A type of massage therapy, deep tissue massage involves applying firm pressure and slow strokes to reach deeper layers of muscle and fascia (the connective tissue surrounding muscles). It’s used for chronic aches and pain and contracted areas such as a stiff neck and upper back, low back pain, leg muscle tightness, and sore shoulders.
How Does Deep Tissue Massage Work?
While some of the strokes may feel the same as those used in Swedish massage therapy, deep tissue massage isn’t a stronger version of a Swedish massage.
At the beginning of a deep tissue massage, lighter pressure is generally applied to warm up and prepare the muscles. Specific techniques are then applied. Common techniques include:
Stripping: Deep, gliding pressure along the length of the muscle fibers using the elbow, forearm, knuckles, and thumbs.
Friction: Pressure applied across the grain of a muscle to release adhesions and realign tissue fibers.
Deep tissue massage usually focuses on a specific problem, such as chronic muscle pain, injury rehabilitation, and the following conditions:
- Low back pain
- Limited mobility
- Recovery from injuries (e.g. whiplash, falls)
- Repetitive strain injury, such as carpal tunnel syndrome
- Postural problems
- Muscle tension in the hamstrings, glutes, IT band, legs, quadriceps, rhomboids, upper back
- Osteoarthritis pain
- Piriformis syndrome
- Tennis elbow
- Upper back or neck pain
According to Consumer Reports magazine, 34,000 people ranked deep tissue massage more effective in relieving osteoarthritis pain than physical therapy, exercise, prescription medications, chiropractic, acupuncture, diet, glucosamine, and over-the-counter drugs.
Deep tissue massage also received a top ranking for fibromyalgia pain. People often notice an improved range of motion immediately after a deep tissue massage.
If you are interested in a massage to prevent sports injury, address sport-specific concerns, or to help with muscle recovery after sports, consider getting a sports massage.
Do Deep Tissue Massages Hurt?
At certain times during the massage, you may feel some discomfort or even some pain as the massage therapist works on areas where there are adhesions or scar tissue.
You should always tell your massage therapist if you feel pain during the massage. The therapist can adjust the technique or further prep the tissues if the superficial muscles are tense.
Pain isn’t necessarily good, and it’s not a sign that the massage will be effective. In fact, your body may tense up in response to pain, making it harder for the therapist to reach deeper muscles.
What Can I Expect?
Massage therapists may use fingertips, knuckles, hands, elbows, and forearms during a deep tissue massage. You may be asked to breathe deeply as the massage therapist works on tense areas.
After the massage, you may feel some stiffness or soreness, but it should subside within a day or so.
Drinking water after the massage may help to flush the metabolic waste from the tissues.
Side Effects and Precautions
Deep tissue massage may not be safe for people with blood clots (e.g. thrombophlebitis or deep vein thrombosis), due to the risk that they may become dislodged. If you have blood clots or are at risk of forming blood clots, it’s essential that you consult your doctor first.
If you’ve had recent surgery, chemotherapy, radiation, or have another medical condition, it’s wise to check with your doctor before starting massage therapy.
Some people with osteoporosis should avoid the deeper pressure of this type of massage.
Massage should not be done directly over bruises, inflamed or infected skin, skin rashes, unhealed or open wounds, tumors, abdominal hernia, fragile bones, or areas of recent fractures. Massage may cause bruising and rarely, hematoma (a localized collection of blood outside of blood cells), venous thromboembolism, and a condition known as spinal accessory neuropathy.
In a case report, an 85-year-old man had a mass in the side of his neck, which was found to be a blood clot (known as external jugular vein thrombus). He had been receiving deep tissue neck massages during the past year, and the cause was determined to be local trauma.
If you have any condition, it’s important to consult your primary care provider firs to find out what type they recommend. For example, people with certain conditions, such as ankylosing spondylitis, may not be able to tolerate the pain of a deep tissue massage.
If you are pregnant, you should check with your doctor if you are considering getting a message. Deep tissue massage (or any strong pressure) should be avoided during pregnancy, but your doctor may suggest a massage therapist trained in pregnancy massage instead.
Possible Side Effects
Deep tissue massage may result in bruising. Case reports have reported venous thromboembolism, spinal accessory neuropathy, hepatic hematoma, and posterior interosseous syndrome after deep tissue massage.
A Word From Verywell
Deep tissue massage is more than just a massage with deep pressure. The goals and techniques are different from a Swedish massage. While it may help with certain conditions, remember that massage doesn’t always have to hurt or make your body sore to be effective. To get the most out of your massage, communicate with your massage therapist.