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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: 44211
Replies to This Discussion
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Permalink Reply by Debra Ann Castrinos on
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It seems there are different types of "soreness". It is only until recently that physicians have asked pain patients to rate their pain on a one- to- ten scale. In massage school, we also learned this practice, in order to have a better understanding of a person's pain. Sometime pain patients don't realize they have crossed over the threshold into a condition called fibromyalgia. There is a difference between the type of pain you get after working out at the gym, and the pain you endure during a fibromyalgia episode. This type of pain is very deep, and when a patient gets a massage, it feels like you are grinding into a bruise. In fact, the next day, the results of a massage are this.... the patient is hurting very much. There really isn't much that physicians know about pain. They have been experimenting with surgery for decades. Sometimes it works, and sometimes it doesn't. We can only offer an amount of comfort for our suffering cleints in the way of a soothing massage.
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Permalink Reply by Boris Prilutsky on
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Dear Alyson.
I believe that there is many and different explanation for post massage pains. following link to my article on this subject . hopefully you will find answer for your question.
http://medicalmassage-edu.com/article_details.php?bn_id=10
Best wishes.
Boris Prilutsky
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Permalink Reply by Gary W Addis, LMT on
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Boris, your reply to Alyson (the article) is detailed and more to the point than any I've read. I'm just beginning a class on NMT/Myofascial Release, and loving it; it's confirming stuff I learned from posted videos, from Myers, Benjamin, and you. Thanks to the education I've received from all of you, I'm a step ahead of my fellow students in the class.
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Permalink Reply by Ingrid Sagdahl on
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That article was very interessting and informative!!! Thank you so much Boris!
Boris Prilutsky said:Dear Alyson.
I believe that there is many and different explanation for post massage pains. following link to my article on this subject . hopefully you will find answer for your question.
http://medicalmassage-edu.com/article_details.php?bn_id=10
Best wishes.
Boris Prilutsky
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Permalink Reply by Peggy Richards on
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I think if the body is not kept hydrated, before and after treatments, their is more of a chance that soreness after a session will be an issue. I like to recommend taking an epsom salt bath on the same day after having a DT session.
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Hi Ingrid and Gary.
I am glad that you did like information within my article. Hopefully that Alyson's question was answered.
Best wishes.Boris
Ingrid Sagdahl said:
That article was very interessting and informative!!! Thank you so much Boris!
Boris Prilutsky said:Dear Alyson.
I believe that there is many and different explanation for post massage pains. following link to my article on this subject . hopefully you will find answer for your question.
http://medicalmassage-edu.com/article_details.php?bn_id=10
Best wishes.
Boris Prilutsky
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Hi Paggy.in cases of post-massage pains I wouldn't recommend epsom salt bath because a) it will further dehydrate body b)if pain is the result of trauma by vigorous pressure , hot water will aggravate condition.I believe that most important aspect as well as conclusion of this discussion is not to confuse traumatic pressure with therapy by means of massage.
Best wishes.
Boris
Peggy Richards said:I think if the body is not kept hydrated, before and after treatments, their is more of a chance that soreness after a session will be an issue. I like to recommend taking an epsom salt bath on the same day after having a DT session.
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Permalink Reply by Alyson C Schlobohm on
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It was truly a great article. Now on to my bigger question, though - how do you know when enough is enough? I had a client come in the other day and request a DT massage. She's getting married this weekend and, even though she told me she had never been sore from a massage, I took it easy(er) on her because I did not want her to be sore. I just heard from her today and she's incredibly sore. I'm so frustrated - I did not notice ANY reactions from her during the massage that would alert me to the fact that I was using too much pressure - no tensing up, no sharp intakes or holding of breath, no verbal communication that it was too much at any point. I'm so frustrated - I really tried hard to prevent any soreness but obviously did not succeed.
Additionally, I have yet to have a client complain of feeling "hurt" (even the client that asked his wife to check for bruises said it was just because he was SO sore) or more tense or stiff after the massage, simply just SORE. I know some people don't mind the soreness, but in the case of my bride, I really wish I had been able to prevent it.
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Hi Alyson.
Really happy that you liked my article. Following link is to the page where I am offering free lessons on the subject including but not limited to how much pressure we should apply
I hope you will like it too and most important will be able to learn from.
http://medicalmassage-ceu.com/CLASS/
Best wishes.
Boris
Alyson Schlobohm said:
It was truly a great article. Now on to my bigger question, though - how do you know when enough is enough? I had a client come in the other day and request a DT massage. She's getting married this weekend and, even though she told me she had never been sore from a massage, I took it easy(er) on her because I did not want her to be sore. I just heard from her today and she's incredibly sore. I'm so frustrated - I did not notice ANY reactions from her during the massage that would alert me to the fact that I was using too much pressure - no tensing up, no sharp intakes or holding of breath, no verbal communication that it was too much at any point. I'm so frustrated - I really tried hard to prevent any soreness but obviously did not succeed.
Additionally, I have yet to have a client complain of feeling "hurt" (even the client that asked his wife to check for bruises said it was just because he was SO sore) or more tense or stiff after the massage, simply just SORE. I know some people don't mind the soreness, but in the case of my bride, I really wish I had been able to prevent it.
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Permalink Reply by Lucianna Johnston on
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Lately I have been experiementing with a lighter touch on certain clients who, in the past I would use deep tissue with. I know this opinion will differ from others but I do not believe that a client should endure pain when receiving a massage. I agree with Gordon on this, I think they should be thinking something like..."that's tender but it feels sooooo good" if they are thinking "yowzers that hurts how long is he/she going to be doing that"..or possible considering asking you to lighten up I think that is too deep. Deep Tissue is not about pressure. Deep Tissue is about treatment of the muscles that are in the deepest layers. Techniques to access deep muscles can be accomlished without deep pressure. That being said, when someone truly enjoys the feeling of deeper pressure and it feels great to them I go for it.
Also, just two days ago I had a client with a back of steel. She lifts weights and has one of the "hardest" backs I work on. She trusts me enough to let me do my thing so the last few sessions I have been using a different approach. In the past I would just be all elbows trying to power through the tension. This last session I did a light to moderate trigger point session on her back and gluts and then went into the massage on each side of the back. I used a pretty moderate pressure with some moments of light pressure. I was amazed at what happened. Those tense muscles melted like butter. She said it was the best massage yet and she felt incredible. My point is be open, you never know what will work. I think what you learn from the book has to be combined with intuition for the best result. I have been doing massage for a while and I never would've thought to use a lighter touch on a back like hers but my intuition was pulling me there so I followed and it worked amazingly.
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Alyson, could the soreness be a result of muscle tension resulting from her emotional tension, and have nothing whatsoever to do with your skillful massage? I think I would explain that to her as the likely cause, and encourage her to go sit in a corner by herself for a while. Or, better yet, get her onto your table, turn down the lights, play soft love songs (Isaac Hayes maybe), and just lay your hands on her--no massage, and allow her to fall asleep (once she is fully relaxes, leave the room and allow her to enjoy the quiet. If you value this client as friend and client, maybe offer this no charge.
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Permalink Reply by Gordon J. Wallis on
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Well part or most of the time its the therapist simply pressing too hard..I know that for sure. One of the Biggest Complaints about massage from people is that it was painful..As a proffesional therapist I hear that from new clients all the time.. Its common place. I'm use to it. The other thing is that, there are layers oppon layers of muscle.. and if say a deeper layer of muscle contains the tight fibers, the healthy more super ficial layers can be smashed or dammaged from the amount of pressure requiered to release the deeper layers..And that creates the post massage soreness. Here is the deal... the most perfect massage for a client is the exact mix of pressure on the area worked with the perfect amount of time...So lets say you are pushing at the perfect healing pressure for that patients problem.. and the patient tells you that it feels sore but really good.. You the therapist, wanting to do good and please your client. Work the area a bit too long.. creating that post massage soreness.. I tell my clients this fact..so they wont freak out if they are a little sore from their massage..then when they come back on their next appointment.. they can tell me how they responded from their massage..Then I tweak the massage accordingly. In this case the amount of time. Every massage I do on a client is more efficient then the last... A lot of times I can really help a client within four massages using this type analysis..Of course its not exact...But thats the ART OF MASSAGE...My clients that need that type of work understand. I make sure they do. My clients know how they felt after their last massage..If they were a little too sore to be comfortable.. they tell me.. and we tweak the time or pressure or both. Depending on my ART... And I feel, after 26 years. I'm on the edge of possessing A HIGH ART.
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