Deep Tissue Massage

Theories and concepts of Deep Tissue Massage is a form of massage that focuses on releasing the deeper myofascial restrictions of the deeper muscles,

tendon and ligaments of the body.   This work is also sometimes referred to as myofascial release and is used by many massage therapists, physical therapists and osteopaths. There are many theories and concepts that have evolved around doing deep tissue massage from the various types of therapists that use the technique.

  1. Blocked circulation is reduces well being and overall health.  Eliminating the blocks that are caused by muscle tightness using deep tissue techniques can lead to enhanced circulation of blood, lymph, interstitial fluids and cerebro-spinal fluids. Enhancing circulation will lead to optimal functioning and health.
  2. Physical activity is needed for optimal health.  The anatomy of the muscles and physiology are related to other functions of the body.  The health of the muscles influences the health of other systems of the body.
  3. Connective tissue plays an important role in creating and maintaining health.  Connective tissue is the most abundant of the four basic types of tissue in the body and therefore plays a role in most systems in the body.  When connective tissue is damaged or not functioning properly due to adhesions or restrictions the function of the associated tissue is impaired or reduced.

There are many different combinations of various techniques of deep tissue (myofascial release) with different purposes or intent. Some use very forceful pressure while others use gentle rocking or very light pressure with the same results – a releasing of the deeper structures of the body.

 Some of the various techniques include :

Rolfing and Structural Integration, Neuro-Muscular Therapy, Craio-sacral Therapy, Polarity Therapy, Travell Triggerpoint therapy, Pfrimmer Deep Tissue, Postural Integration, Soma Neuromuscular Integration, Thai Massage, Trager and many others. 

Deep tissue massage does not necessarily mean a painful massage.

Discuss deep tissue massage concepts, techniques and theories on the blog.

 

Methods of Application of Deep Tissue Massage Therapy

There are many various levels and planes of fascia that can be accessed through the application of specific pressure.  The major method of access

 regardless of the type of stroke one uses in deep tissue therapy is through the intent behind the touch.

You can use the following general rules for focusing your intention to access the various levels of fascia.

  1. Direction of pressure is determined by the direction of the resistance in the myofascial structure.  Press directly into the resistance of pull from the resistance depending on the intent.
  2. Depth is determined by the level of the tissue to be treated and the minimum amount of pressure required to engage the resistance in that tissue.
  3. Duration is determined by the rate of release in the muscular reflexes and the rate of change in the ground substance of the connective tissue.
  4. Pressure is applied only to the minimum level necessary to obtain access to the tissues and is necessary for the self care of the therapist.
  5. To develop effective techniques, the practitioner must develop skill in palpation of the musclo-skeletal system and fascial structures.
  6. Deep tissue massage/bodywork is only a tool to set up a framework for developing a therapeutic relationship which is really the core of healing.  The practitioner who is aware of their codependent tendencies and other dysfunctional behaviors will be the most successful and effective.  The process of peer supervision can support the therapist in this process.
  7. Practitioner awareness is necessary when doing deep tissue massage.  Proper body mechanics and using the weight of one’s body to apply pressure is one part of awareness.  The other is the awareness of one’s self (see #6 above)
  8. Intuition needs to be activated and always improved upon to stay as present with the client as possible.  Intuition is a combination of applying knowledge and experience while you are staying present with what you are feeling in your own body as a result of the interaction with the client.
  9. The practitioner needs to stay present to observe physical, emotional, mental and spiritual changes taking place in the clients body.
  10. The best form of feedback is how you feel (not the client).  We are always reacting and responding to others based on our own needs at the time.  You are a mirror for the receivers of the deep tissue massage.  Use your feelings to guide your touch.

Qualities, Intentions and Purposes of Deep Bodywork

Deep Tissue Bodywork is applied with the intention of accessing the deeper layers of the body.  Pressure is applied with the intention of finding the

 resistance of the body and sustaining the pressure until the resistance is released.  This is called a direct technique. 

There is also an indirect method that moves in the opposite direction of the resistance.  In both instances the amount of pressure used is dependent on the amount of resistance in the tissue and using the minimum amount of engagement needed to release the tissue.

Contrary to some popular beliefs that “no pain, no gain” and “more is better”, deep tissue massage does not require great strength nor does it need to be painful.

Creating a clear intention is what creates effective results.  Some of the qualities, intentions and purposes of deep massage/bodywork include:

  1. It is sensitive to the state of receivers and requires that the giver have a highly developed awareness of themselves and others.  The intention is to increase the receivers’ awareness and sensitivity.
  2. The increased awareness of the practitioner results in mirroring of the clients’ body tension.  Using Deep tissue massage techniques allows the receiver to become more aware of holding patterns and the emotional content that is stored there.  It is important that the practitioner learn to be of service and be able to set aside their agendas in order to adequately meet the clients tissue and provide the listening (through their hands, ears and eyes) that the client needs.
  3. Increasing the receivers awareness allows the work to go even deeper.
  4. It is effective in releasing deeply held emotions that cause tension thereby resolving many chronic pain patterns.
  5. Deep tissue massage may help improve the functioning of the internal organs and any associated symptoms or diseases.
  6. Improves posture and re-establishes proper movement of muscles.
  7. Releases myofascial restrictions for optimal health.
  8. Deep tissue massage done with intention and awareness can help reduce the automatic reflexes to stress thereby creating less tension
  9. Is effective in working on injuries and the resulting compensations in other areas of the body.
  10. Emotional stability can result as the deeper restrictions are released.

The art of doing deep tissue massage/bodywork lies in being able to remain present and adjust your approach and technique to each person.

Qualities of a Good Deep Tissue Massage Therapist

  1. Little to no pain – yes that is right.  Deep tissue bodywork can be and should be done without pain.
  2. Will be in constant contact with you about the level of discomfort you are feeling.  It is important to set up a system for communicating this information – something like choosing a number between 1-10 with 10 being unbearable.
  3. NO Bruising.  If tissue is being bruised it is being damaged.  Many deep tissue therapists will tell you that is part of the treatment.  In my opinion, it should not be.  Bruising indicates that the tissue is not strong enough or healthy enough to be worked on that deeply.  You can back off on your pressure and use other methods to get the tissue healthier. 
  4. There are other methods of therapy that achieve the same things as deep tissue.  You don’t have to get it.
  5. Be aware that people like deep tissue because they think they aren’t getting their money’s worth if they can’t feel the work.  This may be an indication that the person’s tissues are numb from chronic holding and armoring.
  6. The key to doing deep tissue work is to relax.  Your hand/fingers should be loose and flopping when you are using your elbow.
  7. Physical strength has little to do with deep tissue therapy.  A good deep tissue therapist will be using their “Ki” or “chi” or energy to access the deeper tissues of the body.
  8. Using force will cause tissues to tighten and resist relaxing.  Using force can inflict trauma.
  9. Deep tissue work that is causing pain and there is no emotional release is usually too much.  Trauma can be emotional as well as physical.  If a person is unable to release the emotions that are held in the deeper layers, they may be re-traumatized and the emotional pain will deepen.
  10. Little to no pain.  Did I already say that??

General Guidelines for Giving a Deep Tissue Massage

  1. Be in communication with your client. Find out what areas need to be addressed and how the person feels to start with.  Is there pain, tightness, numbness or tingling anywhere?
  2. Ask them to assign a number to the level of pain they are feeling – on a scale of one to ten, ten being the most painful or stopping level.
  3. Be sure to tell them that they are in control of the session and that their feedback is important to the session.  They can tell you to apply more or less pressure or to stop at any time.
  4. Be sure the client is as present as possible. Keep their awareness under your fingers by asking them questions about what you are doing and what they are feeling.  Can they feel the change in pressure and pain?
  5. Be aware of their breathing at all time.  Most people do not know how to breathe deeply and possibly can’t because of the restrictions in the rib cage and torso. Coach them into breathing deeper and into the pressure. Give them breathing exercises to help them become more aware of their breath.  Ask them to notice how the ribs move or don’t move, how does the air feel, what does the rest of the body do when breathing?  When do they hold their breath?
  6. Be present at all times for the client.  What do you feel?  What are you thinking about? What is for lunch?  Can you stop your thoughts completely and listen to the clients words and body responses?  What does the tissue feel like? What layer of the tissue are you working on?  Can you feel the change?  Can you feel the clients breath? Can you feel the skin, the hair, the temperature of the skin?  Practicing meditation is one way to assist you in stopping your thoughts.  Many thing can be meditative – movement, dance, gardening, hiking, walking, running – whatever activity that allows you to stop your thoughts and just be totally immersed in that activity can be considered meditation. Finding the practice that works for you is important.
  7. Pause often enough to give the client a break and time to notice the changes that are happening in their body.  Ask them to compare sides or notice how they feel.  Can they feel more or less contact with the table? Do they feel lighter or heavier? What emotions come up?
  8. Release can come about in many ways: shaking, moving, yawning, sighing, crying, yelling, screaming.  Be prepared to have any of these happen.  The best response on your part is just to be there when it happens. Don’t say anything unless you are also a qualified counselor of some sort.  Quietly place one hand on their abdomen and one hand on their wrist and let them get through it.  They are very vulnerable in this condition.  Anything you say will become part of their reality.  If you start asking them questions or making suggestions like ” oh it must be due to your abusive mother or father” or “the sky is green and the grass is blue”  they will believe it.  They are so open to any suggestions and very fragile.
  9. Make sure the client leaves grounded and centered.  Working the extensors of the back and forearm usually create positive emotions. Working the psoas or ASIS can assist in getting the energy back down to their legs and to the ground.  Pulling their fingers and toes can help relieve that sick feeling that some may feel.
  10. Bodywork and massage is a dance that takes two people.  Learning to adjust your work to what the client needs and what they can handle will make for a very effective session.  Learn to turn your thoughts off and listen to the clients words and body. Ask for feedback as to how your touch feels and what is going on inside them and ask often during a session as things change minute to minute.

Guidelines for Receiving Deep Tissue Bodywork Sessions

  1. Be in constant communication with your practitioner. It is important to tell your practitioner what you want worked on and then tell them when things hurt, how painful it feels, where does it radiate to, when to apply more pressure and most importantly, when to STOP.
  2. Be willing to express the pain.  Move with the pain or however your body feels like moving. You are not required to lay motionless during a session. Verbally express the pain; yelling, moaning, crying, and swearing are all acceptable forms of releasing the pain. You are allowed to express yourself in any way you feel necessary.
  3.  Focus on what it feels like to be on the table. Be aware of what every  breath feels like.  What muscles are moving, what muscles are contracting and releasing. Is the air cool, warm, or just right? Does other areas of your body move or not move?  How does your body feel as it lays on the table? Can you feel the contact in all areas?  Do some areas not touch the table?
  4. Be aware of your breath. Your breath can assist you in staying with the pain or other feelings that arise. Breathing into the pain so that area of the body is filled with air and then exhaling to release the area and any pain or emotion associated with that area. Can you feel what happens in the rest of your body as you breath? What muscles contract? What muscles relax? Can you feel the air go into your lungs and through the passageways?  Can you feel it move other areas of your body like the bones of your skull or the joints of your feet and ankles? Can you feel the exhalation take away the pain or reduce the pain?
  5. Be in constant communication with your practitioner to inform them as to what you are feeling.
  6. The practitioner should pause after working intensely in areas and allow you to feel the changes that have taken place.  How does the area feel? Does it lie differently on the table?  Does it tingle, feel more alive or just ache or throb? Is it different from the other side?
  7.  Can you tell what direction the pressure is in and how much pressure is being applied? The practitioner may ask you to assign a number to the level of pain that you are feeling ( 1-10 with 10 being the highest amount of pain you want to feel). Can you immediately assign a number to your pain level ? When asked to assign a number to the level of pain do you hesitate and think about it or do you immediately know? If you are able to say without hesitation this is a sign that you are more present in your body and with the pain.
  8. Make sure you feel balanced and grounded when you leave the office. Do you feel shaky, nauseas, light headed or  sick in anyway?  Report these to your therapist at once.
  9. When you are leaving the office see if you can notice any difference in how you walk?  How do you hold yourself? How does it feel to breathe?  How do other people look to you?  Does the world look any different?
  10. Take care of your self after a session.  Drink as much water as you can to flush the tissues out and rehydrate them.  Take a  bath in epsom salt, baking soda and sea salt ( about 1 cup of each).  Allow yourself to relax and feel your body.
  11. Report any feelings to your therapist the next day or the next session.  Call them if you are not feeling well in any way.

Should deep tissue massage hurt?

There is much controversy over whether or not deep tissue massage should feel painful to the client or not.  Different therapist have different opinions on this topic.

 Many feel that deep tissue without pain is not being effective.  Clients may often feel that if they can’t feel pain, it isn’t doing any good.

The intention of deep tissue massage is to reach the deeper structures of the body.  To do this deep pressure must be applied to get through the superficial layers of the body.  The key to doing deep tissue work without inducing pain or more trauma lies in knowing how to use your Ki or energy and to use awareness to stay in touch with the clients body to be able to know when they are resisting more so that you can adjust the pressure you are applying.  A good deep tissue therapist will know how to do just that.

Often people like the pain of deep tissue massage.  (I used to be one of them.  I thought it felt good and was necessary to relieve the pain and tension.)  There will also be people who say that they have a high pain tolerance or they may even have spots in their muscles that are numb.   Do they really have a high tolerance for pain or are they just out of their bodies and not self aware?  Do people like to experience more pain and in some unconscious way continuing to cause themselves more harm?

While there is no one answer to this, there is much room for discussion…Post your opinions, thought and feelings on the blog

 

Resources:

Real Bodywork – Videos to learn deep tissue bodywork, offers a free reflexology class, learn muscles with interactive games free online.  Great resource site!

Deep Tissue Bodywork A Visual Guide to Massage Therapy Techniques Art Riggs – Deep Tissue

 Manual with many excerpts from book, Videos, 

Eric Dalton Freedom from Pain Institute – Some good articles on deep tissue.  7 piece home study class.

Massage and Bodywork article Deep Tissue Massage
Part 1 – The Tools By Art Riggs

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