For most spa-goers, a massage is best followed by a stint in the sauna — not a trip to the emergency room.
But for 27-year-old Kellia Rogers of Brooklyn, N.Y., a supposedly relaxing massage last month turned into an excruciating hour of torture on the table of a heavy-handed masseuse.
"Punch, punch, punch," Rogers said. "I felt like she was digging for something … I felt abused."
Fortunately for spa fanatics, such spa "abuse" injuries don't happen too often. But some doctors report that they do occur.
"I recently had one patient who had an abrasion on her back … from a vigorous massage," said Dr. Tina Dobsevage, an assistant clinical professor and internist at Mt. Sinai School of Medicine in New York.
Kaiser Permanente Emergency Medical Services national medical director Dr. Jay Goldman said he has even seen patients with more severe injuries.
"A woman went for a massage … [with] a massage therapist," Goldman said. "All of a sudden, she feels this searing pain through her shoulder and yelled out, but the therapist insisted this was what she needed."
The outcome was a tear in her shoulder tendons, Goldman said.
And spa injuries aren't limited to bad massages.
"I've had several folks suffer burns in tanning beds, develop skin rashes from massage oils, or finger/toe infections from manicures/pedicures," said Dr. Richard G. Roberts, professor of family medicine at the University of Wisconsin School of Medicine.
Communication Is Key
For Rogers the massage didn't soothe her muscles, it left her with severe muscle injury from her neck to her pelvis.
Part of the problem could have had to do with a communication barrier. Indeed, the American Massage Therapy Association (AMTA) recommends that consumers "communicate clearly" with their masseuse.
The AMTA also encourages consumers to "report any discomfort [and] give feedback about [the] amount of pressure."
But this may not be as easy as it sounds, Rogers said.
"She seemed very confused," she recalls. "I told [the masseuse] I wanted a Swedish massage, but she still seemed confused … when she popped my neck, I said 'Don't do that!' She just nodded … like everyone says that."
As the assault continued, Rogers describes the masseuse as "pressing my leg down … trying to get it to crack, but I'm not flexible like that. I had to stop her."
And when the masseuse asked Rogers if she was OK, she felt the masseuse's concern was "more like an uncomfortable [being naked] 'OK,' not [asking] if I was hurting 'OK'."
Even her back massage was unconventional. According to Rogers, "I heard her hop up on the table [with me]."
Rogers said the masseuse then pulled her arm backwards, "like you would put handcuffs on" — and that's when her pain really began.
"She put her knuckles [in my back] … She was pressing me," she said. "I felt smushed between the pressure [of her knuckles] and the table … My ribs were pressed."
Telling the masseuse that she was in pain should have stopped her torture, but Rogers finally realized, "I don't know if she understands English that well."
Once her tormenting massage was over, Rogers says she "felt sore in my ribs and back a little … I thought maybe I was just tense."
She tried to "fight it" for a few days, but the pain became unbearable.
"I leaned over in my chair to pick up a pen off the floor and I started crying," she said. "It hurt to breathe."
Looking for answers, Rogers went to New York University Medical Center TISCH Emergency Department. Upon hearing her story and observing her crippling pain, Dr. Dainius Drukteinis became worried about possible broken ribs, a blood clot in her lungs, or even damage to her spleen from the pressure applied during the massage.
Drukteinis, who said he has "definitely seen patients with muscle strains from massage," felt the seriousness of Rogers's symptoms called for "more complex scans … because she was in a lot of pain."
Fortunately, Rogers's tests were normal. The doctor diagnosed her with severe muscle strain and treated her with heavy pain medications and strict instructions to rest.
How Can You Protect Yourself?
Luckily, such trauma from a spa visit is rare.
"I can see how these things could happen, but I have yet to see [an] … injury," said Dr. Daniel Rubin, assistant professor of community health and family medicine at the University of Florida College of Medicine.
Dr. John Sutherland, emeritus director of the family practice residency program at Northeast Iowa Medical Education Foundation, also said he has never treated anyone whose injuries came from a massage or spa treatment.
"I have not had any experience with [these] incidents in 45 years," he said.
Most of those who opt for a Swedish massage, according to the AMTA, can expect "the most common type of massage, to relax and energize you" — a far cry from the Swedish beat-down Rogers received.
In spite of Rogers's ordeal, Goldman still has faith in the power of a good massage.
"If [massage] makes them feel better then it's a good thing," he said, but he added a caution: "Pain is a warning sign."
Dr. Danelle Williams, family practitioner at Malcolm Grow Medical Center at Andrews Air Force Base in Maryland, concurs.
"If something feels painful to you, bring it to the attention of the massage professional," she said.
She offered advice for spa patrons: "Always make sure you go to a licensed and reputable massage center and check with your doctor if you have questions."
Williams added that those with known back problems, women who are pregnant, children and those with osteoporosis should be even more cautious when it comes to trusting their body to a masseuse. Those with a small frame — Rogers, for example, is a petite size 0 — may also run a higher risk of a massage-related injury.
But choosing the right spa may be the wisest move of all.
"In other spas, you feel like you don't want to leave," Rogers said. "No one is jumping on the table, pressing you … I'm never getting that massage again, it was so painful."