Massage therapy, like any healthcare practice, depends on the relationship formed between the practitioner and client. In my experience, this relationship has many facets and many benefits but none so profound and important as understanding.
While "understanding" could include many aspects of a client-therapist relationship, it is in terms of pain and body perception that I am most interested here.
I often think of myself as playing detective. I ask questions, I gather information, I refine those questions, I decipher the information I am given, and I help the client be witness to their body and pain. Client's often come with a vague idea of their complaint: "my back hurts," for example. However, this is an incomplete picture that needs to be filled out if productive work is to be done.
Asking questions is only one way to suss this picture out. Much of the work I do is in intuiting pain by reading body language and then, depending on how receptive my client is, asking my client to describe the discomfort they are feeling. Often, my client's descriptions of their pain while we are working are much more expressive and informative than in the interview. A client may describe a pain as emanating from the point I am pressing, traveling across, up, or down, feeling hot or warm, sharp or achy, deep or superficial. All of these descriptors help both me and my client's understand the complaint we are working with.
As a therapist, all I can really experience is the tightness and restriction of my client's tissues. I only feel my own pain, though I struggle to perceive my client's by reading their body language. The tightness and restriction is felt by me as observer while the pain and sensation of tightness and restriction are felt directly by the client. I have no access to that subjective experience of the massage but, fascinating to me, my client's often don't have access to it either. On so many occasions, client's will zone out of their massage and feel only very vague feelings of pain or discomfort without an explicit picture of where it is or what it feels like. Back pain, head aches, jaw tightness, hip soreness, etc, are all unpleasant experiences and often the most available solution is to ignore them. Only when a problem becomes debilitating is a client ever really forced to confront the experience of their complaint.
To be honest, avoidance is a pretty compelling tool to deal with discomfort as avoiding a complaint often leads to the perception of its resolution. At least insofar as one stops feeling the discomfort, a complaint certainly seems resolved when no pain is felt. However, a string of complaints followed by ignoring those complaints can make for a very disjointed and inaccurate picture of exactly what one's current complaint stems from and a short term and complicated "resolution."
"Understanding," in this context, is from both the client and the therapist's perspective. Understanding is facilitated by the therapist via asking questions explicitly but also by intuiting what the client feels via body language (both visually and through touch during the massage). During the massage itself, every technique and every stroke gathers information on the complex feeling of the client's complaint. Many tender points and areas of discomfort are relevant and many are not and it is hard work to differentiate between the two for both the therapist and the client.