A type of massage therapy, deep tissue massage uses firm pressure and slow strokes to reach deeper layers of muscle and fascia (the connective tissue surrounding muscles). It’s used for chronic aches and pain and contracted areas such as a stiff neck and upper back, low back pain, leg muscle tightness, and sore shoulders.
How Does It Work?
While some of the strokes may feel the same as those used in Swedish massage therapy, deep tissue massage isn’t the same as having a regular massage with deep pressure.
It’s used to break up scar tissue and physically break down muscle “knots” or adhesions (bands of painful, rigid tissue) that can disrupt circulation and cause pain, limited range of motion, and inflammation.
At the beginning of the massage, lighter pressure is generally applied to warm up and prep the muscles. Specific techniques are then applied. The most common techniques include:
Stripping – deep, gliding pressure along the length of the muscle fibers using the elbow, forearm, knuckles, and thumbs
Friction – pressure applied across the grain of a muscle to release adhesions and realign tissue fibers
Deep tissue massage usually focuses on a specific problem, such as chronic muscle pain, injury rehabilitation, and the following conditions:
- Low back pain
- Limited mobility
- Recovery from injuries (e.g. whiplash, falls)
- Repetitive strain injury, such as carpal tunnel syndrome
- Postural problems
- Muscle tension in the hamstrings, glutes, IT band, legs, quadriceps, rhomboids, upper back
- Osteoarthritis pain
- Sports concerns (runners, athletes)
- Piriformis syndrome
- Tennis elbow
- Upper back or neck pain
According to Consumer Reports magazine, 34,000 people ranked deep tissue massage more effective in relieving osteoarthritis pain than physical therapy, exercise, prescription medications, chiropractic, acupuncture, diet, glucosamine, and over-the-counter drugs.
Deep tissue massage also received a top ranking for fibromyalgia pain. People often notice an improved range of motion immediately after a deep tissue massage.
Will It Hurt?
At certain points during the massage, you may feel some discomfort or even some pain as the massage therapist works on areas where there are adhesions or scar tissue.
You should always tell your massage therapist if you feel pain during the massage. The therapist can adjust the technique or further prep the tissues if the superficial muscles are tense.
Pain isn’t necessarily good, and it’s not necessarily a sign that the massage is working. In fact, your body may tense up in response to pain, making it harder for the therapist to reach deeper muscles.
What Can I Expect?
Massage therapists may use fingertips, knuckles, hands, elbows, and forearms during a deep tissue massage. You may be asked to breathe deeply as the massage therapist works on tense areas.
After the massage, you may feel some stiffness or soreness, but it should subside within a day or so. Be sure to contact your massage therapist if you have concerns or if you feel pain after having a massage.
Drinking water after the massage may help to flush the metabolic waste from the tissues.
Warnings and Precautions
Deep tissue massage may not be safe for people with blood clots (e.g. thrombophlebitis or deep vein thrombosis), due to the risk that they may become dislodged. If you have blood clots or are at risk of forming blood clots, it’s essential that you consult your doctor first.
If you’ve had recent surgery, chemotherapy, radiation, or any other medical procedure, it’s wise to check with your doctor before starting massage therapy. Some people with osteoporosis should avoid the deeper pressure of this type of massage.
Massage should not be done directly over bruises, inflamed or infected skin, skin rashes, unhealed or open wounds, tumors, abdominal hernia, fragile bones, or areas of recent fractures.
If you have any condition, it’s important to consult your primary care provider beforehand to find out what type they recommend. For example, people with certain conditions, such as ankylosing spondylitis, may not be able to tolerate the pain of a deep tissue massage.
Pregnant people should check with their doctors first if they are considering getting a massage. Deep tissue massage (or any strong pressure) should be avoided during pregnancy, but your doctor may suggest a massage therapist trained in pregnancy massage.
Possible Side Effects
Deep tissue massage may result in bruising. Case reports have reported venous thromboembolism, spinal accessory neuropathy, hepatic hematoma, and posterior interosseous syndrome after deep tissue massage.
Deep tissue massage is more than just a massage with deep pressure. The goals and techniques are different. It may help with certain conditions, but remember to communicate with your massage therapist to get the most out of the massage.
Massage Therapy for Health Purposes. National Center for Complementary and Integrative Health. NIH. https://nccih.nih.gov/health/massage/massageintroduction.htm
Romanowski M, Romanowska J, Grześkowiak M. A comparison of the effects of deep tissue massage and therapeutic massage on chronic low back pain. Stud Health Technol Inform. 2012.
Disclaimer: The information contained on this site is intended for educational purposes only and is not a substitute for advice, diagnosis or treatment by a licensed physician. It is not meant to cover all possible precautions, drug interactions, circumstances or adverse effects. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regimen.