Deep tissue massage therapy at back using forearm and elbow

Massage Therapist’s Guide to Deep Tissue Massage

Curious about how deep tissue massage can benefit your practice and client outcomes? These techniques go beyond surface-level relief, penetrating into the body’s deepest layers of muscle and connective tissue. It offers a powerful remedy for chronic tension, pain, and stress, providing your clients with the relief they seek. As a versatile tool in a massage therapist’s tool belt, deep tissue massage techniques can enhance your offerings and elevate your practice by addressing an extensive range of physical ailments and stress-related conditions.

What is deep tissue massage? Deep tissue massage is a targeted therapy that focuses on the deeper layers of muscles, tendons, and connective tissues. It employs slow, intentional strokes and firm pressure to treat a variety of musculoskeletal issues including chronic pain, muscle tension, and injuries, by breaking down rigid bands of tissue, or ‘adhesions.’ This technique is distinct from others in its therapeutic capacity to improve blood flow, reduce pain, and restore normal movement.

In this article, we’ll dive deep into the science and art of deep tissue massage. We’ll explore what deep tissue massage is, what techniques are used, the numerous benefits it provides, what safety measures are needed, and how it differs from other types of massage therapy. Whether you’re a seasoned massage therapist, in massage therapy school, or preparing for the MBLEx, this guide will offer valuable insights to enhance your knowledge and practice.

What is Deep Tissue Massage?

Deep tissue massage (DTM) is a specific type of massage therapy that focuses on the deeper layers of muscles and connective tissues such as fascia and tendons. It uses sustained pressure and slow, deliberate strokes to address chronic patterns of tension and relieve a range of physical ailments. The philosophy behind deep tissue massage stems from the belief that tension, injury, or even stress can accumulate in our muscles, creating what are known as “adhesions” or “knots”.

Adhesion is where fibrous bands of scar tissue bind together tissues that are not usually connected. These can form as a result of injury, surgery, or as a response to inflammation, hindering the normal sliding mechanism between tissue layers, like muscles, ligaments, fascia, or tendons. When adhesions occur, they can lead to impaired circulation, reduced range of motion, pain, and diminished function by restricting tissue movement and flexibility. Adhesions can also distort and disrupt normal anatomical structures, potentially leading to complications in virtually any part of the body. Their diagnosis and treatment can be challenging and may include physical therapy, massage, or surgical intervention in severe cases.

Deep tissue massage works to break up these adhesions, thereby relieving pain and restoring normal movement.

Deep Tissue Massage vs Other Types of Massage

To understand deep tissue massage fully, it’s important to see how it compares to other common massage modalities. We’ll compare it with Swedish massage, sports massage, myofascial release, and trigger point therapy. And if you are preparing for the MBLEx, it’s good to be familiar with these differences.

Deep Tissue vs. Swedish Massage

Often regarded as the most common form of massage in the US, Swedish massage primarily targets the superficial layers of soft tissues to enhance relaxation and reduce mental stress. It uses a combination of long, gliding strokes, kneading, and vibration, which are generally lighter in pressure compared to deep tissue massage. Where Swedish massage focuses on relaxation and promoting a sense of wellbeing, deep tissue massage focuses on mechanical effects to reduce muscle tension and soft tissue restrictions. DTM also requires more drag or friction against the skin (less glide), so very little lubricant is used.

Deep Tissue vs. Sports Massage

Designed specifically for the athletes’ needs, sports massage aims to prevent and treat injuries, improve flexibility, and enhance athletic performance. While it has many similarities with deep tissue massage in terms of targeting deep muscle tissue, sports massage often incorporates other techniques tailored to the athlete’s sport of choice. Deep tissue massage, on the other hand, is more universally applied to alleviate chronic muscle tension, pain and related conditions.

Deep Tissue vs. Myofascial Release

Myofascial release, often categorized as a massage type, is also regarded as a method utilized within the comprehensive practice of deep tissue massage. MR techniques aim at releasing tension in the fascia, which is the connective tissue that envelops the muscles. While deep tissue massage also addresses connective tissues, myofascial release is unique in its exclusive focus on the fascial network. It uses gentle to firm, sustained pressure to alleviate fascial restrictions, promoting strength, flexibility, and range of motion.

Deep Tissue vs. Trigger Point Therapy

Trigger point therapy, also called neuromuscular therapy (NMT), is considered to be a specific type of deep tissue massage. It focuses on specific “trigger points” or knots that cause referred pain in other parts of the body. The therapist applies deep, concentrated pressure to these points to alleviate myofascial pain. While deep tissue massage may address some trigger points, its primary focus is to treat muscle tension as a whole rather than seeking out trigger points to treat.

Contrary to what some might think, deep tissue massage isn’t necessarily about the amount of pressure applied, but rather the ability to reach and manipulate the deeper muscles and connective tissues. It involves a range of techniques that employ the massage therapist’s fingertips, knuckles, hands, elbows, and forearms. 

The table below compares some of the characteristics of deep tissue massage to those of other types of massage:

Deep Tissue MassageSwedish MassageShiatsu MassageRemedial MassageHot Stone Massage
IntentFocuses on treating musculoskeletal issues via sustained or dynamic pressureAims to promote mental and muscle relaxation, and increase circulationBalances energy flow and treats specific health problemsAddresses specific issues or injuries and helps restore normal health and functionPromotes deeper muscle relaxation through the use of hot stones at specific points on the body
TechniquesInvolves applying deep, slow strokes to reach the deep layers of muscles and connective tissuesInvolves kneading, long strokes, deep circular movements, and passive joint movementsInvolves finger pressure in a rhythmic sequence on acupuncture meridiansUses a wide variety of techniques that are often personalized to the clientCombines traditional massage techniques with heated stones
Level of PressureHighMedium to LowMediumMedium to HighLow to Medium
Ideal ClienteleIdeal for people with chronic muscle tension, or in the chronic stage of injury healingIdeal for beginners or people with a lot of tensionIdeal for people looking for a more holistic approach to relaxation and healingIdeal for people recovering from injuries or chronic painIdeal for people looking for a high level of relaxation
Training RequirementsMost basic massage therapy education programs teach thisBasic massage therapy educationRequires specialized training in Shiatsu techniquesRequires advanced training in remedial massage techniquesRequires training in hot stone techniques

Please note that the details in the table, such as level of pressure, are average or typical values and may vary based on specific practitioners or clients’ needs.

Deep tissue massage at upper back using forearm and elbow

Techniques in Deep Tissue Massage

Deep tissue massage utilizes a variety of specific techniques that differ from those used in other types of massage therapy, such as Swedish massage, lymphatic drainage massage, or hot stone massage, which primarily target more superficial layers. 

A deep tissue massage is a personalized blend of various techniques, tailored to meet individual treatment goals and cater to client tolerance. The therapist’s skills, limitations, and preferences also play a significant role in the massage approach, making each session unique and targeted towards achieving the best possible therapeutic outcomes. All of these techniques require the therapist to have a robust anatomical understanding and careful client-therapist communication to maintain comfort and safety.

Let’s look at some of the main techniques used in deep tissue massage.

Slow Strokes: In deep tissue massage, the massage therapist may use slow, deliberate strokes that apply even pressure into the muscle tissue. These slow strokes allow the therapist to reach the deeper muscle layers and connective tissues that can’t be comfortably accessed with faster moving strokes. This technique can be particularly effective at reducing chronic muscle tension and breaking up scar tissue.

Static Pressure: Deep tissue massage often involves applying sustained pressure using the fingers, knuckles, elbows. Therapists will often use various tools to deliver pressure and while protecting their fingers.

Friction: Friction is a technique that involves applying pressure in a back-and-forth or circular motion to stimulate blood flow and create heat in a specific area. This technique is also used to break down scar tissue and adhesions, ultimately reducing pain and improving movement. Cross-fiber friction is a type of friction where pressure is applied perpendicular to the muscle fiber direction to break down scar tissue and adhesions.

Muscle Stripping: This technique involves applying deep, gliding pressure along the length of a muscle, from origin to insertion, using fingers, knuckles, or thumbs. This technique helps to realign muscle fibers, break down adhesions, and decrease muscle tension.

Active Release Techniques: This method is an advanced form of deep tissue massage where the therapist applies firm pressure to a tense muscle while the client actively moves the muscle group, often in a specific direction. By combining movement and pressure, Active Release Techniques can help to break up adhesions, increase range of motion, and reduce pain in the affected area. 

Muscle Energy Technique (MET): MET is a form of deep tissue massage that involves the client’s active participation. The therapist instructs the client to resist using a specific muscle or muscle group while the therapist applies counter-pressure. This resistance creates a therapeutic ‘tug of war’ between the client and the therapist, helping to lengthen shortened or spasmed muscles and improve range of motion. 

Myofascial Release: This is a highly specialized deep tissue technique that targets the connective tissue, or fascia, that surrounds and interconnects all muscles, bones, and organs in the body. The therapist applies slow, sustained pressure to the fascial network, which can help to release fascial restrictions and alleviate chronic tension patterns. 

Trigger Point Therapy Techniques: These involve the therapist applying pressure to hypersensitive nodules in muscle tissue. Using fingers, knuckles, or accessories like a massage ball, the therapist applies slow, sustained pressure to these “trigger points.” This pressure can reduce muscle tension and alleviate pain.

These techniques often involve more intense pressure than other massage techniques, which can sometimes lead to a bit of discomfort or muscle soreness following the massage. It’s important to remember that while deep tissue massage can feel intense, it should never be painful. Pain during a massage can cause the clients’ muscles to tighten up, counteracting the benefits of the massage.

Benefits of Deep Tissue Massage

Deep tissue massage provides many physical and psychological benefits, enhancing overall wellness. Whether your client is an athlete nursing sports-related injuries, an office worker burdened with chronic muscle tension, or just someone seeking relief from daily stress, your skills in deep tissue massage therapy can significantly improve their well-being.

  1. Pain Relief: One significant benefit of deep tissue massage is its ability to alleviate chronic pain. This therapy can also stimulate blood flow and reduce inflammation, thereby addressing both the symptoms and underlying causes of chronic pain. Studies have shown that deep tissue massage is often more effective in reducing pain than traditional medical remedies.
  2. Reduced Blood Pressure and Heart Rate: Deep tissue massage has been associated with a reduction in both blood pressure and heart rate. These effects can contribute to overall heart health, potentially helping to mitigate the risks of conditions such as hypertension.
  3. Stress Relief: The process of receiving a deep tissue massage can be very relaxing, providing relief from stress and anxiety. This therapeutic massage technique can stimulate the production of oxytocin and serotonin, hormones associated with feelings of happiness and relaxation.
  4. Increased Mobility and Range of Motion: Deep tissue massage therapy helps to break down adhesions (bands of painful, rigid tissue) that can disrupt circulation and limit your range of motion. This makes it a popular choice for people who experience stiffness or pain that limits their movements.
  5. Enhanced Recovery from Injuries or Surgeries: Deep tissue massage can enhance the recovery process after an injury by reducing muscle tension and promoting tissue repair. It’s often recommended for people who are recovering from sports injuries or surgeries, as it can help to break up scar tissue and reduce swelling.
  6. Improvement in Posture and Body Balance: Poor posture can lead to muscle tension and pain. Deep tissue massage helps to relieve this tension, allowing the body to position itself in its natural-and pain-free-posture. This can lead to long-term health benefits including improved body balance.
  7. Improved Athletic Performance: Athletes often use deep tissue massage as part of their recovery process. This massage technique can help to eliminate toxins, increased blood flow to muscles, and improve flexibility – all of which can enhance athletic performance.

Contraindications and Safety Measures

While deep tissue massage has numerous benefits, there are certain situations and health conditions where this therapeutic massage might not be advisable. It is crucial to be aware of any contraindications that your client may have, and get clearance from the client’s healthcare provider if you have any concerns about the safety of providing massage services.

  • Blood Clots: People with a history of blood clots or suffering from conditions that cause clots should avoid deep tissue massage. The firm pressure and manipulation might dislodge a clot, potentially leading to serious complications such as a stroke or heart attack.
  • Osteoporosis: For individuals with osteoporosis, osteopenia, or osteomalacia, the intense pressure applied during a deep tissue massage might cause fractures in brittle or weak bones.
  • Infections, Wounds, and Skin Conditions: Any acute skin condition, open wounds, rashes, or infections should be avoided during any type of massage. Deep pressure could exacerbate the condition or lead to further issues.
  • Certain Diseases: People with certain pathologies and conditions such as cancer or rheumatoid arthritis should consult their healthcare provider before getting a deep tissue massage. The same caution applies to those undergoing chemotherapy or radiation treatments. DTM is contraindicated for people with bruising or bleeding disorders such as hemophilia or thrombocytopenia.
  • Pregnancy: Pregnant women should avoid deep tissue massage unless specifically advised by a doctor. Prenatal massage by a trained therapist is typically a safer option.

Deep tissue massage therapists should conduct a comprehensive client intake, including a detailed medical history, to ensure safety and efficacy. It is crucial to communicate any discomfort during the session to adjust your technique or further decrease pressure to meet the client’s comfort level. 

Additionally, it’s essential to remember that deep tissue massage may cause some discomfort during the session and muscle soreness after the session. However, this should resolve within a couple of days. If the client is sore for longer than two days, any follow-up treatments should be less aggressive. Using a cold pack on the affected area can help reduce inflammation and alleviate soreness after treatment.

Deep Tissue Massage of Back Muscle

Deep Tissue Massage in Practice

Client communication is paramount in any massage therapy practice, especially when applying deep tissue techniques. It’s essential for massage therapists to discuss treatment goals, pain tolerance, and the client’s comfort level. Clear and open communication enables therapists to adjust techniques according to individual needs and comfort levels, which can lead to more effective treatment and a better overall massage experience.

It’s also essential to manage clients’ expectations about deep tissue massage. While it can provide significant relief from chronic pain, it’s not a quick fix and may require multiple sessions to see improvements. Also, because of the firm pressure used, some discomfort during the massage and muscle soreness afterwards can be expected. However, this should be temporary and resolve within a day or two.

Massage therapists should also be mindful of their own wellbeing when practicing deep tissue massage. Applying firm pressure and deep strokes can put a strain on a therapist’s hands and fingers over time. It’s essential to utilize proper body mechanics and techniques, such as using the forearm, knuckles, or an elbow, to protect from overuse injuries. Therapists may also find it beneficial to limit the number of deep tissue sessions they perform in a day to prevent burnout and maintain the quality of care.

Combining Therapeutic Modalities

Deep tissue massage is a versatile therapy that can be seamlessly integrated with other therapeutic modalities to enhance health benefits and achieve specific treatment goals. The powerful combination of deep tissue work and other techniques provides a comprehensive approach, addressing not only superficial layers but also the deep layers of muscle and connective tissues, enhancing overall treatment efficacy.

For instance, combining deep tissue massage with hot stone therapy can help to further alleviate muscle tension and pain. The heat from the stones relaxes the muscles, allowing the massage therapist to work deeper layers without applying intense pressure. Similarly, aromatherapy, known for its calming effects, can be used in conjunction with deep tissue techniques to help manage chronic pain and reduce stress levels.

Reflexology can also be incorporated to target specific points related to organs and body systems, thus fostering whole-body wellness. These integrative approaches consider both the physical and mental aspects of health, and they offer clients a well-rounded, holistic treatment plan that can be tailored to their unique needs.

Tips For Performing Deep Tissue Massage

Here are some practical tips for massage therapists performing deep tissue massage:

  1. Understand your client’s needs: Each client is unique, and so are their needs. Spend time discussing their health history, specific pain points, and their tolerance for deep pressure before you begin. *Also, be sure to warn your clients that they will likely be sore for a couple of days.
  2. Consider contraindications: Certain conditions like high blood pressure, blood clots, or acute injuries may not be suitable for deep tissue massage. Always check for contraindications.
  3. Start slow: Deep tissue massage focuses on applying sustained pressure using slow strokes. Gradually build up pressure to allow the client’s body to adjust and to prevent muscle tension or injury.
  4. Maintain good communication: Regularly check in with your client to ensure the pressure level is comfortable. Remember, effective deep tissue massage is not about causing pain but relieving it.
  5. Use a variety of techniques: Incorporate techniques like cross-fiber friction, active release, muscle stripping, and myofascial release. These can all be useful in addressing various deep tissue issues.
  6. Use good biomechanics: Use your body’s weight and gravity to apply pressure, rather than relying on muscular strength. This not only conserves your energy but also allows for more precise and effective pressure application.
  7. Proper ergonomics: Ensure that your massage table is at the right height, use good posture, and avoid overreaching or twisting your body unnaturally. This will help prevent fatigue and possible injury.
  8. Post-massage care: Advise your clients on after-care, such as using a heating pad for any muscle soreness or drinking plenty of water to help flush out toxins released during the massage.
  9. Take care of your hands and fingers: Using proper techniques can help avoid overuse injuries. Consider using tools or your forearm and elbow to deliver pressure. Also use self-care techniques such as exercises and stretches to take care of your body.
  10. Document treatments thoroughly: Accurate SOAP note documentation after a deep tissue massage is vital for monitoring client progress, adapting treatment plans, ensuring clear healthcare communication, and providing legal safeguarding.
  11. Continual learning: Consider additional training to improve your deep tissue massage techniques and understanding of the injuries or conditions that you commonly treat. Also, it is important to have a strong understanding of anatomy and areas of caution, also called endangerment sites, to avoid using DTM techniques at areas of the body that can cause injury.

The Business Side of Deep Tissue Massage

Deep tissue massage therapy is recognized for its effectiveness in treating chronic pain and muscle tension, which makes it a sought-after service. As such, massage therapists offering this service can set themselves apart in the wellness industry. By educating clients on the benefits of deep tissue massage, therapists can not only help clients understand its value, but also foster client loyalty and word-of-mouth referrals.

Strategic marketing can significantly enhance the business of deep tissue massage. In addition to highlighting the benefits of deep tissue massage, creating case studies and client testimonials can be powerful tools to demonstrate the effectiveness of deep tissue massages in real-life scenarios. Also consider including your deep tissue skills in your massage bio.

You can also consider offering packages combining deep tissue with other techniques such as Swedish massage or hot stone therapy can attract clients looking for a comprehensive wellness approach.

Furthermore, therapists who specialize in this massage niche can broaden their client base by partnering with local businesses, gyms, sports clubs, and healthcare providers. Collaborations like these can offer mutual benefits and raise the profile of your massage therapy practice. Regularly upgrading skills through further study and staying abreast of research in the field can also enhance your business’s reputation and assure clients of your professionalism and dedication to providing the best care possible.

Research Supporting Deep Tissue Massage

Research continues to demonstrate the significant benefits of deep tissue massage, further establishing it as an effective type of massage therapy. Here are some key studies:

Reduction of Stress and Anxiety Levels: In a pilot study by Moraska and Chandler, tension-type headache patients underwent a series of deep tissue massage treatments over several weeks. The researchers used multiple psychological measures before and after the treatments and found significant reductions in stress and anxiety levels, suggesting that deep tissue massage might be beneficial for managing tension-type headaches (1).

Effective in Chronic Back Pain Management: Munk, Krüger-Jensen, and Bach Jensen conducted a preliminary study on patients with chronic back pain. Patients underwent deep tissue massage treatment regularly for a few months. They recorded an improvement in chronic back pain, highlighting the potential of deep tissue massage as a non-pharmacological alternative for managing chronic back pain (2).

Combining Massage with Anti-Inflammatory Drugs: Xiong and colleagues conducted a prospective randomized trial comparing the effectiveness of deep tissue massage combined with nonsteroidal anti-inflammatory drugs (NSAIDs) to NSAIDs alone in treating low back pain. The combined treatment group experienced significantly more pain relief, demonstrating the benefit of incorporating deep tissue massage into conventional drug treatment plans (3).

Comparison with General Therapeutic Massage: Romanowski and his team compared the effects of deep tissue massage and general therapeutic massage in treating chronic low back pain. Participants underwent several weeks of their assigned treatment, and those who received deep tissue massage reported more significant pain reduction, suggesting it might be more effective than regular therapeutic massage for chronic low back pain (4).

Improvement in Fibromyalgia Patients: Castro-Sánchez and her team conducted a study on patients with fibromyalgia, a chronic condition characterized by widespread pain and fatigue. Patients underwent massage-myofascial release therapy, a component of deep tissue massage, regularly for a few months. They reported improved quality of life, suggesting that deep tissue massage could be a beneficial addition to the management plan for fibromyalgia (5).

Effect on Cardiovascular Health: In a study led by Kaye, participants received deep tissue massage therapy, and their blood pressure and heart rate were measured before and after the session. The study found a significant decrease in both blood pressure and heart rate, suggesting that deep tissue massage might play a role in managing cardiovascular health (6).

These research findings underline the wide-ranging benefits of deep tissue massage and provide evidence for its role in holistic healthcare.

Deep Tissue Massage of Trapezius Muscle

Case Studies

In this section, we present three hypothetical case studies that demonstrate the potential applications of deep tissue massage. These scenarios offer insight into how a massage therapist might approach various client needs, applying deep tissue techniques to address specific issues and achieve desired outcomes.

Case Study 1: Chronic Back Pain Management

Client Profile: Michael, a 45-year-old office worker, has been struggling with chronic back pain for several years. The pain has affected his quality of life, and over-the-counter pain relief methods have been minimally effective.

Therapist Intervention: The massage therapist, after a thorough consultation with Michael, devised a treatment plan that incorporated deep tissue massage therapy focused on his back area. Techniques like friction and slow strokes were applied to the deeper layers of muscle tissue to relieve the chronic patterns of tension in the body. Trigger point therapy techniques were also used to target specific areas of tension and tight muscles.

Outcome: After several weeks of treatment, Michael reported a significant reduction in his chronic back pain. He noticed an improvement in his posture and a decrease in tension in his back muscles. His range of motion also improved.

Case Study 2: Anxiety and Tension Relief

Client Profile: Sarah, a 30-year-old marketing executive, frequently deals with high stress and anxiety levels due to her demanding job. She often experiences tension headaches and has trouble sleeping.

Therapist Intervention: The massage therapist integrated deep tissue massage techniques, like active release techniques and myofascial release, into Sarah’s therapy sessions. The sessions focused on relieving tension in her neck, shoulders, and back muscles – common areas that retain stress.

Outcome: Following several deep tissue massage sessions, Sarah’s stress levels showed a significant reduction. She experienced fewer tension headaches and reported an improvement in her sleep quality. The benefits of deep tissue massage therapy extended beyond physical relaxation, positively impacting her mental health as well.

Case Study 3: Post-Sports Injury Recovery

Client Profile: Jack, a 25-year-old professional football player, recently recovered from a knee injury. However, his leg muscles are tight and lack flexibility, impacting his performance on the field.

Therapist Intervention: To help Jack regain flexibility and reduce muscle tension, the massage therapist utilized a combination of deep tissue massage techniques, including muscle energy techniques (MET) and cross-fiber friction. The deep pressure applied helped in reducing inflammation and promoting blood flow to the affected area.

Outcome: Following regular deep tissue massage therapy sessions, Jack noticed an improvement in the flexibility of his leg muscles and a reduction in muscle tension. The treatments aided in his sports-related injury recovery, enabling him to return to optimal performance more quickly.


Deep tissue massage, a significant part of massage therapy, uses techniques such as Stripping, Friction, Cross-fiber friction, Active release Techniques, Muscle Energy Technique (MET), Myofascial Release, and Trigger Point Therapy to target the deep layers os soft tissues. It helps in reducing chronic pain, improving blood pressure, and alleviating fibromyalgia symptoms, among other benefits.

However, it’s vital to remember that deep tissue massage isn’t for everyone and must be carefully administered, considering various health conditions. As massage therapy students and practicing therapists, understanding its applications and individualizing techniques to client needs are vital. The efficacy of deep tissue massage, backed by research and demonstrated through case studies, truly makes it an invaluable tool in massage therapy practice.

Enhance your knowledge and readiness for the MBLEx with our comprehensive MBLEx practice tests and MBLEx Prep Course. These resources, tailored specifically to massage therapy content and exam structure, can bolster your understanding, provide invaluable test-taking strategies, and instill the confidence you need to successfully navigate the MBLEx and step into your career as a professional massage therapist.

FAQs about Deep Tissue Massage

How is deep tissue massage different from Swedish massage?

These two forms of massage therapy have different goals and techniques. Swedish massage is typically gentler and more focused on relaxation, and uses superficial techniques like long gliding strokes (effleurage), kneading (petrissage), and percussion (tapotement). Deep tissue massages, on the other hand, aims to relieve chronic tension in the muscles and connective tissue or fascia.

What should I expect for my first deep tissue massage?

For your first deep tissue massage appointment, you’ll likely begin with an intake process that involves discussing your medical history, any specific pain points, your pain tolerance, and your desired outcomes from the massage with the therapist. This conversation helps the massage therapist tailor the session to your needs. During the massage, you’ll typically undress to your comfort level and lie on a massage table under a sheet; the therapist may use a little oil or lotion and apply slow, firm pressure to targeted areas. It’s crucial to communicate with your therapist throughout the session regarding your comfort and pain levels. Following the massage, you might experience some muscle soreness for a day or two, and it’s generally recommended to hydrate and rest, allowing your body to recover and respond to the deep muscular therapy.

Does deep tissue massage hurt?

A deep tissue massage can cause some discomfort or even temporary pain, particularly in areas where you have muscle tension or chronic pain, as it involves firm pressure and slow strokes to reach deep layers of muscle and fascia. However, it should NEVER be unbearably painful. Your massage therapist should be attuned to your comfort level and adjust their technique or pressure to suit your needs. Any soreness experienced after the massage is typically temporary and part of the muscle healing process.

What conditions can deep tissue massage help with?

Deep tissue massage is particularly effective for chronic musculoskeletal issues such as lower and upper back pain, sciatica, osteoarthritic pain, and fibromyalgia. Furthermore, it is often recommended for relieving a stiff neck, tightness in the shoulders, osteoarthritis pain, tendinitis, plantar fasciitis, frozen shoulder, thoracic outlet syndrome, carpal tunnel syndrome, piriformis syndrome, IT band syndrome, myofascial pain syndrome, and specific sports injuries like tennis elbow and golfers’ elbow. DTM is also beneficial for improving poor posture and promoting better overall physical alignment.

Are there any contraindications for deep tissue massage?

Yes, there are several contraindications for deep tissue massage. These include conditions such as recent surgery, fractures, severe osteoporosis, high-risk pregnancy, deep vein thrombosis, severe thrombocytopenia, infectious skin disease, rashes or open wounds, severe burns, bleeding disorders, those on blood-thinning medications, heart disease, tumors, severe hypertension, acute inflammatory conditions, hernias, severe edema, neuropathy, uncontrolled diabetes, hemophilia, and kidney disorders. The firm pressure and manipulation used during the massage could potentially exacerbate these conditions or pose serious health risks.

What are the benefits of adding deep tissue techniques to my range of services as a massage therapist?

Offering deep tissue massage can diversify your skills, allow you to serve a broader range of clients, and potentially increase your income. It can also enhance your professional development and satisfaction in your ability to help clients alleviate chronic pain and muscle tension.

Is deep tissue massage covered by insurance?

Coverage for deep tissue massage varies widely among insurance companies and plans. Some may cover massage therapy if it’s prescribed by a physician or physical therapist, while others may not. It’s important to check with the specific insurance provider for details.


  1. Moraska A, Chandler C. Changes in psychological parameters in patients with tension-type headache following massage therapy: a pilot study. J Man Manip Ther. 2009;17(2):86-94.
  2. Munk N, Krüger-Jensen L, Bach Jensen R. The Effectiveness of Massage Treatment on Chronic Back Pain: A Preliminary Study. Glob Adv Health Med. 2019;8:2164956119875037.
  3. Xiong J, Ye YY, Wang R, et al. Deep-tissue massage and nonsteroidal anti-inflammatory drugs for low back pain: a prospective randomized trial. Sci Rep. 2018;8(1):5743.
  4. Romanowski M, Romanowska J, Grześkowiak M. A comparison of the effects of deep tissue massage and therapeutic massage on chronic low back pain. Stud Health Technol Inform. 2012;176:411-4.
  5. Castro-Sánchez AM, Matarán-Peñarrocha GA, Granero-Molina J, Aguilera-Manrique G, Quesada-Rubio JM, Moreno-Lorenzo C. Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evid Based Complement Alternat Med. 2011;2011:561753.
  6. Kaye AD, Kaye AJ, Swinford J, et al. The effect of deep-tissue massage therapy on blood pressure and heart rate. J Altern Complement Med. 2008;14(2):125-8.

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