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What does it mean to be ticklish? What causes this reaction to touch? Are some people for certain reasons more ticklish than others? Also what causes severe ticklishness around the knee cap? When I get a massage I get very squimish and ticklish when someone works around my knee cap.

Hi James,

Good questions.  Some people do not seem to have a tickle response at all and I once met a woman who was so ticklish all over that I questioned how she would ever have a relationship!

Fear may play part of it.  For instance, if you are fearful that your knee caps will be injured or displaced, you may respond by laughing instead.

And, as you know, you don't even have to be actually touched to start laughing from being tickled--all someone has to do is 'threaten' to tickle you; to pretend they are going to tickle you.

And, in the massage field, I have heard many times that ticklish areas are hiding painful areas.  The tickle response prevents the therapist from getting into the painful area.

Interestingly, many people seem to outgrow the tickle response as they get older.

Lots of times I have had clients who were amazed when they realized I was touching their feet, and that they could tolerate it, because they were so ticklish there.  Often, by the time I have gotten to their feet their body knows that I can be trusted and am not going to tickle them so they don't have the tickle sensation.

Your massage therapists can alter the way they work around your knees to prevent you having that response.  Just let them know in advance.  Some techniques will work better for you than others.  Ask for compression (but not on the knee cap) rather than gliding.  Also, if the therapist secures your knee cap with their fingers to keep it from moving, you may discover that it reduces the tickle sensation.

I wish I knew more.  I would also like to know why we laugh when we are tickled but it's not funny--it hurts!  

I hope this helps.



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Kathryn Merrow


I can respond to questions about migraines and headaches, carpal tunnel syndrome, hand-wrist-arm pain, upper back pain, and other assorted and miscellaneous pain symptoms. I can also respond to general questions about massage and how to select a massage therapist.


I have been a massage therapist since 1992 specializing primarily in pain relief techniques. I utilize the St. John Method of Neuromuscular Massage Therapy (NMT) and other bodywork modalities. I'm The Pain Relief Coach online.

Professional Member of American Massage Therapy Association (AMTA) Nationally Certified in Therapeutic Massage & Bodywork (NCTMB)


My initial training in massage was at Health Enrichment Center in Lapeer, Michigan. I have had advanced training or workshops with Kurashova Institute for Studies in Physical Medicine, St. John Neuromuscular Institute of Pain Relief, Center for Self-Healing and many others. I now share my education and experience as a Massage Instructor and Pain Relief Coach.

Awards and Honors
The highest honor I receive is when someone tells me that they finally understand why they had pain, that they took action and that their pain is either less or is totally gone.

Past/Present Clients
I have done well over 20,000 therapeutic massage sessions, primarily with clients with various types of pain or painful syndromes.

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