Deep Tissue Massage - What exactly does that mean and does it have to hurt?

Prospective clients often ask me if I do Deep Tissue Massage. This question is tricky to answer due to common misconceptions about Deep Tissue Massage and how subjective the term is because everybody has a different sense of “deep” and “heavy pressure” massage. My answer is Yes, I massage the deep tissues but not with painful, fast, high-intensity pressure that many people associate with Deep Tissue Massage.

So what exactly is Deep Tissue Massage?

The intention of a Deep Tissue Massage is to affect many layers, instead of just gently massaging the superficial layers (nearest the skin) for relaxation. (Light Swedish Massage has a myriad of benefits too, but isn’t as helpful for chronic tension.) Quite simply, it’s massage of the deeper layers of tissue in the body, including muscles and connective tissue. For example, in the abdomen the rectus abdominus is the superficial layer, easily palpable and visible as the “6-pack” abs. Very deep beneath that lies the psoas muscle which is important for trunk stability, hip flexion and often involved in low back pain. Another deep muscle is the subscapularis, which lies between your scapula (shoulder blade) and ribs. If you’ve had massage in your armpit for computer posture tension/pain, you’ve experienced how wonderful it is to have this muscle relaxed!

My personal approach can be described by visualizing a wet, hard-packed surface of a sandy beach. If you run or jump on that area, you put a lot of pressure into the sand very quickly, but hardly make an impact in the sand. The light footprints quickly subside. But if you stand still or walk slowly, allowing your toes and feet to gradually sink in, you actually create deeper and longer lasting footprints with less effort and impact! I see the same effect in massage. When I try to use faster and more forceful pressure, the tissue responds with resistance. But in moving slowly until the connective tissue softens and allows me to sink in, I access the deeper structures while also creating a relaxation response in the nervous system. Even though I’m treating the deep layers, the massage doesn’t feel particularly deep because there is no resistance or pain response.

Doesn’t Deep Tissue Massage have to hurt in order to be effective?

This is the most common misconception I hear and I strongly disagree. Massage should be within your comfort zone. When treating body areas with chronic pain or tension you are likely to feel some tenderness/discomfort with massage, but it should be tolerable in a way that you can still breathe through it. If you are “grinning and bearing it,” clenching your fists, holding your breath or otherwise toughing it out until it ends, the massage is likely doing more harm than good.

If it shouldn’t hurt, why does some Deep Tissue Massage cause pain?

Every therapist differs in their training, skills and style of bodywork. Many therapists believe that using a lot of fast, hard and intense pressure forces the tissue to relax. When a session begins this way, the tissue hasn’t been appropriately warmed up and softened so you will likely feel pain. Ever have someone just dive right through your abdomen into your psoas muscle with a lot of pressure? OUCH! That’s a perfect example of not properly warming the tissue and waiting for the body to allow deeper work. Also, if your body is already tense in anticipation of pain, it’s not going to feel as good as when you are relaxed and receptive to manual therapy.

Find a therapist who will listen to your limits and work within your comfort zone so that the massage is most effective and enjoyable for you. After all, if you’re not looking forward to it, you’re not likely to go in for treatment when you need it!

Is Deep Tissue Massage appropriate for me?

If you’re experiencing chronic pain or tension from a restriction in deep tissues, then massaging the deep layers will be beneficial to you. Your therapist should be willing to work within your comfort zone and adjust pressure and speed so that it feels comfortable each session. Some clients need multiple sessions of other treatment modalities until they can tolerate deeper tissues being accessed. This is especially true with recent injuries or anyone highly sensitive to touch. Deep Tissue Massage is contraindicated at times so be sure to tell your therapist about current or recent health concerns and injuries.

What if I like a really intense massage? No pressure is too much for me!

I’ve met people who love a massage with tons of pressure as they believe “no pressure is too much.” For these people, a high-intensity Deep Tissue massage is great because they aren’t actually in pain during it, or the pain “hurts so good” so it’s still within their comfort zone. That’s not the style of massage I do, but everyone needs to seek the treatment that best meets their needs!