The purpose of this article is to convey my own philosophy about therapeutic deep tissue massage work. You should not have to be in pain for a week to feel good after a massage. I will tell you a few things I have had new people tell me, and then I will tell you how I feel about this work and how you could feel having this work done to you. Skip to my thoughts
I have been a licensed massage therapist for over seven years at the time this post was written. I still have new people who show up and say something like, “I just don’t feel that the massage is good unless I am bruised or don’t hurt for a week after the session is over.”
That is really not necessary,” I say.
I have heard other therapists take pride in bruising people. This baffles me. I had a client tell me that he was on the massage table at another massage place, and was there for a deep tissue massage. The female therapist working on him was using her body weight behind an elbow and was dragging that elbow along his ribs. When he told her that the pressure was too much, she said, “If you’ll just shut up and lay there, you will feel better when I am done.”
I have had bodybuilders tell me how much they hate massage because it hurts them so bad. I have had other people tell me they hate massage because it felt like they were being tickled the whole time and they saw no improvement in their pain levels. How do we help these people?
Communication is important. The therapist working on you needs to be able to listen to you and needs to ask you questions before they decide what area(s) of your body they need to work on. Once they have told you what they want to work on, you have to give them permission to do so or they cannot work on the area(s) in question. If they mentioned an area of your body you do not want them to touch, SAY something.
Therapeutic massage should always begin with firm Swedish massage strokes to warm up the area before any kind of deep pressure is applied. Once the therapist feels the upper layers of tissue become pliable, they may then start working on the deeper layers. Doing this allows the client’s body to relax more and not be constantly tensing up while the therapist is trying to work. This also allows the therapist to reach deeper tissues in your body without all the pain normally associated with someone shoving their elbow into your glutes with no warm-up, for example.
The key is to warm the area up and then go only as deep as the client’s body tells the therapist to go to get the adhesion to release. I have a number of clients who schedule three-hour deep tissue sessions and sleep through most of it.
I believe that the therapist should ask the client if they have appointments of some kind after their session. If not, and the therapist has time, spend a little more time on the client than they asked for. Some clients have trouble relaxing at the beginning of the session, so I normally go over on time a little bit, assuming I am not making another client coming in after them late. This gives them a little time to talk and calm themselves down. I feel that you can relax more if you are not worrying about a stopwatch running. This extra time cannot be given every session, but the clients appreciate the extra care when it happens.
My last thought is to demonstrate appropriate stretches and postural corrections after the client has dressed. A lot of your pain can be caused by poor posture, so giving you some homework to do seems to improve your pain levels assuming you actually do the stretching and whatnot. Are there other things you can do, or things to mention to your therapist, to make your sessions better?
What do you need to do?
You need to decide how much time you have to spend on the massage table. What should your expectations be? One hour is NOT enough to perform a full-body deep tissue massage properly. This seems to be one of the main reasons for the super painful massages for the bodybuilders I mentioned. If you cannot spare more than one hour of time, or it is too cost-prohibitive, you should decide what area(s) hurt the most and tell the therapist to work on the muscles causing this pain. This does not mean that the therapist will work on your low back because you say there is pain there. The low back pain is usually from the hip flexors, glutes, or even the abdominals. The therapist should discuss all of these things with you. But if you demand to have work done on the low back, the therapist will comply but should warn you about the chance your pain will not lessen.
Have you ever had a massage before? This can affect the depth at which the therapist can work. I have lost count of people out in public telling me that they tried massage once, but it did nothing for them except cause them more pain. I wish their therapist had taken into account that this was their first time and should not have had really deep pressure used. If you have never tried massage, or you had a bad experience, please inform your therapist. If they do not seem to listen to you or start cranking away you with heavy pressure, you CAN get off the table and tell the therapist the session is over because they are not listening to you. I hope that if that occurs, you seek out another therapist.
Another thing people seem reluctant to do is to communicate with the therapist they want to see before the massage session. You should be able to ask them questions, or simply talk with them on the phone to determine what you feel about them. If it sounds like they are not paying attention to you, find another therapist.
If you have questions about any of this, please feel free to email, call, or text me. My number is on the contact page. Please also look through the Case Studies section to read real-world issues that have been helped through our massage work.