The term "Deep Tissue Massage" is among the most misunderstood, misused, and misapplied in the world of massage and bodywork. When a client calls to make an appointment for a “deep tissue” massage, all that it tells me is that we need to have a longer conversation to make sure that I clearly understand their needs and expectations.
Most people seem to assume that deep tissue simply means intense pressure (frequently in the upper back, shoulder and neck region) that may very well require them to endure pain and discomfort in order for the massage to be effective. They are looking for a therapist who is strong and willing to use force. A colleague of mine has a client who said to her at his first deep tissue appointment, “If I’m not crying, you’re not trying.”
In fact, nothing could be further from the truth. Deep pressure alone, applied broadly and blindly, is NOT going to solve the problem. The efficacy of any bodywork treatment relies upon two things: accurate assessment and specificity of treatment.
Pain in one area of the body is usually the result of imbalance elsewhere in the body. So while we will certainly address and treat the painful area to reduce discomfort (which does not always require deep pressure), long term recovery requires that we address the causative factors as well. Effective massage will consist of strategic positioning of the limbs, careful selection of techniques and strokes to be employed, and application of pressure that will release tissue without causing bruising and without causing the body to resist or brace against the threat of injury (in the form of too much depth of pressure).
In order to determine how much pressure to apply to a body structure, I take a lot of information into account. At the very least I am evaluating the warmth of the tissue, the preparedness of the skin over the tissue, and I am watching the client’s breath to determine their level of relaxation and readiness. But the only way that I can really know is if I ask. And often when I check in with clients during deep work to see if the pressure is too much, the response I will hear is something along the lines of, “It hurts, but it's okay. I know I need it.”
This is a common misunderstanding. You should never endure pain or discomfort during a massage in my office. There are reflexes in the body which are more powerful than any amount of pressure that I can apply. As soon as your body perceives pain these reflexes will act to defend you whether you realize it or not. And rather than being soothed and released, the muscles and structures being treated will grip and hold to protect.
Your body is intelligent. We do not aim to fight it, to force it, or to hurt it during our treatments. We engage in a dialogue with it. We work regularly, consistently, and patiently with the understanding that every aspect of your lifestyle (your relationships, your stress level, your diet, your sleep schedule, your psycho/emotional state) contributes to those sensations perceived as pain or tightness. In the course of a one hour massage it is not possible to release every single fiber of every single muscle- and I believe it would be irresponsible and dangerous to try.
The manual manipulation of tissues that I employ is only one half of the healing equation in a massage treatment. Of equal importance is the gradual mind-body awareness that is developed within you from session to session. Over time, your muscles and tissues will begin to let go of all that they are holding and they will begin to remember and retain a state of balance and ease. Too much pressure applied to quickly or for too long will only inhibit and impair this process.
As always, I invite and welcome your questions or comments on this, or any other, massage issue.
