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Why are some clients sore after a Deep Tissue Massage and others are not?
I've been practicing Massage for about a year now. During the Massage Program I completed, we learned Deep Tissue and even practiced it on each other. I always tried to work with one person in particular because she was so strong and did amazing DT work. There were times when I felt as though the pressure was too much, but I never told her to let up and I never developed any soreness - of course, at this point, we were practicing on each other 3-4 times a week, meaning I was getting several Massages each week for several months.
In the past year, since finishing the program and working on my own, I've come across a lot of different levels of soreness after DT work. I have some clients who come in, haven't had a Massage in a couple of years, receive a DT Massage (and I know I'm strong based on client feedback) and have NO soreness. I have other clients who come in and are extremely sore after their first DT Massage, and then I have OTHER clients who are not sore after their first couple of DT Massages, but become sore after their third, fourth or fifth DT Massage. I've even put together a spreadsheet looking for any sort of consistency in what causes the soreness, but I have yet to come across any patterns.
Two other factors - I ALWAYS do Trigger Point work when I do DT, and I try to ensure that I work slowly - starting superficially and working deeper.
Does anyone know or have a theory on why some clients develop soreness, why some never do, and why some develop it later after several treatments?
Views: 44188
Replies to This Discussion
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Permalink Reply by Gordon J. Wallis on
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Well it makes things very clear to me...but no use arguing . Even if its incorrect (it is though) Results are what count..And Im getting really good results now with my clients that need trigger point work.. Very good results...Way better then ever before. The first person that I treated with a trigger point problem that I know of was in 1985 ,and I made them go away then...its 2011 now...Could I have possibly learned anything during that time period? Trigger points are way easier to get rid of now.. Way easier.
Boris Prilutsky said:
Gordon. There is many different ways and causes for trigger points development,as well there is different types of trigger points but all of them having the same morphology, as well and therefore was developed adequate treatmentby applying different techniques.for example techniques for subcutaneous TP is a different than direct compressions,against localization of motor trigger points,but in both cases we contributing to additional ischemia for 30 seconds in order to trigger adequate blood supply. The data presented at this vid. Is correct and in case if muscles will be not strained never pain will be developed. at the time,proposed information has nothing to do with act of TPT.this is crucial to separate in order to be on one page at this discussion including but not limited to TPT.
Best wishes.
Boris
Gordon J. Wallis said:
http://www.youtube.com/watch?v=HcWX-b07qqM&feature=related That explains what Ive been saying... I dont just make stuff up...
Gordon J. Wallis said:
Boris...I call then sore spots now....trigger points , knots, or whatever.... Sore spots is good enough for me now...and I use different techniques to make them go away as best I can...And Im better at it now then I ever have been. I just call them sore spots now...And if they are pretty much in the belly of the muscle somewhere..I can make them go away. Quite often.
Boris Prilutsky said:Hi Gordon.
Practically I am possessing all works of Dr.Travell including books that she wrote with Dr.Simons.I believe you are mistaking them mentioning " muscle knots" as a term. most likely you saw it at some other books. More than this I don't believe that any pathology and histology texts referring as well as describing muscle knots as a pathological changes within muscles or mentioning it at all. I believe that"muscle knots" is a sensation description by people who is suffering from pinpoint pain localization .as a practitioners we shouldn't keep in mind "muscle knots"pathology in our minds because it can lead to some techniques that can harm. I mean if pathology is not existing and you trying to apply some techniques to "open up muscle knots"it can be not only not productive but also traumatizing.On the other hand morphology of trigger points is very much known fact, as well proposed treatment designed to address this blood supply insufficiency to this particular inflamed cells. Have a proposal let's stop in our discussion to use this term, and let's stop simplifies massage therapy in general including simplifies adequate trigger point therapy that's a little bit more demanding then you have described in your posts.
With respect.
Boris PrilutskyGordon J. Wallis said:
Boris, I dont have that book anymore...I read it when it first came out like five times...I formed my entire massage around the information in that book. The information is in there somewhere. The entire book is about muscle knots (trigger points).
Boris Prilutsky said:Hi Gordon.
Couldn't find term" muscle knots" at Travell's texts.will appreciate if you will refer to page.thanks.
Boris
Gordon J. Wallis said:I hope it is in a text book...Ive never seen it in a text book. Well not a massage book.. Travells Myofacial Pain and Dysfunction is where I got that or figured it out from back in the eighties. I have asked many many therapists if they can tell me what a knot in a muscle is....Im talking hundreds of therapists.. Probably weakly sense 1986.. lol They dont know this.. So , I hope it is in a text book...Trigger Points are crucial to understand, if you want to be a massage therapist..Crucial.
Massage Gnome said:Hi Gordon,
You mention that this is not taught in schools but it is in all the textbooks I have seen. Was this not in yours?
Gary W Addis said:Gordon, that is an absolutely eloquent explanation, an actual explanation of what causes the damage--thank you.
Stephen Jeffrey said:Gordon's explaination from knot in muscle thread. =
Hmm.....How do I say this???? Well first off...I'm not trying to start any aguments in here...Or challenge anyone as to what they think.or whats real...Like my way or the highway... Im right your wrong kinda thing... But Ive been doing this kind work for 26 years now..So I think what I say should at least be considered. That's all... Not saying that I might not change my mind later?...And Jody Hutchenson gave a really interesting answer, that made sense...But I came up with something comletely different?? I think they are both true.. And I will try to integrate Jody's definition, in with mine.. Does that make sense? Anyway .. Hardly any massage school teaches what a knot in a muscle is, from what I can tell?? And I find that very very interesting.. Because when you consider that 85% of all pain is caused directly from trigger points( knots ) in muscles, and that trigger points are involved in 95% of all pain syndromes...Seems important to know? If you ask me?? Anyway..........
Your muscles are made up of bundles of cells.. They are long and skinny like the hairs on your head. Wrapped around each muscle cell is an organelle called a Sarcoplasmic Recticulum. One of the things the sarcoplasmic recticulum does is to control calcium flow within the cell...So when there is an electrical signal from the brain for the muscle cell to contract. The sarcoplasmic recticulum exudes calcium from its membrane, and that calcium mixes with a protein in the cell called myosin. That starts a chain reaction, and then the muscle cell( fiber ) contracts...Then when there is an electrical signal from the brain for the muscle cell to relax or lengthen ... The sarcoplasmic recticulum reobsorbs the calcium , seperating it from the myosin, and the muscle fiber relaxes.
Now do to stress. And stress is a big word( Emotional Tension,Repetitive movements, a blow from an accident, sudden movement ,or whatever) the sarcoplasmic recticulum can rupture or beak...And when it breaks, the calcium just leaks out,and mixes with the myosin thats present in the area.. So whatever muscle fibers run through that mxsture, they Contract. And thats your Knot.. An area of contracted muscle fibers within a relaxed muscle..
Anyway, when you find a Knot, Trigger Point, Sore Spot or whatever you wanna call it...When you press on it, you are pushing that calcium myosin mixture out of the area.. Back into the venous system. Then the muscle fibers can open up and lengthen..Now the cellular damage is still there. But now the fresh blood can get in and repair the damage(broken sarcoplasmic recticulum ) .. That's why trigger points tend to linger ,until they get stretched out or pressed out . The capillary flow is cut off... So that's what I figured out about massage as it pertains to do with knots in muscles..... But I don't hear that being taught in schools schools? Not sure what that means? .Considering that 85% of all pain is directly caused from knots in muscles.. And that's why I thought your answer was not correct. But not saying I know everything.. Cause I know I don't - Gordon.
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Permalink Reply by Massage Gnome on
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Gary, The technique is not done slowly tho it is fast and vigorous and very deep. Very painful as I have had 2 kids without any pain killers and I about passed out. Then it bruises and heals back up and the tissue is renewed. Check your phone book under chiropractors and you may find a practitioner who offers it that can meet with you and go over details.
MGGary W Addis said:
MG, I checked out the Graston technique. They don't have a demo video onsite, so I have to guess. Appears to me to be MFR with a variety of probably expensive stainless steel tools rather than forearm. Going deep to the point of light tenderness, then slowly stripping the muscle lengthwise at that level. Not saying Graston ain't affective; today we learned to sweep along lamina groove, down from occipital and across, stripping a big area of TPs and adhesions. But maybe my guess is wrong.
From the Graston website:
Why is scar tissue a problem? A. Scar tissue limits range of motion, and in many instances causes pain, which prevents the patient from functioning as he or she did before the injury.
How is scar tissue different from other tissue? A. When viewed under a microscope, normal tissue can take a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense, irregular and loose with fibers running in multiple directions. In either instance, when tissue is damaged it will heal in a haphazard pattern--or scarring--that results in a restricted range of motion and, very often, pain.
How are the instruments used? A. The Graston Technique® instruments are used to enhance the clinician's ability to detect adhesions, scar tissue or restrictions in the affected areas. Skilled clinicians use the stainless steel instruments to comb over and "catch" on fibrotic tissue, which immediately identifies the areas of restriction. Once the tissue has been identified, the instruments are used to break up the scar tissue so it can be absorbed by the body.
Is the treatment painful? A. It is common to experience minor discomfort during the procedure and some bruising afterwards. This is a normal response and part of the healing process.
Sounds like NMT/MFR to me.
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I posted a reply to this last night but I don't see it on here. No I am not saying that he is committing malpractice. I was pointing out and especially new therapists may see this and repeat things that are said. Clients could easily misconstrue this type of explanation as a diagnosis and if they had anything happen at all it could come back on the therapist as a malpractice suit. So somewhere in this post is my response about that and I had apologized to Gordon for any misunderstanding. I don't fully understand why my posts are going where they are.
Gary W Addis said:
Gordon, you have already contributed so much. When you have something to say, we ALL want to hear it. I don't think MG was saying that you are committing malpractice, are you, MG?
Gordon J. Wallis said:
Oh come on????? All I do is massage people..and if I find a sore spot. I make it go away... Im a massage therapist...You accuse me of malpractice...I massage doctors.. lol Im a massage therapist that sees nothing wrong with educating clients... Those books are medical books...any good massage therapist that wants to know about trigger points has read them...I come in here to tell people what I do...What do you want me to do? Just repeat the same ole stuff everybody else says? Ive dont this 26 years... I know my job...That explanation about trigger points came from a medical book...That book started a lot of modalities used today by many good massage therapists. Im not doing anything thats out of the scope of my profession. I dont think I will bother saying anything in here anymore...
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found my post from last night under my discussions and copy/print it for you. LOL
Gordon,
You misunderstand what I am saying. I am not accusing you of anything, least of all malpractice. What I am saying is by telling your clients the way you say the client could easily accuse you of it. I also work on doctors and nurses from the Mayo Health system here. My comment was to say that it is best to be careful how you say things. At the Ethics convention from the AMTA a few years ago, we were told about a lot of actual cases where things like that happened for a whole lot less. To the point of them trying to restrict us from selling essential oils, supplements and the like in our profession just to keep the court cases down. I have no doubt in my mind that you are a very talented and dedicated massage therapist. I just wanted to point out that things we as professionals say and the way we say them can be used against us in this way so it is best to be cautious, choose your words wisely (not on the forum we are here to voice our views, right?) But in our practice we deal with people from all over, in different backgrounds and values and you don't know what they are capable of. That is all that I meant. So please forgive me if I offended you in any way, it was not my intention.
MG
Gary W Addis said:Gordon, you have already contributed so much. When you have something to say, we ALL want to hear it. I don't think MG was saying that you are committing malpractice, are you, MG?
Gordon J. Wallis said:
Oh come on????? All I do is massage people..and if I find a sore spot. I make it go away... Im a massage therapist...You accuse me of malpractice...I massage doctors.. lol Im a massage therapist that sees nothing wrong with educating clients... Those books are medical books...any good massage therapist that wants to know about trigger points has read them...I come in here to tell people what I do...What do you want me to do? Just repeat the same ole stuff everybody else says? Ive dont this 26 years... I know my job...That explanation about trigger points came from a medical book...That book started a lot of modalities used today by many good massage therapists. Im not doing anything thats out of the scope of my profession. I dont think I will bother saying anything in here anymore...
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Gordon,
I was not saying that you were right or that you were wrong in what you were saying. My point was that how you tell clients things can be construed as out of our scope or practicing medicine without a license. That was all.
MGGordon J. Wallis said:
http://www.youtube.com/watch?v=HcWX-b07qqM&feature=related That clearly states what role the sarcoplasmic recticulum plays in muscle contractions... I read study and apply information..I dont just repeat what Ive been told.. lol Truth seems to upset the norm? Whats that make the norm? Is that false information? NOT
Gordon J. Wallis said:
Massage Gnome said:
Gordon,
You misunderstand what I am saying. I am not accusing you of anything, least of all malpractice. What I am saying is by telling your clients the way you say the client could easily accuse you of it. I also work on doctors and nurses from the Mayo Health system here. My comment was to say that it is best to be careful how you say things. At the Ethics convention from the AMTA a few years ago, we were told about a lot of actual cases where things like that happened for a whole lot less. To the point of them trying to restrict us from selling essential oils, supplements and the like in our profession just to keep the court cases down. I have no doubt in my mind that you are a very talented and dedicated massage therapist. I just wanted to point out that things we as professionals say and the way we say them can be used against us in this way so it is best to be cautious, choose your words wisely (not on the forum we are here to voice our views, right?) But in our practice we deal with people from all over, in different backgrounds and values and you don't know what they are capable of. That is all that I meant. So please forgive me if I offended you in any way, it was not my intention.
MG
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Permalink Reply by Therese Schwartz on
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No worries! I was thinking about the guy who invented Tide laundry soap - it worked wonderfully but no one would buy it. He went broke, sold the formula to a company that added a sudsing agent and the rest is history! Off topic for the thread, but fun.
Lucianna Johnston said:
Haha...I'm reading back now.....you are talking about bubbles ;).....semantics always get me in trouble on here....
Lucianna Johnston said:Um...actually they do need suds. The scrubbing and "sudzing" pulls the germs off the hands or other part of the body and moves them into the suds. That's why when you use regular soap vs. antibacterial soap it doesn't contribute to antiobiotic resistant strains of bacteria in our environment...sorry...I had to comment I am a hand washing advocate. LOL....
Therese Schwartz said:MG - that reminds me about the fact that people need suds to think their soap is working! :)
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http://saveyourself.ca/tutorials/trigger-points.php
Massage Gnome said:
Gordon,
I was not saying that you were right or that you were wrong in what you were saying. My point was that how you tell clients things can be construed as out of our scope or practicing medicine without a license. That was all.
MGGordon J. Wallis said:
http://www.youtube.com/watch?v=HcWX-b07qqM&feature=related That clearly states what role the sarcoplasmic recticulum plays in muscle contractions... I read study and apply information..I dont just repeat what Ive been told.. lol Truth seems to upset the norm? Whats that make the norm? Is that false information? NOT
Gordon J. Wallis said:
Massage Gnome said:Gordon,
You misunderstand what I am saying. I am not accusing you of anything, least of all malpractice. What I am saying is by telling your clients the way you say the client could easily accuse you of it. I also work on doctors and nurses from the Mayo Health system here. My comment was to say that it is best to be careful how you say things. At the Ethics convention from the AMTA a few years ago, we were told about a lot of actual cases where things like that happened for a whole lot less. To the point of them trying to restrict us from selling essential oils, supplements and the like in our profession just to keep the court cases down. I have no doubt in my mind that you are a very talented and dedicated massage therapist. I just wanted to point out that things we as professionals say and the way we say them can be used against us in this way so it is best to be cautious, choose your words wisely (not on the forum we are here to voice our views, right?) But in our practice we deal with people from all over, in different backgrounds and values and you don't know what they are capable of. That is all that I meant. So please forgive me if I offended you in any way, it was not my intention.
MG
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Permalink Reply by Gary W Addis, LMT on
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Unless I'm mistaken, whiich is likely, the website said that it is done slowly. If the sweeping with the stainless bar is done wuickly, seems that the chiro might not snag and stretch everything. And, yeah, digging in with a steel bar does seem painful.
A couple of local chiros use a kind of airgun that gives a wee punch of compressed air that supposedly snaps everything into alignment. Useless, the way the doctor I saw used it.
Massage Gnome said:Gary, The technique is not done slowly tho it is fast and vigorous and very deep. Very painful as I have had 2 kids without any pain killers and I about passed out. Then it bruises and heals back up and the tissue is renewed. Check your phone book under chiropractors and you may find a practitioner who offers it that can meet with you and go over details.
MGGary W Addis said:
MG, I checked out the Graston technique. They don't have a demo video onsite, so I have to guess. Appears to me to be MFR with a variety of probably expensive stainless steel tools rather than forearm. Going deep to the point of light tenderness, then slowly stripping the muscle lengthwise at that level. Not saying Graston ain't affective; today we learned to sweep along lamina groove, down from occipital and across, stripping a big area of TPs and adhesions. But maybe my guess is wrong.
From the Graston website:
Why is scar tissue a problem? A. Scar tissue limits range of motion, and in many instances causes pain, which prevents the patient from functioning as he or she did before the injury.
How is scar tissue different from other tissue? A. When viewed under a microscope, normal tissue can take a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense, irregular and loose with fibers running in multiple directions. In either instance, when tissue is damaged it will heal in a haphazard pattern--or scarring--that results in a restricted range of motion and, very often, pain.
How are the instruments used? A. The Graston Technique® instruments are used to enhance the clinician's ability to detect adhesions, scar tissue or restrictions in the affected areas. Skilled clinicians use the stainless steel instruments to comb over and "catch" on fibrotic tissue, which immediately identifies the areas of restriction. Once the tissue has been identified, the instruments are used to break up the scar tissue so it can be absorbed by the body.
Is the treatment painful? A. It is common to experience minor discomfort during the procedure and some bruising afterwards. This is a normal response and part of the healing process.
Sounds like NMT/MFR to me.
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Its a primate technique .. it works ok. There are way easier ways to remove trigger points and painful areas though.
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I am kinda digging your conversation this thread is getting a bit intense for me.
Therese Schwartz said:
No worries! I was thinking about the guy who invented Tide laundry soap - it worked wonderfully but no one would buy it. He went broke, sold the formula to a company that added a sudsing agent and the rest is history! Off topic for the thread, but fun.
Lucianna Johnston said:
Haha...I'm reading back now.....you are talking about bubbles ;).....semantics always get me in trouble on here....
Lucianna Johnston said:Um...actually they do need suds. The scrubbing and "sudzing" pulls the germs off the hands or other part of the body and moves them into the suds. That's why when you use regular soap vs. antibacterial soap it doesn't contribute to antiobiotic resistant strains of bacteria in our environment...sorry...I had to comment I am a hand washing advocate. LOL....
Therese Schwartz said:MG - that reminds me about the fact that people need suds to think their soap is working! :)
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I have never visited any sites or done any research on it but am familiar with it only because I have received it 4 or 5 times in the last few years because I don't stick to the limitations of 5 hours of massage a day. I tend to average more like 10. It has given me back my arms on all occasions and I have not yet met a MT who could affect my issue effectively. But if it is something you would like to learn more about I would recommend finding someone who practices the technique. I am at the limit on this technique.
MG
Gary W Addis said:Unless I'm mistaken, whiich is likely, the website said that it is done slowly. If the sweeping with the stainless bar is done wuickly, seems that the chiro might not snag and stretch everything. And, yeah, digging in with a steel bar does seem painful.
A couple of local chiros use a kind of airgun that gives a wee punch of compressed air that supposedly snaps everything into alignment. Useless, the way the doctor I saw used it.
Massage Gnome said:Gary, The technique is not done slowly tho it is fast and vigorous and very deep. Very painful as I have had 2 kids without any pain killers and I about passed out. Then it bruises and heals back up and the tissue is renewed. Check your phone book under chiropractors and you may find a practitioner who offers it that can meet with you and go over details.
MGGary W Addis said:
MG, I checked out the Graston technique. They don't have a demo video onsite, so I have to guess. Appears to me to be MFR with a variety of probably expensive stainless steel tools rather than forearm. Going deep to the point of light tenderness, then slowly stripping the muscle lengthwise at that level. Not saying Graston ain't affective; today we learned to sweep along lamina groove, down from occipital and across, stripping a big area of TPs and adhesions. But maybe my guess is wrong.
From the Graston website:
Why is scar tissue a problem? A. Scar tissue limits range of motion, and in many instances causes pain, which prevents the patient from functioning as he or she did before the injury.
How is scar tissue different from other tissue? A. When viewed under a microscope, normal tissue can take a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense, irregular and loose with fibers running in multiple directions. In either instance, when tissue is damaged it will heal in a haphazard pattern--or scarring--that results in a restricted range of motion and, very often, pain.
How are the instruments used? A. The Graston Technique® instruments are used to enhance the clinician's ability to detect adhesions, scar tissue or restrictions in the affected areas. Skilled clinicians use the stainless steel instruments to comb over and "catch" on fibrotic tissue, which immediately identifies the areas of restriction. Once the tissue has been identified, the instruments are used to break up the scar tissue so it can be absorbed by the body.
Is the treatment painful? A. It is common to experience minor discomfort during the procedure and some bruising afterwards. This is a normal response and part of the healing process.
Sounds like NMT/MFR to me.
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