A big misconception in the massage field today is about the definition of “deep tissue” massage. Even massage therapists continue to make this confusing, either because they are trying to work with their clients’ expectations, or they were taught differently than I. At the end of the day, this misunderstanding isn’t a big deal as long as people get the therapeutic service they are hoping for. However, I’ve met enough people who did not get what they were looking for that I would like to share what I know on the subject.
- Deep Tissue: Tissue that is deeper than more superficial tissue.
- Deep Pressure: Pressure that feels deeper than lighter pressure. Not a style, form, or modality. Just an amount of pressure.
- Deep Tissue Massage: Massage that affects tissue that is deeper than more superficial tissue. This does not necessitate that the techniques or forms employed use deep pressure.
Many people who are under the impression that they want a “Deep Tissue Massage” really are looking for a “Deep Pressure Massage.” They want their muscles rubbed and they want to “feel” like they were rubbed. It is a good feeling, I don’t blame them. Others who seek a deep tissue massage do so because they want to feel well again and the words “deep tissue” sound very impactful. They are willing to bear any pain it takes to affect those deep structures in order that they feel better after. They should sign up for a service called “Tissue Massage” since it is not only “deep” tissue that is involved in muscle tightness and pain.
Massage doesn’t need to be painful to be effective. Massage doesn’t need to be painful to work with deep structures. Pain is a message your tissues send to your brain, and it means only one thing: tissue damage. So even if it’s during an activity categorized as “therapeutic,” the pain you experience during a massage with pressure that is too deep is signaling tissue damage. This means that instead of helping your muscles relax, the therapist is pushing against a muscle that is literally pushing back.
There is “good” pain, such as the feeling of soreness after extra physical exertion (during which, yes, there was tissue damage in the form of micro-tears that stimulate the building of greater muscle tissue). Or the enjoyable, mild tenderness when muscles are kneaded and rubbed. But when that feeling becomes such that you are holding your breath, clenching your fists, or tensing up, that massage technique is no longer as useful as it would be if it were still below your pain threshold.
I think when many people say they have a high pain threshold, they mean they have a high pain tolerance. Pain tolerance means you are experiencing pain but you’re able to deal with it—you’re not writhing and screaming yet. People who have suffered from chronic pain for years and years have a pretty high pain tolerance. So when it comes to massage, maybe you are thinking, “I’ve dealt with my body’s pain so long, next to that this bit of pressure is nothing.” Or perhaps someone gave you the impression that the phrase “No pain, no gain,” applies to everything, including massage.
In conclusion, I’m in full support of those who enjoy the feeling of soreness during massage or exercise. But if you feel like you need to grit your teeth and bear it because it’s for your own good, it’s actually more worthwhile to speak up and let your therapist know they should back off the pressure a bit. They can still work with deep muscles like the psoas and QL. They can still be just as effective—if not more so—in easing muscle tension and aiding tissue healing. And you can still get just what you were looking for: a deep tissue massage.