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Do I want deep tissue, or deep pressure?

Researched and written by Angela Nye, MS, CSCS, CES, Licensed Massage Therapist


Deep-tissue massage is known to be an effective tool for reducing muscle and connective tissue pain, while improving joint range of motion. However, it is a type of massage modality that is often confused with deep-pressure therapeutic massage. What’s the difference?


What is Deep-Tissue Massage?

In a study on the comparison of the effects of deep-tissue massage versus therapeutic massage for people with ankylosing spondylitis, Romanowski et al (2017) define deep tissue massage as a variety and combination of lengthening strokes that extend a joint at the same time while massaging the muscle to lengthen, trigger point therapy and oblique pressure, cross-fiber strokes (massaging a muscle or tendon perpendicular to the fibers), and pin and stretch techniques to loosen an entrapped muscle.


One defining difference between deep tissue massage and normal therapeutic massage is that deep-tissue often utilizes stretch techniques to extend a joint in combination with lengthening massage techniques. A good example of this is when a therapist will extend a shoulder joint while simultaneously massaging a shoulder muscle to lengthen such as the latissimus dorsi on the back or the pectorals in the front. Sometimes trigger point therapy will also be utilized in this combination to address a muscle bound up with a tender node or taut band of muscle fiber. Another primary difference between deep tissue and therapeutic massage is the use of oblique pressure (force in a cross-diagonal direction) to mobilize an entrapped muscle.


While deeper pressure may be utilized during deep-tissue massage particularly when addressing a trigger point, it is not what truly defines deep-tissue massage. Deep tissue massage effectively is addressing muscle tissue with the purpose to reduce pain and normalize function that is impeding the movement of joints, which are, in practicality, the deepest part of the musculoskeletal system.


What is Deep Pressure Massage?

Deep pressure massage is just that - a strong amount of deep pressure used with the common massage strokes. Pressure is best considered as a client preference rather than a

Photo above: a deep pressure massage technique used after cupping

specific massage modality. Some clients love the feeling of deep pressure, while others do not. Most clients prefer more or less pressure in just certain areas of the body. Receiving a massage with deep pressure does not necessarily mean deep-tissue massage techniques are being used. As a massage therapist, I commonly use my forearm to apply a deeper pressure while gliding along the erector spinae group of back muscles simply because it typically feels good to the client. It has a therapeutic effect, but it has little deep-tissue effect to reduce pain or increase joint mobility.


Concluding Thoughts

Clients often confuse deep pressure with deep-tissue massage and request deep-tissue with the thought that they will receive the deep pressure they find so comforting or soothing. In contrast, some clients shy away from deep-tissue massage, believing they will receive the deep pressure they find to be painful and uncomfortable. Granted, trigger point therapy is a type of deep-tissue massage that certainly can be uncomfortable due to the deeper pressure in a tender area, but most other deep-tissue massage can be administered without the need for deep pressure.


While deep-tissue massage requires an advanced knowledge of kinesiology and anatomy that not all massage practitioners possess, pressure is a client preference that most massage practitioners can usually accommodate (though some will upcharge because it can be physically harder to administer). This pressure preference is often an important component to finding the right massage therapist as some are more inclined toward giving greater or less pressure. Communicating your pressure preferences ahead of time and during the massage can speed the process of finding the right massage therapist for you and helps the therapist to provide the best massage customized to your needs.


At Peak Health Massage, we have both therapists that specialize in deep-tissue massage and that can administer the deeper pressure that some clients seek.



About Angela Nye: Angela is a licensed massage therapist, practicing at Peak Health Massage, in Kalispell Montana. Inspired with a love for movement, Angela is a learned practitioner with an adept focus on addressing muscular imbalances and restrictions. Her background in exercise science and endurance sport provides an in-depth understanding of the recovery and healing needed for the athletic person to maintain a robust lifestyle of activity. She provides a healing touch with effective therapy through the use of sports massage, Swedish, deep tissue, deep pressure, neuromuscular therapy, and various stretching techniques.

In addition to her massage therapy licensure, Angela holds a masters of science in applied exercise science with a focus on human movement and is also a certified strength and conditioning coach (CSCS) through the NSCA and corrective exercise specialist (CES).


References


Romanowski, M. W., Špiritović, M., Rutkowski, R., Dudek, A., Samborski, W., and Straburzyńska-Lupa, A. (2017). Comparison of deep tissue massage and therapeutic massage for lower back pain, disease activity, and functional capacity of ankylosing spondylitis patients: A randomized clinical pilot study. Evidence-Based Complementary and Alternative Medicine, 2017, 1–7. https://doi.org/10.1155/2017/9894128




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