Why are some clients sore after a Deep Tissue Massage and others are not?

Replies to This Discussion

Permalink Reply by Gary W Addis, LMT on July 3, 2011 at 5:18pm

I googled it and watched a youtube video that wasn't very informative.   Finally found an article about the different reflex responses posted by a university.  Then I tried it on myself.  According to the video, clasp-knife reflex is referring to a leg reflex only.  But the article said that the principle can be applied to all reflex actions.  So I set my lower leg up, tapped the patella tendon and got the reflex kick; then gripped the arm of the chair hard with one hand and tapped the tendon again--the reflex response was much much stronger.  I take it the point is that when the mind is distracted with another task, and not interfering, the muscle reflex action is much stronger.  Is that what your'e referring to?

 

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Permalink Reply by Gary W Addis, LMT on July 3, 2011 at 5:40pm

Wow, Lolita, that's an average of 65 per month...16 per week,  for 32 years.  I know a couple of skilled local MTs who think they're having a good week if they log five in a week.  A friend working in one of the casino spas on a normal day does 8 consecutive massages without a pause.  In total during my one year in MT, I've performed maybe  50 hour-long table massages and 20 or so chair massages.

Gordon, during a massage I zone out everything except the feel of the soft tissue on my table; my eyes tend to close naturally as I listen to the tissue.  In the beginning I couldn't do that, I had to make certain I followed the school's protocol, counting strokes, etc.  Now, the client's body dictates the flow and direction of the massage.
Lolita Knight said:

With 32 years of experience of full time massage, I have literally given over 25, 000 massages and still love my profession.  The first 2 years I bruised clients and they were sore afterwards, but were better and willing to accept the painful side effects.  Then I changed and did 85+% cross fiber strokes, warmed the tissue first, did my deep strokes slowly and then "flushing" strokes followed by relaxation massage.  Now very very seldom is there soreness or bruising.  In 1997, when in Fiji, I learned barefoot massage and found that the foot was deeper yet more gentle than my elbow and developed the Fijian Massage which I now teach as well as various Deep Tissue methods in my Panoramic Deep Tissue classes.  In these classes I stress not only a slow speed, but to add pauses so the circulation can benefit the muscle immediately after the deep tissue cross fiber strokes. Details on my web page www.fijianmassage.com.

Perhaps when your clients were not sore, you were doing more cross fiber, going slower or having pauses.  hope this helps.  Lolita Knight

 

kristi marco said:

Gordon J. Wallis said:

Just another comment.   To me at this point.. Deep tissue or not deep tissue, means nothing to me..There is only one kind of massage.. And thats a GOOD ONE.  Thats it...Only one kind.. One thats so good, they dont wanna leave...And they cant wait to get another one.. Thats it.  Deep tissue means working specifically as opposed to working generally. . Everybody has a certain pressure that feels so perfect to them regardless if you are using your palm, thumb or elbow. Holding steady on one point or moving in broad  strokes. ..But we as therapists,give them two choices.. Deep tissue or not deep tissue..   But what they (clients) really want is a  Good Massage..  A massage with perfect pressure...its not taking pain or breathing through it or anything..Thats b*******..lol   What most people want is firm substantial massage that feels really freakin good...Call it what you want.. Again, just telling you MY truth. Not arguing or challenging...Just telling you My Truth...But we all have our perspectives.. Jesus means something   completely different to a Hindu then to a Christian...So...just telling you My Truth.  Uhm, also, not trying to dominate this issue...or tell anyone Im right and you are wrong...I think we all believe what we want anyway..

Gordon J. Wallis said:

Its hard to explain things online, in print.. But I can tell you..Its not even a remote issue for me any more...It was for the first ten years...But not at all for the last 16.  A zero issue now..  Not arguing...because we are just typing.. and words are open to interpatation.. so,,just at least consider what Im saying is all..Thats why I commented...Cause Im making money because of this issue... Every time I gain a new client thats been seeing another therapist.. Had one today...Its because the massage hurt too much, or it was too soft.. Otherwise they wont leave you.  And when they say I want deep tissue..you know its because other massages have been to soft...And when they say, I dont want deep tissue, its because other massages they've had were too hard...Good healing massages feel so freakin good you dont want em to stop.. Thats it.   Trust me...for the last 16 years, its been a none issue for me....but we all have our own path,, and Im not saying I know it all.. Cause I dont... lol   But I know that issue is a pretty good source  of income for me.. lol  Worth thinking  about.  I made $60.00 off it today.

Alyson Schlobohm said:

Nyema, I completely understand where those clients are coming from. I ALWAYS ask a client what type of pressure they want for that session, no matter how many times they've been in. Even if they say something along the lines of, "Oh, I like a TON of pressure", I ask them if they mean Deep Tissue specifically. If and when they say they want Deep Tissue, I tell them there is a possibility of becoming sore, taking all precautions before I actually perform Deep Tissue work. What is "general adaption syndrome"?

 

Gordon, I don't mean any disrespect because I realize you've been practicing much longer than I have, but I'm not sure that's the answer. When I'm performing DT work, I ALWAYS tell my clients to keep their pain threshold around a 7 or 8 on a scale of 1-10, then I watch for signs of pain and check in with them verbally concerning the pressure throughout the massage. I have a dozen clients that I've used the same amount of pressure on and some develop soreness, others don't and this is what's baffling me.

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Permalink Reply by Therese Schwartz on July 3, 2011 at 6:20pm

Gordon, I had one of those days last week!  Job hazard...

 

About the pressure - people really don't know what kind of pressure they like.  They aren't stupid, but they don't know.  Gordon, I really agree with you. People who say they only want light or moderate pressure can take a lot more if it's a slow, careful broad stroke that engages a lot of tissue.

 

I mentioned something about people's belief systems in an earlier post.  You really are engaging the beliefs with massage.  And boy can that be a challenge!

 

Boris, if you are still reading this thread, your article about the different types of pain felt after massage was really helpful!  It makes so much sense and I'd never heard it put so clearly.  Also, thanks for your comments on Epsom salt baths.  I never really got that whole Epsom salt bath thing.

 

Gordon, I doubt the Wikipedia article on an oak tree would mention its energy field! :)

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Permalink Reply by Boris Prilutsky on July 3, 2011 at 7:44pm

Dear Therese.

I'm really glad to learn that you liked my article “ aggravation by  massage VS. reaction”. most important is that you find it helpful.

 As I have stated in my article ,there is many causes for post-massage pains that could be just, positive reactions, restrains, emotional releases that will provoke some pain as well unpleasant coincidences. For example. One year ago , multiple locations SPA at South California did invite me to be witness expert in case of supposedly postmassage disc herniation that lead to surgery etc. plaintiff claimed that next morning after massage she developed untolerant pain in neck with terrible irradiating pain to upper extremity . She went to ER and during few weeks after ,got spinal Surgery. Surgery went very bad including permanent damages (loss of reflexs). Claim was more than they possibly could to cover . Plaintiff’s lawyer filed lawsuit against surgeon as well  against SPA. Lawyer that represent SPA’s professional liability insurance have provided me with ER documents. I also prepared questions to plaintiff’s deposition, as well interviewed massage therapist who provided treatment. To make a long story short it was absolutely obvious that massage therapist did nothing wrong to cause disc herniation. The client arrived with nonsignificant neck pain, and received full body stress management massage including on neck area. All disc herniation clinical phenomenon was in process to be developed to ER situation, and this innocent massage as plaintiff and massage therapist described had nothing to do with all this tragedy. Sadly to say that if massage therapist would apply full orthopedic massage protocol instead of just “relaxation” techniques most likely she would prevent pain escalations as well surgery.BTW. We win this case big-time. On cross-examination I provided information that plaintiff’s orthopedic surgeon just couldn't argue differently, and agree with me, that this innocent massage couldn't cause disc herniation.

At this discussion we talking about massive phenomena of trauma by a so-called deep tissue massage. This phenomenon of vigorous pressure

have to be stoped. Few years ago I presented to local fibromyalgia support group, on important role that massage therapy can play in management of this devastating syndrome. I was invited by group leader, who got significant improvement due to massage therapy, as well between audience was a  group of people who got significant improvement from my treatment. At this meeting also presented rheumatologist who consider to be one of the leading experts in fibromyalgia treatments. In the end of presentation we kind became friends, and he stated that maybe to me he will refer some of his patients but never will refer to other massage therapists. I asked him why not? The answer was that he having lists of 200 patients who developed fibromyalgia secondary to this vigorous pressure”massage”. We talking on data of one doctor. Not only fibromyalgia syndrome could be developed due to this vigorous pressure trauma it including but not limited to difficult muscular syndrome developments .

I agree that some school teaching very wrong as well some massage therapists believing that if they will press very strong they will provide good care. No matter where from this wrong notions coming it have to be stopped. I believe that we all investing in such discussions , helping us to stop this phenomena.

Best wishes.

Boris Prilutsky.

Therese Schwartz said:

Gordon, I had one of those days last week!  Job hazard...

 

About the pressure - people really don't know what kind of pressure they like.  They aren't stupid, but they don't know.  Gordon, I really agree with you. People who say they only want light or moderate pressure can take a lot more if it's a slow, careful broad stroke that engages a lot of tissue.

 

I mentioned something about people's belief systems in an earlier post.  You really are engaging the beliefs with massage.  And boy can that be a challenge!

 

Boris, if you are still reading this thread, your article about the different types of pain felt after massage was really helpful!  It makes so much sense and I'd never heard it put so clearly.  Also, thanks for your comments on Epsom salt baths.  I never really got that whole Epsom salt bath thing.

 

Gordon, I doubt the Wikipedia article on an oak tree would mention its energy field! :)

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Permalink Reply by Therese Schwartz on July 3, 2011 at 8:03pm

Boris, for some reason the people coming out of the school I went to want to do the vigorous deep tissue work - really, it is actually brutal.  I'm a massage therapist and I wouldn't go to anyone in town after trying to trade with one of the therapists and she really hurt me. I just recently discovered that one of the massage therapists I've heard about in town was trained at a different school.  I went to her last week and she was fabulous!!

 

I don't know what to do about my friend/colleague who is hurting people.  I need to send her information about how what she's doing can be damaging.  When she's worked on she wants to be hurt as well.

 

Thanks for the information about the case you worked on, and the information from the doctor.  It's more "ammunition" in the case against brutal work.

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Permalink Reply by Joan Cole on July 3, 2011 at 9:41pm

1) It's not just about whether the pressure was too much.  Sometimes it's that your strategy isn't right.  Very often, the actual problem isn't where the pain is.  The pain is an arrow, but the problem is somewhere else, and THAT'S what needs to be released.  Don't go trying to lengthen tissue that is in crisis because it is already overstretched.  Lengthen the tissue on the other side of the chain that is CAUSING the painful tissue to be overstretched.  It's like chess - you need to be reasoning several moves ahead.   

2) Compression isn't the only game.  Often the tissue needs decompression, torsion, shear or needs to be approached from a more oblique angle than what you are attempting.

3) Don't spend too much time in one place, as that DOES tend to traumatize.  If it isn't releasing, hammering on isn't going to make it release.  There may be something wrong with how you have the client positioned.  For instance, they may need to be sidelying for you to successfully position an extremity to release that spot, and trying to do it with them prone isn't going to get you anywhere.  Your angle may be wrong.  Your depth may be wrong.  Try searching in a shallower layer.  You may be working on the wrong spot.  You may not be relaxed in your own body.  Stop and reconsider.  Release something elsewhere in the chain and come back after taking a break.  

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Permalink Reply by Gary W Addis, LMT on July 3, 2011 at 10:47pm

Therese, can it be an idiosyncrasy of the MT and not of the school's teachings?  One of my fellow students was infamous for demanding bone crushing pressure (even directly on bone).  Because she craves the pain she thinks everyone else should also.  The first time I worked on her, when she began to demand, I said, "Sorry, I don't do torture.  But I understand that Gitmo has an open cell."   I proceeded to apply what I perceive to be appropriate pressure when hard pressure is requested (which won't break bone).  With a combination of  compression and deep transverse friction I released the scalenes which were referring to infraspinatus and rhomboids.  But she literally sighed with relief when I found and released trigger points in the bilateral subscapularis.  When she  got off the table she was smiling and relaxed, and remarked that it was the best massage she had ever received.  But did the experience somehow diminish her need to be hurt? Unfortunately, no.  The other day I overheard her telling another student that she really really really needs real hard pressure.  Well, someone else can attempt to please the masochist. I don't do torture. 

Therese Schwartz said:

Boris, for some reason the people coming out of the school I went to want to do the vigorous deep tissue work - really, it is actually brutal.  I'm a massage therapist and I wouldn't go to anyone in town after trying to trade with one of the therapists and she really hurt me. I just recently discovered that one of the massage therapists I've heard about in town was trained at a different school.  I went to her last week and she was fabulous!!

 

I don't know what to do about my friend/colleague who is hurting people.  I need to send her information about how what she's doing can be damaging.  When she's worked on she wants to be hurt as well.

 

Thanks for the information about the case you worked on, and the information from the doctor.  It's more "ammunition" in the case against brutal work.

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Permalink Reply by Gordon J. Wallis on July 4, 2011 at 12:22pm

I didnt say that people that ask for light massage can take a lot more pressure...People that ask for light massage..Have had painful massages before, and dont want that experience again...so they ask for relaxation massage or say they dont like deep tissue..

Boris Prilutsky said:

Dear Therese.

I'm really glad to learn that you liked my article “ aggravation by  massage VS. reaction”. most important is that you find it helpful.

 As I have stated in my article ,there is many causes for post-massage pains that could be just, positive reactions, restrains, emotional releases that will provoke some pain as well unpleasant coincidences. For example. One year ago , multiple locations SPA at South California did invite me to be witness expert in case of supposedly postmassage disc herniation that lead to surgery etc. plaintiff claimed that next morning after massage she developed untolerant pain in neck with terrible irradiating pain to upper extremity . She went to ER and during few weeks after ,got spinal Surgery. Surgery went very bad including permanent damages (loss of reflexs). Claim was more than they possibly could to cover . Plaintiff’s lawyer filed lawsuit against surgeon as well  against SPA. Lawyer that represent SPA’s professional liability insurance have provided me with ER documents. I also prepared questions to plaintiff’s deposition, as well interviewed massage therapist who provided treatment. To make a long story short it was absolutely obvious that massage therapist did nothing wrong to cause disc herniation. The client arrived with nonsignificant neck pain, and received full body stress management massage including on neck area. All disc herniation clinical phenomenon was in process to be developed to ER situation, and this innocent massage as plaintiff and massage therapist described had nothing to do with all this tragedy. Sadly to say that if massage therapist would apply full orthopedic massage protocol instead of just “relaxation” techniques most likely she would prevent pain escalations as well surgery.BTW. We win this case big-time. On cross-examination I provided information that plaintiff’s orthopedic surgeon just couldn't argue differently, and agree with me, that this innocent massage couldn't cause disc herniation.

At this discussion we talking about massive phenomena of trauma by a so-called deep tissue massage. This phenomenon of vigorous pressure

have to be stoped. Few years ago I presented to local fibromyalgia support group, on important role that massage therapy can play in management of this devastating syndrome. I was invited by group leader, who got significant improvement due to massage therapy, as well between audience was a  group of people who got significant improvement from my treatment. At this meeting also presented rheumatologist who consider to be one of the leading experts in fibromyalgia treatments. In the end of presentation we kind became friends, and he stated that maybe to me he will refer some of his patients but never will refer to other massage therapists. I asked him why not? The answer was that he having lists of 200 patients who developed fibromyalgia secondary to this vigorous pressure”massage”. We talking on data of one doctor. Not only fibromyalgia syndrome could be developed due to this vigorous pressure trauma it including but not limited to difficult muscular syndrome developments .

I agree that some school teaching very wrong as well some massage therapists believing that if they will press very strong they will provide good care. No matter where from this wrong notions coming it have to be stopped. I believe that we all investing in such discussions , helping us to stop this phenomena.

Best wishes.

Boris Prilutsky.

Therese Schwartz said:

Gordon, I had one of those days last week!  Job hazard...

 

About the pressure - people really don't know what kind of pressure they like.  They aren't stupid, but they don't know.  Gordon, I really agree with you. People who say they only want light or moderate pressure can take a lot more if it's a slow, careful broad stroke that engages a lot of tissue.

 

I mentioned something about people's belief systems in an earlier post.  You really are engaging the beliefs with massage.  And boy can that be a challenge!

 

Boris, if you are still reading this thread, your article about the different types of pain felt after massage was really helpful!  It makes so much sense and I'd never heard it put so clearly.  Also, thanks for your comments on Epsom salt baths.  I never really got that whole Epsom salt bath thing.

 

Gordon, I doubt the Wikipedia article on an oak tree would mention its energy field! :)

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Permalink Reply by Boris Prilutsky on July 4, 2011 at 12:35pm

Hi Therese.

Happy Independence Day.

You said :” I don't know what to do about my friend/colleague who is hurting people.  I need to send her information about how what she's doing can be damaging.  “Actually my believe is that discussions like this can make big different. We all who cares should forward links to this discussions to friends, including but not limited to your friend/colleague who is hurting people, as well to instructors from your school. It is fair, honest and right things to do.

Sometime people choosing to be “kind” and “nice” and  not   speaking out on subject directly to the people who performing this brutal techniques as well to instructors who teach it wrong. In my opinion this is   not responsible, not professional, not loyal to our industry, and not fair and moral to all parties but first of all not moral to our clients. Clients who trusting us.Joan Cole as well my friend Gary proposed some ideas that hard to argue with, but in my opinion we all meantime should focus on the vigorous pressure because in most cases this kind of false dramatizing DTM is the main cause for post-massage pains. Phenomenon is huge to ignore it and to look for different reasons. The bottom line is that there is no such a thing DTM. Any clinical work should be directed not only to superficial tissues but also to deep tissues. We are stimulating and mobilizing not only muscular tissues, but also fascia that first layer is very superficial as well techniques are very different from muscles mobilization techniques. How this crazy pressure mobilizing this soft issues? If one press  vigorously and cannot explain why he/she doing so, it means that one don't know what she/ he doing. If one don't know what she/he doing and why one pressing vigorously one shouldn't do it in first place. Simple like this. If one don't know one not doing it. Let's all of us focus on it and we will make different. We'll help our colleagues as well will protect our clients.BTW.you graduated from the same school but thank God somehow realized that this traumatizing pressure is not a therapy but opposite. We can make different on this.

Best wishes.

Boris

Therese Schwartz said:

Boris, for some reason the people coming out of the school I went to want to do the vigorous deep tissue work - really, it is actually brutal.  I'm a massage therapist and I wouldn't go to anyone in town after trying to trade with one of the therapists and she really hurt me. I just recently discovered that one of the massage therapists I've heard about in town was trained at a different school.  I went to her last week and she was fabulous!!

 

I don't know what to do about my friend/colleague who is hurting people.  I need to send her information about how what she's doing can be damaging.  When she's worked on she wants to be hurt as well.

 

Thanks for the information about the case you worked on, and the information from the doctor.  It's more "ammunition" in the case against brutal work.

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Permalink Reply by Lolita Knight on July 4, 2011 at 12:36pm

I assume this a reply to Gary so hope I am following the thread correctly.  Yes there were several years when I averaged 35-42 hours of massage per week with 95% wanting and getting deep tissue massage.  I cringe when therapists say they can only do 5 hours per day.  With the Fijian Massage, massage tools and  cross fiber elbow strokes with leaning in with your hip with the opposite elbow it is easy to do 35-40 hours of massage per week.  Lolita

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Permalink Reply by Lolita Knight on July 4, 2011 at 12:45pm

Think I am replying to both Gary and Gordon.  Gary, did you call to remind your clients of their appointments.??  Also, I often give 2 hour massages.  In fact, for me to give a full body massage takes 4 hours.  This is like a body tune-up massaging the sides of the fingers, the top of the fingers, the bottom of the fingers etc etc.  Plus  you have the option of giving a deep tissue followed by a relaxing massage or a facial/scalp massage.

Gordon--I try to not ask "yes or no" questions about pressure.  i.e. "is the pressure okay" as they normally say "yes" but could mean "no".  Instead I ask "Would you like the pressure lighter or deeper".  That way they have to think and tell you exactly what they want. cheers, Lolita

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Permalink Reply by Daniel Cohen on July 4, 2011 at 12:56pm

I have been blending my deep tissue Korean Martial Therapy with Lomi Lomi and my clients love it. With the long soothing strokes of lomi and the deep tissue pressure of KMT I can get in deep but then do a sweeping stroke that makes them feel like a cuddled baby. A bit like my friend Klemens video http://www.youtube.com/watch?v=D3zhqbpkK68. It inspired the massage I've been doing lately. I still cause some pain (not injury) but it is gone as soon as I release and the pain they came with is gone.The two go well together since they both use lots of arm work.

 

Boris I like that you mention the layers of fascia, superficial and deep. We are doing massage and it is about the body and its many parts.

 

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