Ask Amy: My Physical Therapist and Massage Therapist Aren't Agreeing

August 5, 2019

I’m a dancer who is currently injured and unable to walk a lot. My physical therapist and my massage therapist are giving me opposite instructions. My PT believes that I should do her exercises, even if they cause some of the “bad pain,” and take three different kinds of exercise classes. My massage therapist tells me that I shouldn’t do anything that causes “bad pain” and only do one exercise class per week for now. Who should I listen to? —Rachel

You’re in a sticky situation, but I think it’s best to defer to your physical therapist for now. Physical therapists have advanced medical degrees and are more knowledgeable with regards to the biomechanics of your specific injury. They’re also trained to develop a prescribed medical program for your rehabilitation, including stretches, strengthening exercises and mobilizations. Massage therapists specialize in soft tissue work and can aid in the healing process, but they may not have the medical background to understand the full scope of your injury.

“A physical therapist always trumps a massage therapist,” says Brent Whitney, a dancer/choreographer and licensed massage therapist in private practice at Strive Total Wellness in New York City. In an ideal situation, he says, your PT and MT would have a discussion about your treatment plan so that they’re both on the same page. (For example, when I was receiving PT for a stubborn back spasm, my therapist referred me to the clinic’s acupuncturist and massage therapist, which helped speed my recovery.)

When that’s not possible, says Whitney, “you must be your own advocate.” Don’t be afraid to question your PT—find out why your she wants you to follow this specific regime (and why she wants you to work through “bad pain”). Communicate any concerns, especially if you’re not progressing or are in a lot of discomfort. You can always seek out a second opinion, or try your MT’s advice, if you’re not getting results.