Understanding Deep Tissue Massage

When I tell people I'm a massage therapist I get a variety of responses, including personal stories of how they had a terrible experience with massages in the past. I have found that the majority of these stories have to do with improperly administered deep tissue massages. As such, I would like to address a number of elements, such as how a correctly administered deep tissue massage it is not about brute strength and should never cause extreme pain. 

First of all, deep tissue massage is the modality of massage "used to release chronic patterns of muscle tension using slow strokes, direct pressure, or friction; [it] is administered to affect the sub-layer of musculature and fascia that support muscle tissues and loosen bonds between the layers of connective tissues"(1).  

Why Deep Tissue is NOT About Brute Strength  

A client that has a deep tissue massage administered in the same way as a regular massage, simply slower and with more strength, can cause problems as it creates a conflict between the client's musculature and the pressure being administered. I know that sounds odd, but if the therapist simply pushes as hard as they can, more often than not the client's muscles will push back. This methodology is where the horror stories of someone being sore for a week or so after a deep tissue massage come from, and is because the client's and the therapist's muscles were in constant conflict with each other for an hour. Instead, a deep tissue massage should focus on modulated and varied pressure, starting light and growing in intensity as problem areas are isolated. Not only does this approach cause the client's body to be more receptive to the therapy, but also allows the therapist to be able to isolate problem areas and handle them accordingly.   

"No Pain, No Gain"  

One of my least favorite things to hear from clients, especially when it comes to deep tissue massage, is "no pain, no gain." Although this may be true to some extent, no massage should be overly painful. I typically tell my clients that their pain level should be within the pain level that they experience during a workout. When a therapist works to the point of causing excruciating pain during a massage the sympathetic nervous system of the client is stimulated. The sympathetic nervous system is the system responsible for the fight or flight responses. Which means that if there is too much pain during any massage, the client on the table will either tense up, "fight," or start to move away from the touch, "flight." The same problem as described before, where the therapist's and the client's muscles are in constant struggle with each other would occur during the "fight" response. With the "flight" response, the client's motion can cause incorrect placement of pressure and, potentially, be harmful. The results of both responses are why communication is key to a beneficial massage. As I like to tell my clients, I am not the one on the table. I typically massage my clients how I would like to receive massages but my pain threshold is different from everyone else's, I don’t know you're in pain unless you tell me.    

How Do I Unlock Muscles To Get So Deep?  

"Deep tissue" certainly lives up to its name, the purpose to a deep tissue massage is to release and relax tissues not typically worked on during a standard massage. In fact, in some very specific instances based on client needs, some deep tissue massages will even go so far as to lengthen the periosteum, the dense tissue surrounding bone.  

Our muscles are very pliable once warmed; therefore the first step in any massage, especially deep tissue, is to warm up the muscles through low pressure stimulation. Once they have relaxed enough, additional pressure is applied, very gradually. A client's body is responsible for the amount of pressure I apply to a certain area, matching the point required to not trigger the sympathetic nervous system response, as mentioned above. Once the client's body exhibits resistance, my pressure stagnates until either the tissue opens for deeper work, or the area has been sufficiently massaged. To facilitate the best pressure, communication is again key, which is why I will ask the client if they require more, less, or the same amount of pressure during most stages of the massage.    

What Can a Client do to Get the Most Out of the Massage?   

A massage, whether a deep tissue or not, is a day-long experience. Before a deep tissue massage I recommend refraining from eating large meals, the digestion process combined with the deep work may not be comfortable. Also, before a massage, hydration is also important; this will help with the pliability of the muscle tissues. Many massages also release lactic acid from the muscles the same acid that causes soreness after working out. Therefore, it is important to also hydrate after the massage while avoiding caffeine and alcohol to flush out the lactic acid. Another very key element to massage day is to not workout. Working out beforehand shortens the muscles and decreases their pliability. In addition, working out after a massage can cause tearing since the relaxed muscles have not been able to reform into their shortened state, which is necessary for working out. In fact, it is recommended that a client wait 24 hours after a massage to "[engage] in vigorous exercise, such as running or weight training"(2). Some alternative healthy options are to is go for a walk, enjoy a sauna, or soak in a hot bath/tub, all of which would aid in the removal of lactic acid as well.    

I love being a massage therapist because of the aid I can provide to my clients with a variety of issues. Deep tissue massage has given me the tools to aid in  

• 
  
• Lowering high blood pressure 
• Treating back pain 

• Helping arthritic pain/symptoms 
• Muscle rehab 
• Breaking down of scar tissue 
• Relieving stress 
• Increasing joint mobility 

• And reducing chronic pain (3) 

Of course, deep tissue massage is not for everyone; those with a history of blood clots should avoid deep tissue massage. Also, those recovering from surgery or any other medical condition should consult with their personal physician before receiving deep tissue massage.  

I look forward to assisting those I can with deep tissue, or any other modality I offer. If you believe I can help you please give Grand Junction Chiropractic Center, PC a call and book an appointment (970)241-1199. 

  

(1) Saeger, J. L., & Kyle-Brown, D. (2008). New Foundations in Therapeutic Massage and Bodywork. New York, NY: McGraw-Hill.  

  

(2) Cespedes, A. (2017, September). Can You Work Out After a Full-Body Massage? LiveStrong.com. Retrieved from https://www.livestrong.com/article/536227-can-you-work-out-after-a-full-body-massage/  

(3) Renaissance College, (2017 July 13). 8 Benefits of Deep Tissue Massage. http://renaissancecollege.edu/8-benefits-of-deep-tissue-massage/