Deep tissue massage is a type of therapeutic bodywork that focuses on realigning the deeper layers of muscle and connective tissue. It goes beyond the superficial muscles to release chronic patterns of tension in the body through slow strokes and targeted physical pressure.
This article will examine the mechanisms behind deep tissue massage and its effectiveness in treating various conditions.
What is Deep Tissue Massage?
Deep tissue massage is distinguished from other types of massage by its ability to work the deeper musculature and fascia (connective tissue) of the body. During a deep tissue massage:
- The massage therapist applies slow strokes and finger pressure techniques on layers of muscle and tissue below the surface.
- Firm pressure is used to break up scar tissue and physically break down muscle knots and adhesions (bands of painful, rigid tissue).
- The therapist targets chronic muscle tension as well as areas of injury or dysfunction in the body.
This type of massage requires the therapist to have specialized skills in identifying areas of tension as well as the appropriate techniques to treat them. The strokes are slower and the pressure is deeper and more focused than with a traditional Swedish massage.
Techniques Used
Deep tissue massage employs many different techniques to work through superficial muscle layers to get to deeper adhesions and misalignments in the body. Common techniques include:
- Stripping – Long, gliding strokes apply pressure along the length of the muscle fibers.
- Friction – The therapist uses their fingers and thumbs to apply circular pressure across the grain of the muscle.
- Trigger point release – Isolated finger pressure targets painful knots in the muscle tissue.
- Cross-fiber friction – Pressure is applied across the muscle fibers to break up scar tissue and adhesions.
These techniques are often used together during a deep tissue massage session to achieve customized results based on the client’s problem areas. The therapist will alternate between techniques to sufficiently warm up the muscle tissue before going deeper.
Physiological Effects
Research suggests massage may work through several mechanisms:
- Mechanical effects:
- Massage techniques like petrissage and tapotement compress tissue, which increases interstitial fluid flow and promotes drainage of waste products like lactic acid. This may reduce pain and speed recovery from exercise.
- Kneading and cross-fiber strokes stretch muscle tissue, which could decrease muscle spasm and increase range of motion.
- Friction techniques can break down scar tissue or adhesions, releasing muscle entrapments.
- Neural effects:
- Massage stimulates large-diameter mechanoreceptors, creating a generalized inhibitory effect on pain signaling in the central nervous system.
- Petrissage increases vagal activity, activating the parasympathetic nervous system for relaxation.
- Massage may decrease excitability of alpha motor neurons, reducing muscle hypertonicity. Studies show massage decreases H-reflex amplitude during application.
- Circulatory effects:
- Superficial massage techniques like effleurage increase skin blood flow, although effects on deeper muscle perfusion are less clear. Enhanced circulation could improve oxygenation and waste removal.
- Massage may lower blood pressure and promote venous blood return by enhancing parasympathetic tone. This could reduce edema.
- Biochemical effects:
- Massage may stimulate release of endogenous opioids like endorphins, serotonin, and oxytocin, reducing pain perception.
- Reduced cortisol and increased dopamine and norepinephrine could improve mood and decrease stress.
- Decreased inflammatory cytokines may reduce pain in chronic conditions like arthritis.
The combination of these physiological changes is what provides the therapeutic benefits of reduced pain, improved flexibility, faster healing, enhanced athletic performance, and reduced symptoms of stress.
Benefits
Reduces Muscle Tension and Pain
Deep tissue massage techniques are particularly effective for reducing chronic muscle tension and pain. The advanced techniques allow the massage therapist to break up knots, adhesions, and lactic acid buildup deep within the muscle tissue. This releases tightness and discomfort that standard massage cannot reach.
Improves Blood Circulation
The firm pressure of deep tissue massage moves blood through congested areas of the body. The slow movements help blood flow to muscles and tissues that are ailing or inflamed. Increased blood flow provides oxygen, nutrients, and chemical signals to cells in need while also flushing out inflammatory waste products.
Corrects Posture
Postural imbalances and misalignments can often be traced back to chronically tight muscles pulling bones out of proper position. Deep tissue massage can help loosen tightened muscles and allow the body to revert back to its natural optimal posture. This helps relieve associated pain and stiffness.
Enhances Athletic Performance and Recovery
Deep muscle treatment enhances athletic performance by improving muscle flexibility and blood flow. Massage preps muscles for increased exertion while speeding post-exercise recovery. The breakdown of lactic acid and increased blood circulation reduces muscle soreness and injury risk.
Lowers Stress Hormone Levels
The type of physical stimulation provided by deep tissue massage has been shown to decrease levels of stress hormones like cortisol. Massage promotes the body’s relaxation response, resulting in feelings of calmness that can help manage anxiety, depression, headaches, and other stress-related issues.
Possible Mechanisms of Deep Tissue Techniques
- Deep tissue techniques like cross-fiber friction, trigger point release, and focused pressure aim to manipulate deeper musculature and connective tissues. This could help break up adhesions, release entrapped nerves, increase blood flow to ischemic areas, and reduce myofascial pain.
- By addressing tissues not accessed by superficial techniques, deep tissue massage may provide pain relief where classic Swedish massage does not. Studies show benefits for chronic low back pain.
- The pressure and tissue manipulation utilized in deep tissue massage manually engages mechanoreceptors which dampens nociceptive signals in the nervous system. This provides an analgesic effect.
- Kneading and longitudinal strokes can reduce muscle hypertonicity, decreasing spasm and promoting relaxation. This could improve range of motion and flexibility.
- Deep transverse and cross-fiber friction can encourage realignment of collagen fibers during healing of injured tendons and ligaments. This supports rehabilitation.
- Increased blood and lymph flow could enhance circulation and drainage from deep muscles, transporting nutrients, oxygen, and waste products. This may aid recovery.
- Releasing fascial restrictions and trigger points could reduce compensatory strain patterns that contribute to pain and dysfunction in musculoskeletal conditions.
- Psychologically, deep pressure massage stimulates the parasympathetic nervous system, reducing heart rate, blood pressure, and stress hormones. This promotes relaxation.
Diene Oliveira Cruz
Physiotherapist, with specialization in Orthopedics and Traumatology by Santa Casa de São Paulo. Pain and Rehabilitation Specialist.