How to Give a Deep Tissue Massage?

Massage Techniques for Deep Tissue Massage

Assuming you are in good health and feel rested and energized, there is little you need to do differently to prepare yourself to apply a deep massage therapy as a therapistAlso, you do need to understand pain management therapy techniques to apply only the proper tension to the muscle without generating pain especially for a client who requested a deep massage suffering from chronic conditions.

deep massage
how to give good massages

 Usually, patients who are suffering from chronic muscle pain highly likely to visit a massage therapist to get rid of the pain to get help from the therapy to get their day to day life better. 

Since a lot of people have a mindset about the therapist who specialized in a deep massage not going to give you a soothing sensation like Swedish massage but will cause back muscle pain and end up with a bad therapy experience. 

However, you will be using your body in a way different from when you apply Swedish massage techniques rather than a deep massage, so you might find it useful to read through these guidelines relating to the use of forearms, fists, and elbows.


Using your forearms to massage means you need to get closer to your client, and it is tempting to flex at the waist to do thisYou will be working with a deep massage treatment couch set at a reasonably low height because this facilitates leverage.

Prolonged unsupported flexion of the trunk strains the ligaments of the back, results in pain, and could lead to problems laterInstead, when using your forearms, ensure you are either in a proper, wide stance or that you are supporting yourself by resting your other arm on the treatment couch (or on the forearm you are using to massage).

using forearm to deep massage

When giving a deep massage, an alternative is to sit on the treatment couch, Using Your Forearm on Trapezius (With Arm Abducted)The disadvantage of sitting in this way is that you need to twist slightly at the waist to apply the stroke, and some therapists find this position uncomfortable.

Something else to consider when using your forearms is that pressure will be more concentrated on the glenohumeral joint of your shoulderWhen working statically, such as when applying compression, this is not usually a problemProblems occur when you start to use forearm effleurage from a static position and do not move along the treatment couch.

With the application of lighter massage, this is fine, but with deeper pressure, you start to both compress and move your own joint, grinding it as you pivot from the shoulderThe simple solution is to try to always move alongside the treatment couch as you effleurage, sustaining pressure through your glenohumeral joint yet minimizing its movement.


To make a fist we must flex the metacarpophalangeal joints that form the knuckles (where the hand meets the fingers) and the interphalangeal joints of the fingers (Please see the figure 2.1).

Figure 2.1

When using your fists to apply strokes in a deep massage it is best to avoid applying pressure while these joints are unsupported.

This prevents directing pressure through the joint in such a way that compromises its stabilityThe pressure is best directed through the bones of a joint when those bones are end to end, rather than angled with respect to each otherBut to work with the bones of the hands and fingers end to end means you have your fingers straight, in the extended position, not in the shape of a fist.

The most preferable way to use your fists safely is either to keep your fingers fairly loose, cup your hands together and press through the relatively flat surface provided by your metacarpals, or you can form a tight fist and press through your proximal interphalangeal joints, which should be firmly supported and unmovable in this position.

As with other joints, it is safer to keep your wrist joint in a neutral position when using fisting to apply deep massage strokesOne reason therapists suffer overuse injuries is that they frequently apply constant pressure through an extended wrist jointWrist extension is, after all, inherent to the stroke of effleurage.

Radial and ulnar deviations also occur in our wrists as we massageTherapists risk injury to this joint when using repetitive rotary-type movements with pressure, such as when using fists to knuckle the upper trapeziusWith light massage, overuse injuries of the wrist are not likely to be a problem, but as the pressure and frequency of your treatment increases, your risk sustaining the painYou might also develop laxity in this joint if it is not protected.


As when using your forearms, when using elbows it is necessary to lean onto the client, so you again need to guard your own posture to prevent injury to your backIn addition, remember that the ulnar nerve runs close to the surface of your elbow.

elbow massage

If you experience pain, numbness, or tingling in your arm when using your elbow, you might be compressing the ulnar nerveYou should stop using the technique or apply pressure with a different part of your elbow.

Tips for Using Your Body Safely

Don’t strain

If after practicing the therapy you are still finding a technique difficult to apply and are unable to modify it in a way that makes it much more comfortable for you, stop using that technique.

Although subsequent chapters contain many tips and tricks to help you grasp the intricacies of this type of deep massage, we have avoided being too prescriptive in terms of exact handholds and stances.

For example, you don’t have to use your elbows for compression; you don’t have to employ dry stretchingLike a chef using whichever ingredients he or she chooses to use, you should create the dish you want in developing a treatment that is unique to youDeep massage should be enjoyable for the client and should also be enjoyable for you to administer.

Don’t hold your breath

When you are first learning deep massage, therapists sometimes unconsciously hold their breath while applying compressive techniquesThis might occur because (being naturally cautious and sensitive to the client) the clinician is anxious about pressing too deeply.

deep massage

Holding your breath increases the tone in your own muscles, and this sensation is transmitted to the clientTry to relax and make a conscious effort to breathe normally while applying deep tissue techniques.

Use leverage

When it is possible, make sure you are working with the best possible mechanical advantage as a therapist while giving a deep massage to the client

Sometimes lowering the treatment couch slightly, working closer to the client, or slightly adjusting the angle with which you direct your compression can make for a significantly different effect.

Listen to your body

When you engage in a new sport or strenuous physical activity for the first time you often experience all sorts of muscular aches and pains, commonly known as delayed onset muscle soreness (DOMS)(sore muscle)

You might discover that DOMS also occurs when you are first learning to use deep massageThis does not necessarily mean you are using the techniques incorrectlyBut if you continue to feel muscle or joint pain, either stop using a particular technique or apply the technique differently.

Choosing Where to Use Forearms, elbows, Fists and Squeezing

Your forearms help you provide compression or compression plus stretch to a broad area of muscle and tissueThey are thus relatively safe to use to help you apply deep massage to most parts of the body.

They don’t work well when used on the chest (because of the bony clavicle), are not appropriate for use on the face, and should be used with caution on the neck, where even broad pressure could be injurious to some structures.

The forearms are seldom used without oil as part of dry stretching because this is uncomfortable to receiveYour fists can be used simply to compress tissue but are more popularly used with oil to compress plus stretch an area.

The pressure delivered with fisting is more specific than when a forearm is used but less targeted than an elbow, so the technique works well when treating the large muscles of the lower limb (such as the hamstrings, quadriceps, and calf) and, with less pressure, can be safely used on the muscles of the upper limb, such as the biceps, triceps, and wrist flexors and extensors, as well as on the hands and feet.

Fisting is particularly much more helpful for treating the iliotibial band on the lateral thigh, where the therapist can often reinforce the point of contact with the client’s body by fixing his or her own elbow to their own waist.

Fisting is commonly used by some therapists in a knuckling type stroke to treat the upper trapezius and lateral neck muscles with the client supineBecause the pressure used here is relatively light, this technique is generally safe for the client.

Your elbows are useful when you need to compress tissues staticallyElbows are commonly used with oil to provide compression plus stretch in what is sometimes called stripping.

They are seldom used without oil as part of dry stretching because this is painful to receiveThe elbow works well for the treatment of small, defined areas, and for this reason, It can be used almost anywhere on the body where you can get leverage and stabilize your point of contact, such as when the elbow is applied to the calf.

deep massage

Static pressure has been found useful in treating trigger spots, and the use of the elbows to apply pressure to these spots is a good alternative to using fingers and thumbsThere are certain anatomical points on the body to which firm direct pressure (by any means) should be avoided.

If pressure elicits pain, numbness, or tingling in the lower limbs when you apply dry stretching to the piriformis muscle, stop because this indicates you are compressing the sciatic nerveAlways avoid the no-pain-no-gain approachSqueezing can be used statically as a form of compressionWhen squeezing is used to pull muscles away from the bone, the oil helps glide the palms over the skin.

Without oil, the technique tends to be uncomfortableSqueezing works best on muscles that can be gripped, or on the hands and feet, but it cannot really be used on flatter muscles, such as the tibialis anterior.

It can be used on the forearms, but this requires gripping the forearm itself rather than the forearm muscles because these many strap-like muscles are wrapped in thick fascia and are difficult to separate from each other or from the bone during squeezing.

deep massage

Now you have got some basic information to get started with deep tissue massage and check the other articles to find out more about what deep massage is, what are the advantages/ disadvantages of a deep massage is and more methods of massage techniques even you are a therapist looking to find out new methods of deep massage therapy how to give the proper tension for a back massage without increasing the pain when giving too much tension to the client.

You may find further information about deep massage in these articles here Which contains two parts of deep massage and more details necessary for a therapeutic massage therapist or for a beginner.

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