Deep Tissue Massage The No Pain, No Gain Misconception

By Stephanie L. Israel, LMT

Deep tissue to therapists generally means doing deeper work to the myofascial structures of the soft tissue, generally that are located deeper in the body. The purpose for the deeper work is to be able to address more localized tension and stress on the muscles by manipulating the soft tissues.

In the case of connective tissue (fascia), substances have an ability to move between fluids. That's why proper exercise regularly, stretching, hydration and good nutrition help to promote fluids in the tissue. Conversely, a sedentary lifestyle, poor hydration and nutrition, and tissue trauma causes the fluid substance to thicken and become stiff, which in turn can lead to pain, a limited range of motion (ROM) and risk of injury.

Adhesions in the soft tissue cause the tissue to stick together and therefore, not readily function. This is also due to aging, inactivity, injury as the collagen fibers start to stick together, causing an increase in the bonding of fibers. Deep tissue massage helps to break down and prevent adhesions from developing.

The No Pain concept is a common misconception when it comes to deep tissue techniques. Many times clients come in and ask for a deep tissue massage based upon a personal touch preference rather than understanding the science behind the technique in relation to the connective tissue. I always state to them that if a session is completely painful, start to finish, that is not the effect that deep tissue should have on the human body. Pain as a discomfort signals the nervous system to contract its muscles as a protective mechanism. This cancels out the effectiveness of doing deeper work, as the client stiffens up during the massage stroke.

There is a term called “Therapeutic Edge.” This concept can be what most clients like to experience during deeper work that allows for a greater change in the tissue. The edge can be described as a “spot” where the client has the “good hurt” experience of releasing tension on tissue accompanied with some pain.

Integrating techniques is important according to Anne Williams, director of education for ABMP. She states that before going deeper, the therapist should first warm the tissue using lighter strokes of basic Swedish techniques. Integrating techniques at varied depths allows for the client's soft tissue to respond positively to the deeper techniques and allow for the tissue to become more mobile and pliable.