MINA DIARIES: on deep tissue massage

One of my most frequently requested modalities of massage is deep tissue. Fortunately for me, I not only learned how to do deep tissue work in school, I also have researched different methods and have worked a lot with athletes. (Many of the athletes were marathon runners, though some of them were also college football players or olympic athletes, and one was even pro, but I won’t be name dropping here). A couple of years into my career, I realized I had never come across a formal definition of deep tissue massage and wondered why.

The answer, as it turns out, is the same answer for why Swedish massage has been redefined the way it has — the American Spa industry. Spas wanted a way to let clients know their therapists could work on them with deeper pressure, so the term “deep tissue massage” was coined. Without creating one unifying defining statement about what deep tissue is, spas simply used this term in a general way so the public would know they could get a massage with deep, therapeutic results.

From that, there have been various definitions that attempt to encompass what exactly deep tissue work is. Some simply define it as a massage with deeper pressure. Some specify that it is a massage that works on deeper muscles or even fluids of the body (see Craniosacral Therapy, which many of its practitioners define as deep tissue because it alleges to work on the cerebrospinal fluid, but does so with a light pressure). Others say that it is a technique where we work against the grain of the superficial muscles, and still others say that it is work WITH the grain of the deeper muscles, essentially massaging the deep muscles with the superficial ones through friction. And many will remind you not to forget that deep tissue work includes work on that thick connective tissue, the fascia, that is found throughout the body (look for a newsletter on facia here in the future). 

I think it can be an umbrella term to encompass all these understandings. I also think deep tissue work can be achieved through a variety of techniques from around the world. So, I chose my three favorite techniques, learned them as best I could and added them to the menu. I will explain them here, in no particular order. 

BALINESE MASSAGE: I really like this modality not only because it encompasses pressure and trigger point work but because of its use of friction. Thumbs are traditionally used for trigger point, but in Balinese massage you can also use a wooden tool such as rosewood, which is what I do. I always begin with thumb work, so that I can feel for myself what’s going on in the tissue. After that, I use the warmed rosewood tool to really dig in. The tool is smooth and shaped sort of like a dolphin, so I can hold it in my fist and use the broad, wider side, or hold it between my fingers and use the pointed end. This strategy of deep direct work the Balinese call “pikur”. Then I do friction work with the thumbs or rosewood tool (called “digdag”,) followed by deep palm friction (“pukulan”). The benefits of this type of friction blended with deep targeted work include reduced muscle tension, increased circulation, reduction of inflammation, and improvement of tissue pliability. What that will feel like to you is akin to a sort of muscle “release”; muscles that were once taut and high-toned will begin to relax and let go. This modality is traditionally performed with a blend of rice bran and coconut oils combined with your choice of lemongrass or frangipani (a tropical flower originally found in Morocco). It also includes a spot-treatment oil, meaning a pain relief oil applied to one spot on the body (and it’s an intense oil, so you really would only want it applied to one area. I had a Balinese massage in Greece that was fantastic but the man bathed my body in pain relief oil, so I was cool and tingly all over). I use Red Siang Pain Relief Oil with menthol and camphor. The camphor blends warmth with the cool of menthol for a warm-cool sensation similar to Icy Hot, but with a more pleasant, spicy scent. 

LOMI LOMI: Hawaiian massage can be done with any pressure from light to deep, but I have recently added “Lomi Deep” to the massage menu because I want all my clients to know and be able to experience the joy of a deep tissue Lomi Lomi massage. The strokes that are best utilized for deep tissue in Hawaiian massage begin with “Kahi”, gliding strokes with the forearm that can begin lighter but can proceed to deeper and deeper pressure, followed by deeper elbow strokes to target specific areas. “Kupele,” kneading strokes, can be done with lots of pressure, as can work with the heated guava wood tool. This tool is shaped like a rounded stick with one angled edge, and can be used to glide or to dig in. Lomi Lomi Deep Tissue not only decreases muscle tension and improves pliability but also activates the parasympathetic nervous system so that muscles and fascia can naturally “let go.” This modality also can include passive stretching or pin-and-stretch, where I compress a muscle while stretching an adjacent muscle, for increased range of motion and relief of joint pain. I perform Lomi Lomi Massage with a blend of rice bran, kukui nut oil (nut free option if you have an allergy), plus a blend of lotus and grapefruit oils which make for a serene yet uplifting scent.

BAMBOO DEEP TISSUE: Years ago I took a class in something called “Mu Xing Massage.” “Mu xing” means “wooden tool” in Chinese (Mandarin or Cantonese, I’m not sure which) and uses a blend of long and short bamboo sticks. Some of them are round, like the guava stick, while others are semicircle; they’re called “full moon” and “half moon” sticks. The full moon sticks glide across muscles, and I can also use the smooth, rounded ends to dig in to muscles and fascia. The half moons, I can grip at either end and push them in a sort of ‘ironing out’ motion. Yes, I iron out your body with heated sticks and it is glorious. If you like the combination of warmth and deep pressure, this is the best choice for you because I use the bamboo sticks throughout the massage and the pressure plus heat makes muscles more pliable, relieves aches and pains, and boosts circulation. You get to choose your aromatherapy for this massage.

There are many other deep tissue techniques out there, and I plan to learn more, so stay tuned. If you are the type of person who does not shrink away from a lot of pressure, I commend you because I am not one of those people. I read a massage textbook once where some famed massage therapist proposed a 1-5 scale to measure pressure, 1 being lightest and 5 being deepest. I can probably tolerate about a 3.5 to 4. This type of measurement hasn’t been widely adopted, probably because there’s too much variability between therapists and cultures to agree on what constitutes a specific pressure measurement, but I think it’s a good guideline. Especially for individual therapists, because we know what our own maximum and minimum pressures we deliver. 

For every client, I record in my notes what pressure I used so I can either duplicate the pressure level or adjust it the next time. If you know you like “deep tissue” massage but don’t know what level of deep tissue you like, that’s okay. I’ll work with you to figure it out. And if you want to try one of these modalities but don’t want it to be “too deep,” that’s okay too. Any therapist who can deliver a lot of pressure can also deliver less! I will not only listen to what you tell me, but listen to your body to figure out what works best for you. If I feel you contracting your muscle or shrinking under the pressure, I’ll adjust my technique. If you’re one of those that isn’t hurt by anything ever, we’ll increase the pressure as needed. 

When it comes to deep tissue or other types of therapy that cause what some people call “good pain”, some people have found it works not only on muscles, fascia and the nervous system directly, but also works to relieve pain indirectly due to what’s called the Gate Control Theory. This is a broader theory of our experience of pain developed in the 1960’s. According to this theory, our experience of pain is controlled by “gates” in the spinal cord that control the nerve signals of pain that are sent to the brain. While you’re experiencing deep tissue massage, the messages of pressure and “good pain” override the messages of a muscle or joint aching. This explains the temporary relief people find from their pain during a deep tissue massage. But with the right sets of techniques to address specific muscle, fascia and joint issues, deep tissue massage has long term benefits in addition to short term.

I hope you’ll book your next deep tissue massage with me, and if you want to try a combination of techniques, don’t worry — you can always select the “Signature Massage” option and let me know what you think will work for you. I can also give you recommendations in terms of stretches, postural adjustments, ergonomic adjustments, and home care (home care sounds much more soothing than homework, I feel like). My clients all feel better and have better results when they do their home care (though if they don’t do it, they just have to see me more often, which I can’t really complain about). 

Also look out for new herbal hot packs coming soon! It’s almost the season to actually start enjoying these again, and I hope you’re looking forward to it as much as I am.