THERE’S A DEMANDING, steep hill toward the end of the trail I take to during my weekly runs. I pause in front of it, and wait for the song blaring through my headphones to build up to a crescendo. The sun slinks away behind the only cloud in sight, and a much-needed, cool breeze speaks up after prolonged silence. Then, I get going—as fast as I can. Every part of me is running—my legs, my core, my mind. By the time I reach the crest of the hill, my calves, glutes, hamstrings and quads are throbbing. Today, I push myself a little more than usual, to go that extra mile, so to speak. I run down to the bottom of the hill, then back up again.

I’ve been running off and on for a few years now—recreationally, of course. For me, exercise isn’t a short-lived New Year’s resolution. It’s a lifestyle. I enjoy yoga, pilates and sometimes, a good, long walk is enough to boost my endorphins for the day. I make healthy nutritional choices (y’know, save for the occasional burger and beer). So this month, as I took stock of this past year, and looked ahead into 2020, I thought: What am I missing here? What can I improve?

A potential answer came to me a few weeks ago when my editor suggested the subject for this month’s column: massage therapy as preventative care. We know that manipulating the soft tissues of the body with a precise choreography of movements provides relief from muscle tension by improving circulation. The literature on therapeutic massage also shows its effect on all sorts of conditions from anxiety, prenatal depression to arthritis and fibromyalgia. It’s even being explored in post-cancer diagnosis, an area of ongoing research.

In preparation for writing this piece, I wanted to see if there was anything to this thousands-year-old practice, to try it out for myself—ahem, in the spirit of research, of course. But the first and most confusing step was deciding where to go. A physical therapy clinic? A chiropractor’s office? A massage center? A spa? I had no idea, which is why I reached out to Dr. John Jefferson, head of the physical therapy department at UAMS Northwest Regional Campus in Fayetteville.

“That’s a tough question to answer, and it really depends on the gamut of signs and symptoms that [patients] have,” he said. “If all they have is tension, then a massage therapist would be a really good person to see. If, however, they have problems with coordination or balance, or doing motor tasks, or if it hurts when they do [those tasks], and that pain is in the joint and not just in the muscle, those are indications that you probably need someone whose scope of practice is broader than massage.”

In a nutshell, a massage therapist focuses mostly on the muscles and fascia. A chiropractor would add in the joints, the musculoskeletal system. A physical therapist, having an even wider scope of practice, would add in the rest of the body, like the nervous system and the cardiovascular system. Because there’s an overlap, you can see the exact same massage technique being done in all three offices.

“Massage is one tool in our belt,” Dr. John explained. “In most PT clinics, it’s done as a means to an end. It’s done for a particular therapeutic goal—to reduce swelling, to reduce muscle tension, to reduce pain. Then, we can get the person to do a more active technique like strengthening or balance exercises that are functional training exercises. It’s usually part of what we do to a patient. We seldom see a patient and just give them a massage. A massage therapist would probably give a much longer, and more in-depth massage. They might do your entire back or your entire body.”

IT’S DARK BY the time I arrive at my first massage-therapy appointment. I can already feel my legs getting heavy from this morning’s hill work. My massage therapist, Michelle, is a 30-something-year-old woman with small hands, slim fingers and a kind, endearing smile that softens her whole face. We have a little tête-à-tête before the session starts, mainly to go over the things that are out of whack in my body so she knows which massage styles to blend together, what sort of pressure to apply and which areas to focus on.

I tell her I run, which oftentimes causes muscle soreness and stiffness in my legs. She gives me brief nods that pass as marks of active listening. “Sometimes, when I sit for too long behind a desk, my back starts to ache,” I continue. More nods. After hearing me out, she comes to the conclusion that my back and shoulders should be the main focus of today’s massage, followed by my legs and then, if we have time, my arms. “That’s perfect,” I give her two thumbs up.

She leaves me alone to undress and slip under the sheets. As I lower my head into the face cradle and stretch out, my body sinks into the plushness of the heated, padded table. Everything, so far, is just what I expected. The low, subdued light. The soothing, polite soundtrack, which makes me feel as though I’m in a musical rainforest. Even Michelle, who walks in after a gentle knock, has what I call the “spa voice,” the sonic equivalent of a firefly blinking and sparkling through the air. Everything is just what I pictured—everything, that is, but the massage itself.

“Take a deep breath,” she semi-whispers before gliding her hands down my back with long, sweeping strokes (a defining characteristic of Swedish massage), warming up my muscles. I exhale and feel a kind of warmth wash over me. It’s not the kind of warmth I can melt into. There’s a bit of an intensity, one that keeps me on my toes.

As she works on my shoulders, her fingers unearth an unexpected pain. I flinch. “I definitely feel something there,” I tell her. “Does it hurt?” Michelle’s voice floats around my left ear. “Sort of, but in a good way. Like you’re fixing something,” I tell her. The muscle she’s pressing on, she notes, is the levator scapulae—a skeletal muscle that starts at the back of the neck and climbs up the sides. And apparently, I have a knot there.

It happens sometimes when you sit with an exaggerated slouch, like I do. (One way to prevent stress in the area is to do shoulder checks throughout the day.) Michelle uses trigger-point massage-therapy techniques to release the constricted area in the muscles. This involves applying direct pressure to the area—and it’s not relaxing, to say the least. As if confirming my thoughts, she says, “trigger-point massage isn’t particularly relaxing.” And that’s one thing that takes me by surprise. There are so many different kinds of massage out there, but they are not all inherently meant for relaxation, and some, such as trigger-point and deep-tissue massage, can even hurt—but, like, hurt good.

I’ve always thought of massage as unnecessary pampering—something that’s reserved for a special occasion, like a boozy romantic retreat to some far-flung, all-inclusive resort or a thoughtful birthday gift for your overworked partner or parent, perhaps. A few days before, when chatting with Dr. John, I asked him if this was a common view on feel-good medicine. “I hope that that view is changing,” he said. “In my mind, I would much rather a patient go for a massage every week than to be taking medication every week. … Also, massages tend to involve human interaction, which I think medicine (what we call integrative medicine) is finally realizing—that there are more important things than giving someone a pill or using a machine or using a surgical technique. We have to [look at] the whole mind, body and spirit.”

As Michelle continues to probe my muscles with practiced, calculated pressure, I think of how many times I’ve been guilty of reaching for Advil for a sore back or neck. She discovers tension in two more areas in my mid and lower back, just by reading the texture of my tissues. She can tell that, after prolonged sitting at my desk, I tend to droop to the left like a tired candle bending in the heat—and she’s right.

As we go deeper into the session, Michelle runs into more knots in the arches of my feet, which I didn’t know about and never bothered me. “I can tell you run,” she chimes in after massaging the tibialis anterior—a thick muscle just below the knee that’s responsible for lifting and controlling the foot. She finds things the same way an MRI machine scans quiet problems in your body. It doesn’t just feel good; it feels necessary—like maintaining good physical fitness, like getting proper sleep, like keeping up healthy relationships. Maybe it’s not as important, but it’s a powerful wellness tool, nevertheless.

I then think of something Dr. John said: “Massage, in my mind, can be used both to help prevent and also to help treat. Just like exercise can be used to both prevent and to treat. And nutrition can be used to prevent and to treat. So is it a worthwhile technique? Absolutely. Will it solve everything? No. The hard part for the consumer is to know when they need a massage and when they need more than a massage.”

After the session draws to a close, Michelle demonstrates a few stretching techniques I can do at home to release tension in my back. Foam rollers and tennis balls are also good tools to massage the calves and feet, particularly after a run, she said. I leave the room feeling changed—and not just because my back feels a thousand times better. Massage used to come low on my list of priorities, and that viewpoint is starting to shift. (Sometimes, it’s OK to allow yourself to just, well, lie there).

At the end of the day, it all comes down to what Dr. John ended our conversation with and what resonated with me the most. “I think you want to strike a balance,” he said. “You want to strike a balance between active techniques and passive techniques. … You don’t have to run a marathon. You don’t even have to run 2 miles three times a week. Just interrupt static positioning and take frequent breaks. That’s what our bodies are built for. … Strike a balance between being active and getting the help when you need it.” 

Looking to treat yourself this New Year? Revisit our guide to local spas at