Deep Tissue Massage – Good or Bad?

The first question I ask before any massage session begins…What type of pressure do you prefer? Today, the majority of clients consistently request deep pressure, but what is deep pressure? Pressure is something that has to be established clearly with each person because much like pain, pressure is on a personal scale. Pressure that is too much for one person may not be enough for another. In talking with clients, I have come to learn that, in general, people do not want a massage to be painful, but also do not want it to be “fluffy” or ineffective.

A common complaint that I have heard from clients is that a bad experience with deep pressure has made them fearful to address their tension and pain. Massage should be healing, no matter what type of pressure is being used, and it should never leave you afraid! As a massage therapist, I work with many clients, all of which have varying levels of tolerance for pressure. The key to an effective, healing massage is communication AND listening. Your massage therapist should be willing to listen, be observant to the body’s response to pressure, and make necessary changes throughout the massage.

So let’s talk about deep pressure and the “pain” factor that so many have commonly experienced in getting a massage, and is it really necessary?

Good Pain

Let’s start by talking about “good” pain, the kind that leaves us saying, “It hurts so good!” I often have clients say, “It hurts, but I know it’s going to feel so much better later.” Another common statement by clients, “Oh, that is sensitive… but feels good!”

This type of pain occurs because we are sensitive to the pressure that is being applied, yet instinctively know that the pain we feel is going to bring us relief. It’s characterized as an unexplained sensory phenomenon that is contradictory, yet makes sense while being experienced. There’s almost no word to really describe this kind of pain! The first thing that comes to my mind when I think about “good” pain is when I was a little girl, and I was about to lose a tooth. Despite the fact that it hurt, I couldn’t stop wiggling it back and forth and pushing it with my tongue, recreating the same discomfort over and over again. It just felt painfully good! Applying deep pressure to specific areas or trigger points within the muscles is much the same way. The short duration of pain creates a release that the body is instinctively willing to accept for the outcome that it will bring about.

A skilled therapist will be able to feel your tissues reacting positively or negatively to the treatment that is being provided. The ability to assess the tissues allows a skilled therapist to adjust pressure as needed and communicate with the client to assure treatment remains within one’s pain tolerance. Let’s face it, there will be times that techniques being used will cause you to be uncomfortable, especially if there are adhesions, trigger points, spasms, or other issues within the muscles. However, at no time should this pain cause you to jump off the table or go beyond your comfort level. This is where communication is key! I always make it a point to explain to a client following any session what they can expect over the next 2-3 days. Some treatments can cause moderate tenderness the following day, but should never be considered painful nor last more than 2-3 days. Follow up is always done between sessions or at the time of the next session before treatment is provided. It is important to assess how a client felt following their last massage. This allows for adjustments and plans to be made, especially when first getting to know how a client’s body responds to treatment.

Bad Pain

In my opinion, “bad” pain should never be part of one’s massage experience. It is dangerous and serves no beneficial purpose. Some clients when asked about pressure have stated, “I have a high pain tolerance.” Others will state, “There’s nothing too deep for me!” These comments are concerning to me as a massage therapist, as it implies that many people expect massage to be a painful experience, and this belief is based on information coming from other massage therapists. As with any profession, there are those that are careless and incompetent, yet practicing. Unfortunately, the profession of massage therapy is no different. There are therapists providing massage under the misguided practice that pain is simply part of the process. Some will even minimize your pain, making no adjustments to pressure and justifying the pain they are causing you. It’s becoming evident to me that this unfortunate occurrence is happening way too often as clients come to me either afraid of pressure due to a bad experience or expecting pain because it is what someone else has led them to believe is necessary.

The biggest difference between “good” and “bad” pain is that “bad” pain is caused by excessive pressure that goes beyond your pain threshold, and there is such a thing as TOO MUCH PRESSURE! It can also involve the massage therapist not taking caution of vulnerable areas referred to as endangerment sites. Endangerment sites include areas in which nerves can become pinched and sensitive tissues compressed. “Bad” pain can also be caused by ungroomed nails and massaging sites that are commonly contraindicated, such as areas of infection or obvious inflammation.

As stated previously, your treatment can commonly leave you sore, but should never result in significant pain. This means that too much pressure was used. You should express this to your massage therapist, if you return to the office. A skilled and trustworthy therapist would make adjustments to your treatment. If your therapist continues to cause excessive pain, look for a more qualified therapist. Massage should be helpful and healing. It should leave you wanting more because of the positive results and benefits that massage brings you!