Deep tissue massage is a type of massage that aims at affecting the deeper tissue structure of the muscles. It also affects the connective tissue, known as fascia. Deep tissue massage helps with both small muscle injuries as well as chronic problems. Deep tissue massage is an excellent way to deal with a whiplash or sports injury, postural misalignment, treating spasms as well as muscle tension. During a deep tissue massage the therapist concentrates on releasing specific chronic muscle tension as well as the muscular knots, or adhesions.

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Deep tissue massage involves manipulation of the deep layers of tissue in the body, including the fascia and other supportive tissue that make up the muscles and joints. Compared to other popular massage techniques — including Swedish massage or acupressure, which tend to be lighter in pressure and can involve moving the body into certain positions — deep tissue massage is usually slower and firmer. (2)
Stroking in smooth movements, kneading to loosen muscles, rubbing or friction with the practitioner using both hands back and forth in opposite directions, and striking (tapping or chopping the body with fingers or hands) are all used in combination. These movements help relax the body, increase circulation, and improve drainage in the lymphatic system.

Although many assume Swedish massage comes from Sweden, Johan Georg Mezger (1838-1909), a Dutch man, is often credited with formalizing the system known as Swedish massage—sometimes referred to as “classic massage” in Europe. Mezger assigned French names— effleurage, petrissage, friction, and tapotement—to the specific strokes used in Swedish massage application. In English, these movements are known as stroking, kneading, rubbing (friction), and striking.


Quick muscle knot orientation: Muscle knots — myofascial “trigger points” — are a factor in most of the world’s aches and pains. Their biology is still mostly mysterious: conventional wisdom says they are tiny spasms, but they might also be a more pure neurological problem. Regardless, they can cause strong pain that often spreads in confusing patterns, and they grow like weeds around other painful problems and injuries, making them quite interesting and tricky. Although they are well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. For more information about how trigger points might be involved in your own medical history, see PainScience.com’s best-selling tutorial:

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In New Zealand, massage is unregulated. There are two levels of registration with Massage New Zealand, the professional body for massage therapists within New Zealand, although neither of these levels are government recognised. Registration at the Certified Massage Therapist level denotes competency in the practice of relaxation massage. Registration at the Remedial massage therapist denotes competency in the practice of remedial or orthopedic massage. Both levels of registration are defined by agreed minimum competencies and minimum hours.[105]
The pressure from Swedish massage is ideal for relieving muscle tension, like the kind that builds up from hunching over a computer all day. This tension can sometimes result in knots: trigger points of extremely tense muscle fibers that form tiny nodules. Massage therapists are trained to feel for these knots, and Swedish-massage techniques are ideal for gently coaxing them away.
One narrative review in Open Access Journal of Sports Medicine explains that the impact of using these two modalities combined are somewhat inconclusive, mainly due to research limitations; however, after looking at 21 randomized controlled trials, the author ultimately concluded that “the effects of cold and static compression are clearly better than no treatment.”
Swedish and deep tissue massages are very similar. The primary difference is the level of pressure involved. If you’re looking for relaxation and relief from tense, tight muscles, Swedish massage is probably right for you. If you’re recovering from an injury, deep tissue massage can be a helpful part of your treatment plan. Feel free to ask questions before you book a massage and to communicate feedback to your therapist during a massage.

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The best we can say is that there is some reason to believe that painful pressures on muscles might be therapeutic for some people some of the time. Pretty decisive, eh? This is why it drives me nutters that so many therapists insist that strong pressures are “essential” to achieve “a complete release.” It really isn’t possible to know! It really does depend! Why would anyone pretend to “know”?

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The therapist may utilize some Swedish techniques to warm up the tissues (kneading, friction, percussion), softening the superficial layers so that he or she can access the deeper ones more easily. Then, with little or no lotion, the therapist utilizes the hard surfaces of their hands and arms — surfaces such as fingers, knuckles, forearms, and elbows — and employs a very slow, sustained type of stroke.

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Pain management. If you have a condition like sciatica or osteoarthritis and are suffering from chronic pain as a result, Swedish massage can be an effective method for managing that pain in a natural way. Notify your massage therapist about your pain points, he or she can target those areas and use a stroking motion to improve local circulation and reduce muscle tension.

Similar to Thai massage, in a Swedish massage the client’s joints and muscles are compressed and stretched. This can cause an immediate release of energy that might cause the skin to flush. Clients might also experience a few temporary aches as the body readjusts itself, depending on their level of flexibility and any current physical ailments. For example, a person who arrives at a practitioner’s office with an ultra-tight muscle that has been traumatized may experience some pain while the trauma is massaged out and worked through. In massage, areas of stress and pain can act as blockages to the body’s circulation, energy flow, and overall well-being.

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The significant difference in the two approaches is their effect on these layers. A Swedish technique uses lubricant to glide over the layers – whether that be on a superficial layer (light pressure) or a deeper layer (firm pressure). There may also be kneading of the muscles, vibration or percussion to stimulate the muscles, and passive and/or active joint movements. All of these techniques serve to increase circulation of blood and lymph, soften and relax the tissues, reduce cortisol levels in the body (the stress hormone), and provide a generalized sense of relaxation for the client.

If you are a massage therapist, or sports physical therapist, it might be a good idea to explain what a this type of massage will accomplish and what to expect.  At first, a Deep Tissue massage might feel like your typical Swedish massage. First, your therapist will warm up and prepare your muscles by applying light pressure to the areas that require attention. Only after your muscles have been sufficiently prepared will your therapist begin applying specific techniques. The most commonly used strokes in Deep Tissue massages are stripping and friction. Stripping usually involves your therapist applying deep and gliding pressure to the length of your muscle fibers with an elbow, forearm, knuckles or thumbs. Friction, on the other hand, applies pressure across the grain of the muscle in order to relieve adhesions and realign the fibers of the tissue.


Ugly pain in massage therapy is, by my definition, never okay. Ugly pain is often caused by things that are not going to offer even minimal, delayed benefits, and may even be dangerous. It’s important to be able to spot ugly pain for what it is and completely eliminate it from any therapy you’re receiving. What kinds of handling may cause “ugly” pain?


Many training programs are now available throughout the world that require a minimum of 500 hours of basic massage therapy training, in addition to continuing education credits that can require up to another 400–500 hours. (19) Always make sure you’re “in good hands” by first checking that a therapist has proper qualifications and experience, specifically asking about training in NMT, trigger point therapy, sports massage, pain management, myofascial release and orthopedic massage.

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Pedro is a graduate from The Florida School of Massage, one of the oldest schools in the country, where he learned a variety of techniques. He specializes in giving relief to chronically tight muscles, as well as clients who experience headaches and postural dysfunction. He is proficient in deep tissue, trigger points, and Swedish massage, favoring different stretches and myofascial techniques in his sessions to best facilitate a melt and soft release effect in muscle tissue, and support gentle structural shifts to the body's alignment. Pedro has experience working in chiropractic offices, salt room spas and as a mobile therapist. ... View Profile
No, because most therapists will customize the pressure of their strokes to suit your requests. According to Shannon Merten, a licensed massage therapist we interviewed about massage etiquette, communication is key. “I would rather my clients leave happy and satisfied than not, so if [the therapist] is doing something that is not enjoyable, a good ‘that’s a little too much pressure’ or ‘that area is too sensitive to be worked on’ should get you satisfying results,” she says.
Elementary Reflexology™ is a form of reflexology incorporating energy balancing with point specific work. Integrating the ancient art of Ayurvedic reflexology with the modern energetic principles of Polarity, and is based on the concept of the inter-relationship of the five elements: Ether, Air, Fire, Water, and Earth. What sets Elemental Reflexology™ apart is its foundation in the assessment and balancing of these five elements. Elemental Reflexology™ is focused exclusively on the feet, because in polarity, they are the most negative pole in the body-the place where energy is the most dense and tends to crystallize and become blocked. Working on the feet frees up this stagnant energy, allowing it to be released and flow freely throughout the body. This process is suited for all ages and many conditions.
Athletes tend to know their bodies fairly well, so information presented to the therapist seems to be better. Compared to the general client, the athlete is also in good shape and is concerned about getting back to the field of play as soon as possible. Some athletes have an obsessive compulsive behavior about their sport. This generally makes them very compliant with the therapists’ recommendations. 

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Reflexology in Thailand is abundantly offered even at spas, centres, markets, and chair beside the street because it is widely known as one of the most relaxing therapies. Colorado School of Thai Massage offers a short course of reflexology about the fundamental practice of Thai Foot Reflexology. For those who are interested, no bodywork experience required to join this course.

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Reflexologists posit that the blockage of an energy field, invisible life force, or Qi, can prevent healing. Another tenet of reflexology is the belief that practitioners can relieve stress and pain in other parts of the body through the manipulation of the feet. One claimed explanation is that the pressure received in the feet may send signals that 'balance' the nervous system or release chemicals such as endorphins that reduce stress and pain. These hypotheses are rejected by the medical community, who cite a lack of scientific evidence and the well-tested germ theory of disease.[9]

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The best we can say is that there is some reason to believe that painful pressures on muscles might be therapeutic for some people some of the time. Pretty decisive, eh? This is why it drives me nutters that so many therapists insist that strong pressures are “essential” to achieve “a complete release.” It really isn’t possible to know! It really does depend! Why would anyone pretend to “know”?

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While many believe that Deep Tissue Massage simply means heavy pressure, this is a misconception.  Deep Tissue Massage includes many of the same techniques from its foundation in Swedish massage, but takes it in a different direction with a different purpose. Often times the pressure is deeper, but it doesn’t have to be.  Remember, deeper isn’t always better.  Deep Tissue Massage should be looked at as technique with a purpose, to provide structural and functional outcomes. 

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An author found that a patient who afflict multiple sclerosis and choose reflexology as the complementary treatment for a period of time had notable symptom relief. It is measured by considering urinary symptoms, parenthesis, spasticity, and muscle strength as the parameters. All parameters showed a remarkable improvement except for muscle strength.30

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Post-event sports massage is given after a competition and is mainly concerned with recovery. It is geared toward reducing the muscle spasms and metabolic build-up that occur with vigorous exercise. Recovery after competition involves not only tissue normalization and repair, but also general relaxation and mental calming. A recovery session might be 15 minutes to 11/2 hours in length. Post-event sports massage is given after a competition and is mainly concerned with recovery. It is geared toward reducing the muscle spasms and metabolic build-up that occur with vigorous exercise. Recovery after competition involves not only tissue normalization and repair, but also general relaxation and mental calming. A recovery session might be 15 minutes to 11/2 hours in length. 

The therapist may utilize some Swedish techniques to warm up the tissues (kneading, friction, percussion), softening the superficial layers so that he or she can access the deeper ones more easily. Then, with little or no lotion, the therapist utilizes the hard surfaces of their hands and arms — surfaces such as fingers, knuckles, forearms, and elbows — and employs a very slow, sustained type of stroke.

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Massage used in the medical field includes decongestive therapy used for lymphedema[10] which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT.[52] However, it is less effective than management of SVT with medications.[53]
Although a lot of Bastian 2014 is certainly relevant to the concept of “good pain,” strictly speaking I don’t think they are writing about the good pain paradox, which is defined by simultaneous pleasure and pain. They are writing about pleasure following pain (relief from pain). This is more comfortable scientific ground: it’s pretty straightforward that relief from pain might be “associated with positive consequences” or lead to “activation of the brain’s reward circuitry,” for instance. Lance a boil, then feel better, right? Of course. But that’s definitely not what we mean by “good pain” in massage. BACK TO TEXT

The massages are geared towards athletes and their sports. For instance, working on a runner will require doing a lot of leg work, but the upper body work will be minimal. Moreover, massages will target those areas that tend to become injured. For example, a massage session with a tennis player will involve a forearm massage that is preventive in the development of tennis elbow. If necessary, a whole session could be spent only on important areas, and skip completely muscles that are not overused in a particular sport.
Swedish massage helps the body heal itself by physically manipulating and stimulating the body’s circulatory and lymphatic systems. This works to energize and help eliminate toxins in the body. Also, through Swedish massage, a high level of relaxation can often be achieved, and this relaxation can help prepare the body to act as an open, receptive vessel in which healing can more rapidly occur. 

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My massage therapist has been doing massages for 30 years. He is really aggressive. I thought that I was going to die. The pain was so intense that I honestly feel that it was worse than having children. When the massage was complete, I felt relaxed. When I got home I felt exhausted, like I had been in a major accident. Truthfully I feel like crap. I ache from head to toe, what the heck is this? I feel absolutely horrible. I had a bath before bed and it did help somewhat. But this morning I still feel like hell …
Massage may be an appropriate technique for helping certain sports injuries, especially muscle injuries, to heal. When treating an injury, however, it is best to seek advice from a qualified sports therapist or a specialist in sports medicine before performing any massage. Certain ligament and joint injuries that need immobilization and expert attention may be aggravated by massage.
Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.
Deep tissue massages are usually “cross-grain,” moving against the muscles to relieve aches or pains rather than moving  with them. This can sometimes feel a bit more painful as a result compared to standard “relaxation massages.” However, the pressure involved in deep massages is actually a good thing. It provides many of the benefits that this type of therapeutic massage has to offer. Deep tissue massages also tend to be slower-paced and longer than many other massages, ideally about 1.5 hours long, which gives bodily tissue enough time to warm up and then relax.
A study in the Journal of Alternative and Complementary Medicine found that people's blood pressure fell after a single 45 to 60 minute deep tissue massage. Additionally, a 2010 meta-analysis in the Journal of Clinical Psychiatry found that massage modalities like deep tissue reduce stress hormone levels and heart rate while boosting mood and relaxation by triggering the release of oxytocin and serotonin.

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