Deep Tissue Massage

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is deep tissue massage?

Deep tissue massage is a type of massage therapy or therapeutic massage. The primary target of most massage techniques are the muscles and connective tissues, including tendons and fascia. Deep tissue massage therapy targets the deeper muscles and fascia.

Fascia connects, stabilizes, strengthens and separates soft tissues. There are four types of fascia—superficial, deep, visceral and parietal. Visceral fascia surrounds organs. Parietal fascia lines body cavities. Superficial fascia is just under the skin and separates it from fat and muscles that are close to the surface. Deep fascia surrounds deeper muscles, bones, nerves, and blood vessels.

Different massage techniques focus on different types and levels of tissue. The different techniques also manipulate the tissues in different ways. Looking at deep tissue massage vs. Swedish massage (traditional massage), deep tissue massage uses slower, more forceful strokes. Swedish massage is a gentler form that uses more flowing motions.

The penetrating pressure of deep tissue massage can help release areas of chronic contraction. This, in turn, helps muscles relax and lengthen. The effects of deep tissue massage can help muscles heal after an injury, relieve pain, and improve posture.

What are the benefits of deep tissue massage?

There are several deep tissue massage benefits. It increases nutrient and oxygen circulation to the muscles and decreases cytokines. (Cytokines are cellular messengers that play a role in inflammation and immune responses.) These actions contribute to pain relief and healing of injuries. Deep tissue massage can also release chronic areas of contraction. This can free up your postural muscles and optimize joint function.

You may benefit from deep tissue massage if you have any of the following conditions:

  • Postural problems (including poor posture)

This is not a complete list of conditions that may respond to deep tissue massage. Talk with your doctor, physical therapist, or massage therapist to find out if deep tissue massage is worth a try in your situation.

Who performs deep tissue massage?

Physical therapists and massage therapists perform deep tissue massage. Physical therapists are healthcare providers who specialize in movement. They use prescribed exercise, hands-on manipulation, and education to help people improve their quality of life. This may include restoring function and movement, managing pain and other symptoms, and preventing disability.

A massage therapist is a licensed professional who uses hands-on manipulation of the body’s soft tissues to improve a person’s well-being both physically and mentally. While anyone can see a massage therapist, you may need a doctor’s order to visit a physical therapist.

How is deep tissue massage performed?

Deep tissue massage typically takes place in a physical therapy clinic, spa, or freestanding massage center. However, today you can find massage stations in places like airports and office buildings.

Therapists generally use two main types of manipulations during a deep tissue massage:

  • Friction uses deep finger pressure across the grain of the muscle or muscle fibers. This helps release knots and align muscle fibers.
  • Stripping uses long, slow strokes, applying pressure with the therapist’s elbow, forearm, knuckles or thumb. Stripping goes down the length of the muscle fibers instead of across them.

What to expect

In general, this is what happens during a deep tissue massage:

The therapist will talk with you about your problem areas (such as an injury or headaches), any recent injuries, and what to expect during the massage. This is the time to make sure you have the same expectations about the amount of pressure and areas of concentration. Mention areas you would prefer the therapist to avoid.

  • After the therapist leaves the room, you will remove clothing and jewelry and lay face down on a massage table, covering yourself with a sheet. You only need to remove as much clothing as your comfort allows. This may mean completely removing clothing for some people. For public venues, you will remain fully clothed.
  • The therapist will start by gently warming up your muscles with light pressure and oil or lotion if you want it.
  • Once your muscles are prepared, the therapist will begin deep tissue manipulations. Be sure to give your therapist feedback about pressure or sensitive spots during the massage.
  • If you are having a full body massage, the therapist will have you turn over onto your back in order to massage the front of your body.

What are the risks and potential complications of deep tissue massage?

Deep tissue massage is not appropriate for all people because it uses forceful strokes and manipulations. In fact, it can be dangerous for people with certain conditions. If you have a medical condition or questions about deep tissue massage, talk with your doctor to be sure it’s safe for you.

In general, you should not have deep tissue massage if you have any of the following conditions:

  • Fractures, rashes, burns, or healing wounds, including surgical wounds
  • Infections
  • Pregnancy

Potential deep tissue massage side effects

The risk of deep tissue massage side effects is low in the hands of an experienced therapist on an otherwise healthy person. Some amount of soreness can occur the day after a deep tissue massage. You may also notice mild bruising if you bruise easily. In rare cases, more serious side effects can occur including:

  • Nerve injury

Reducing your risk of side effects

Most problems with deep tissue massage occur from too much pressure. Speak up and let your therapist know if something doesn’t feel right or if you are in pain.

You can also help your therapist and ensure a safe massage by:

  • Informing your therapist if you are nursing or if there is any possibility of pregnancy
  • Notifying your therapist about recent illnesses
  • Telling your therapist about your medical conditions, medications and allergies
  • Verifying with your therapist the amount of pressure you want and any sensitive or problem areas

How do I prepare for a deep tissue massage?

No special preparation is necessary for a deep tissue massage. For your comfort, empty your bladder before the massage starts. If you are having a full body deep tissue massage, you will be lying on your stomach halfway through the appointment. For this reason, it may also be helpful to avoid large meals before a massage. Enjoy a nutritious snack about an hour before your massage.

Plan to arrive about 15 minutes before your session begins. This will give your mind and body time to relax and think about what to share with the therapist.

Bring a bottle of water with you.

Questions to ask your therapist

If you are considering deep tissue massage, here are some questions you may want to ask the therapist:

  • Are you licensed or registered if the state requires it?
  • What kind of deep tissue massage training have you completed?
  • How long have you been practicing deep tissue massage?
  • Is deep tissue massage right for me? Or do you recommend a different technique to accomplish my goals?
  • Have you treated people like me or with my problem with deep tissue massage? What were the results?
  • How many massage sessions do you think I need?
  • Could my massage be covered by health insurance? Do you accept it?

What can I expect after a deep tissue massage?

Knowing what to expect can help you relax and get the most benefit out of your deep tissue massage.

How long will it take to recover?

In general, you can resume normal activities right after a deep tissue massage. However, you may feel very relaxed or even “out of it” for some time afterwards. It may be best to postpone strenuous or rigorous activities until another day or time. Your therapist will likely advise you to drink a lot of water after the massage.

Will I feel pain?

You may feel sore the day after a deep tissue massage. Some people even feel soreness right afterwards. However, you should not feel pain during or after the massage. If something is painful during the massage, tell your therapist.

Trying to “get through pain” during a massage can be counterproductive. Your muscles will contract and resist the pressure if it is painful. Instead, it is better to back away from the edge of pain, so your muscles will release in response to the pressure.

When should I call my doctor?

If you have pain or other concerning problems after a massage, call your doctor right away or seek prompt medical care.

How might deep tissue massage affect my everyday life?

Deep tissue massage can improve your quality of life, whether you enjoy it as a stress reliever or use it to treat a medical condition—or both. Like many treatments, it takes time to see the greatest effect. You will likely need multiple sessions to reach the goals you and your therapist set.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Mar 8
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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