Everything You Need To Know About Deep Tissue Massage & Why You Shouldn’t Fear It

Many people have a misconception when it comes to a deep tissue massage. Everyone thinks it’s going to be extremely painful, they are going to be black & blue afterwards or you are going to limp out of the treatment room. No pain, no game- right? WRONG! I specialize in deep tissue massage and trigger point therapy and as a Registered Massage Therapist at Choice Health Centre I am here to help educate you on what to expect in a proper therapeutic deep tissue massage.

What Is a Trigger Point & How Do They Form?

A trigger point is a specific spot in your muscles which has a buildup of lactic acid, that, over time, creates a very specific and controlled pain point in your body. The lactic acid is formed from a decreased amount of oxygen in your muscles. Your muscles burn oxygen when you workout, sit at a desk, watch TV-  even when you don’t realize it! In fact, the sustained muscular contractions needed to hold a prolonged posture are often the muscles that develop trigger points, as there is less movement, less blood flow and therefore, less oxygen through these tissues to flush out the lactic acid.

How & Why Do Trigger Points Refer Pain?

Trigger points refer pain when the muscle is at its maximum capacity of lactic acid that it can store. Think of your muscles as a water balloon. When there is just the right amount of water, the balloon has a nice shape, you can move the water around with ease and the walls of the balloon aren’t over stretched. If there is too much water, there is no room for the water to go and it pushes on the walls of the balloon (i.e. your skin) making everything very tight (causing pain) and the walls misshapen. If there is too little water, the balloon won’t have enough in it to keep its shape, there is too much unoccupied space and things don’t move as fluidly as they should.  You need just the right amount of lactic acid in a muscle to keep it healthy, working properly and ready for use.

Trigger points have very specific pain patterns that have been mapped out through extensive amounts of scientific research. The first to research trigger points was medical physician Dr. Janet Travell (happened to also care for President Kennedy’s back pain) and her co-researcher, Dr. David Simons. The work of Travell and Simons as well as Andrew R. Biel, a fellow Registered Massage Therapist, who wrote the award winning book “Trail Guide to the Body” has changed the way health care practitioners assess and treat myofascial (muscular and fascial) pain.

Therapists use their hands to place a specific amount of pressure on a trigger point in order to release the lactic acid build up. When a trigger point is releasing, it sends out a signal to a different part of your body called a referral pattern. Referral patterns can be quite intense, but only for the first 10-15 seconds depending on the severity of the trigger point and how long it’s been there. An example of a common trigger point is that of the trapezius muscle, which is often the source of a tension headache- when this trigger point is being released, patients can feel the pain into their head that almost to a tee mimic’s their tension headache.

Deep Tissue Massage Should Not Be Painful

We don’t all have the same pain tolerance and a good therapist will work within the patient’s own tolerance. We use a pain scale from one to ten, one being little to no pain and ten being the most painful experience you’ve had in your life. When releasing trigger points, I get the patient to go up to a six out of ten on the scale, meaning you should feel pain present but be able to talk your way though it & breathe normally. If you are holding your breath or can’t sit still it is probably too much pressure. Keep in mind pressure is a preference, a six out of ten for you will be different for someone else.

Communication is Key During A Massage Treatment

“No pain, no gain” is not acceptable. The goal is to safely & effectively remove the trigger points without causing the patient excessive pain. Getting the muscle to twitch during trigger point release is all we are trying to recreate. When your muscles are twitching that means the lactic acid is being forced out and your muscle is released. Sometimes we don’t even need to get to that six out of ten on the scale to produce these results. As long as the muscle firing gives off the appropriate response,  that’s all we are looking for. In the end it is YOUR treatment. Don’t suffer in pain because you were too shy to tell your therapist to ease up.​

Flushing, water, heat and stretching are all huge components in a deep tissue massage. After doing any form of deeper work you need to flush out the area being worked. When you force out lactic acid you are also releasing all the blood in the muscle. If you do not flush the area out, which is basically long, lighter passes on the muscle tissue, the muscle does not have the fluids it needs to thrive. This is going to help increase circulation to the muscle & move around lactic acid around.

  • Once released the acid cannot get back into the muscle- it dissipates into your body. Drinking lots of water helps to rid your body of it as well as other toxins released by treatment.
  • Heat will also help not only bring blood flow to the surface but heat is beneficial for muscle rehabilitation.
  • Stretching is also important to elongate the muscles, help the circulation of those important fluids and keep those muscles flexible, strong and healthy.

When coming out of a deep tissue massage you may feel a little sore or tender. If you are coming out of treatment black & blue, stiff & unable to move your therapist has not flushed correctly therefore creating Delayed- Onset Muscle Soreness (DOMS). This is caused by either not fully releasing a muscle, too deep/too much pressure or triggering a protective muscle spasm. A good massage therapist can effectively treat any & all conditions without harming someone severely. A certain degree of DOMS the day after a massage is expected, but it will feel like you just had a good workout, not been hit by a truck.

So remember the next time you see your friendly neighbourhood massage therapists … TALK! Ask questions during the massage, let your therapist educate you on what condition you have and how they can fix it. Too much pressure?  Don’t like a certain technique being done? Let them know! Unsure if they can treat a specific injury? Ask! Still unsure about deep tissue? Come see me, I would be honoured to help you!

To book an appointment with Michael Chappelle, RMT or one of our other health care professionals at Choice Health Centre call (902) 404-3668 or book online.

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