Considerations for Massage with Arthritis

When you work on people with arthritis there’s not necessarily a whole lot you need to change, but there are two main things I’d like you to consider as you go through the session:

The first thing is extra prop use – more blankets and more cushioned surfaces, specifically for affected joints. There tends to be more focused sensitivity around the arthritic joints and so adding in extra soft surfaces helps to increase comfort.

The second suggestion I have is related to the applications of our “slow it down” mantra. The way that we approach Thai-inspired manual therapy, we have various ways in which we can use that mantra (for example, the slow application of pressure, more repetition before approaching the end-point, pausing with pressure applied, slow joint articulations, and so on).

For folks with arthritic joints, I would recommend reducing the length of our pauses or holds. Where normally I recommend long, long holds to really access the golgi-tendon organ response, for cases where arthritis is involved I would suggest only brief holds (less than 3 breaths).

That’s because when we do really leverage the golgi-tendon organ response, we’re relaxing the muscles around the joint in order to drive more force into the passive elements of the joint – whilst this does allow for us to have a greater impact on things like the collagen arrangement in the interstitium, we end up placing greater force through things like the ligaments, joint capsules and other passive joint components too.

For joints that aren’t arthritic, this is comfortable and likely beneficial to a degree, however for arthritic joints, this is frequently uncomfortable – especially on the release of the long hold.

To be clear, I’m not saying that it’s bad for the joint – I don’t know that there’s any data on that one way or the other – instead what I’m saying is that it often hurts (remember hurt doesn’t necessarily mean damage). So for the sake of enhancing the comfort of the experience for our clients, it’s best to reduce the duration of the hold – especially in the “deeper” joint positions in postures like knee to elbow.

Oh – and speaking of comfort and good sensation – many people with arthritis will absolutely love a gentle joint decompression. It’ll just be a temporary moment of relief, but for some that’s a big moment.

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If you liked this piece, you’ll probably also like to check out “Why “listening to your body” is much more complicated than you think.” or “Can you feel fascial release?“.