Massage Therapy Journal Fall 2025

56 • Massage Therapy Journal

AMTA Continuing Education

exposed to extreme, life-threatening situations. Soldiers are taught from the first day of basic training to ignore their own physical cues of pain or suffering so that they may work for the good of their unit, carry out orders and protect others from the dangers of conflict. 178,179 Injuries obtained during battle may become a source of pride for some, battle scars that prove the mettle and heroics of the soldier. For example, if a soldier loses a leg in battle but succeeds in saving a child’s life, the soldier may perceive that the loss of a leg is worth the child’s life. The resulting amputation becomes a part of the soldier’s life story that represents heroism and everything that is celebrated about soldiers and those who keep others safe at great personal risk. Unfortunately, soldiers encounter many situations where their capacity to respond is swamped by terrifying circumstances. They know their lives are at risk. They know they have no control over the outcome of a situation. Yet they have no choice but to move forward in the face of terrible odds. There are casualties that soldiers cannot prevent. When soldiers feel helpless to change the course of a bloody conflict, especially in repeated circumstances, they leave their

posts carrying heavy feelings of deep remorse, inadequacy, shame, rage and sorrow. Such high levels of stress may result in suicidal thoughts or actions, anger, insomnia and night terrors, all of which can be signs of post-traumatic stress. 180,181,182 The world of a soldier is not safe; this is a reality of the job. But, when soldiers experience repeated life-threatening situations that compromise their sense of safety, value and ethics, they may experience post-traumatic stress that leads to unhealthy tension-reducing behaviors, such as addiction, engaging in self injury, hypervigilance, or freezing as a way of numbing the pain and distress. 183,184,185 The goals of client-centered care are at odds with military training. Soldiers are taught to put their own pain and suffering second to the end goal they are working toward. In contrast, massage therapy encourages clients to become actively aware and conscious of their responses to stress, pain and the application of touch.

Therapist Diary: Trauma and Pain

scale, it’s a 2–3 out of 10. On a civilian pain scale, it’s an 8 out of 10.” It was interesting to hear him acknowledge the difference in pain perception based on the demands of his job. This also told me that he probably wouldn’t say anything to me about the pressure being too deep or intense during treatments. I knew that there was a difference in how the two worlds he existed in experienced pain, and even though he was skeptical about the efficacy of the treatment, he actually gave really excellent subjective information about his pain.

One of my clients is a military veteran, now working in security. He came to the clinic for relief from persistent low-back pain, on referral from his doctor. He had been to physiotherapy and felt no relief. He thought that massage therapy probably wouldn’t help either, but he would give it a try. I asked him about the intensity of his pain using a 1–10 pain scale, and he said this: “Ok, so here’s the thing. I’m a military guy, we are trained to put pain aside and get the job done, no matter what. So here’s how I’ll put it to you: on a military pain

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