Deep tissue massage is delivered by the practitioner with very little to no lubricant on bare skin. Unlike Swedish massage where fluid movements are key, deep tissue massage requires a deeper, sometimes slower connection to the muscle tissue. The intention of deep tissue massage is to free congestion in the muscular attachments to the skeleton, to re-establish independent muscle action, and to realign posture and movement patterns.
Deep tissue massage includes myofascial techniques for myofascial pain. There is a common misconception that “deep” means “hard”. Deep tissue massage modalities often consist of applications of intense, localized pressure to access the deep tissue layers, but there are also some very subtle techniques that can accomplish the same thing.
The massage therapist warms the fascia and superficial muscle fibers before gradually increasing pressure to the chronically contracted tissue. There may be pain involved, but it’s more of a pleasure pain than painful pain. This pleasure/pain line is different for everyone so a feedback scale is used to find the client’s perceived level of intensity of the work.
A client is often asked to use a scale from 1 to 10, where 10 is the highest level of pain. Ideally the massage therapist works at a 6 or 7 on this scale. The client is very aware of the tissue being worked, often stating it’s uncomfortable but not painful. An experienced massage therapist can finesse their way deep into muscle tissue with minimal pain felt instead or forcing their way in. You should never be bruised after a deep tissue massage.
One deep tissue technique used by Massage La Mesa therapists is a firm, constant compression and strokes applied parallel to the muscle fibers. The work is intended to affect the deeper structures of the musculo-skeletal system, as well as the skin and the more superficial fascia and muscles. To reach these deeper layers, the massage therapist uses fingers, knuckles, elbows, forearms, heel of hand, or any bony body part as tools. Pressure is gradually applied to a tight area until a resistance is met. Pressure is maintained at a constant while the tissue relaxes and until release is completed. Due to the very specific nature of this technique it is imperative the massage therapist have a clear understanding of anatomy to know precisely the origin, insertion, and direction of muscle fibers for the muscle they are treating. This knowledge must be more than intellectual facts. The massage therapist must be able to visualize in their mind’s eye a picture of the muscle being worked.
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Cross-fiber friction is another form of deep tissue massage. Also called deep transverse friction, this connective tissue technique can be used to help heal muscular, tendinous, and ligamentous dysfunctions resulting from injury and overuse. Cross-fiber friction can be very painful and there are instances where pain may cross the 7 on the pain scale. Although these instances are reserved until the massage therapist knows the client’s body well and other more conservative approaches don’t yield results. Cross-fiber friction can be followed with ice massage or some type of hydrotherapy to limit inflammation.