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Deep Tissue Therapeutic Massage

Deep tissue massage is a technique that focuses primarily on the deeper layers of muscles and the fascia (the connective tissue surrounding muscles). This technique involves the massage therapist using firmer pressure and slow strokes to reach deeper layers of muscles, in order for them to release.

This particular massage is often recommended for people who need relief from chronic aches and pain, and contracted areas such as a stiff neck and upper back, low back pain, leg muscle tightness, and sore shoulders. 

Deep tissue massage makes movement easier.  Scar tissue forms when an area of the body is injured and heals. Although the most common scars are those that result from a visible cut, sometimes they occur deeper in the body, such as when you damage muscles, ligaments or tendons. It is this type of scarring that deep tissue massage can help resolve, making it easier to move and promoting greater range of motion.

Deep tissue massage may be able to lessen pain. For example, research published in an April 2014 issue of Manual Therapy found that deep tissue massage to posterior calf muscles, along with self-stretching exercises, helped reduce participants’ pain associated with plantar fasciitis.

Deep tissue massage can lower heart rate and blood pressure.  A study published in 2008 in the Journal of Alternative and Complementary Medicine involved 263 participants who reported muscle spasm or strain. Each individual’s blood pressure and heart rate was assessed prior to a 45 to 60-minute deep tissue massage, as well as after. The result was lower systolic and diastolic pressure, as well as heart rates around 10 beats less per minute.

This modem of massage is for those clients who are comfortable with a slightly more intense touch. However, deep tissue massage can also refer to gentle yet sustained pressure targeting the myofascial layer. The belief that deep pressure equals pain is a myth; however, the benefits of deep tissue massage are beyond question.

How Does It Work?

While some of the strokes may feel the same as those used in Swedish massage therapy, deep tissue massage isn’t the same as having a regular massage with deep pressure.  It’s used to break up scar tissue and physically break down muscle “knots” or adhesions (bands of painful, rigid tissue) that can disrupt circulation and cause pain, limited range of motion, and inflammation.

What are the benefits of deep tissue massage? 

Deep tissue massage usually focuses on a specific problem, such as chronic muscle pain, injury rehabilitation, and the following conditions:

  • Low back pain
  • Limited mobility
  • Recovery from injuries (e.g. whiplash, falls)
  • Repetitive strain injury, such as carpal tunnel syndrome
  • Postural problems
  • Muscle tension in the hamstrings, glutes, IT band, legs, quadriceps, rhomboids, upper back
  • Osteoarthritis pain
  • Sciatica 
  • Sports concerns (runners, athletes)
  • Piriformis syndrome
  • Tennis elbow
  • Fibromyalgia
  • Upper back or neck pain

According to Consumer Reports magazine, 34,000 people ranked deep tissue massage as being more effective in relieving osteoarthritis pain than physical therapy, exercise, prescription medications, chiropractic, acupuncture, diet, glucosamine, and over-the-counter drugs.

Deep tissue massage also received a top ranking for fibromyalgia pain. People often notice an improved range of motion immediately after a deep tissue massage.

What can I expect during a deep tissue massage?

At the beginning of the massage, lighter pressure is generally applied to warm up and prep the muscles. Specific techniques are then applied. The most common techniques include:

Stripping – deep, gliding pressure along the length of the muscle fibers using the elbow, forearm, knuckles, and thumbs.

Friction – pressure applied across the grain of a muscle to release adhesions and realign tissue fibers.

Massage therapists may use fingertips, knuckles, hands, elbows, and forearms during a deep tissue massage. You may be asked to breathe deeply, or move in a certain way as the massage therapist works on tense areas.

After the massage, you may feel some stiffness or soreness, but it should subside within a day or so. Be sure to contact your massage therapist if you have concerns or if you feel pain after having a massage.

It is very important for you to drink a lot of water after the massage to flush out the metabolic waste that is released as a result of the massage from your body tissues.

Will deep tissue massage hurt?

You and your massage therapist will always work as a team.  You provide feedback during all parts of your massage. 

At certain points during the massage, you may feel some discomfort or even some pain as the massage therapist works on areas where there are adhesions or scar tissue.  You should always tell your massage therapist if you feel pain during the massage. The therapist can adjust the technique or further prep the tissues if the superficial muscles are tense.  Pain isn’t necessarily good, and it’s not necessarily a sign that the massage is working. In fact, your body may tense up in response to pain, making it harder for the therapist to reach deeper muscles.

Warnings and Precautions

Deep tissue massage may not be safe for people with blood clots (e.g. thrombophlebitis or deep vein thrombosis), due to the risk that they may become dislodged. If you have blood clots or are at risk of forming blood clots, it’s essential that you consult your doctor first.

If you’ve had recent surgery, chemotherapy, radiation, or any other medical procedure, it’s wise to check with your doctor before starting massage therapy. Some people with osteoporosis should avoid the deeper pressure of this type of massage.

Massage should not be done directly over bruises, inflamed or infected skin, skin rashes, unhealed or open wounds, tumors, abdominal hernia, fragile bones, or areas of recent fractures.

If you have any condition, it’s important to consult your primary care provider beforehand to find out what type they recommend. For example, people with certain conditions, such as ankylosing spondylitis, may not be able to tolerate the pain of a deep tissue massage.

Pregnant people should check with their care provider first if they are considering getting a message. Deep tissue massage (or any strong pressure) should be avoided during pregnancy.  Treasured Birth is specially trained in pregnancy massage. 

Remember to communicate with your massage therapist to get the most out of any modem of massage.

Sources:

Massage Therapy for Health Purposes. National Center for Complementary and Integrative Health. NIH. https://nccih.nih.gov/health/massage/massageintroduction.htm.

Romanowski M, Romanowska J, Grześkowiak M. A comparison of the effects of deep tissue massage and therapeutic massage on chronic low back pain. Stud Health Technol Inform. 2012.

Massage Magazine, 2017.  The Benefits of Deep Tissue Massage.

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