FAQs about Deep Tissue Massage What is Deep Tissue Massage? (and what it’s Not!) Some believe that Deep Tissue Massage means that the therapist pushes as hard as possible with their elbow into someone’s muscles. The more it hurts, the more effective the work.“No Pain, No Gain.” This is not only an inaccurate and potentially harmful picture of this type of massage, but such misguided practices can bruise muscles, elicit a defensive reaction in a client’s body, and worsen pain cycles. Also it does not convey the rich possibilities afforded by this versatile style of bodywork. Properly executed deep tissue work, on the other hand, should not cause the client to grit their teeth in agony. On the contrary, it should be performed with great sensitivity to the client’s comfort level and can be deeply relaxing. While deep work can be intense, and sometimes requires moderate discomfort to achieve it’s ends, that intensity is typically the result of tissues being stretched in a profound way. The result is often significant pain relief, greater freedom of movement, and a more fluid sense of balance in the body. A Working Definition of Deep Tissue Massage (Adapted from Art Riggs's excellent book, Deep Tissue Massage: A Visual Guide to Techniques) Deep Tissue Massage is NOT... • A hard, painful massage • A massage that follows the “No Pain, No Gain” motto • A massage requiring extraordinary strength and effort • A massage which causes the recipient to be sore for days afterward Deep Tissue Massage IS... • A massage working with, not on, the layers of the body’s tissues • A massage focused on relaxing and lengthening these tissues to improve their health, their flexibility, and their overall function (i.e. — to support the joints in particular, and the body in general) • A massage whose purpose is to work deeply into and with these tissues in the most efficient way possible (i.e. — with the practitioner working with a relaxed body and using the least amount of effort possible) • A massage in which the primary goal is less about general relaxation and more about promoting change in structure by releasing muscular and fascial restrictions Why Study Deep Tissue Massage? Being properly trained in Deep Tissue Massage is fast becoming essential for massage therapists. In some chiropractic offices it’s a required skill, and increasingly health clubs and spas are recommending theirtherapists be proficient in deep tissue techniques. For the therapist working in her own practice, being able to provide deep tissue work has become essential for maintaining a thriving business. The reasons for the popularity of Deep Tissue Massage are easy to understand: chronic pain of all kinds (back, shoulder, neck, hip) is caused by accumulated tension and rigidity in the body, often a symptom of shortened fascia and fascial adhesions. Deep Tissue Massage, when properly applied by a well-trained therapist, is extremely effective in relieving such problems. While Swedish massage is wonderfully effective for many issues, it is not effective for restoring length to shortened fascia. What’s This Thing Called Fascia? The fascia, or connective tissues, literally holds the body together, wrapping around every muscle, nerve, organ, blood vessel, and bone. These wrappings are all interconnected in a three-dimensional maze. In a healthy state, the fascia is made up of thin, lubricated, elastic sheets of tissues that support and facilitate physical movement. But injury, lack of movement, postural distortion, repetitive movement patterns, and aging can cause the fascia to lose its elasticity such that it becomes thickened, tough, and rigid. Also, the fascia between two or more muscles can become adhered together such that when you move one muscle you actually drag several others along as well. As a result, range of movement deteriorates, and the involved muscles can become quite painful. If this phenomenon progresses to several parts of the body, quite serious dysfunction and pain is possible. What’s the difference between Deep Tissue Massage and Neuromuscular Therapy? They are two quite different techniques. In Neuromuscular Technique the goal is to calm both the nervous system and the muscular system. This is first accomplished by putting a spastic or ischemic muscle in the most slack or relaxed position. Then lotion is applied and detailed, repeated strokes are administered to the muscle belly, origin, and insertion. If trigger points are discovered, gentle static compression is used to release them. In Neuromuscular work, the emphasis is on relieving chronic pain by identifying ischemic muscles and trigger points and then treating with repeated, moderately paced strokes. This calms both the nervous system and the muscular system. Rather like stroking a child’s head or a cat’s back to calm them down. Deep Tissue Massage, on the other hand, has a very different focus and style of application. The goal of Deep Tissue work is to lengthen shortened tissues and to separate adhered muscle compartments. Instead of putting soft tissue in a slack position, tissues are put on a stretch. Then, with little or no lotion, the practitioner utilizes the hard surfaces of their hands and arms — surfaces such as fingers, knuckles, forearms, and elbows — and employs a very slow, sustained type of stroke. With no lotion or oil to cause sliding, it becomes possible to fully get a hold of the shortened fascia; this is necessary in order to lengthen it. Also, it becomes possible to separate adhered muscle compartments. The fascial sheaths that surround two or more adjacent muscles can become stuck to one another. This can result in distorted joint movement, pain, and the inability of the involved muscles to lengthen and shorten properly in normal movement. Slow, sustained strokes are what can change this tissue from a short, hardened state to a lengthened, fluid state. The process is not unlike stretching salt water taffy. You've got to get a hold of it, warm it up, and work it very slowly. A Professional’s Opinion I have been utilizing Deep Tissue Massage in my private practice for many years. It has become one of the most useful, helpful modalities that I employ. Not only have I had success relieving lower back pain in scores of individuals, but also chronic musculoskeletal pain of all kinds including neck, shoulder, and hip pain, pain in the arms and hands, legs and feet, migraines, athletic injuries, and many other problems. I highly endorse this type of bodywork. My only caution is that you refuse to work with any practitioner who insists that the work must be very painful for it to be effective. This type of practitioner is probably inexperienced. A more sophisticated therapist should be sought out. If you would like to learn about Art Riggs's wonderful book, Deep Tissue Massage: A Visual Guide to Techniques, or his fantastic DVDs about this work, click here. Return to Neuromuscular Therapy of Vermont Home Page