What exactly is Deep Tissue Massage?

What just is deep tissue massage? I’ve been doing a little research via Google search engine and it seems it depends on who you ask. I’m a massage therapist and I took a break from massage for about 4 years from the years 2008–2011. When I came back to massage, I noticed that everyone seemed to be asking for two things, Swedish Massage or Deep Tissue Massage. I was trained in Neuromuscular Massage, Swedish and Sports Techniques so this Deep Tissue request was new to me. I kind of dismissed it at first as a marketing term. It sounded great, “Deep Tissue.” It could be sold as an opposite to Swedish massage which was gaining the reputation of being gentle, flowing and relaxing. I guess what bothered me about the term the most is that it was being used to describe the pressure client’s wanted. It is as if there were some massage therapists giving too soft (pressure) massage and now you could be certain you wouldn’t get that if you ordered a deep tissue massage. I would try to correct people, “What you are asking for is firm pressure.” Massage Therapy is a fairly new industry and the public has not gone very far in their understanding of the different modalities — the different massage techniques. Add to that the different styles that are being taught in different massage schools and it can get very confusing for the consumer.

Let’s try to simplify things a little bit. Swedish massage consists of several strokes that can be done with light or firm pressure. Neuromuscular massage , is a problem solving massage, which involves working at many different layers with varying degrees of pressure. Myofascial Release Massage is generally using lighter pressure to get to deeper layers. See, that one, is confusing. The myofascia or fascia, is the thin white layer that is just below the skin. It also runs in strands through all of the muscles and surrounds the organs to hold everything in place. When you look at a piece of uncooked chicken breast, fascia is the thin, delicate white layer on the outside of the meat — and also running through the deeper layers of meat.

There are many massage modalities, but if you can understand Swedish, Neuromuscular Massage Therapy, and Myofascial Release you will be way ahead of where most people are in understanding massage techniques. Also, be sure to do your own google searches to find out what is being sold to you on the massage menu. When you get a front desk person who cannot answer your questions, ask to talk to a massage therapist.

Let’s get back to deep tissue massage. Like I said, I did some searching online for some definitions and one of the first pages that came up was a description on the site Angie’s List entitled, “The Truth About Deep Tissue Massage.” I’ll include a link to the article below.

So, what is a deep tissue massage? It’s the manipulation of the deeper layers of muscle and soft tissues in the body. The massage therapist uses warm oils and direct pressure to relax the top layer of muscle in order to reach deeper layers of the muscle tissue.
Many people get a deep tissue massage to help relieve chronic aches and pain. Some feel the benefits of a deep tissue massage in minimizing lower back pain, releasing tension in a stiff neck, sore shoulders, upper back, or loosening tight muscles in their arms and legs.
A massage therapist may not be able to penetrate the deep layers of muscle and soft tissue in the first session. Depending on the situation, the therapist may need to modify the massage to keep the client comfortable so they do not subconsciously resist the work. https://www.angieslist.com/articles/truth-about-deep-tissue-massage.htm

In Massage School, the above description is how I learned how to work the deeper layers without using Fascia Release Techniques. You warm up the upper layers of muscle in order to gain access to the deeper layers. This takes some time, so in a one hour session you might only do this technique for a specific area or two. I think the Angie’s List description is good at describing what deep tissue massage is for the most part. They should specify more that is for one or two problem areas. Many people think they can get a Deep Tissue Massage all over in a one hour session. There just isn’t time. If you educate them on this they may reply, ok, “Give me firm pressure throughout the massage.” Even this, doesn’t really make much sense, depending on how firm they are talking. To reach the deeper layers you have to work the upper layers first. It’s best to find a good massage therapist that knows how to work all of the layers at the right time.

Wow, this is a long article. Do you see why some Massage Front Desks/Booking People have steered clear of this conversation. It takes forever. Best to just simplify it with some catch phrases, “Deep Tissue”, “Swedish”, and keep moving. The same could be said for massage therapists. Do we really want to go into these dissertations on what everything is during a one hour massage session? Not that I haven’t tried before. I like to talk about massage in case you haven’t noticed. Now, I just point them to my website with articles.

Ok, where were we? Deep Tissue. We are not done with Angie’s List. I was pleasantly surprised to see them describe Deep Tissue as a “category” that other massage modalities can fall into. Now this makes more sense, maybe I will start using the phrase Deep Tissue afterall. The Angie’s List quote is below:

There are many techniques or modalities that fall under the category of deep tissue work. Neuromuscular therapy (NMT) and myofascial release are just two that can be described as advanced deep tissue techniques.

In some of my other search results, I found descriptions of Deep Tissue Massage which sounded more like what my client’s had been coming to me and requesting. Check this description out from the national massage franchise Massage Heights.

Deep Tissue Massage releases the chronic patterns of tension in the body through slow strokes and deep pressure to help reduce pain, increase range of motion, and improve circulation. http://www.massageheights.com/massage/massage-types/deep-tissue-massage/

There it is in writing. Notice the phrase above, “deep pressure.” In my trying to be humble opinion, Deep is depth and pressure is firm, light or moderate, etc…. There isn’t any “deep pressure” is there? You must use more firmness in some techniques to get deep but going deep depends on upper layers allowing you “in.” Just because you are using more pressure does not mean you are “in” to deep layers. It just means you are pressing hard.

Let’s see how La Vida Massage, another massage place in my city describes Deep Tissue Techniques.

During the massage session, the therapist uses his or her hands, elbows, fingertips, knuckles or forearms to stimulate the muscles and reduce adhesions. The slower pace of this type of massage means that every muscle receives the optimal level of care. Guests may be asked to breathe deeply throughout the session, especially when tense areas are being targeted. Deep breathing supplies the muscles with plenty of oxygen and can ease discomfort.
A professional, LaVida Massage therapist can create a comprehensive and unique therapy plan based on individual needs — which is why the initial consultation is so important to the process. No two sessions are ever quite alike because they are customized to address the specific problems of each guest. The therapist can target certain muscle groups to ensure that you emerge from the table feeling refreshed and free of pain, whether you are suffering from a chronic condition, stress or a sports injury. http://www.lavidamassage.com/massage/deep-tissue-massage.html

Not a bad description overall. I just think we should make it clear that this is a problem solving technique that focuses on where the client is having the problem.

Maybe things are better than I thought. Those are some pretty good descriptions overall. It still is a bit confusing as to whether Deep Tissue is a category or “umbrella term” meant to refer to many different types of massage such as NMT, Myafascial Release, Tai Massage, etc.. I think we are going to get there. There probably isn’t going to be any agreement anytime soon but any discussion is better than none.

The Strictly Therapeutic website had this warning.

A full body massage should never consist entirely of deep tissue strokes because it is overwhelming to the client and would not achieve therapeutic results. It is important to understand that, although strokes are deep, they are done mindfully with caution and confidence. The therapist is assisting the client to release chronically spasmed areas. The depth and quality of muscle release varies for each client and with each session and the effects are usually longer lasting than those of Swedish massage.

Let’s check in with a medical dictionary.

A type of massage in which the fingers, thumbs and elbows are used to release chronic muscle tension, using slow, deep strokes and friction; the therapist may work perpendicularly to the length of the fibres of the superficial muscles, with the intent of massaging muscle that lies underneath. The therapy borrows from other forms of bodywork, including Chua ka, cross-fibre friction massage, deep tissue sculpting, Hellerwork, Rolfing and others; it is believed to increase blood flow and to be of greatest use in problem muscles for pain, rehabilitation and arthritic complaints. http://medical-dictionary.thefreedictionary.com/deep+tissue+massage

My favorite description of Deep Tissue Massage can be found at Transformational Wellness.net

If you have ever been treated to a 60- or 90-minute massage and were told that you received a full-body “deep tissue massage”, either you or your massage therapist may have been seriously misinformed. The term “deep tissue” is probably the most over-used and misused term in massage therapy. “Deep Tissue” implies that the therapist will be penetrating into your muscle tissue, working IN BETWEEN your muscle tissue fibers — something that is impossible to accomplish with broad, gliding massage strokes over relaxed muscles. In fact, a thorough, full-body “deep tissue” massage would take several hours to several days to accomplish, regardless of the technique being used, and is not recommended for beginner massage recipients due to the large volume of toxins released during such a lengthy, aggressive process.
Many will argue that true Deep Tissue techniques aren’t really “massage” at all because the client doesn’t get to relax until after the treatment is finished. In many cases, the treatment more resembles Physical Therapy than Massage Therapy, as the client is often required to participate by doing a good deal of the work.
Many people, including many misled or under-trained massage therapists, mistakenly believe that a Swedish-type massage (a massage consisting of long, flowing strokes) that is applied with very firm pressure is a “deep tissue massage”, but this is not an effective deep tissue technique, and this use of the term is inaccurate and misleading. Most commonly, deep tissue technique(s) are applied to one or two areas of the body during an otherwise relaxing, full-body, Swedish-style massage, which allows for a full-body treatment with focus to specific problem areas in a relatively short appointment-time. This may be what was originally referred to as a full-body “deep tissue” massage and may potentially be the origin of today’s misconception. http://www.transformationswellness.net/_articles/deeptissue.asp

For a great description of what Neuromuscular Massage Therapy, see Take the Magic Step.com

As noted by the Buckland Massage & Neuromuscular Center, NMT seeks to eliminate pain, chronic or acute, by addressing five key elements that cause pain:
Ischemia: the lack of blood flow to soft tissues that causes hypersensitivity to touch.
Trigger points: highly irritated points in muscles that refer pain to other parts of the body.
Nerve entrapment/compression: pressure on a nerve by soft tissue, cartilage or bone.
Postural distortions: imbalance of the muscular system resulting from the movement of the body off the longitudinal and horizontal planes. Longtime poor postural habits are the most common cause of pain from this element.
Biomechanical dysfunction: imbalance of the musculoskeletal system resulting in faulty movement patterns (i.e., poor lifting habits, computer keyboarding, bad mechanics in a golf swing or tennis stroke).

We covered a lot and we learned a lot. One thing that hasn’t really been talked about much is an area where I tend to think about quite a bit. Some bodies are very dense and hard. On those bodies, it is very difficult to reach the deep layers. When they ask for a Deep Tissue massage I know they just want me to use a lot of pressure. When talking about massage it is important to know who is asking for what. So a softer body, I can probably reach the deeper layers with no problem. This is another discussion and can be saved for another day. For now, keep getting massage and following these articles. Comments and questions are welcome below.

Marty Kunsman is a graduate of the Academy of Somatic Healing Arts (ASHA) (Atlanta, Georgia). He currently writes and practices massage therapy in Charlotte, NC. He is the author of two books.

Hard Body Pain/Soft Body Bliss 2006, 2014

Hard Body Pain and Massage Therapy Solutions 2014

Available at Amazon.com

comments: hardbodypain@gmail.com