If you are a newly qualified massage therapist you might have realized already that learning about deep tissue massage is a useful next step in your training
If you are a trained sports massage therapist, you might already be using some of the techniques described here and might be curious to know if there are any extra tips and tricks you could use to further enhance your massage technique
You might be reading this guide with interest in how massage and soft tissue interventions can help improve treatment outcomes for patients with musculoskeletal problemsOr perhaps you are a sports therapist with interest in using compression and stretching techniques to facilitate rehabilitation following injury
Whatever your background and training, you can use the skills described here to help you develop your own style of treatmentthe elements that make up deep tissue massage are simple and may be modified or combined in many ways
Like cooking, where three chefs start with the same ingredients and use them to create three different dishes, therapists using deep tissue techniques create massage treatments using combinations of skills
It is thus useful to acknowledge that different therapists have different approaches to how deep tissue massage should be used and how best to prepare for itA common belief among some therapists is that deep tissue massage should be painfulThis issue tends to divide practitioners of deep tissue massage, so let’s start with it.
Some massage therapists strongly believe in a no-pain-no-gain approach to massageThis is a particularly strong view among some sports masseursThey believe that to be effective, deep tissue massage must be inherently painfulTheir argument is based on personal experience, having observed clients report improvements in the days following sometimes excruciatingly painful work to problem areas such as the iliotibial band and calf muscles
Consequently, there are now some clients who also believe deep tissue massage must be painful to be effective
Fortunately for those of us wishing to avoid giving or receiving pain, the idea that deep tissue massage must be painful is something of a myth
As I hope you will discover from practicing the techniques in this guide, there are many ways to work deeply into tissues, and there are other treatments (myofascial release, acupuncture, etc.) of treating excessively tight tissues that in some cases might be more appropriate for a client than deep tissue massage
Most therapists are altruistic in nature, with a desire to do good for their clientsEven those therapists with a brusque approach are unlikely to remain working if they do not meet the expectations of their clients at least in part
While teaching a sports massage course, I noticed that one of the students had severe bruising on her lateral thighWhen questioned by another student, she explained that she was a keen runner and regularly received massage to her iliotibial band, which was excruciatingly painful but which she ‘knew’ worked
Though somewhat weary, the runner seemed resigned to the idea that to stay in training she had to undergo massage severe enough to cause bruising
This led to a debate in class and, interestingly, although many of the students abhorred the idea, some agreed that bruising was a natural consequence of deep tissue massage and felt that if they weren’t bruised their treatment was less likely to be effective.
Nevertheless, dispelling the no-pain-no-gain myth is important for those of us working in the massage profession because buying into it has three hugely negative consequences for us allFirst, believing that deep tissue massage must be painful puts off the many thousands of massage therapists who are interested in learning this form of massage but do not want to hurt their clients
These therapists might otherwise employ deep tissue massage safely and effectively without causing painThey would have developed a useful skill with which to help treat a wider variety of clients with a wider variety of conditions.
Second, the myth puts off many clients who like the idea of receiving a deeper, more firm massage but who have heard how painful it can be
Third, the myth confuses some clients who think that all therapists who incorporate deep tissue techniques are going to inflict painPerhaps these clients have received a massage treatment in the past that was painful and are reluctant to go for a massage again, even with a different therapist, despite having a condition that might be usefully treated with massage
A premise of this guide is that deep tissue massage should never be painful, and there are good reasons to uphold this approachIf you are uncertain whether deep tissue massage should or should not be painful, ask yourself these three questions
1) Is it ethical?
If a treatment happens to be painful, that’s one thing, but to deliberately set out to inflict pain, believing pain to be necessarythis is quite something elseGoverning bodies the world over require therapists to work within a code of conduct and a code of ethicsWhat do your codes say about inflicting pain? Perhaps this issue is not mentioned in your codes
Should it be mentioned?
Remember that we are not talking here about the kind of pain that occurs when you are first learning to massage and perhaps press a little too deeply (and quickly ease up); nor are we referring to the kind of ‘grateful pain’ inherent to the treatment of trigger spots
The kind of pain that some therapists believe is necessary to achieve their treatment outcomes is often prolonged and results from sharp, fast movements or the use of excessively deep pressure
In which they try to force structures to lengthen mechanicallyThis kind of pain causes clients to wince, grit their teeth, or hold their breathIt often results in bruising.
2) Is it legal?
All massage requires consent from the clientHowever, pain is highly subjective, and it seems risky to agree to apply or to receive a treatment that might be painful when degrees of pain are difficult to quantify
Experienced therapists might argue that they know their clients and know how much pain they can take and how much pain is usually needed to be effectiveBut could there be legal implications if there is a misunderstanding between the therapist and the client (even when a consent the form has been signed)?
3) Do painful treatments really work better than techniques applied without pain?
Physiologically, pain results in the body being flooded with endorphins and an increase in muscle tension all over the body (albeit, this is temporary)Surely, increases in muscle tension are counterproductive to what we are trying to achieve in massage, namely relaxation and a reduction of tension in the muscles.
Finally, if you still firmly believe that for a treatment to be effective for some clients and to some parts of the body it must be painful, ask yourself these additional questions:
- Are you certain that you cannot achieve the same result without causing pain?
- Could it be that there are some deep tissue techniques you have not yet discovered that might enable you to achieve the same treatment outcome or a better treatment outcome, without causing pain?