What is Deep Tissue Massage?

Deep Tissue (DT) Massage works on the muscle deeper within the body as well as the deeper portions of thick muscles that located are more superficial. Deep tissue massage is performed on muscles that are chronically tense, tight, knotty, inflamed, sore, and/or painful. These conditions can affect the blood flow and therefore the amount of oxygen to the muscles; this results in the build-up of toxins in the tissues, causing chronic pain. Muscles affected in this manner are often shortened and can result in distorted postural positions by pulling the bones from their normal position.

Tense tight muscles can be caused by physical work, by over exercising, stress, injury, congenital conditions, among others causes. Deep Tissue is not generally applied to the entire body as Swedish massage is. It is performed only on tense, tight muscles; and may be applied only to one or two body parts in a session, for example:

• The back;
• Runners may have DT done to their thighs and/or lower legs;
• People who use their arms extensively in their work (such as massage therapists [big smile] or construction workers) would have their arms done;
• People who use computers extensively would want DT to their necks and shoulders.

A little bit of Swedish Massage is actually done first: In order to affect the deeper muscles, the muscle layers above them (the superficial muscles) must be relaxed first, allowing the massage therapist access to the deeper muscles. But the deeper muscles are often unaffected by this lighter massage technique.

To work on the deeper muscles, the massage therapist (MT) uses greater pressure and more specificity. One muscle at a time is worked. To work deeper, the massage therapist will use any of the following tools: his/her fingers with hands either side by side or one on top of the other, individual fingers and thumbs, heel of the hand, fist, knuckles, forearm and elbow. The massage table is lower than for a Swedish massage so that the MT has leverage. While some of the same Swedish strokes are used, they are done more slowly and with deeper pressure. Friction is generally faster and deeper and across the grain of the muscle fibers.

How Deep Should Deep Tissue Massage Be?

Since the pressure is deep and the muscles involved are generally tense, tight and sore, there can often be some pain associated with a DT massage. However, and this is a big however, it should not be excruciatingly painful. Massage therapists use a 10-point pain/pressure. Pressure that is a "10" would be the most excruciating pain you could ever image. The lightest touch would be a "1." Pain that hurts but hurts good is generally rated a "7;" once it goes beyond hurting good, it has become an "8" or a "9." Everything below a "7" is generally not painful, but is felt as varying degrees of pressure. Most Swedish massage is done in the 3-5 pressure range: you feel the pressure and it feels good.

In a DT massage, the MT aims to work the muscles at the 6-7 pain/pressure level. If the pressure is at this level, the client should not experience pain afterwards because of the massage. This level of pressure most effectively relaxes muscles by lengthening the muscle fibers (the level of the pressure will also decrease during the process), releases deeply held patterns of tension, and increases the flow of blood which helps to remove toxins in the tissue. It is imperative to drink lots of water after a massage: This flushes the toxins out of the body and helps to eliminate that source of the pain.

Deep Tissue massage requires good communication between the MT and the client. The MT should be checking often with the client on the pain/pressure level, to ensure not exceeding the 7 level. A good MT will also be aware of the client's body language in determining pain/pressure level: a twitch, a jerk, holding the breath, tensing of surrounding muscle groups are all signs that the pressure is too much. But, it is also incumbent upon the client to let the MT know immediately if the pressure reaches and especially exceeds a 7. This two-way communication on pressure helps to ensure that the MT gives the client the best massage possible with the least amount of discomfort from massage-induced pain.

It is also important to understand that the level of pressure felt is relative to the client. Everybody has different tolerance of pain/pressure. What is a 5 to one person could a 3 to another and a 7 to a third person. Also, with the MT exerting the same amount of pressure to different body parts or muscles on the same client can be perceived at different pain/pressure levels. Whether the MT's touch is considered pleasurable or painful depends on multiple factors: Amount of tension in the tissues; condition of the muscles (healthy or injured); client's perception of the touch, ability to relax and accept deeper pressure, confidence in the MT.

What Results (Benefits) Can I Expect From a Deep Tissue Massage?

As I stated earlier, the muscles will relax, releasing toxins, and the soreness and tension will be decreased, and hopefully gone. (The improvement in pain will depend upon how long the muscles have been tight, sore and achy. The longer the condition has existed, the more likely it is that multiple massage sessions will be needed for total relief.) Where there has been postural distortion, posture will become more normal and balanced as the relaxed muscles permit the bones to return to their normal position. This results in improving structural and functional integrity for the client, including improved range of motion. Pain caused by inflammation (such as from arthritis and tendinitis) will be reduced.

Sometimes after the massage, the muscles hurt more before they get better. This is called a "healing crisis." Muscles that have been neglected for some time can respond with varying amounts of pain. Sometimes it may take a day or two for these muscles to react to the massage. Then the pain will decrease and the client should feel better.

Sources:

1. Everything You Want to Know About Massage, About Massage.com, http://rs6.net/tn.jsp?t=pryej4bab.0.0.hcxxg5bab.0&ts=S0240&p=http%3A%2F%2Fwww.aboutmassage.com%2Ftechniques.htm&id=preview
2. Deep Tissue Massage and Therapy: Getting to the Root of the Problem, Amy Mullen, http://rs6.net/tn.jsp?t=pryej4bab.0.0.hcxxg5bab.0&ts=S0240&p=http%3A%2F%2Fwww.associatedcontent.com%2Farticle%2F20229%2Fdeep_tissue_massage_and_therapy.html&id=preview
3. Top Ten Massage Techniques: More Natural Therapies Solutions. Adapted from New Choices in Natural Healing, edited by Bill Gottlieb, Editor-in-Chief, Prevention Magazine Health Bookds. http://rs6.net/tn.jsp?t=pryej4bab.0.0.hcxxg5bab.0&ts=S0240&p=http%3A%2F%2Fwww.care2.com%2Fchannels%2Fsolutions%2Fself%2F385&id=preview
4. Therapeutic Massage Techniques: Deep Tissue Massage. © 2006 Therapeutic Kneads, Ltd., Highland Park, IL. http://rs6.net/tn.jsp?t=pryej4bab.0.0.hcxxg5bab.0&ts=S0240&p=http%3A%2F%2Fwww.wekneadyou.com%2Fpages%2Ftechniques.htm&id=preview
5. What Is Deep Tissue Massage? From Anitra Brown, Your Guide to Spas. http://rs6.net/tn.jsp?t=pryej4bab.0.0.hcxxg5bab.0&ts=S0240&p=http%3A%2F%2Fspas.about.com%2Fod%2Fmassag1%2Fa%2Fdeeptissue.htmGlossary&id=preview
6. Glossary. MassageTherapy.com. http://rs6.net/tn.jsp?t=pryej4bab.0.0.hcxxg5bab.0&ts=S0240&p=http%3A%2F%2Fwww.massagetherapy.com%2Fglossary%2Findex.php%23D&id=preview
7. What is Deep Tissue Massage? Mama'sHealth.com. http://rs6.net/tn.jsp?t=pryej4bab.0.0.hcxxg5bab.0&ts=S0240&p=http%3A%2F%2Fwww.mamashealth.com%2Fmassage%2Fdtissue.asp&id=preview
8. Scheumann, Donald W. The Balanced Body: A Guide to Deep Tissue and Neuromuscular Therapy, 2nd edition. Philadelphia, PA: Lippincott Williams & Watkins, 2002

Benefits of Lymph Drainage

One of my clients asked for more details about the benefits of Lymph Drainage. Here are some selected benefits:

• Reduce edemas (swelling) and lymphedemas of various origins
• Detoxify the body (removal of toxins and waste products)
• Relieve chronic pain
• Relieve numerous chronic and subacute inflammations(e.g., sinusitis, bronchitis and otitis)
• Reduce symptoms of chronic fatigue syndrome and fibromyalgia
• Regenerate tissue (burns, wounds and wrinkles)
• Create deep relaxation to counter insomnia, stress, loss of vitality
• Reduce effects of aging
• Antispastic actions to relieve conditions such as muscle hypertonus and some forms of constipation
• Decrease problems associated with adiposis and cellulite tissue

I will be doing several articles on Lymph Drainage, probably in June 2007. Benefits of Lymph Drainage will be expounded at that time.

SOURCE:

Upledger Institute, Lymph Drainage Therapy, http://www.iahe.com/html/therapies/ldt.jsp

Self-Massage

Have you ever rubbed your arms when you are cold? Or your neck or shoulders when they are sore and achy? Or your forehead when you have a headache? Or your feet after standing and/or walking all day and they hurt? Or your legs? Or your hands? Or your arms? Or your back against a door jam? Then you have just given yourself a massage! Easy, wasn’t it!? And you didn’t think you could do massage.

So, what did you accomplish when you massaged yourself? You stimulated blood flow. When you were cold, this helps you to feel warmer. For sore, achy, and/or tense muscles, this relaxes them and relieves the pain.

When done slowly and gently, the massage relaxes you. But, did you know that doing the same strokes quickly and with vigor will invigorate you, wake you up, make you feel more energetic? So, when you wake up or need more energy during the day, put a more oomph into your self-massage. When you want to relax or if you have problems falling asleep, do a gentle slow massage.

One of my clients recently asked me "What type of self-massage is the most beneficial?"

Not to be facetious, any self-massage that you perform will be beneficial. If you massage yourself when you are tense, tired, achy, sore and that feeling decreases, then that massage is beneficial. You pretty much instinctively know how much pressure to apply; rarely will you press so hard that it brings you uncomfortable pain. You will use strokes or techniques that you enjoy and will bring you relief. These could be the smooth gliding strokes and kneading of a Swedish massage, the deep pressure of a Deep Tissue massage, or Foot (and/or Hand) Reflexology, or Acupressure, or Trigger Points, or Lymph Drainage, or any other technique; or you could use a hand-held massage tool of some sort.

Regular self-massage also has benefits when you are not tense or achy or sore. It can enhance your wellness by aiding in digestion, removing waste products, improving your immune system and its capabilities to fight illness and disease, improving your circulation, and helping you to feel better (through the release of endorphins, natural pain killers which may also elevate your mood).

Now you probably would like to know "How do I do self-massage?"

I would start by gently gliding my hand(s) over the skin and muscles moving toward the heart. If you would like to use oil or lotion, you could apply it at this time. Then, I would knead my muscles (like I would knead bread); I could also make circles with my hands or fingers. This is where I would work deeper, apply more pressure for sore muscles. I would finish as I started, by gently gliding my hand(s) over the skin and muscles moving toward the heart. To adequately work your entire body, I would recommend spending at least 20-30 minutes a session.

There are many sites on the Internet that guide you through a specific protocol with directions and photographs. Here are a few, from very general to specific:

• http://www.kreinik.com/articles/news.php?newsid=32
• http://www.rd.com/content/learn-the-art-of-self-massage/
• http://www.coolnurse.com/massage.htm

"Should I use a massage tool?"

Massage tools can be very effective both for applying deeper pressure with little effort and for reaching hard-to-reach body parts. The Back is especially hard area to massage using your own hands (DUH!). So it would be beneficial to use some sort of tool. Rolling on a tennis ball (tied in a sock or not) is an inexpensive tool that can be very effective. There are many tools out there. This Internet page describes many of them:
https://www.nwhealth.edu/healthyu/liveNaturally/sm9.html

Now, Go give yourself a massage!

Sources:

1. "Self-Massage Techniques," Dave Otis., LMT (Licensed Massage Therapist), http://www.coolnurse.com/massage.htm
2. "Self Massage Techniques," Kim Draper, Feb 26, 2003, http://www.selfgrowth.com/articles/Draper1.htmlhttp://www.selfgrowth.com/articles/Draper1.htmlhttp://www.selfgrowth.com/articles/Draper1.html
3. "Self massage techniques," http://ga.essortment.com/selfmassagetec_rspq.htm
4. "Self Massage Techniques," Kim Draper, http://the-vu.com/Self_Massage.htm

What is Swedish Massage?

If you ask to have a massage without further discussion or a massage for rest and relaxation, you will receive a Swedish massage. Initially developed in Sweden in the early 19th century, Swedish massage uses oils or lotions and gentle manipulations of the skin and superficial muscles to relax the muscles and improve blood circulation. It is the most common form of massage used in America; it is also sometimes called "therapeutic massage," though that term is used by many to describe medical massages. Swedish massage forms the basis for many other types of massage.

STROKES

Five different types of strokes are used:

• Long, flowing strokes called effleurage are the primary strokes used in a Swedish massage. They are predominantly done in the direction of the heart. These strokes really result in the "feel good" sensation of the massage. They assist in improving the venous flow of blood back to the heart.
• Kneading strokes called petrissage occur when the massage therapist lifts the skin and muscle below and lightly squeezes, rolls or twists the tissue, just like a baker does when kneading bread dough. Petrissage has the effect of mechanically relaxing tight muscles and it also enhances the flow of blood and oxygen to and waste products away from the tissues.
• Tapping strokes called tapotement are done with the fingers [tapping], cupped hands [cupping], the little finger side of the hands [hacking], the palm of the hands [slapping], or fists. Tapotement is generally done when the massage therapist has finished with the massage on a specific part of the body or at the end of the massage to help "awaken" or stimulate the client. It can be very light such as tapping on the face or "heavy" when hacking or cupping on the back. Not every massage therapist will use tapotement, and many will use it sparingly.
• Friction is done either in a circular motion or across the fiber of the muscle by one or several fingertips while moving the skin. It is a very rapid movement to mechanically relax a very tight muscle, a knot in a muscle or tightness at the muscle’s tendon. This is a deeper stroke, the deepest used in Swedish massage. It brings blood to a specific area of a muscle/tendon. Done for a long period of time, it can result in a controlled inflammatory response. During a Swedish massage, friction would be used only for a few seconds and not too many times.
• Vibration is a rapid side-to-side movement of the hand or fingertips while the hand is gliding or in one spot; it is in effect shaking the tissue. In Swedish massage, its primary purpose is to break up the monotony of the massage. It also"wakes up" the nerves that may have been put "to sleep" during effleurage; this enables the body to respond better to the stimulation of the other strokes.

While not specifically a stroke, the massage therapist may also move the client’s joints. This can be either active with the client doing the movement while the massage therapist applies pressure or massages tissue at the joint. Or it can be passive where the massage therapist moves the joint. This is often done to increase the range through which the client can move a joint (referred to as range of motion) where there is some restriction.

BENEFITS

I have already mentioned improving circulation, providing relaxation, relieving tight muscles, removing waste products, and improved range of motion of joints. A previous post extensively discussed the benefits of massage. All of these apply to Swedish massage.

WHO SHOULD NOT HAVE A SWEDISH MASSAGE?

There are times when it is not in the client’s best interest to have a Swedish massage:

• Illness (acute illness, diseases contagious or not)
• Running a temperature
• Recently broke a bone or had surgery
• Under the influence of alcohol or drugs
• Recent history of phlebitis or thrombosis (these are conditions where the client may have blood clots which if dislodged could travel to the lungs, with potentially fatal results).
• Too sore, and/or achy, and/or bruised for example, after a car accident.

Sources:

1. Mosby’s Fundamentals of Therapeutic Massage by Sandy Fritz, 2004.
2. Encyclopedia of Alternative Medicine, http://www.answers.com/topic/swedish-massage
3. "Swedish Massage - The Right Therapy to Relax Muscles, http://www.alternateheals.com/massage-therapy/swedish-body-massage.htmhttp://www.findarticles.com/p/articles/mi_mOFKA/is_n3_v59/ai_19182310
4. http://www.touch-of-health.net/395667.html
5. http://spaworldtravel.com/gloss.html
6. http://www.freep.com/money/consumer/gsidea11_20010211.htm

What Are the Benefits of Massage?

There are many physical, mental and emotional benefits of massage. Different types of massage or bodywork share many of the same benefits, while each individual type has some benefits specific to it. What I am presenting here are the shared benefits.

Physical Benefits

The physical benefits come from the direct manipulation of the body’s soft tissues (muscles, ligaments, tendons, and the connective tissue called fascia) and directly or indirectly of the body’s organs/glands.

Many of the benefits are to the muscles, tendons, ligaments and joints: Massage effectively does the following: loosens tight muscles and stretches connective tissue around muscles; eases muscle pain, tension, cramps and spasms; decreases muscle fatigue; firms up muscles; increases muscle strength; quicker recovery from strains (a stretch, tear, or rip in the muscle, tendon or muscle fascia) and sprains (a traumatic joint twist resulting in stretching or total tearing of a ligament and/or to elements of a joint); and improves flexibility; loosens joints; and improves the range of motion of joints.

Some benefits affect the body as a whole: Massage causes the body to relax, stimulates the circulation of the blood, lowers blood pressure for people with hypertension, assists in the removal of toxins from the body, improves lymphatic drainage of metabolic wastes, improves the immune function, delivers nutrients to tissues and cells more efficiently, firms up skin tone, calms the nervous system, and an increase in energy.

Others benefits include quicker healing from injury and illness; aid in recovery from medical and surgical procedures; and relieving the symptoms of many disorders and dysfunctions, including but not limited to the following: asthma; arthritis; carpal tunnel syndrome; chronic and acute pain syndromes; Myofascial pain; headaches; multiple sclerosis; Alzheimer’s; cancer; and temporomandibular joint (TMJ) dysfunction.

Mental and Emotional Benefits:

Most of the mental and emotional benefits of massage are a result of the release of various hormones and chemical substances within the body. The major reason that many people receive massage is for relaxation (mental as well as physical). Massage also relieves stress, depression, anxiety and irritation; improves the length and quality of sleep; increases the ability to concentrate; and improves the sense of well-being.

Sources:

• Mosby’s Fundamentals of Therapeutic Massage by Sandy Fritz, 2004.
• Encyclopedia of Alternative Medicine, http://www.answers.com/topic/swedish-massage
• Swedish Massage, http://www.scotmass.co.uk/Therapies/swedish_massage.html, Scottish Massage School, UK
• Massage Therapy, http://uimc.discoveryhospital.com/main.php?id=3089
• University of Illinois Medical Center Health Library (at Chicago)
• Complementary and Alternative Medicine for Serious Illness, Columbia University, http://chaos.cpmc.columbia.edu/camform/diseases.html