Time Out for Deep Tissue Massage

Deep tissue massage is the work horse of the massage world. It's also the most frequently misunderstood type of massage in my opinion. Almost every therapist will tell you they have had clients ask for deep tissue massage, or state that they only like deep tissue massage but when you question them further you end up discovering what they really wanted was a firm Swedish massage.

What's the difference you ask? Well let me tell you...

You've read the Time Out for Swedish Massage blog and now you know what a nice Swedish or classic relaxation massage is all about. In the realm of relaxation massages one of the things you as a client help to determine is the amount of pressure you like. In my intake paperwork one of the questions is what type of pressure do you prefer? Light, medium or firm. So a firm Swedish massage just means the pressure the therapist puts behind those basic strokes we talked about before. It's still all about overall relaxation.

Deep tissue, on the other hand, isn't about overall relaxation. Deep tissue is focused massage on a specific area. Athletes are prime candidates for benefiting from deep tissue massage. I believe I will stay with my previous format of walking you through a session to help you understand deep tissue a little better.

You are an athlete coming to me because your legs are spent from a long run you have had, or your arms are toast from a training cycle you are just beginning. We would go through the same basic intake process as a Swedish Massage, the difference being, before you get on the table you point out to me areas on your body where you are sore or stiff. We are also going to spend some time talking about areas to avoid. Blisters on your feet, road rash from a tumble off the bike, chaffing from your heart monitor any open wounds or bruising needs to be avoided during the massage session. Doesn't mean you can't have a massage, just means I need to know before we start.

I leave the room you disrobe and get on the table, seems familiar right? Let's say we are focusing on your legs today. This is the biggest difference between deep tissue and Swedish massage, we might not even touch your back or your arms depending on what is going on with your legs and how long it takes to work on those issues. Deep tissue is focused work. When I come back in to the room we are going to begin with your hamstrings and then move on to your calves.

The warm up work is much like Swedish massage, I am going to use some of the same strokes. The layers of tissue must all be warmed up so I can work with them. So I want to bring blood to the surface, and I want to get everything moving. I also am using this time to feel for areas that are tense, tight or congested. I want to "see" with my touch what I am working on. Sometimes people will come in complaining of hamstring tightness and we discover it's not the hamstrings at all, it's the gastrocnemius (part of the calf) or vice versa. I take the time I am warming the tissue to determine this.

Once the tissue is warmed up the work begins. And what I am going to do is lean. Deep tissue work is slow and focused and the best way to perform the work is just to lean into the tissue. Now this sounds really simple and you might think reading this that nothing is happening, but I guarantee you my clients will tell you you are wrong. The other part about deep tissue work is that it can be uncomfortable. Uncomfortable being the nice way of saying pain. It's a therapeutic pain, but it's still pain. There should never be a sharp pain, or an unbearable pain, but there will be some discomfort. It ranges from a mild pressure to a "breath deep" ache. What I am looking for is a release of tension in the muscle, basically you have a knot, I lean into it, it releases. Or for the muscle to begin to work independently again.

What do I mean by work independently? I will use the calf and the thigh as examples. You probably know that the thigh is made up mostly of the quadriceps and you might have heard triceps surae for the calf. But those aren't just words. Quad is four and tri is three. Meaning those are separate muscles that should be working independently though in co-operation with each other. What tends to happen is they get "sticky" either through dehydration, over use, or even micro tears and the muscle groups start to stick to each other instead of slide against each other as they work. In the quads this can cause your running stride to pull to the left or right, causing strain on your hips, knees and ankles. In your calf this can cause you to stay in a semi-flexed position causing fatigue and those wonderful evening leg cramps that wake you from a deep sleep.

So what I want to do is unstick them. And to do that I am going to lean. And then when I feel the tissue start to soften I am slowly going to move up the muscle still leaning into it. Sometimes I am going to use a really broad pressure, like my entire forearm, sometimes it's going to be more targeted, like an elbow or a knuckle. Sometimes I am going to add a little vibration to the lean from my other hand. But the basics are still there. Deep slow pressure until the tissue releases. Or until we get as much release as we can.

Sometimes you need more than one session to really get into an area. And sometimes the body does not want to release an area at all. Usually, that's a guarding mechanism that means something else is wrong. So if I work on an area for awhile and it won't release we will leave it alone. Either until the next session or if it is particularly troublesome until you can get to a doctor and have the area checked out for a possible underlying injury.

Now as I am leaning and moving the muscle you will feel when the group unsticks. It's an interesting feeling and hard to describe, but you will know when it happens. The next thing you will feel in the area is a tingle or a rushing feeling. This is your body sending in blood and fluids to help rehydrate and keep that area moving freely. After spending time getting the muscles to move I am going to jostle the muscle around a little then stretch it out. We want the muscles to move freely and to be happy to do so. Depending on the time we can do a few areas, legs and arms, legs and back. Back and shoulders. Or we can focus deep tissue on one area and a nice firm Swedish for the rest.

Again, it's your time and you can customize it how ever you would like. Usually with my athlete clients we focus on the area that needs the most work for half of the session and then give the rest of the body a quick touch up for the other half. Long distance runners need lower back and leg work most of all, but their shoulders and neck shouldn't be ignored. Body builders and multi-sport athletes need everything depending on their training schedules for that week. You can also book a longer session if you know you need some focused deep tissue on one area but would really like a relaxation massage as well. A 90 minute session can help you achieve both goals.

Once the massage is done and I leave the room I am going to have you spend a little time before you stand up and get dressed kind of shaking your arms and legs out. You need to let your body know where everything is again. I know it sounds a little silly, but trust me, after a deep tissue session you don't want to pop right off the table or you might end up falling right down.

Exit interview is the same, drink a LOT of water. I will recommend that you ice the area we worked on and you will promptly ignore me because no one likes to ice. :-) And if it's your first session we will talk about how you should feel over the next few days. Depending on how deeply we worked the odds are that you are going to feel a little sore the next day. It's the soreness you feel after a work out. Again, no sharp pains, just a dull yeah, that muscle got worked pain. By the second day you should feel better than you did before you came in to the studio. For some very lucky people, and my more hard core athletes, the next day soreness seems to be very little and they are feeling better right away. We can then make your next appointment and I will see you soon!

So now you know the difference between Deep Tissue and Firm Swedish. Next time we will talk about Trigger Point Therapy. Aren't you excited? ;-)