What does deep tissue mean? Is it the same as deep pressure? When do I apply this technique, or do I? How is it performed without hurting my client? and, without hurting myself? It is a common term used regularly by clients and therapists. Clients say “I want a deep tissue massage”; “you can’t hurt me”; and “no pain, no gain”. Every massage therapist is faced with these comments and questions at some point and are best armed with educational tools and good communication to help clear up the deep tissue issue before, during, and after a massage therapy session.
Certain types of deep pressure and deep tissue massage are more demanding on a therapist's body. It is imperative the therapist gets fully trained with proper body mechanics and confidence working the deeper tissues. I believe deep pressure and deep tissue are two different terms with varying degrees of cross-over.
While there are varying depths of pressure in a typical massage session, deeper, firmer pressure is related to the more fluid and whole body experience of Swedish Gymnastics. During the intake session, a client is typically asked whether they want light, medium or firm pressure. Although this is subjective, a massage therapist will fine-tune the pressure to the client throughout the massage.
Deep tissue massage is aimed at the deeper tissue structures of the muscle and fascia that are causing chronic pain or are limiting range of motion. The focus is specific to an area that requires a concentrated amount of work. Such as a client requesting specific sciatic work because they are experiencing pain in their upper leg and gluteal area. Deep tissue work is easily incorporated into a general whole body massage session. A well trained massage therapist will have many techniques in their tool bag to deal with these deeper structural problems.
Deep tissue work does not always hurt, a common misconception. If a client on the table starts to squirm, the therapist has missed an opportunity to adjust the treatment or communicate with the client about the sensation of pain before the emotional brain kicks in. Tom Myers explains in the March 2018, Issue 262 issue of Massage Magazine, pain like this: “in my experience, we have to talk about imposed pain versus exposed pain. If I am leaning into the body and working away, I may be imposing pain on the body, and that in my book, is a bad deal. If there is pain stored in the tissues, I am willing for the work to be sensationful as a way to expose and expel the stored congestion.” Sensationful is a term Myers coined to be mindful of the pain a client is experiencing during a session.
Pain is real and sometimes happens in a massage session. There are a plethora of massage techniques that work more efficiently at releasing congestion than just pressing harder into the tissue. The no pain, no gain attitude is not why most therapists got into this business. However, all massage therapists should develop an understanding of and study the deeper structures to be able to offer a truly effective deep tissue massage while keeping the client safe.