types of therapeutic massage:
therapeutic deep tissue, clinical massage, orthopedic bodywork, neuromuscular therapy, structural integration, medical massage, sports massage, trigger point therapy

The most important distinction to make is technique vs. goal of therapy. Focus on the goal. The technique may bring you down the wrong path.

As a consumer it's very confusing. In fact, if you are a smart consumer of massage you may end up knowing a lot about types of massage. That can be both a blessing and a curse. You know what you like and what seems to help. But do you really know what is going to help you achieve your therapeutic goals?

Let me take a step back and acknowledge that patients often know more about what is going on in their bodies and what helps than their doctor. Not because the patient is smarter, but because the answer is often in the context and details that doctors can't know as an outsider to your body. Also, for the sake of efficiency they must make generalizations and have little time to hear all the possible causes of your problem or to entertain alternate diagnosis. You know all the little the nuances of your body and your life.

That said, for more advanced cases and where you are seeing a specialist, hopefully the doctor can add a lot of helpful information to the picture. For example, if you have a sleep disorder and you KNOW melatonin works. Maybe you know you stay up too late on the computer. Melatonin helps you sleep. Stop looking at the computer late at night and/or take a melatonin. Voila! Now you are probably more effective than your doctor in this scenario. But what if you had a head injury and can't sleep? Treating the injury with a specialist would be more appropriate and effective. Telling you head injury specialist to just give you an prescription for a melatonin like drug and call it a day is not that useful.

 When you have a persistent injury or postural problem, there are several steps to effective treatment:
- Case history: when did this happen, what was going on at the time (or span of time) of the injury, what is happening now, what is happening when you hurt or can't do what you need to do, how much pain or immobility, what other body/emotion issues do you have?
- Test at the beginning and frequently throughout treatment to know if the treatment is working.
- Select the appropriate treatment and use other treatments if not working.

Selecting the appropriate treatment requires a practitioner that both knows how to do assessment and knows different kinds of treatment. This is where you, as a consumer, can run into issues. Not all jobs require the same tool. Hammering a screw is possible but not appropriately effective. But some clients keep ordering the hammer and go to therapists who only know how to use a hammer.

Then you might be asking, how do I choose? You don't necessarily choose on your own, but you can communicate to your therapist that one technique seems to be helping in the moment and another doesn't. Therapists are generally not mind readers. Communicating with your practitioner makes them much more effective at helping you. I have the greatest successes when clients help guide me through my treatments with what they are feeling, not just a quick, did that work yes-or-no answer at the end of the session.

On the other hand, I have the most treatment failures when my clients order me to do one technique on a specific area that hurts. For example, "Trigger point therapy helps my IT band, just do that." Quiet frankly, I could do that and you'd be back in a few days with the same pain, and you could do it to yourself at home. A skilled LMT will be able to tell you why she is doing what, which may include working on areas that might not be the area of complaint but are related in ways you might not understand yet.

As a smart massage consumer, here's some advice:
- Have an idea what you'd like to work on or if it's severe, get a diagnosis and tests from a doctor
- Ask your therapist if they have experience with your issue and what range of techniques they can apply, or look at their bio
- Give a lot of detail about your issue to your therapist at the beginning of the session
- Give a lot of feedback about treatment during the session: the good, the bad, and the little details
- Give feedback at the end
- Notice how you feel in between sessions: what improved, stayed the same, got worse and note what you were doing at the time

The types of massage I listed (therapeutic deep tissue, clinical massage, orthopedic bodywork, neuromuscular therapy, structural integration, medical massage, sports massage, and trigger point therapy) are somewhat meaningless. All of these are therapeutic, clinical, medical and orthopedic. All are relevant to sports applications.  Neuromuscular therapy (NMT) and trigger point therapy are the same thing only NMT is broader. Medical massage includes orthopedic bodywork but can also just be oncology massage. In a way, all of these types of massage are gimmicks so don't worry too much about them. However, training is not a gimmick, it's crucial, and so is specialized experience. If you have an injury, look for someone with significant orthopedic training. If you have a postural issue, look for someone with structural integration training. There are no standardized certifications for specializations in massage so go for someone with credibility, looking at their training.

In general, the more training someone has the better they will be at their specialization. Or if they have different kinds of training, the more appropriate and effective the treatment will be. I have seen many therapists with decades of general experience who weren't nearly as effective at treating issues as someone recently out of school with lots of extra training. But the former may have more confidence.

If your treatment is not working after a few sessions, try someone else with more training. Loyalty is not necessary, your health is. Regardless of whether you like the technique, if the treatment isn't meeting your goals, it's time to move on.