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Manual Therapy
Back Pain
Musculoskeletal Problems
Your First Treatment

Deep Tissue Massage

Deep Tissue Massage, or Remedial Massage, as it is sometimes referred to, involves the application of deep pressure to release chronic muscle tension. The focus is upon the deepest layers of muscle tissue, tendons and fascia. It is used for a number of conditions including chronic aches and pains, stiff neck, lower back pain, and tightness in the legs or shoulders. The techniques are similar to those used in massage therapy, but movement is slower, and the pressure is deeper. A particular area of tension and/or pain is concentrated on, in order to reach the sub-layers of muscles and fascia (sheet of connective tissue). ‘Adhesions’ form when there is chronic muscle tension or injury. They are painful, tight bands of tissue and can affect muscles, tendons and ligaments. They can cause a restriction of the circulation to the affected area, cause pain and restricted movement. Deep Tissue Massage can break down adhesions, giving freer movement and a reduction in pain.

Diagram of an adhesion

It is advisable not to eat a heavy meal immediately prior to having a massage. During a treatment, you would be required to take off as much clothing as you were happy with. A sheet or a towel would be used to cover the parts of the body not being worked on. Deep Tissue Massage is usually a part of a full body massage. Any problem areas can be concentrated on, with the causes varying from a sport’s injury to a repetitive strain injury. The focus is upon stretching the fascia, which is a 3D web of connective tissue that surrounds, supports and penetrates all of the muscles, bones, nerves and organs. Massage therapist treating a patient

Deep Tissue Massage works upon every layer, through the connective tissue and muscles down to the deepest accessible layers. The aim is to change posture and increase movement by releasing fascial adhesions and chronic muscle tightening. Adhesions and scar tissue form in the muscles as a result of injury, poor posture, chronic or acute inflammation and repetitive movement. Massage encourages the circulation of blood and lymph, and lengthens and relaxes the superficial muscles. It can also stimulate the action of peristalsis in the intestine. Micro-tears are created in the fascia which fill with elastin and collagen, giving more flexibility to the muscles. Stretching is important after a session, in order to retrain muscles and prevent a reoccurrence. Diagram of fascia- micro-tears being healed

There are 5 general techniques used in Deep Tissue Massage: -

  1. Active Motion- the client works with the therapist to flex and stretch the affected muscle as the therapist applies pressure. The process allows the therapist to penetrate the muscle, e.g. ‘Rolfing’. Rolfing is a therapy which releases and realigns the connective tissue.
  2. Passive Motion- The therapist works the muscle with one hand and moves the body part being worked with the other, e.g. Myofascial Release.
  3. Static Pressure- The therapist uses their fingers, thumbs and elbows to apply firm pressure to individual parts on a muscle. This happens very slowly and deliberately. It can cause some discomfort and bruising, e.g. Trigger Point therapy.
  4. Muscle Stripping- This may be rapid or slow. Rapid Muscle Stripping is an aggressive but effective technique. The therapist uses knuckles or elbows to strip the muscle whilst the client takes deep breaths. A rapid stretching movement is performed on the affected body part. Slow Muscle Stripping involves the therapist using thumbs and elbows to perform firm, deep movements. The muscle is being reinjured to allow healing to occur.
  5. Negative Pressure- Suction cups are applied to the skin surface to cause the muscle fibres to expand and separate. Expansion allows additional space to form which encourages lactic acid and other toxins to be released more rapidly. The suction forces body fluid to flow through the tissue which also encourages the release of toxins. Tight muscle fibres may be more effectively realigned. The therapy is called ‘Cupping’, and can leave a red mark behind.

Deep Tissue massage is helpful in treating a number of different conditions and has a number of health benefits: -

  • Treating chronic pain1. The pain was shown to have reduced in chronic lower back pain sufferers during a study in 2014.
  • Massage can help to lower high blood pressure2.
  • It reduces stress, anxiety and muscle tension.
  • Breaks up adhesions and scar tissue and helps to stretch tight or twisted muscle masses. As the muscles relax, pain decreases.
  • It improves the recovery and performance in athletes. The use of Deep Tissue Massage off-season produces changes in movement to which they become accustomed to before competing again.
  • It encourages blood and lymph flow to and from the area to aid healing and improve range of movement.
  • It increases the level of serotonin produced by the body. Serotonin is a hormone produced by the body which promotes feelings of happiness.

Pain or stiffness may be experienced after a Deep Tissue Massage. Ice can be used to help with this. Water should be drunk after a session to flush out toxins released from the muscles, and to rehydrate them. This helps to minimise stiffness and aching, as will stretching. Strenuous activities should be avoided immediately after a Deep Tissue Massage.

Some conditions are not conducive to this type of massage. It may be unsafe for clients with blood clots as they may become dislodged. If you have had surgery or another medical procedure recently, it is advisable to check with your doctor if this therapy is safe for your condition. Sufferers of osteoporosis may need to avoid this type of massage. The therapy would not be used over areas of bruising, infected skin, rashes, open wounds tumours abdominal hernias, fragile bones or recent fractures. Pregnancy is not conducive to Deep Tissue Massage.

References
  1. Majchrzycki M et al ‘Deep Tissue Massage and Non-Steroidal Anti-Inflammatory Drugs for Lower Back Pain: A Prospective Randomised Trial.’ The Scientific World Journal 2014.
  2. Kaye AD et al ‘The Effect of Deep Tissue Massage Therapy on Blood Pressure and Heart Rate’. Journal of Orthop. Sports Phys. Ther 1981 Vol 3 p21-26.
  3. Art Riggs ‘Deep Tissue Massage: A Visual Guide to Techniques ‘. 2007.
  4. www.transformationswellness.net