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  • Deep Tissue or Deep Pressure Massage, Which Do You Need?

    Deep Pressure Massage

    It never ceases to amaze me at the number of people who ask for deep tissue massage and then either 1) complain that it hurts or 2) complain that they don’t feel enough pain or discomfort. It seems that everyone has their own personal definition of what deep tissue massage is and what it should feel like. Add to that a subjective term like deep and you’ve got a recipe for some major misunderstandings. For these reasons, when someone asks me for deep tissue I always ask them what they mean by deep and the responses vary wildly. But at least I know what the expectation is.


    What I’ve discovered over the years is that most people who ask for deep tissue massage are really looking for deep pressure massage thinking that the two terms are synonymous. The thing is, they’re not the same thing… not the same thing at all.

    Here’e a quick breakdown of each:

    Deep Pressure:

    • Feels Deep – It feels like your therapist is really “getting in there and digging it out.” The thing is, it may feel as if the therapist is going deeper than they really are because at some point during a deep pressure massage, the muscles usually start to contract to protect themselves and keep the invading therapist out.
    • Painful or deeply uncomfortable to receive – Deep Pressure massage doesn’t let up when your body starts to resist, it usually just amps up the pressure.
    • Painful for 2-4 days after – This isn’t a feeling of fatigue, it’s a feeling of  “Uunnhhh… I can barely move.”
    • You need to breathe through it – Lamaze breathing often comes in handy during a deep pressure massage.
    • It may cause micro-tears in the muscle fibers – When muscles contract to protect themselves and the pressure/strain on them increases, something eventually has to give. Usually it’s the muscle fibers themselves in the form of micro tears, which is one of the reasons you have pain for several days.
    • Often works against the body – the more your muscles contract to protect themselves, the harder the therapist presses. This is why it’s painful during and after. It’s also why you have to breathe through it.
    • Works on the premise of inducing “therapeutic inflammation” – Therapeutic inflammation is one of your body’s natural healing mechanisms. It kicks in when you’re injured to create inflammation which sends the body’s repair team into action. The problem with inducing this reaction is that you have to be injured in order for it to take place. If you weren’t injured/didn’t have this happening in your body already… well, I’ll just leave you to ponder how it gets started during a massage.

    Deep Tissue:

    • Usually doesn’t feel deep – It may not always feel like much is happening because it doesn’t hurt, but with a true deep tissue massage the therapist can get much deeper than they can using deep pressure.
    • Is not painful to receive – There might be times where it’s uncomfortable, but no one’s gonna have to peel you off the ceiling.
    • May cause muscles to feel fatigued for a day or so – Your muscles may be tired for a day or two but you’ll be able to move.
    • Deep breathing merely assists the work, but is not necessary to tolerate the work – You should be able to talk and provide verbal, coherent feedback at all times during a deep tissue massage.
    • Works with the body instead of against it – With deep tissue massage, the therapist stops when they feel the muscles beginning to resist them. They use a pressure that your body is comfortable with, and by doing so they don’t trigger protective muscle contractions. As a consequence, they don’t have to fight their way in – your body simply lets them in.
    • Does not cause damage to the muscles – It’s a lot of work to go from a continually contracted state to a more relaxed state, even if some of the tension remains. For this reason, your muscles will often feel tired and fatigued the next day but should not be painful or difficult to move.
    • Works on the premise of “If it ain’t broke, don’t fix it” – If your body is not currently injured and producing a therapeutic inflammation, the deep tissue therapist’s goal is to NOT trigger it. In other words, causing you injury in order to trigger a healing response is something they try to avoid. The goal is to release deep muscles by first warming up the layers of tissue above it and then slowly sinking into the level of the muscles they want to affect.

    Pain Equals No Gain

    When I was in  massage school, one of the first things we learned was that the old adage “No Pain, No Gain” didn’t apply to massage. You see, pain is the body’s way of telling you that something is wrong. One of the last things they told us in massage school, just as we were preparing to graduate is that “The first rule of massage is, ‘do no harm.'” This is one of the reasons massage therapists check in and ask about the pressure. This is also one of the reasons that I don’t do deep pressure massage. (The other reason is that it’s really, really hard on the therapist’s body and I want to be able to keep doing this for a long, long time.)

    Now I want to hear from you. Tell me about your experiences with “deep tissue” massage. Do you think it was really deep pressure massage you received? How did you feel afterward?