest side), which means your bladder may get full while you’re relaxing. The day or two before your massage, wear sunscreen if you’ll be spending time outdoors. Sunburns don’t like to be touched, and touch is what we do here.

Once you get here your therapist will ask about your goals for the session. It’s a good idea to check in with yourself the day of your massage. What areas of pain or tension do you notice? Are you feeling stressed? Tired? This is all useful information for your therapist. After your intake, the therapist will step out of the treatment room and you can undress and get on the massage table. Some modalities are practiced fully clothed. Most of the time, however, our clients undress for their massage. You’ll be draped with a sheet and comfy blanket, and we can even turn on an electric table warmer if you like to stay toasty.

During the massage your therapist will focus on the area(s) discussed in your intake. You will remain draped for the entire session, exposing only the body part being massaged. Your therapist will check in with you on pressure - your tolerance may change during the massage - but also speak up anytime if more or less pressure will feel better. Generally, you will be massaged lying face up and also face down. Your therapist will tell you when it’s time to turn over and they’ll hold the drape for you. If those positions aren’t comfortable to you, you can also be massaged while lying on your side. Oh, and the face cradle your head is resting in while face down is also adjustable. You should be lying in a position of comfort at all times, we even have special pillows if your chest needs more support while prone.

You might be surprised how quickly 60 or 90 minutes can fly by, and just how much relief you can feel. Reach out if you have any questions or concerns before your first session. We can also make recommendations for which therapist to book with based on your needs. There’s no need to put off scheduling your first massage any longer!

Let's talk modalities: Sports Massage!

It’s time for another installment of know your modality! Today we’ll be discussing sports massage, a close cousin of deep tissue. These two modalities have so much in common the intention behind them can be what distinguishes a sports massage from deep tissue.

Sports massage targets the muscles most utilized in an athlete’s given sport. It is intended to facilitate recovery, thereby improving performance. Like with deep tissue, the pressure can often be quite firm. A sports massage won’t necessarily be a full body session; we’re more focused on treating areas of injury or pain. Of course, you don’t have to be a professional athlete to benefit - whether you’re an avid crossfitter or training for your first 5k, a sports massage will address training-related tension. You might feel a bit sore afterwards, but a skilled sports massage can help you get your swing back!

One note of caution - sports massage is not as relaxing as other modalities. Again, this is where intention matters. A sports massage is usually about helping the client feel a sense of relief - alleviating a marathon runner’s tight hips, for example - and it takes some sweet discomfort to get to that place of relief. If you’re looking to relax and unwind, a Swedish massage might be more your style. Even marathon runners want to relax sometimes, we got you.

Any of our therapists can offer sports massage, although some are particularly skilled with certain injuries. We’re always happy to help match a client with the best-suited therapist for their goals. Call or text us if you need help determining which therapist to book with!

Jaw Tension, More Common than You Might Think!

Upper back, neck and shoulders are the most commonly requested areas of focus from our clients, followed by low back and hips. And doesn’t it feel good to have tension in those areas worked out! A good back massage can be life changing - okay, maybe not quite, but it can certainly feel life changing in the moment if your shoulders have been tense for a while. 

Sometimes, clients will mention another area of tension in passing. “My shoulders feel like they’re up to my ears, and I’m grinding my teeth in my sleep, but you probably can’t do anything about that.” …Actually, we can totally help with that. Surprised? We’re going to address some of the overlooked areas for massage, starting with the jaw. Are you a teeth grinder? Do you get frequent headaches? Is it ever difficult or painful to chew? This post is for you.

Let’s start with a brief anatomy overview: the lower jaw moves at the temporomandibular joint, which is where your jaw meets your cheekbone. Several muscles help move the TM joint, the most prominent being your masseter. Put your hands on your cheeks and clench your teeth. That bulging muscle you feel is your masseter, and it is the most powerful muscle in the body relative to its tiny size. Have you ever struggled to chew through an overcooked piece of meat? Thank your masseter for its service.  

Assisting the masseter in chewing, and also moving your lower jaw from side to side, are the pterygoids. They are deep to the masseter, and you have two on each side of your face. You can partially work the pterygoids from the face, but the most direct access is from inside the mouth, above your upper molars. Several of our therapists are trained in intraoral massage. Don’t worry, they wear gloves.

Finally, the temporalis muscle connects the side of your skull to your lower jaw, also helping to move the TM joint. Bite down again, this time with your hands and your temples. That’s your temporalis contracting. To work temporalis, we will delicately massage along the cheek bone into the side of the head - yes, a scalp massage! A skillful scalp massage can do wonders for alleviating jaw tension. 

Not sure if this work is for you? Try a self test: open your jaw nice and wide. Do you have three fingers width of space between the upper and lower jaw? Let your jaw return to a neutral position. Is there space between your upper and lower molars, or are they clenched? Finally, slowly open and close your jaw a few times in front of a mirror. Does your chin go down straight towards your breastbone, or does it veer to the left or right? If your jaw moves at an angle, clenches or doesn’t fully open, mention it to your therapist at your next session. Your jaw will thank you.

Don't worry, you're not gross!

Getting a massage is vulnerable. We get it - a stranger is touching you and working muscles that might even be painful. Perhaps you’ve worried your therapist is judging or otherwise uncomfortable with your body. If this isn’t you - stop reading; you’re doing great. The last thing we want to do is introduce any unnecessary insecurity or anxiety to your next massage! But if you do identify with anything we’ve said so far, let us clarify things about your massage from your therapist’s perspective.

We’re here to help you feel better in your body, not to enforce beauty standards and cause you anxiety about your appearance. Some client’s concerns are more common than others so we’ll address those more specifically.

1. We’re not bothered by acne. Be it on the face, back, or anywhere else - skin has pimples. It’s not a big deal. Clients are usually most concerned about acne on their backs, “bacne” if you’re a fan of portmanteau. Yes, we can massage your back even if there’s acne. We’re not going to pop any pimples working on you but if your skin is sensitive from a breakout, just let your therapist know and we can massage your back over the sheet. It’s not an iron clad rule that massage has to include skin-to-skin contact. 

2. We’re not bothered by body hair. As mammals we literally have hair all over our bodies. Some of that body hair is so fine it’s not even visible, and sometimes it’s denser, darker, and coarser. We’re not going to let body hair get in the way of a good massage, and you shouldn’t either. If you’re worried we’re offended by your hairy legs/back/arms/toes/whatever - we’re not! Please don’t apologize for being human.

3. We’re not bothered by body fat. Bodies come in all shapes and sizes, and bodies of all shapes and sizes deserve massage - full stop. Our hydraulic massage tables are rated up to 600 lbs. We got you, we promise.

Here’s a little context about our work as massage therapists. We’re blessed with a busy practice at Mantis. Our therapists will provide anywhere from 500-1,000 massages in a year. Sure, some of those sessions are for repeat clients, but clearly we touch a lot of bodies! Our attention is on your tension patterns, not your grooming habits!

Here’s what we do ask of our clients. 1. We ask that you come generally clean to your massage. No need to do extra deep cleaning right before your session, but we’d love it if you didn’t, for example, skip showering for a week and then run to your appointment in the summer heat. A little sweat is inevitable in the summer– we do live in Austin, after all–but we have wet wipes if you need a quick refresh before you get on the massage table. 2. We ask that you let us know about any communicable skin condition, e.g. athlete’s foot, poison ivy, etc. and keep the affected body part(s) covered. That’s pretty much it. Above all else, we just want you to have a great massage. You deserve it!

Structuring a Massage

Each massage therapist has their own way of approaching the work. If you have three deep tissue massages with three different therapists, you’re going to have three distinct experiences. Common threads will link these sessions together: targeted, detailed work to your areas of focus; firmer pressure; etc. But each massage will feel notably different - because filling the sixty or ninety minutes of a session is more than applying a uniform list of techniques until the clock runs out.

Recently, a client asked one of our therapists how she determined what to do “next” in the massage. It’s a great question because it probes how massage therapists craft a session. We decided to also ask the team of Mantis therapists, curious to hear what everyone’s answers would have in common, and where they would differ.

Universally, everyone answered acknowledging the client’s goals for the session. Why has the client come in for a massage, and how are they feeling in their bodies today? This information lays the foundation for our session. Note to clients who struggle to articulate their goals for the massage: take a moment to run a mental body scan - what do you notice? Is there a pain in your shoulder? Stiffness in your low back? Does your neck turn more easily to one side than the other? Or perhaps what you notice is a lot of mental and emotional cacophony - that’s also useful information for us!

“The broadest answer I can give,” Cori said, “Is when I’m applying a stroke I’m paying attention to not only the muscles under my hand, but how the rest of the body moves around and/or because of my pressure. If those structures feel restricted, we go there next.” You know the bodywork cliche that says everything’s connected - that’s what Cori’s speaking to. If we’re working the left shoulder and notice the right hip isn’t moving as easily, that warrants some investigation.

Mattie incorporates postural and range of motion assessment in her sessions. “I balance the concerns they brought up while thinking about the biomechanics of where that stress came from, and then work related muscle groups.” If you’re having shoulder pain, and Mattie notices your thoracic rotation is restricted, she may address your shoulder while working your back and rib cage.

Abbey and Megan also mentioned a desire for variety. “It’s very much based on what they asked for, what I feel like doing, and what I’m feeling from their body,” Abbey said, “I’ve gotta keep it fresh.” Megan added, “If I’m seeing a regular client for a chronic issue, or I’ve had several clients with a similar concern, I’m asking myself how else I can work these structures. I can’t just rely on the same techniques.”

As you can see, we all work differently. The starting point is the same, however: what are the client’s goals for the massage today? There is no massage to give without a client on the table, afterall. We appreciate your trust in us!

Let's talk modalities: Pre-Natal Massage!

We get calls almost daily asking if we offer prenatal massage. And the answer is: absolutely! We love supporting our pregnant clients, as the benefits of massage to both the pregnant person and even baby are well known.

If you’ve ever been pregnant - or perhaps someone close to you has - you understand just how tough pregnancy can be. During pregnancy, ligaments of the pelvis loosen in preparation for childbirth. As the uterus expands, center of gravity shifts forward and stresses the lumbar spine. Muscles of the spine and hips tighten in response - hello hip and back pain. Hormonal changes in early pregnancy are often linked with headaches, and pregnant people are typically advised not to take NSAIDs for pain relief. Swelling in the hands and feet and fatigue are also common. We promise we’re not trying to scare you; massage can help alleviate all of these pregnancy-related symptoms.

Perhaps less well known are the emotional benefits of massage during pregnancy. In two studies, women who received massage during pregnancy reported not only decreased leg and back pain, but also decreased depression and anxiety. Cortisol levels decreased as well (that’s the primary stress hormone). These studies also found that women who received massage were less likely to deliver prematurely. An additional study looking specifically at pregnant women diagnosed with major depression produced the same results - reduced cortisol and depression - and these benefits carried into the postpartum period as well. In case you were wondering, newborns of massaged mothers were also found to have reduced cortisol levels. We’re telling you, massage is potent stuff.

Massage is safe for most pregnant people throughout their entire pregnancy. Check with your doctor if your pregnancy is considered high risk, as there are additional guidelines for pregnant people with certain conditions. Pregnancy massage incorporates additional bolstering and positioning to accommodate the body during pregnancy. Don’t be shy to let your therapist know if some positions are more comfortable than others - we want you to enjoy your session! If you normally ask for deep tissue massage, the pressure may feel lighter, particularly in the legs. Pregnant people are at higher risk for blood clots, and deep massage has the potential to dislodge a clot.

We also advise booking ahead of time, if you’re able. Pregnancy massage is a very popular modality, and therapists who are certified in it tend to book quickly.

Let's talk modalities: Manual Lymphatic Drainage!

This month, we are looking at Manual Lymphatic Drainage (MLD). MLD is a series of light, gentle strokes intended to facilitate movement of lymph in the body. 

What does the lymphatic system even do, anyway, and why do we care so much about lymph? 

The lymphatic system regulates fluid levels in the body and fights infection. Lymphatic vessels, a network of tubes throughout the body, absorb lymphatic fluid (lymph) from the body’s interstitial space. Inside the lymphatic vessels, lymph is filtered through the lymph nodes, removing debris and pathogens. Eventually, lymph is returned through to the bloodstream at the subclavian artery under your collar bone. Like the veins of our circulatory system, lymphatic vessels have one way valves that keep fluid moving toward the heart. But while the circulatory system has the heart acting as a pump to keep blood moving, the lymphatic system has no such pump. Instead, it relies on surrounding muscles to move lymph through the vessels. If you want to get your lymph moving - move your body!

In healthy people, the lymphatic system operates just fine on its own. Injury, illness, surgery, cancer treatment or certain genetic disorders are known to adversely affect the lymphatic system. Perhaps the most well known application of MLD is for treating breast cancer related lymphedema. It is frequently necessary to remove lymph nodes during mastectomy. One in five breast cancer patients develop breast cancer related lymphedema, and MLD has been shown to enhance the compression bandaging and exercises routinely prescribed. MLD has cosmetic applications as well, as moving fluid can have a temporary slimming effect (you might have seen this on social media).

What can I expect during a MLD session?

There are a few different approaches to MLD, but they all involve light and rhythmic pressure, and methodical tensioning of the skin. The intention is to increase interstitial pressure inside the body, which in turn promotes lymph uptake into the lymphatic vessels. More research here is necessary, and the mechanism of MLD remains theoretical. 

Most or all of the session will occur with the client face up. Clients will frequently fall asleep while receiving MLD, as the work is very relaxing. It is also not uncommon, however, to need to use the restroom mid session. Massage stimulates the parasympathetic nervous system (think rest and digest), and we’re specifically targeting fluid in MLD. Don’t be afraid to speak up if you have to pee! 

Call or text if you’re specifically interested in MLD. This is specialized bodywork, and some but not all of our therapists are certified in it.

Let's talk modalities: Ashiatsu and Thai!

How many modalities of bodywork exist? Off the top of my head: Swedish, deep tissue, neuromuscular, trigger point, myofascial release, structural integration... and many, many more. What makes one modality different from another, and how can you decide which approach is right for you? Welcome to the first installment in an ongoing series in which we explain different systems of bodywork! To start, we are looking at two modalities from Asia: Ashiatsu and Thai massage. 

Have you ever seen bars or straps suspended over a massage table and wondered what their use was? Ashiatsu is your answer! Ashiatsu is a Japanese modality in which the practitioner’s primary tool of choice is not their hands, but their feet. Those overhead bars are for the therapist’s stability while they walk, and also glide, on your tissue. Typically, the client will undress and the therapist will use massage oil or cream, although ashiatsu can also be done with the client clothed. If you’re not sure what to make of feet as massage tools, let me assure you they are potent. While not quite as dextrous as hands (no thumbs), feet have more surface area and are much stronger. The therapist can use their full body weight in this modality, so if massage hasn’t quite felt deep enough - or you love broad, gliding pressure - ashiatsu might be the modality for you.

Thai massage is practiced with the client wearing comfortable, loose fitting clothes, and it incorporates passive stretching, range of motion and deep compression. The therapist may use their feet during the session like in ashiatsu, but they will also use their hands, forearms, and even knees. This is another modality that allows the therapist to use their full body weight; although the pressure feels more focused with less glide - a feature of the client remaining clothed. Thai massage traditionally takes place on a floor mat, although it is modified quite easily for the table. Studies have shown Thai massage to be beneficial in treating low back pain, headache and joint stiffness. If you like the idea of a full body assisted stretch coupled with deep compression - or perhaps you dislike massage lubricant - consider a Thai massage.

Remember as well that massage is adaptive. Knowledge of one modality can inform another and your therapist may incorporate multiple modalities to customize a session for your therapeutic goals. So while it is useful to understand different bodywork systems, no two massages are ever identical. In fact, the rapport between therapist and client influences the session just as much as any particular modality! 

We have several skilled therapists at Mantis practicing Ashiatsu and Thai massage. Call or text for more information, or book online. And it’s always helpful to let your therapist know at the start of the session if there is a modality you’re interested in, or curious about. We’re here to help. 

What the Cup?

Cupping. Perhaps you’ve seen people sporting those tell-tale round, brownish-red marks on their shoulders and arms. Or maybe you’ve already tried cupping, but aren’t sure what it’s all about. Allow us to fill you in with a crash course! 

Cupping is an ancient folk remedy hailing from China and the middle east, but it only gained prominence in the United States this century - Michael Phelps competing with visible cupping marks at the 2016 Olympics was the first time many Americans learned of the practice. The cups themselves can be made of glass, plastic or silicone, and they cause suction to the skin by creating negative pressure - a bit like a vacuum, actually.

Why would I want cupping?

While massage is compression-based, cupping lifts and decompresses. If you’re already getting massage, cupping introduces a novel stimulus to your nervous system. The brain loves variety! To that end, cupping can be static - left in one spot for up to several minutes; or dynamic - gliding on the targeted area much like a therapist’s hands would. Your therapist may use static, dynamic or both techniques in the session. If you find you prefer one over the other, let us know! The amount of suction from each cup also varies, so let your therapist know if something feels too intense or not strong enough. 

Those marks look like bruises. Are they bruises?

We’re going to get into hot water here with some massage therapists, but yes - the marks from cupping are bruises. Negative pressure from the cups stretches the skin and dilates capillaries, increasing blood flow. Eventually, the capillaries rupture, causing a bruise. There is no damage to any deeper tissues like muscles, and the marks generally go away within a few days. Factors affecting how much a person will bruise from cupping include amount and duration of suction, and genetics. Cupping might not be for you if you have any bleeding disorders, but otherwise it is widely regarded as a safe therapy for (almost) everyone. 

The mechanism of action for cupping isn’t well understood, unfortunately, so we can’t confidently say how it achieves its therapeutic effects. What we do know is that people report decreased pain and increased range of motion after receiving cupping therapy - much like they do from almost any kind of bodywork. In empirical studies, the term “nonspecific effects” is used when a client feels relief, but we can’t fully explain why. 

How can I try it?

Many, but not all of our therapists incorporate cupping into their practice. Call or text us and our studio managers can help you find the right therapist. Additionally, our therapist bios include some (but not all) of the modalities each therapist uses. When in doubt, feel free to reach out!

Transparency Rules!

At Mantis Massage, we believe in easy to understand pricing - we don’t even offer add-ons to “upsell” your massage. Love cupping? So do we! If that’s a service your therapist offers, there’s no extra charge. Scalp massage? Yes, please. No need to pay for an extra ten minutes, scalp love is included. Want some tiger balm or peppermint essential oil applied to that painful spot in your back? We got you - and no, it doesn’t cost extra. 

If only the rest of the healthcare industry could get on board with such a streamlined, no nonsense approach. We see clients with all kinds of aches and pains, and maybe your doctor has ordered an X-ray of your painful shoulder. Where to start with pricing that? In the last couple of years, however, rule changes at both the federal and state levels have tried to address the murky mess of medical billing. Think of this blog post as a Mantis PSA!

The Hospital Price Transparency Rule

Did you know that hospitals are required to disclose their pricing? This federal regulation went into effect in January of 2021, and it requires hospitals to provide easily accessible pricing information online for all items and services - both insurer-negotiated and cash prices. They’re supposed to do this two ways: in a comprehensive machine readable format (a spreadsheet, in other words) and a standard charges display for the 300 most common services. The Hospital Price Transparency Rule is meant to allow patients to shop around for the best prices. Doesn’t that sound great?

Unfortunately, compliance has been abysmal and rule enforcement lax. You might find missing, incomplete or hard to understand information from your local hospital. Also, this rule only applies to hospitals - what if you just want to get a mole checked, or follow up with your primary care provider?

Health Plan Price Transparency Rule 

Starting in July 2022, health insurance companies were required to list online the prices they pay for covered items and services. This pricing is also available to third parties - looking at you, app developers. Imagine being able to easily shop around for the most affordable root canal or MRI. 

Both of these federal rules fall under the purview of the Centers for Medicare and Medicaid Services. Is your hospital or health plan not compliant? Drop CMS a line and let them know.

Texas Hospital Price Transparency Rule

Taking a cue from the federal government, Texas’ own hospital price transparency rule went into effect in March 2023. The requirements are similar to the federal rule, but with stiffer fines for violations.

So if your doctor does want an X-ray of your achy shoulder, here’s a short guide on how to shop for prices.  

Additional reading:

Necessity and Limitation of Price Transparency in American Health Care - AMA Journal of Ethics

FEBRUARY 2023 SEMI-ANNUAL COMPLIANCE REPORT — PatientRightsAdvocate.org

Weekly, Monthly, Yearly?

“How often should I get a massage?”

This is one of the most commonly asked questions from our clients. Well, it depends on what your goals are. 

Are you looking for stress relief?

Ah, stress. Muscle tension is a natural response to stress, a protective mechanism that’s not always helpful in modern life. Massage is known to lower cortisol levels - the body’s main stress hormone, and raise serotonin - a neurotransmitter that regulates mood. We may be biased, but we find massage to be a pretty potent wellness practice! 

If you are living through a period of more-than-usual stress, starting with weekly or biweekly sessions might be most helpful to you. As life calms down, so can your massage frequency. A general guidance for maintenance massage (when nothing urgently needs attention) is once a month. Some clients prefer to come in more frequently, while others can space their sessions farther out without trouble. Check in with your own body between sessions and take note of how you’re feeling. Check in with your massage therapist as well, we also have perspective on how your sessions are progressing and it can be helpful to compare notes. 

Are you looking for pain relief? 

Current research suggests two to three sixty minute massages a week for several weeks is best for longer lasting results. If that sounds like more massage than your calendar or pocketbook can sustain, it’s important to note that massage therapists were not allowed to offer self-care recommendations in this study. We have some insight into how you feel better between sessions! 

Anecdotally, we notice that clients who are initially able to come in more frequently seem to fare better over time with regards to pain relief. That might mean weekly massages at least initially, and then tapering off to a maintenance massage schedule. If a weekly massage is not in the cards for you at this time (we get it), don’t despair. Your therapist will be able to discuss treatment plan options with you, and provide self care recommendations to help you feel better between sessions. 

Perhaps the greatest wisdom of the monthly massage is that it's easy to remember. Consistent bodywork can go a long way to reduce pain, and boost mood. Doesn’t that sound like something worth coming in for?

Taking the Plunge

Hydrotherapy is an age-old folk remedy. Who doesn’t love a nice soak in a hot tub, or a brisk dip at Barton Springs? Barring any hydrophobia, it feels so good to be in, on, and around water. But what about contrast baths - alternating hot and cold plunges - is that next level water wellness, or just an exercise in uncomfortable extremes?

Athletes have long used contrast baths to aid recovery, although evidence supporting the practice is far from conclusive. It is theorized that the contrast baths cause vasodilation and vasoconstriction, resulting in a muscle-pumping effect that moves metabolic waste from the muscle back into the bloodstream. One study has shown contrast baths to improve hemodynamics and oxygenation of the gastrocnemius (that’s a calf muscle). So if you overdid your last workout, a contrast plunge might help get you moving more comfortably again.

Studies have shown contrast baths to decrease muscle soreness compared to a control group, however contrast hydrotherapy didn’t beat any of the other recovery modalities studied - including massage. Other studies have found similar benefits to contrast baths and cryotherapy, so it’s not clear what added benefits, if any, come from the hot water plunge. And speaking of cryotherapy, there’s a lot to dig into so stay tuned for a future blog post on the topic. 

Another theory states the benefits from contrast baths are simply due to hydrostatic pressure from the water, and not the temperature of the water. Hydrostatic pressure increases venous return, compresses joints, reduces swelling and facilitates lymph drainage. Because the temperature of the water doesn’t affect hydrostatic pressure, you can reap these benefits swimming or soaking in any body of water!

Contrast baths have been used to treat limbs, hands and feet, and they’re relatively easy to DIY - you just need a bucket of hot water (not too hot) and a bucket of cold water. Take turns placing the affected limb in each bucket. You can certainly do a full body contrast bath as well, although that’s less easy to do at home. As for temperature of the water, or the duration of each soak - there’s no agreed upon protocol. Most start with hot water. Shoot for about a 20-30 minute protocol, but again, there’s no consensus so listen to your body. And if you give contrast baths a try, let your massage therapist know how it goes. We’re always curious about your experience with self-care and recovery.

“So is that a knot?”

“So is that a knot?”

As massage therapists, we hear that question a lot. Let’s say I have my forearm in between your spine and shoulder blade, and start to sink deeper into your rhomboids. The tissue feels firmer and denser, not as supple as the surrounding muscle. You might feel a dull ache with the compression, or it could even reproduce the pain you notice after sitting at the computer for a while. “That’s it,” you say. “You found the spot. So is that a knot?” 

Sure, let’s call it a knot. We can both feel it’s different from the rest of the muscle, and it can certainly give the sensation that your upper back twisted like a kindergartener’s shoe string. But what is a knot, really? 

Let’s start with what a knot isn’t. It’s not your muscles somehow tied or stuck together - don’t worry, that’s not a thing. A muscle knot also isn’t visible in any kind of imaging - wild, right? To the best of our knowledge, these hyperirritable spots in a muscle are myofascial trigger points. Trigger points are thought to be caused by both overuse and muscle weakness (yes, sitting at the computer all day does fatigue your muscles!). 

Trigger points can be active, meaning they’re hurting right now and probably why you’re getting a massage, or latent - those tender spots you didn’t know were there until your therapist started pressing on them. Either way, you should feel relief during and after your massage. Keep in mind, though, if a knot has been bothering you for a while it may take more than one session to notice longer lasting benefits. 

Trigger points can be found in just about any skeletal muscle, not just the upper back. Other common spots are the neck, glutes, IT band, and calves. A massage ball or foam roller can help, along with varying your posture and activities throughout the day (sometimes easier said than done, I know). But if your DIY treatments on that knot just aren’t doing the trick - finding and treating trigger points is what we do.