Orthopedic Massage: What It Is and How It Can Help You Move Better
Written by: Kiyoki Rykman, LMT CCT CMLDT
If you hear the words orthopedic massage, you might picture a massage therapist wearing a tiny doctor’s coat and yelling, “Your hamstring is out of alignment!”
Thankfully, it’s not quite that dramatic.
Orthopedic massage is a specialized approach to massage therapy that focuses on muscles, connective tissue, movement, and the way your body handles pain and physical stress. Instead of simply giving you a relaxing rubdown, the therapist looks at why something may be hurting and chooses techniques based on what they find.
Think of it as massage with a detective hat.
So, What Exactly Is Orthopedic Massage?
Orthopedic massage isn't one single technique. It is better understood as a way of thinking about and treating musculoskeletal problems.
Whitney Lowe, one of the major educators in the field, describes orthopedic massage as an approach involving assessment and a variety of treatment methods for soft-tissue and musculoskeletal problems. The emphasis is on understanding the problem, matching treatment to the person, and adapting the treatment as the person responds.
This is also a major theme in the work of James Waslaski, who developed an integrated approach combining assessment, hands-on treatment, pain-free movement, and rehabilitation principles. His work emphasizes treating the person rather than blindly attacking the spot that hurts.
Another influential approach comes from Erik Dalton, whose Myoskeletal Alignment Techniques combine soft-tissue work with movement, stretching, joint and nerve mobilization, and an understanding of how the nervous system influences pain and movement.
Different schools use different techniques, but the basic philosophy is similar:
Don't just chase the pain. Figure out the bigger picture.
What Happens During an Orthopedic Massage?
A good session usually starts before the therapist puts their hands on you.
The therapist may ask questions such as:
When did the problem start?
What makes it better or worse?
Did you injure yourself?
What activities do you do every day?
How does the problem affect your movement?
Where do you actually feel the pain?
They may also watch you move, check range of motion, feel the tissues, and perform appropriate orthopedic or movement assessments.
Then comes the hands-on portion.
Depending on the situation, treatment may include myofascial techniques, stretching, trigger-point work, soft-tissue manipulation, movement-based techniques, nerve mobilization, or other methods. The treatment should be adapted to the individual rather than following the exact same routine for everybody.
And here's an important point:
Orthopedic massage should not be a contest to see how much pain you can tolerate.
More pressure does not automatically mean better results.
Waslaski has particularly emphasized pain-free orthopedic treatment, while Dalton's approach includes techniques designed to reduce protective muscle guarding and make previously painful movement feel safer to the nervous system.
In other words, your therapist shouldn't be trying to make you jump off of the treatment table.
How Can Orthopedic Massage Help?
Orthopedic massage may be helpful for people dealing with problems such as:
Neck and shoulder tension
Low-back discomfort
Sports-related muscle problems
Restricted movement
Repetitive-use injuries
Certain tendon and soft-tissue problems
Postural strain
Muscle guarding after injury
General aches associated with physically demanding activities
The research gives us a reason to be optimistic—but also a reason to keep our feet on the ground.
A 2024 systematic review published in JAMA Network Open examined the research on massage therapy for pain from 2018 through 2023. The researchers identified 129 systematic reviews covering a wide range of pain conditions. Their findings suggested that massage therapy can be associated with improvements in pain for some conditions, but the certainty of the evidence varied (Mak et al.).
Massage isn't a magical cure for every ache, and orthopedic massage hasn't been proven to “put bones back into place” or permanently correct every muscular imbalance.
What massage may do is help reduce pain and muscle discomfort, improve how comfortable movement feels, and become a useful part of a broader plan for managing musculoskeletal problems.
For example, a person with a painful, tight neck might experience less discomfort after treatment and find it easier to move. That doesn't necessarily mean the therapist “fixed” the structure of the neck. Pain is complicated, and many different factors—including the nervous system, stress, sleep, activity, and tissue sensitivity—can influence how we feel.
That may sound less exciting than saying someone “released a stuck muscle,” but it's a much more accurate picture of the human body.
Massage Isn't the Whole Solution
This may be the most important part.
If your shoulder hurts because you spend eight hours every day hunched over a laptop like a question mark, massage might make your shoulder feel better.
But if you go right back to the same habits, your shoulder may eventually say, “Hey, remember me?”
Long-term improvement often requires a combination of appropriate hands-on treatment, movement, strength, activity changes, sleep, ergonomics, and sometimes physical therapy or medical care.
A skilled orthopedic massage therapist should also know when a problem is outside their scope of practice and when you need to see another healthcare professional.
That's not a failure.
That's good healthcare.
Who Might Benefit From Orthopedic Massage?
Orthopedic massage can be especially appealing to people who don't simply want to feel relaxed for an hour—they want to move better and understand what's going on with their body.
That might be a weekend athlete with a cranky knee, a desk worker with a constantly angry neck, a construction worker with an overworked back, or someone whose old injury keeps coming back to say hello.
The goal isn't necessarily to make every muscle loose and floppy.
The goal is to help you move more comfortably, improve function, and better manage the factors contributing to your problem.
The Bottom Line
Orthopedic massage is essentially problem-solving massage.
It combines anatomy, movement assessment, hands-on therapy, and individualized treatment to address musculoskeletal pain and movement problems.
The best therapists don't simply ask, “Where does it hurt?”
They ask:
“Why might this be happening, what can we safely change, and how can we help you move forward?”
And that is what makes orthopedic massage different from simply getting someone to rub your back while you take a very expensive nap.
Sometimes the answer really is massage.
Sometimes it's movement.
Sometimes it's strengthening.
Sometimes it's seeing a doctor or physical therapist.
And sometimes it's all of the above.
The body is complicated. Fortunately, you don't have to figure it out alone.
BOOK YOUR ORTHOPEDIC MASSAGE TODAY with one of our knowledgeable therapists!
Works Cited
Mak, Selene, et al. “Use of Massage Therapy for Pain, 2018–2023: A Systematic Review.” JAMA Network Open, vol. 7, no. 7, 2024, e2422259. doi:10.1001/jamanetworkopen.2024.22259.
Gross, Anita R., et al. “Massage for Neck Pain.” Cochrane Database of Systematic Reviews, no. 2, 2024, CD004871. doi:10.1002/14651858.CD004871.pub5.