Is massage having its subluxation moment?

by Aran Bright

“Massage has to be painful to work” (a common public perception of massage therapy. Variation of “no pain, no gain”).

“My spine is out and needs to be put back in” (common assumption of chiropractic clients).

In this blog post, I would like to explore the idea that, not only is it OK for massage therapists to have an existential crisis but it may even be essential. Although it’s uncomfortable, questioning fundamental beliefs, values and assumptions allows our profession to grow and improve both individually and collectively. In fact, here’s a great example of a professional existential crisis from the AMT blog archive.

So, let’s talk about a parallel journey that is occurring in the field of chiropractic. Specifically, we’ll examine the concept of subluxation and its contested role in modern chiropractic practice.

What is subluxation?

Most massage therapists are familiar with the concept of chiropractic subluxation —it’s the origin of the concept that a spinal joint has “gone out”. However, you may not be aware that many health practitioners now view this as a misunderstanding, one that the chiropractic profession is gradually moving beyond.

Mainstream medical definitions of subluxation generally refer to “partial or incomplete dislocation of a joint or organ”.

Here is an alternate definition taken from an Australian chiropractic clinic website:

“… a slight dislocation, misalignment, or joint dysfunction of one or more of the spinal joints.”

The chiropractic profession is currently divided on the validity of this concept, with significant debate and differing viewpoints. The General Chiropractic Council, one of the peak bodies for Chiropractic in the UK, issued this position statement 15 years ago:

“The chiropractic vertebral subluxation complex is an historical concept but it remains a theoretical model. It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease.”

Subluxation has also been the subject of extensive debate and introspection in Australia, as evidenced in this 9 page discussion between two peak bodies. In summary, a high proportion of Australian chiropractors and osteopaths do not see subluxation as a valid diagnosis for the cause of disease for humans. A significant number of chiropractors (and osteopaths) have rejected the theory altogether, while others have chosen to refine and update the definition rather than discard it completely.

The Australian Spinal Research Foundation focused on developing an understanding of the theory and offered this definition in a public statement:

“A vertebral subluxation is a diminished state of being, comprising of a state of reduced coherence, altered biomechanical function, altered neurological function and altered adaptability.”

Their statement makes no reference to joint position, alignment, or structure. The only assertion this article makes about chiropractic subluxation is that the profession is engaging in a thoughtful and critical discussion about one of its core beliefs. While the Australian Spinal Research Foundation does not claim to be the ultimate authority on chiropractic matters, it is evident that at least some within the profession have taken a long hard look at themselves in the mirror.

Right, so what does this have to do with massage therapy?

This example of chiropractic challenging some of its longest-held beliefs should be viewed as a sign of maturity and constructive critical thinking. It does not imply that chiropractic lacks therapeutic value or is without merit as a healthcare intervention – quite the opposite in fact. Rather, it demonstrates that there is ongoing rigorous debate, self-reflection, and a commitment to improvement within the chiropractic profession.

Is it time for massage therapists to do the same? Could massage therapy be facing its own “subluxation moment”: a critical juncture where we must confront outdated ideas and redefine our professional identity?

There is a good chance that you have read or heard criticism around some of massage therapy’s sacred cows. For example, trigger points are not knots, fascia can’t be lengthened, muscles can’t be broken up, and massage is unlikely to improve blood flow (although that one is a bit complex).

It has also become clear that massage does not need to hurt or be painful to be beneficial.

Challenging long-held professional beliefs isn’t easy. It can feel deeply uncomfortable, even threatening. Most people have experienced cognitive dissonance, which is that uneasy feeling we get when we are confronted with information that contradicts what we have always believed to be true. When this happens, our natural reaction is often defensiveness: we instinctively shut down, resist, or dismiss the new perspective rather than engage with it. If you need proof of this happening, just open any social media platform with online discussions. You’ll find endless debates fueled by people repeatedly triggering one another, reinforcing their own viewpoints rather than genuinely considering different perspectives.

This reaction is precisely why it’s difficult for established professions, massage therapy included, to shift their thinking. But as we’ve seen in chiropractic’s evolving stance on subluxation, true professional growth comes from embracing that discomfort rather than avoiding it. If we can lean into this challenge rather than recoil from it, the massage therapy profession has an opportunity to redefine itself in ways that better align with client-centred principles.

Just as the chiropractic profession is critically examining its long-held beliefs, the massage therapy profession has an opportunity to move beyond the outdated “no pain, no gain” mindset. For too long, the effectiveness of massage has been linked to deep pressure, tissue manipulation, and even discomfort as a marker of success. However, nervous system and biopsychosocial models suggest that we do not need to rely on tissue-based explanations and provocation to be effective. Instead, therapists can embrace approaches that prioritise the nervous system, relaxation, and client-centred care, focusing on comfort, adaptability, and the individual experience of wellbeing.

The career crisis blog I mentioned earlier shows that some therapists have been doing this work for many years. And the experience described in the post is entirely normal: wondering whether massage has any value at all, then wondering “why am I doing this as a job?”. Hearteningly, it also shows that there is life on the other side.

This underscores the importance of broad-ranging professional development, to support an exploration of where the value in massage therapy lies, and help let go of old, unhelpful beliefs. There is a whole other blog post about why there is such a massive focus on tissue and modality-based professional development within the massage industry which can reinforce outdated beliefs. But that’s a gigantic topic unto itself.

Conclusion

The ability to question, adapt, and evolve is not just beneficial – it’s essential for professional growth.

Just as chiropractors have critically examined subluxation, massage therapists must be willing to challenge long-held beliefs about pain, pressure, and the mechanisms behind our work. The idea that massage must be painful to be effective is outdated, just as the assumption that spinal misalignment causes disease. Letting go of these rigid ideas doesn’t weaken our profession, it strengthens it, opening new doors for innovation and deeper, evidence-based care.

Massage therapy has enormous untapped potential in Australia’s healthcare landscape. By embracing critical thinking, ongoing education, and client-centred approaches, massage therapists can redefine their role and expand their impact in ways we are only just beginning to understand. The question is: are we ready to have our own “subluxation moment”?

About the author

Aran is a massage therapist, myotherapist and educator. He lives on the Sunshine Coast in Queensland on traditional Jinibara country, where he runs a massage clinic with his wife Sheree. He also works for Q Academy, an RTO, teaching remedial massage and myotherapy. His interests include doing massage, researching massage and talking about massage.

He also plays tennis. And occasionally thinks about massage.