Deep tissue massages are a popular treatment many seek when looking for a Massage Therapist. Some compare it to a sports massage while others may overestimate the pain involved. The Deep Tissue Massage Therapists at Hand in Health Massage Therapy explain what a deep tissue massage is. Also learn about what the benefits are and when to use caution regarding too much pressure.
What is Deep Tissue Massage?
The term has no specific medical definition. What it means tends to vary from one massage therapist to the next. However, deep tissue massage is commonly referred to as a collection of massage techniques that involve slow strokes, direct pressure or friction movements that go across the muscle grain.
Unlike classic Swedish massage therapy, which is used for relaxation, deep tissue massage usually focuses on a specific problem such as chronic pain, limited mobility, or recovery from an injury. Massage therapists use their fingers, thumbs or occasionally even elbows to apply the needed pressure. It is especially helpful for chronically tense and contracted areas such as stiff necks, low back tightness, and sore shoulders.
In practice, deep tissue massage mostly means a “strong massage.” The majority of therapists offering deep tissue massage consider causing mild to moderate pain to be a normal and acceptable part of the work. However it’s important to remember that not everything that hurts is therapeutic, but not every therapeutic procedure is painless!
What are the Benefits of Deep Tissue Massage?
When there is chronic muscle tension or injury, there are usually adhesions located in muscles, tendons, and ligaments. Adhesions, commonly referred to as “knots”, are bands of painful and rigid tissue. Adhesions block circulation, cause pain, limit movement, and cause inflammation. Deep tissue massage works by physically breaking down these adhesions to relieve pain and restore normal movement.
Other benefits of a deep tissue treatment include:
How to know how much pressure is enough?
Pressure tolerance is extremely varied between not only individuals but also different body areas. For example, some patients can take extreme pressure on their back but the same pressure applied to their legs may be excruciating. To help distinguishing between what type of pressure is appropriate, we like to use the “good hurt”, “bad hurt”, “never hurt” model.
The Good Hurt
During the massage, your therapist is using firm strokes and techniques that are aimed to physically break up adhesions, scar tissue and myofascial restrictions. When performed properly this should result in a “good hurt” sensation. A skilled therapist begins with light to medium pressure strokes and warms up the tissue first before applying their deep tissue techniques. They are careful to avoid endangerment sites such as bony structures or nerve bundles. A trained deep tissue massage therapist pays close attention to the breathing of their patient and looks for any signs their technique may be causing too much pain and adjusts accordingly. During the massage your body naturally releases endorphins, such as oxytocin, resulting in a feel good sensation that is the best good hurt that “hurt” isn’t even really the right word.
The Bad Hurt
Such pain is usually caused by excessive, although mostly harmless, pressure with no obvious or immediate benefit. Bad pains are usually sharp, burning, hot, or stabbing. This type of pain may be challenging to breathe through and result in the patient tightening or clenching other areas of their body in reaction to the pain. Although typically this type of pain is not enough to do any long term damage, other than some temporary bruising, it may have lost its therapeutic effect. While some live by the adage, “no pain, no gain”, that is not always the case with a deep tissue massage.
The Never Hurt
This type of pain is never okay and may even be dangerous. It is important to recognize this type of pain and immediately remove it from your treatment. Some examples include:
- Inability to breathe through the treatment due to pain
- Absolute excessive pressure that cannot be tolerated for that particular day or situation
- An overstretch that feels like muscle tearing
- Painful direct sustained deep pressure strokes or friction on bony landmarks with no apparent therapeutic benefit
- Prolonged nerve compression with an electric/zapping feeling or a gland compression in one of the body’s endangerment zones (i.e. armpit, behind the knee, front of neck)
- Excessive pressure on any inflamed or swollen areas of the body
The pain in this category is typically inflicted by careless or incompetant therapists. Unfortunately, there are massage therapists who believe that any painful sensation is simply part of the deep tissue process. If you ever find yourself in a treatment where your pain tolerances have been pushed too far and are no longer experiencing a therapeutic benefit, inform your therapist immediately. This open communication will allow them to adjust their technique. If they refuse to adjust, advocate for yourself and end the treatment for your safety. In New York State, you may report any therapist using excessive pressure who refuses to adjust at your request by filling a professional misconduct complaint.
Are there times when the “bad hurt” is acceptable?
This is a highly debatable topic amongst massage therapists. Research is inconclusive and results vary from person to person. Some massage therapists firmly believe that a deep tissue massage should never be painful while others view it as a workout for themselves and their patients.
At Hand in Health, we take the view that any “bad hurt” experienced by a patient should be brief, intentional and worthwhile in the long term despite the short term pain. If it is not therapeutic then you are paying for pain without a benefit. That should be considered the “never hurt” type of pain. Here are some situations where a “bad hurt” pain may be acceptable for a brief and mutually agreed upon amount of time:
- Myofascial trigger points, nodules that are formed in bands of muscle, are highly tender but respond well to direct sustained pressure. A skilled massage therapist will work with you to set up a pain scale and apply pressure through a series of deep breaths. When this technique is administered correctly, this “bad hurt” is temporary and therapeutically beneficial.
- Deep multi-directional friction to areas of the body where scar tissue is present from an injury (such as a strain or sprain) is highly effective in increasing mobility and function. However, this technique can be quite unpleasant to receive. Brief periods of friction that can be tolerated followed by stretching techniques are typically worth the “bad hurt”.
- Myofascial release performed with deep pressure can also have therapeutic benefits as connective tissue lines are released in the body. This can be uncomfortable and may be challenging to breathe though. Sometimes this type of work and pressure also results in somatoemotional releases where the painful sensations can stimulate repressed emotions expressed in the body.
Whenever you move past the “good hurt” sensation and you are unsure if there is a therapeutic benefit, speak up and ask your therapist questions to determine if the pain you are experiencing is appropriate. You are always in control of the pressure your therapist uses.
Is a Deep Tissue Massage for you?
During a deep tissue massage, much can be achieved while inflicting only “good hurt” pain on patients that “bad hurt” pain must be justified by quick, and somewhat lasting benefits. At the end of the day, all massage treatments must be justified by their benefits. There is no point in tolerating, and paying for, a painful treatment without an obvious return on your massage investment. Be sure to work with a Licensed Massage Therapist who has a detailed treatment plan to address your concerns for your session.
At Hand in Health Massage Therapy, we may recommend using deep tissue techniques to help address chronic pain or an injury. To help facilitate a successful deep tissue treatment, we encourage setting up a pain scale so we can stay in tune with you and your body. As a rule of thumb, we never want your pain to exceed a 7/10 during a deep tissue treatment. Once we reach that tolerance, our techniques can be modified and still work the deep tissue structures in your body without excessive pain. Any “bad hurt” pain will be discussed and justified based on your treatment plan. Our patients are always in control of the pressure we use during a treatment.
Want to set up your deep tissue massage appointment? Are you located in the greater Syracuse, NY area? Hand In Health is ready to customize a massage therapy treatment plan for you. Let our Licensed Massage Therapists and Certified Fitness Professionals show you the benefits of deep tissue massage. Contact our Wellness Centers in Downtown Syracuse or North Syracuse today!