Effects and Benefits of Deep Tissue Massage

Massages have been used as a healing and relaxation technique for thousands of years. By manipulating the tissues and muscles of a recipient using a combination of pressure, rubbing, stroking, and even heat, various health benefits have been observed.

Main Benefits of Massages

According to the American Massage Association, recent research shows the benefits of massaging for a variety of issues:

  • Fatigue or pain caused by cancer
  • Back pain and stiffness
  • Osteoarthritis in the knee
  • Post-operative recovery and pain
  • Carpal tunnel syndrome relief
  • Fibromyalgia
  • Boosting the immune system function
  • Decreasing the frequency of headaches
  • Blood pressure
  • Alcohol withdrawal symptoms

Based on data collected between July 2016 to July 2017, here are the primary reasons people in the US get a massage:


Other interesting data points:

  • 89% of respondents agree massage is effective for pain relief
  • 61% of physicians have recommended massaging to their patients


Massage strokes can be considered to have one or more of the following effects.

What Are the Benefits?
  • Stress Relief. Deep tissue massage is a great stress reliever. …
  • Reduces Pain. …
  • Lowers Blood Pressure and Heart Rate. …
  • Breaks Up Scar Tissue & Makes Movement Easier. …
  • Reduces Arthritis Symptoms. …
  • Rehabilitates Injured Muscles. …
  • Helps With Labor and Delivery.
What happens when you get a deep tissue massage?
It involves applying sustained pressure using slow, deep strokes to target the inner layers of your muscles and connective tissues. This helps to break up scar tissue that forms following an injury and reduce tension in muscle and tissue.
How often should you get a deep tissue massage?
For stress relief: Every one to two weeks
Therapeutic massage by a trained professional massage therapist has been found to help alleviate stress, anxiety, and stress-related insomnia. If you are going through a particularly difficult time, aim to book a therapeutic home massage service every one to two weeks.
What happens in your body when you get a massage?
The physical manipulation in massage has two major physical effects: An increase in blood and lymph circulation. Relaxation and normalization of the soft tissue (muscle, connective tissue, tendons, ligaments), which releases nerves and deeper connective tissues.

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).1 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.

Potential Benefits

Deep tissue massage usually focuses on a specific problem, such as chronic muscle pain, injury rehabilitation, and the following conditions:2

  • 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
  • Sciatica
  • Piriformis syndrome
  • Tennis elbow
  • Fibromyalgia
  • Upper back or neck pain3

Not all of these benefits have been scientifically proven. But 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.5


What to Expect

Deep tissue massage techniques are used to break up scar tissue and physically break down muscle “knots” or adhesions (bands of painful, rigid tissue) that can disrupt circulation and cause pain, limited range of motion, and inflammation.

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 is applied along the length of the muscle fibers using the elbow, forearm, knuckles, and thumbs.
  • Friction: Pressure is applied across the grain of a muscle to release adhesions and realign tissue fibers.

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. Be sure to contact your massage therapist if you have concerns or if you feel pain after having a massage.

Drinking water after the massage may help to flush the metabolic waste from the tissues.

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.

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.

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.


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.6

If you have blood clots or are at risk of forming blood clots, it’s essential that you consult your doctor before getting a deep tissue massage.

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.7

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 first 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,1 but your doctor may suggest a massage therapist trained in pregnancy massage instead.

Deep tissue massage may also result in bruising. Case reports have reported venous thromboembolism, spinal accessory neuropathy, hepatic hematoma, and posterior interosseous syndrome after deep tissue massage.


A Word on Deep Tissue

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.


Breaking adhesions

Often when a muscle has been overworked, tense, or stationary for a period of time the layers of myofascial within the muscle can become adhered to each other. This restricts circulation to the muscle cells and leads to a build-up of metabolites such as lactic acid. Massage strokes that break this type of adhesions typically involve a cross-fiber component. Consider this image of the muscle structure.

When you apply pressure to the epimysium of the muscle, then apply a cross-fiber force, can you see how the epimysium will tend to rotate around the muscle?

This rotation breaks adhesions between the epimysium and the deeper perimysium.

Now consider the effect of the same stroke on the deeper myofascial of the muscle. When the epimysium rotates, it tends to drag the perimysium with it. The perimysium as it moves pulls on the endomysium. In this way, a simple cross-fiber stroke can work right into the center of a muscle, acting to break myofascial adhesions between many layers of fascia.

Breaking adhesions restores circulation and freedom of movement. The stored metabolites are then able to move back into circulation.


After doing some deep tissue work, you should always flush out the area that you have just worked into. The massage will have opened up circulation to the affected muscle, but the metabolic wastes will be sitting in the interstitial fluid. Flushing the area helps to return these metabolites to circulation via the lymphatic system and the cardiovascular system.

The effect of flushing on the lymphatic system

The lymphatic system is driven by a mechanical pumping action. When you flex and extend your elbow, the increased fluid pressure in the fold in the fold of your elbow (i.e. Cubital fossa) acts to push lymphatic fluid into your lymphatic capillaries. Lymphatic vessels are one-way tubes so that when fluid enters the tube it pushes all the fluid in that tube along.


Lymphatic capillaries
Lymphatic system

Lymph glands act as collection channels and pumps for the lymphatic system. They tend to cluster around the joints because these are the areas that are subject to the greatest changes in fluid pressure.

Any stroke that increases the fluid pressure in the tissues will push fluid into lymphatic capillaries and therefore increase lymphatic flow.

It is typically considered that more superficial strokes have a greater effect on lymphatic return, and that deeper strokes have a greater effect on venous return.

Manual Lymphatic Drainage is a specific bodywork application that aims to maximize this effect. It is used in the hospital treatment of lymphoedema among other things.

The effect of massage on the cardiovascular system

Massage has two main effects on the cardiovascular system.

  • Vasodilation
  • Increasing venous return

The application of massages stimulates the release of histamine, which increases the permeability of the capillaries (Hertling & Kessler, 1996) causing local vasodilation. The pinking effect that you get on the tissues after you’ve worked an area is a sign of this increase in blood flow. Local vasodilation increases blood flow into the tissues and blood flow back into circulation. This increases the natural rate of flushing both during the massage, and also after the massage (as movement also has a flushing effect).


Histamine is an organic nitrogenous compound involved in local immune responses as well as regulating physiological function in the gut and acting as a neurotransmitter.[2] Histamine is involved in the inflammatory response. As part of an immune response to foreign pathogens, histamine is produced by basophils and by mast cells found in nearby connective tissues. Histamine increases the permeability of the capillaries to white blood cells and some proteins, to allow them to engage pathogens in the infected tissues.[3] From Wikipedia, the free encyclopedia

Venous return
Local fluid pressure has some effect on venous flow, but the most significant effect massage has on venous circulation occurs as a result of deep longitudinal strokes in the direction of the heart. Venous return is dependent largely on the pressure exerted by the contraction of muscles on the veins (Marieb, 2004). Deep longitudinal effleurage strokes in the direction of the heart act to increase venous return by pushing blood through the veins.

Influence Of Massage On Circulation 

By: Thanks to Pat Donohue

Massage provides an additional assist to the veins and lymphatic vessels, aiding in their mechanical emptying and facilitating the forward movement of blood and lymph. The effect is similar to a combination of suction and a force pump. Careful observation, of the superficial veins, will show the veins collapse and refill as they are manipulated by the hands of the therapist. This aids the circulation in the deep veins as well as that in the arterioles and capillaries of the region. Gentle centripetal stroking massage is a mild stimulant to the vasomotor nerves supplying the blood vessels of the skin. Prolongation of the massage brings about hyperemia of the region. The massage usually arouses dormant capillaries and increases the speed and extent of the circulation in that region.Studies researching the effects of massage on circulation conclude that deep stroking and kneading massage produces a moderate, consistent, and definite increase in the blood flow to the extremities of patients who have flaccid paralysis, just as it does in normal extremities.A demonstrated increase in the diameter and permeability (the condition of the capillary wall that enables substances in the blood to diffuse into tissue spaces or into cells, or vice versa) of capillaries after mechanical stimulation has been recorded. Also, massage provokes the release of histamine (stimulates gastric secretions, flushing of the skin, dilatation of capillaries, lowers blood pressure, and reduces headaches) and acetylcholine (an ester of chorine occurring in various organs and tissues of the body. It is thought to play an important role in the transmission of nerve impulses at the synapse and myoneural junctions), accompanied by vasodilatation, while increasing blood flow and discharge of erythrocytes (a mature red blood cell) from the spleen. As already noted, the mechanical effect of massage increases the movement of blood, making the exchange of nutrients and waste more efficient and improving the tropic (concerned with nourishment) state of the skin and underlying structures.Massage gives a brief increase in arterial blood pressure, but after the massage, the net outcome is a decrease. The reason for this outcome is the venous pressure is increased. So the effect of massage is the arterial circulation is hastened by the quicker outflow from the veins and the diminishing pressure within them. After the massage, there is active hyperemia in the skin and the muscles, and the number of erythrocytes in the superficial vessels is increased by 40 to 50 percent. Reports have definitely observed peripheral vasodilatation together with an increase in the rate of peripheral blood flow the following massage. The release of acetylcholine and the production of histamine and histamine-like substance in the tissues play an important role in vasodilatation induced by massage.Light pressure results in an instant temporary capillary dilation, whereas heavier pressure results in a more enduring dilation, with connective tissues playing an important role in the vasodilatation induced by massage. Deep stimulating massage acts as nerve transmission and is used selectively in order to stimulate the sensory endings of the nerves and to produce vasodilatation by means of axon reflexes and release of histamine. Massage produces a definite increase in the circulation and increased exchange of substances between the bloodstream and the tissue cells, along with improved metabolism.The Vascular System: Reference: Pathology for Massage Therapist 2nd Edition by Don Newton, MA, DC pages #33-#52. Massage therapy has a powerful effect on the blood and lymph systems. Knowledge of the common vascular diseases is therefore of great significance to the massage therapist and maybe lifesaving to the client.Client/Patient under Physician’s care: (Including blood thinner medication pre and post-operative.) Ethics plays a major role in this situation. One of the basic principles of ethical behavior is RESPECT. That includes esteem and regard for clients, other professionals, and oneself. The client’s attending physician should be contacted out of respect in order to treat their patient with Massage Therapy. (The doctor’s patient becomes our client.) A simple prescription, which at first can be a verbal release by phone, is all that is necessary. Therapy should not be given until the client’s doctor has been consulted.Treatment Protocol: The following protocols are designed to establish a way for the student to become familiar and comfortable with the hands-on application of medical massage techniques. They are intended for use on complaint-related conditions and syndromes. Medical history, palpatory, and assessment skills, and ongoing client/therapist communication are all important to the successful treatment of soft tissue pathology.These routines are a model for the student to base their work and to feel comfortable in addressing these client situations. Keep in mind, there are numerous ways to accomplish the same thing and get similar results. Different strokes and different approaches may well be effective. These protocols offer a basis for which you can establish your own individualized work as a Massage Therapist.Heart Conditions: The client should always have their upper and lower extremities supported. It’s vital to remember never to stress the heart. Use gravity to assist the massage treatment. No stripping of the muscles; always use mild and gentle, yet firm, evenly distributed pressure through the hand while contouring to the musculature of the body. Applications of ice or heat must be moderate as well. Ice would shock the body causing stress on the heart, as well as to its systems, while too much heat would injure the capillaries when vasodilatation occurs. The focus of the massage should be to the lower extremities to increase the venous circulation while decreasing the pressure on the arterial walls. No direct pressures should be applied to the chest or deep pressures on the posterior aspect of the heart while massaging the back.Characteristics:

  • Weakness in the heart
  • Compromised cellar structure (e.g.: capillaries)
  • Edema in the extremities
  • Emotional component (e.g.: depression)
  • Tends to feel cold (poor circulation)

Assessment: Visual

  • Broken capillaries
  • Edema (extremities – ankles)
  • Lack of muscle tone (tonicity)
  • Body posture or attitude (anxious or irritated – depression


  • Coldness to the touch (extremities)

Treatment Plan:

Place the head and legs in an inclined position with bolsters and pillows to encourage venous blood flow.

  1. All effleurage strokes are to be mild to moderate, with NO deep stripping of the muscles.
  2. Employ all forms of petrissage to increase blood and lymphatic circulation.
  3. Use mild joint movement and static friction where applicable.
  4. Use longitudinal friction when necessary to warm and lengthen muscle tissue and finish the area with a moderate passive effleurage stroke to stretch muscles, keeping in mind the goals of your treatment.

High Blood Pressure:

The abdominal area is a contraindication for massage application because of the extra pressure, which stresses the inferior vena cava and may endanger the client’s health.

Note – Be aware of the clients who are on mind-altering drugs or alcohol. These clients are not to be treated. Hemorrhage in the tissue may occur due to the extreme vasodilatation occurring in the capillaries.

Diabetes Mellitus:

Reference: pages 82-84 Pathology A to Z by K. Premkumar
Up to 10% of the U. S. population has diabetes mellitus (hyperglycemia). Family history as well as a viral infection of the pancreas may play a role in its etiology. Other risk factors include obesity, stress, pregnancy, and some medications.

There are two types. Type I (insulin-dependent; juvenile-onset) diabetes usually occurs before age 30 and may be present at birth. It involves defective pancreatic insulin production and is usually treated with regular insulin injections.

The more common Type II (non-insulin-dependent; adult-onset) diabetes usually occurs in obese adults after the age of 40 and is treated by diet, exercise, and drug therapy. (At all times, consult with the patient’s physician and explain your proposed treatment, and what you expect to do.) The normal glucose level in the blood is between 80-120 mg/100 ml, whereas in a patient suffering from diabetes mellitus, the fasting glucose will be 200-300 MB/100 ml. It is most common in people who are overweight and in the older age group. The cause of diabetes, here, has been attributed to a decreased number of defective receptors for insulin in fat cells. There is an association between the incidence of diabetes and family history.

Focus and Intent of treatment:


  • Emotional and physical stress must be addressed. Relax the nervous system. Long rhythmical continuous effleurage (30% of treatment) gentle medium/slow continuous strokes are used to relax the body while encouraging the circulation of blood.
  • If the patient has an inactive lifestyle but needs to increase his or her amount of exercise, your massage can act as a passive exercise for this patient. Petrissage should be utilized for at least 50% of the treatment time to help tonify muscles.
  • Peripheral nerve damage – add some gentle friction to the lower extremities after a sufficient amount of effleurage has been completed to aid the body in the absorption of fluids. This will give a more adequate flow of blood to the extremities. (Remember friction can not be done on areas that are swollen, as direct pressure down – characteristic of friction – will further close the dysfunctional vessels. If done improperly, friction will cause more vascular damage and bruising. Your massage should create no pain. Lighten the pressure to defer to pain.
  • Stimulation through vibration (20%) improves visceral reflexes – including the function of the adrenal glands, which play an important role in the body’s autoimmune function. Apply vibration over the adrenals. Vibration has been proven to improve some visceral reflexes, including the function of the adrenal glands. Adrenal glands play an important role in the body’s autoimmune function, so by stimulating the suprarenal glands, you will aid the body’s own restoration process.
  • Massage therapy assists with the complications that occur from diabetes. The high glucose levels have detrimental effects on almost all systems. Eyesight is affected due to bleeding in the retina. There is the loss of sensation in the periphery especially the hands and feet. (The massage therapist should observe the patient’s feet carefully while treating.) The effect on the autonomic nervous system results in parenthesis (low back pain supine/prone) diarrhea, and impotence. The high levels of cholesterol in the blood speed up the formation of arteriosclerosis with its associated complication of thrombosis and emboli. The patient is generally dehydrated, weak, and fatigued. A diabetic is prone to infection and takes longer to heal. Massage therapy increases circulation, decreases, and addresses swelling especially in the lower extremities, stimulates periphery nerve impulses in hands and feet, affects the autonomic nervous system.



  • Edema in extremities
  • Compromised cellular structure (e.g.: capillaries)
  • Emotional stress
  • Back pain (from adrenals)
  • May have an inactive lifestyle
  • Injection site (insulin-dependent)
  • Neuropathy (lack of feeling in feet)


  • Visual
  • Foot irritation (cuts, infection)
  • Edema (extremities – ankles)
  • Discoloration (capillaries)
  • Injection site discoloration
  • Monitor aspects of depression


  • Coldness to the touch (extremities)
  • Poor muscle tone
  • Contracted muscles of the back

The focus of Treatment: Attention should be given to the adrenal glands, latissimus dorsi, and teres major muscles as well as the lower extremities especially the feet.

Treatment Plan for Diabetics:

Do a general full body massage with special attention to the legs and feet. Execute with long effleurage strokes mild/moderate pressure, no stripping of the muscles.

The additional focused area in the prone position to be added to the back massage.

To palpate adrenals, place hand (ulnar) crosswise at the level of 12 ribs, the kidney is underhand adrenal at thumb above the kidney.

These techniques provide improved nutrition to kidneys and adrenals.

  1. Compression/twist to latissimus dorsi – fingertips together, in a rotary motion. Emphasis is on fingertips creating a rotary force as one unit on the flat muscle structure.
  2. Latissimus dorsi stretch – from the same side of the table, hand-over-hand, inferior to superior, following lats up into the axillary area as joint movement simultaneously occurs to fully elongate the muscle.
  3. Vibration – hand-over-hand, placed longitudinally, starting with the heel of the hands at the crest of the ileum moving superiorly in 1/2-inch increments to the inferior angle of the scapula. This action can be executed inferior to superior as well.
  4. Rhythmic shaking (vibration) of the adrenals – same side of the table, moving the hands in a wave-like motion, two hands on one side of the lats, shuffle back & forth while entrapping the organs. This vibration can be done for 30 seconds up to three minutes, with some rest in between, and should be done at the end of the back massage.

Client Position: Supine

  • Bolster in the supine V position (wedge under back/neck and legs/feet)
  • Keep client warm (extra blanket – warm room) because of poor circulation
  • General massage consisting of
    • 30% effleurage
    • 50% petrissage
    • 20% vibration
  • Focus on extremities
  • For edema – work proximal /distal/proximal
  • Do not massage near injection site for insulin-dependent clients

Client position – Prone

  • General massage as above (bolster under feet)
  • Adrenal twist – stand at the side of the table and place both hands flat on the ribs. Your little finger (of the lower hand) is on the 12th rib. With slight compression, twist your hands to the left and then to the right – repeat 3X
  • Latissimus Dorsi stretch – hold your client’s arm overhead (with your upper hand) and use your lower hand to glide from the lower spine to the axillary/deltoid region.
  • Vibration – hand over hand from the PSIS (iliac crest) to the inferior angle of the scapula. The direction you use does not really matter. You can start at the scapula or at the crest.
  • Adrenal shake – rhythmic shaking of the adrenals glands. Stand at the side of the client-facing their head. Place your upper hand on the posterior ribs and your lower hand on the side ribs. The motion is lateral rocking. The top hand goes down and out – the side hand goes in and up. Create a rhythm with the movement.


Summary of the effects of massage on circulation

  • Increasing fluid pressure will increase lymphatic flow and to a lesser extent venous flow
  • More superficial strokes have a greater effect on lymphatic return.
  • Deeper strokes have a greater effect on venous return.
  • Strokes in the direction of the heart increase circulatory return
  • Strokes away from the heart are unlikely to have a major effect on a circulation, as the arterial blood pressure is largely driven by the heart.


Although most of the stretching effects of massage occur because of stimulation of the nervous system stimulation, it’s useful to consider them separately because of their importance.

Any massage stroke that engages with the muscle and produces a pull in the direction of the muscle fibers (i.e. a longitudinal stroke) will act to stretch the muscle. The effect on the body is similar to if the client stretched that muscle themselves. Deep longitudinal effleurage on the hamstrings will have a similar effect to the stretch demonstrated here.

The stretching effects of massage are likely to affect the tissues in two ways

  • Breaking myofascial adhesions
  • Altering muscle balance

When stretching muscles move against each other. This breaks fascial adhesions that may have formed, freeing up movement. Stretching also stimulates the proprioceptors of the muscles leading to either toning (rapid stretching) or relaxation/lengthening (long slow stretches).

Nervous system stimulation

The stimulus provided by massage stimulates a cascade of hormones and neurotransmitters which have some dramatic effects on the client including

  • Reducing stress, anxiety & depression
  • Improving the ability to relate to others
  • More positive perspective
  • Improved wound healing and immunity
  • Improved sleeping patterns
  • Pain reduction

Types of Massages good for Deep Tissue

Neuromuscular Massage Therapy

Neuromuscular massage therapy is a specialized form of manual massage in which digital pressure and friction are used to release areas of strain in a muscle. Strain areas are called tender or trigger points, and they tend to be the cause of ongoing muscular pain symptoms. These trigger points are small areas of the muscle in which there is a contracture of tissue, and the lack of blood and nutrients in that area causes an inability for that muscle to relax. The area is hypersensitive and can cause pain, fatigue, and weakness in the muscle. Trigger points can lead to referral pain, which refers to a phenomenon in which areas far away from the trigger point experience sensations of pain, tingling, or numbness.

Neuromuscular massage therapy involves applying alternating levels of concentrated pressure to the trigger point – usually using the fingers, knuckles, or elbow. Once applied, the pressure should not vary for 10 to 30 seconds.

Neuromuscular Massage vs. Deep Tissue Massage

A deep tissue massage is a form of massage that is generally used to address muscle aches and pains associated with daily stress. Deep tissue massage is usually administered on an on-off basis whenever a client decides they need a bit of extra relaxation and rest.

Neuromuscular massage techniques, on the other hand, are medical in nature. The manual therapy techniques are highly-specialized and are designed to correct pain and movement dysfunction by treating trigger points, muscle adhesions, and connective tissue patterns. The problems are normally caused by a specific trauma, repetitive movements, or even bad posture. Neuromuscular massage is considered an ongoing treatment – not just something a person does whenever they feel a bit achy.

What Does Neuromuscular Massage Therapy Treat?

Some of the medical issues for which neuromuscular massage can be an appropriate treatment include:

  • Low back pain
  • Upper back pain
  • Carpal tunnel-like symptoms
  • Sciatica-like symptoms
  • Calf cramps
  • Plantar fasciitis
  • Tendonitis
  • Knee pain
  • Jaw pain
  • Tempomandibular joint pain (TMJ disorders)
  • Hip pain
  • Headaches
  • Iliotibial band friction syndrome

What Are The Neuromuscular Therapy Massage Benefits?

In general, patients who undergo neuromuscular massage therapy can experience the following benefits:

  • Reduced or complete elimination of pain
  • Higher levels of flexibility and strength
  • Increased ease and efficiency of movement
  • Better posture
  • Balanced musculoskeletal and nervous systems
  • Improved blood circulation
  • Lower levels of body toxins
  • Higher levels of energy and vitality

Active Release Therapy

Active Release Therapy/Technique (ART) was developed nearly thirty years ago by Dr. P. Michael Leahy. The idea of Active Release Therapy originated for elite athletes to return to peak performance as quickly as possible, without the long-windedness of a full massage. ART treats minor soft tissue disorders within the:

  • Muscles
  • Ligaments
  • Tendons
  • Fascia
  • Nerves

Active Release Technique, though originally developed for athletes, can be beneficial for anyone. It directly aims to release built-up scar tissue within the deep muscle, which occurs when the muscles are overused for an extended period of time.

In fact, ART is the only soft tissue manipulation therapy that directly repairs the muscle’s full range of motion because it directly targets the underlying issues within the muscle.

Muscle overuse happens from long bouts of exercise, as well as normal daily activities like walking, grocery shopping, a more active job (such as a teacher or construction worker, etc.), taking your dog around the neighborhood, and cooking.

ART Specialists are trained in over 500 specific stretching techniques. These techniques cover all major muscle groups, such as the quadriceps and hamstrings; upper back; shoulders; and chest. Each individual is unique, therefore there are no basic steps for the completion of an Active Release Therapy session. However, the overall protocol remains the same:

  1. The ART specialist uses his hands to identify scar tissue within the muscle.
  2. The specialist will then implement several trigger point methods using either his hands or small instruments to release the tension built within the scar tissue.
  3. The patient is asked to move that muscle through a specific range of motion.

ART sessions can last anywhere from 30-60 minutes and should never occur more than once a week unless specifically addressed by the specialist.


  • ART is a good option for high-training athletes with point-specific pain.
  • ART is the only type of massage therapy that directly deals with the underlying muscle and not the connective tissue, or fascia, above the muscle.

Myofascial Release Therapy

Myofascial release is the most rudimentary type of massage therapy — so much so, in fact, that the individual does not need outside assistance to complete it! The myofascial release describes the breaking down of tight fascia, which is the fibrous layer of connective tissue above the muscle and under the skin. Fascia is what allows our body to move and hold different bodily positions, and when we feel surface-level muscle tightness, it is generally the fascia that is bunched and not the muscle underneath.

Myofascial release can be executed with several different instruments:

  • Foam roller
  • Lacrosse ball / tennis ball / softball / golf ball
  • Rumbler roller
  • HyperVice
  • Body Bar
  • Trigger Point balls and rollers

There are also two different styles of myofascial release techniques: active and passive. Active release therapy is when the client is tensing the affected areas and is normally used with any of the above instruments. Passive release therapy is when the muscle is completely relaxed and is normally used during soft tissue mobilization and trigger point massage.

Any individual can choose to either have a massage therapist in myofascial release techniques upon tight muscles, or you can choose to do it yourself. It is more beneficial, however, to receive trigger point massage therapy to relieve fascia strain. Generally, this is the process:

  1. The practitioner will apply either gentle, sustained force on an area or gentle and light stretching, depending on the severity of the strain.
  2. They will use their fingers, knuckles, elbows, and any of the above tools to slowly break down the manipulated fascia.
  3. For direct myofascial release therapy, the practitioner will work slowly through each fascial layer until the strain is apprehended.
  4. For indirect myofascial release therapy, the practitioner will use both passive and active muscle tensing to gently rid the fascia of any strain.

Generally, myofascial release sessions can last up to a half-hour and can be utilized by anyone with tight muscles. In fact, myofascial release — while somewhat painful if using a direct method with a massage therapist — should be sought out first when dealing with tight muscles, as it serves many more direct benefits than a classic massage.


  • Myofascial release therapy can be done either independently or with the help of a licensed massage therapist.
  • Myofascial release therapy specializes in releasing acute fascial pain.

Medical Massage

A medical massage is normally met with heaps of controversy, as it typically adopts many different styles of already present massage therapies. These include deep tissue massage, trigger point therapy, osteopathic techniques, and cranial-sacral techniques. However, a medical massage is still heavily utilized for decongestive therapy, which helps with breast cancer; pain alleviation; and palliative care, or dealing with the issue by focusing on surrounding pain and not the issue itself.

Overall, medical therapy can be used to treat a wide assortment of physical and mental ailments, such as:

  • Reduced anxiety
  • Reduced blood pressure
  • Reduced heart rate
  • Delayed onset of pain

Most anyone can benefit from medical massage therapies, though the degree of how much it helps varies from case to case. There is still some scrutiny about how much medical massage aids in mental illnesses, such as anxiety and depression, though classic massage has been shown to alleviate some mood swings and increase relaxation.

Methods and time durations for medical massages will also vary on a case by case basis.


  • Medical massages are a good option for those suffering from medical pains.
  • A medical massage is used to help treat physical (stiff joints, etc.) and mental (anxiety, depression) pains.

Cupping Therapy

Cupping therapy is another massage technique that is ridiculed because its basis is not backed by hard scientific fact. Cupping therapies can actually be dated back to 3000BC, and since then has been used as an official method for short-term pain relief and for increased movement and blood flow.

Generally, cupping therapy is carried out by:

  1. The massage therapist will find a tight and/or sore area of the body
  2. The pressure is applied to the area by suctioning a cup onto the skin
  3. Pressure builds in the area as blood runs to the surface
  4. The cup remains on the body for a few minutes, depending on both the size of the cup and the amount of pain the muscle has been causing
  5. Sometimes, the practitioner will encourage the patient through a series of movements to further increase blood flow to the affected area
  6. The cup is removed

There are also three different cupping styles, which include:

  1. Dry Cupping → Dry cupping is most common and generally focuses on creating a small area of pressure underneath the skin. Normally, the cup is latched onto softer skin because it can create a better seal around the cup, which increases the overall pressure. Cups ranging from one to three inches in diameter are used.
  2. Fire Cupping → Fire cupping includes glass cups, instead of plastic ones, and is carried out by soaking a cotton ball in near-pure alcohol, lighting it on fire, and quickly inserting it into the cup and onto the body. The cup stays in place because of the rapid heating and cooling of the glass cup. Cups can also glide across the skin in a practice called “moving to cup,” but only if massage oil is applied.
  3. Wet Cupping → Wet cupping draws blood out by creating a small incision, and all is held in place with a suction cup. It is very popular in Islamic culture.

Though cupping is seen as pseudoscience and is claimed to have no health benefits, others swear by it for short-term health benefits. Studies are still inconclusive about the good or bad traits of this massage practice.

Cupping sessions generally take up to an hour and can be performed on nearly anyone.


  • Cupping therapy is a good option for short term pain management or muscle tightness.
  • Cupping is preferred by those with more generalized pain over softer tissue.

Trigger Point Therapy

Trigger point therapy, which is often mistaken for pressure point therapy, deactivates trigger points anywhere along the body that may cause mild or severe pain. Painful trigger points can result in muscle strain, pain, or even headaches. Trigger point therapy was first mapped by Janet G. Travell, who worked with President Kennedy, and David Simmons. However, it was not until 2007 that trigger points were mapped with MRI scans.

Generally, a trigger point follows very similar protocols as other massage practices. A tender and painful spot is found, and pressure is applied to relieve this pain. However, unlike classic massage, the trigger point delves deep into the fascial layer to release tension at the neuromuscular junction (NMJ), which differentiates it from other massage therapies.

Trigger point sessions can last anywhere from ten minutes up to an hour, though it is normally intense and somewhat painful, so some caution for longer sessions apply. It can also be utilized by any aged patient and is generally reserved for intense, painful muscle strain.


  • Trigger point therapy is preferred by those with very intense and site-specific pain.
  • Trigger point therapy focuses on instant relief of intense joint or muscle pain by applying direct pressure with a thumb, elbow, or another extremity.

Thai Massage Therapy


The Thai massage has been utilized since BE 2556, and for good reason. A classic Thai massage is an ancient practice that combines Indian Ayurvedic principles, acupressure, and some assisted yoga poses to alleviate painful muscle tensions.

A participant is clothed during the session in loose-fitting clothes. While muscle relaxation is the goal, the practitioner utilizes pulling, stretching, compression, and rocking with the patient instead of hands-on bodywork through kneading and pressure.

A Thai massage generally follows specific body lines, called “sen,” and can last up to two hours. As each practitioner and participant have their own styles, each session is different. However, some basic guidelines still apply:

  • The practitioner may use their hands and feet to position the recipient
  • Pulling forces are utilized, such as knuckle cracking; pulling fingers, toes, and ears; walking upon someone’s back, and moving the participant’s body through a multitude of basic yoga poses

All of these criteria must be met, though each therapist has their own personal style. Anyone can benefit from a Thai massage, however, if looking for more invasive techniques, it’s best to look elsewhere.


  • A Thai massage is a method of non-invasive therapy used by those who require ample stretching.
  • A Thai massage is preferred for those who do not have any site-specific pains or strains.


Reflexology, or “zone therapy,” is another nontraditional method of massage therapy. Reflexology utilizes the body’s natural reflexes in the hands and feet of the participant through a series of specific thumb, finger, and hand techniques without the use of oil or other balms.

During a session, which varies from practitioner to practitioner, the body is broken up into ten various zones: five on the left and five on the right. It is believed that the pressure applied to the feet travels through these “zones” through nerve signals, which helps to alleviate muscle tension and pain throughout the body. It is also thought to release some hormones, such as dopamine or endorphins, to help alleviate pain.

However, this evidence is not entirely backed by research. Therefore, reflexology can be utilized for short term and mild pain relief, but should not be sought out for severe medical problems. Even still, any aged person with mild pain can utilize reflexology, and sessions can last up to an hour for more extreme cases.


  • Reflexology is a good option for those looking for a short-term solution for mild pain.
  • Reflexology breaks the body down into ten “zones” and utilizes nerve signals to release muscle tension.

Ashiatsu Therapy

Ashiatsu massage therapy is derived from Chavutti Thirumal, a deep-tissue massage practice that utilizes the feet and legs. It was first developed in the Kerala region of India and has since made its way overseas.

Ashiatsu is a barefoot style of massage, where the masseuse holds onto either a rope or parallel bars above the client and presses into their back with their feet. It requires a lot of oil and a lot of patience. It also utilizes the sesamoid, heel, arch, and/or whole plantar surface of the foot to deliver treatment.

The feet are chosen in this ancient practice because the foot offers wide compression, shear forces, and tension without the pain normally associated with the elbow. It is most ideal for large muscles in the legs and back, and also for long-duration compression upon the trapezius muscle in the upper back.

Because of its strange nature, Ashiatsu is hard to come by in a typical spa or clinical setting. However, if found, it can be proved beneficial for someone with tight muscles and sensitive skin, as it’s less invasive than other deep tissue offerings.


  • Ashiatsu is a very invasive massage style that is good for those who suffer from back injuries.
  • Ashiatsu focuses on using the feet to release muscle tension.

Structural Integration Therapy / Rolfing

Structural Integration therapy, or Rolfing, is another form of alternative medicine. It was developed by Ida Rolf in the late 1800s, and its goal is to combine superficial and deep tissue therapy work with movement prompts. Rolf believed that the body contained a special “energy field” that benefited when aligned with the Earth’s gravitational field, and works to realign the body’s fascia with the Earth’s gravitational field.

However, it is not entirely proved whether or not Rolfing is effective for long-term health benefits.

Like deep tissue work, Structural Integration therapy works on manipulating the fascial layers of the body. It’s known to be quite painful. Rolfing is normally done in a ten-step series called “The Recipe.”

  • The first three sessions focus on the superficial fascial layers
  • The next four work on the deeper tissues, especially in the pelvis
  • The final sessions encompass the entire body

Typically, sessions last anywhere from an hour to an hour and a half. Though it can be painful either during or after the sessions, Rolfing has been used on all age groups — from children to the elderly — and normally involves sitting, lying, and standing.


  • Structural Integration therapy is broken up into ten sessions that each focus on a specific fascial layer.
  • Rolfing is a good option for those who suffer from mild to severe fascial strain.

Lymphatic Drainage Therapy

Lymphatic drainage therapy is supposed to drain the lymph, which carries waste products away from the tissues and back towards the heart. Lymphatic drainage uses both pressure and rhythmic movements to encourage lymph drainage. Since both the smooth and hard muscles are required to drain the lymph in a normally functioning system, this practice soothes the muscles and allows the lymph to drain.

Lymphatic drainage was developed by Emil and Estrid Vodder in the 1930s. It became widespread in France after World War II, when they noticed that several soldiers had swollen lymph nodes.

Today, however, there is no clear indication that lymphatic drainage therapy has any long-term health benefits. Men and women of all ages can have the therapy performed in a clinical setting only, and sessions vary in length depending on the severity of the lymph nodes.


  • Lymphatic drainage therapy is used primarily for short-term relaxation of the smooth muscles.
  • A lymphatic drainage is a good option for those with a clinical inability for lymph drainage.

What is a deep-tissue massage?

Deep tissue massage is a massage technique that’s mainly used to treat musculoskeletal issues, such as strains and sports injuries. It involves applying sustained pressure using slow, deep strokes to target the inner layers of your muscles and connective tissues. This helps to break up scar tissue that forms following an injury and reduce tension in muscle and tissue.

It may also promote faster healing by increasing blood flow and reducing inflammation.

Read on to learn more about deep tissue massage, including how it stacks up against Swedish massage and what to expect during a session.

What are the benefits of deep tissue massage?

Deep tissue massage offers both physical and psychological benefits. Unlike other massage techniques that focus on relaxation, deep tissue massage helps to treat muscle pain and improve stiffness. But it can still help to you unwind mentally, too.

A 2014 study involving 59 participants found that deep tissue massage helped to reduce pain in people with a chronic low back. The authors likened its effects to those of nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil).

People have also reported that deep tissue massage helps with:

  • sports injuries
  • fibromyalgia
  • plantar fasciitis
  • high blood pressure
  • sciatica
  • tennis elbow
How does it compare to Swedish massage?

Deep tissue massage and Swedish massage are two different types of massage therapy. Both use some of the same strokes, but they have different uses and vary greatly when it comes to the amount of pressure used.

Here are the key differences between deep tissue massage and Swedish massage:

  • Intended use. Deep tissue massage is primarily used to treat chronic pain and muscle and sports-related injuries. Swedish massage is mainly used to promote relaxation and reduce muscle tension caused by everyday activities, such as sitting at a computer.
  • Pressure. Swedish massage is a gentler form of massage that uses far less tension than deep tissue massage. Both types involve the use of the palms and fingers to knead and manipulate your tissues, but the elbows and forearms may also be used to apply increased pressure during a deep tissue massage.
  • Area of focus. Deep tissue massage targets the inner layers of your muscles. It’s used to treat muscle and tendon injuries, pain, and stiffness in your major muscle groups and joints. Swedish massage targets the superficial layers of muscle and focuses on the parts of your body that tend to hold the most tension, such as your neck, shoulders, and back.
What happens during the massage?

Before your deep tissue massage, your massage therapist will want to know about your problem areas. A deep tissue massage can involve your entire body or just one area.

Once ready, you’ll be asked to lie on your back or stomach, under a sheet. Your level of undress is based on your comfort, but the area being worked on will need to be exposed.

The massage therapist will warm up your muscles using a lighter touch. Once you’re warmed up, they’ll start working on your problem areas. They’ll use deep kneading and stroking with varying amounts of intense pressure.

Are there any side effects?

It’s not unusual to have some lingering soreness for a few days following a deep tissue massage. Using a heating pad or a cold pack wrapped in a towel may help to relieve soreness.

Though massage therapy is generally safe, deep tissue massage uses very firm pressure and may not be safe for everyone.

Speak to your doctor before having a deep tissue massage if you:

  • have a history of blood clots or a clotting disorder
  • are taking blood thinners
  • have a bleeding disorder
  • have cancer or are undergoing cancer treatment, such as chemotherapy or radiation

Anyone with osteoporosis or cancer that’s spread to the bones should avoid deep tissue massage as the firm pressure used may cause a fracture. You should also hold off on deep tissue massages if you’re pregnant. Gentler types of massage, such as Swedish massage, maybe a better option.

If you have an open wound or skin infection of any kind, you’ll need to reschedule to avoid developing new infection or making an existing one worse.


Therapeutic Massage Santa Barbara, Goleta, Ca Santa Barbara Massage Therapy,  Licensed Massage Therapist, Lymphatic Therapy Santa Barbara, Sports Massage Santa Barbara,  Pain Relief Santa Barbara, Deep Tissue Massage.

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.