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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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Garry, I could tell everything I know about massage to you in a day, I think? How long is your school? Thats all Im saying.
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Regardless of what kind of pressure a client tells me they want... What they are really saying is I want a really good massage. Then I explain to them what a healing massage feels like..It feels really freakin good...It can be really sore but it always has to feel so good you hardly want it to stop. I dont know any number for that? Its not about keeping pain at a certain level. I dont think? .That sounds painful not good..its gotta feel good..a good massage.. Once you get that pressure, its just a matter of how long too work the area..Thats kind of the hard part..If you over do it... You can cause some post massage sorness..So you explain that possibility to your client..So they understand how to get a massage. I dont even think numbers.. They would moan and say OH That FEELS Sore but REally Good.. You can think the way you think...Im just telling you what I do..Thats all.. lol Really.
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 Gary W Addis, LMT on
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Gordon, you haven't said anything offensive. I for one am picking up things from you.
Gordon J. Wallis said:
Im sure every one in and involved in your school is a fine person...Im talking the system.. I dont know any of that stuff you are learning.. I cant pass the national cert.. But Ive lasted 26 years in a career where the average career span is only 6. I would just teach massage differently..it has nothing to do with the fine people teaching you. Its just my truth..Muscle Anatomy would be about the only equivalency I have to your school or any massage school.. I dont mean to insult people. My way of thinking...Why bother learning all that NMT stuff when you can easily make trigger points go away with only a light touch in a few seconds.. I just look at things differently.... People are fine.. I think it could be taught in a much more easier way? Maybe Im wrong though? But Im feeling really good about my work no. Im getting better..And they dont teach the stuff I know in schools...I cant pass any of your classes...But I feel very confident in my work????? lol Really... I dont know how to talk in here.. I mean you've read some of the stuff Ive written in here.. I think it has a different view that makes sense? I would find it very difficult to go though your training..because I dont use any of the information you are learning??? really? lol maybe I wont comment much anymore... Its also hard for me to impart my true feeling in type here? And you know how testy things can get on this site.. The Scientists got run off.. All I say is MY TRUTH.. Please nobody take offense with what I say...Look at me as a Nut Case if you must.. BUT Please dont take offense to anything I say.
Gary W Addis said:Gordon, I know you meant no insult to anyone. Just the same... I don't know a thing about other schools, but I defend mine. I have one fellow student who wears his fingernails 2" beyond his fingertips, but every other classmate I've worked with will one day make a first rate MT. And with the exception of my Anatomy & Physiology instructor who is a successful chiropractor, my instructors are all practicing MTs. I'm receiving a full quarter of study in swedish, MFT, NMT, DT, reflexology, shiatsu, special population massage (pregnancy, sports, etc), PNF and other modalities I have yet to study. We are all required to work in the student clinic 4-6 hours per week, on a variety of bodies, many with a smorgasbord of health problems. It's not just about passing the boards: it's about learning, about gaining experience and especially confidence. Already, I am confident in my abilities, and I am accumulating wisdom with every massage I am privileged to give.
Now, I'm not claiming that any school is a replacement for real-world experience. A person can graduate truck driving school in 6 weeks, but after 23 years of driving a truck long haul (more than 3 million accident-free miles), I confess that I learned something new every single day I spent behind the wheel. I'm 63, so I'm unlikely to gain your vast store of knowledge before I begin o sleep the endless sleep. But I'd love to sit down with you over a beer or coffee and pie and pick your brain.
Gordon J. Wallis said:Well, once you become skilled. Its not as much of a problem...I haven't created any post massage soreness in years. However, explaining to your client whats going on is key... Deep tissue massage requires understanding and communication. Takes two to tango. Everybody I work on knows what Im doing and why. It really speeds up the healing process....Most things are common sense.. I didnt learn this anywhere...I look at the way they teach massage ..and I shake my head...Im going to be giving informal seminars here real soon...Nothing that Im going to teach came from a text book or from a teacher or an exam.. First thing I tell people is forget everything they taught you in school. These schools teach how to pass all exams.. They dont teach how to massage..That seems obvious to me.. Now not bragging...Because I dont know everything...But twhat they teach now? I shake my head.
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Yea everything I say in here is my truth, and thats it. I just dont really get why they teach all that stuff in the schools..Just from what I know about massage...So Im either freakin crazy or they are teaching massage wrong? I lectured some at a local massage school the other day...Believe me they found it very interesting.. lol They seemed very interested in my explanations of why I do what I do.. or how I handle a situation, or anything to do with massage....cause its like way different from what they were learning. It lasted an hour or more I think? The advanced class ....It was cool.. They would ask me questions on anything they wanted about massage.. And then I answered.. So now they are interested in paying me to give a seminar..Not the school, but the students. Very casual.. no tests. Not telling anyone there how to do it..I just tell them what I do and how I think.... Thats all.. NO CE credits. Just tell people what I know.. They can do whatever they want with it.. lol Its fun for me...
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Gordon J. Wallis said:
Regardless of what kind of pressure a client tells me they want... What they are really saying is I want a really good massage. Then I explain to them what a healing massage feels like..It feels really freakin good...It can be really sore but it always has to feel so good you hardly want it to stop. I dont know any number for that? Its not about keeping pain at a certain level. I dont think? .That sounds painful not good..its gotta feel good..a good massage.. Once you get that pressure, its just a matter of how long too work the area..Thats kind of the hard part..If you over do it... You can cause some post massage sorness..So you explain that possibility to your client..So they understand how to get a massage. I dont even think numbers.. They would moan and say OH That FEELS Sore but REally Good.. You can think the way you think...Im just telling you what I do..Thats all.. lol Really.
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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In one sentence in this thread I think I said... Once you become skilled.. I should of said.. In time you will find post massage soreness wont be much of a problem.. This is how I handle things to keep that issue to a minimum...But Im not a very good writer.. I can express myself vocally, but its not so easy in here. Sometimes I come across in a way I dont mean too.
Gary W Addis said:
Gordon, you haven't said anything offensive. I for one am picking up things from you.
Gordon J. Wallis said:
Im sure every one in and involved in your school is a fine person...Im talking the system.. I dont know any of that stuff you are learning.. I cant pass the national cert.. But Ive lasted 26 years in a career where the average career span is only 6. I would just teach massage differently..it has nothing to do with the fine people teaching you. Its just my truth..Muscle Anatomy would be about the only equivalency I have to your school or any massage school.. I dont mean to insult people. My way of thinking...Why bother learning all that NMT stuff when you can easily make trigger points go away with only a light touch in a few seconds.. I just look at things differently.... People are fine.. I think it could be taught in a much more easier way? Maybe Im wrong though? But Im feeling really good about my work no. Im getting better..And they dont teach the stuff I know in schools...I cant pass any of your classes...But I feel very confident in my work????? lol Really... I dont know how to talk in here.. I mean you've read some of the stuff Ive written in here.. I think it has a different view that makes sense? I would find it very difficult to go though your training..because I dont use any of the information you are learning??? really? lol maybe I wont comment much anymore... Its also hard for me to impart my true feeling in type here? And you know how testy things can get on this site.. The Scientists got run off.. All I say is MY TRUTH.. Please nobody take offense with what I say...Look at me as a Nut Case if you must.. BUT Please dont take offense to anything I say.
Gary W Addis said:Gordon, I know you meant no insult to anyone. Just the same... I don't know a thing about other schools, but I defend mine. I have one fellow student who wears his fingernails 2" beyond his fingertips, but every other classmate I've worked with will one day make a first rate MT. And with the exception of my Anatomy & Physiology instructor who is a successful chiropractor, my instructors are all practicing MTs. I'm receiving a full quarter of study in swedish, MFT, NMT, DT, reflexology, shiatsu, special population massage (pregnancy, sports, etc), PNF and other modalities I have yet to study. We are all required to work in the student clinic 4-6 hours per week, on a variety of bodies, many with a smorgasbord of health problems. It's not just about passing the boards: it's about learning, about gaining experience and especially confidence. Already, I am confident in my abilities, and I am accumulating wisdom with every massage I am privileged to give.
Now, I'm not claiming that any school is a replacement for real-world experience. A person can graduate truck driving school in 6 weeks, but after 23 years of driving a truck long haul (more than 3 million accident-free miles), I confess that I learned something new every single day I spent behind the wheel. I'm 63, so I'm unlikely to gain your vast store of knowledge before I begin o sleep the endless sleep. But I'd love to sit down with you over a beer or coffee and pie and pick your brain.
Gordon J. Wallis said:Well, once you become skilled. Its not as much of a problem...I haven't created any post massage soreness in years. However, explaining to your client whats going on is key... Deep tissue massage requires understanding and communication. Takes two to tango. Everybody I work on knows what Im doing and why. It really speeds up the healing process....Most things are common sense.. I didnt learn this anywhere...I look at the way they teach massage ..and I shake my head...Im going to be giving informal seminars here real soon...Nothing that Im going to teach came from a text book or from a teacher or an exam.. First thing I tell people is forget everything they taught you in school. These schools teach how to pass all exams.. They dont teach how to massage..That seems obvious to me.. Now not bragging...Because I dont know everything...But twhat they teach now? I shake my head.
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Permalink Reply by Lee Edelberg on
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Hi Alyson,
My experience as a receiver is that when I feel sore later it seems to be because the giver spent a fair amount of time working deep in a very localized area, and the muscle(s) get irritated.
When I feel the MT is skilled and what they are doing is effective in helping resolve some deep tension, then it's usually OK with me. Other times it feels to me that the MT doesn't really know what he or she is doing and is going over and over the same area with the same technique(s), past the point of therapuetic benefit and into the bruising/inflammatory zone.
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Partly it's because of the push to gain "credibility" with doctors and university professors, who tend to be rather snooty ("don't you dare call me Gary or even Mister, I'm a DOCTOR!"), that sort of snobbishness. Look how long it took chiropractors to earn credibility.
But already I'm finding most of what I'm learning to be useful. I'm learning labels, etc, that your career has proven than an MT doesn't have to know in order to be effective, but you gained your knowledge over two decades. Everybody's in too big a hurry to take such a slow route these days. I certainly don't have 20 years: I'm on social security, and not yet a year into my MT education...rather old to be starting this career. I wish I could plug a socket into your brain lay my hands on your hands and absorb their skills. Well, I ain't Spock, I can't do a Vulcan "mind meld." The schools and the books and the webinars and the youtube videos are my only route to your store of knowledge.
Every day I thank the gods for Tom Myers, Ben Benjamin, Til Luchau, my friend Boris, Arianna--MTs first, educators second. Then there are MTs like you and Daniel, who for the love of our profession share your knowledge with anyone who will listen; no doubt if MTs like you were independently wealthy you'd put a sign above your offices offering free massage to anyone in need but lacking the means to pay.
It's not that what you're doing is "way different." Frankly, with only a few exceptions, a few years out of school instructors begin to forget some of the clinical names-- I mean, it isn't like an MT needs to know the location of the corpus collosum, or the inner workings of the heart--it's great to know these things, but as an MT we don't need to know. The other day, one of my instructors confused the locations of the coracobrachialis and the brachialis, but for certain she knows how to work both muscles...the locations of both passive and active trigger points affecting those muscles. Melissa's got the book knowledge, but also, more importantly, she has skilled hands, and sensitive fingers and elbows, and eyes that can diagnose postural problems with a glance. But she tells anyone who listens that she too is still a student of the human body--she would sit down across from you, Gordon, and listen raptly to the voice of your 26 years of experience.
Gordon J. Wallis said:
Yea everything I say in here is my truth, and thats it. I just dont really get why they teach all that stuff in the schools..Just from what I know about massage...So Im either freakin crazy or they are teaching massage wrong? I lectured some at a local massage school the other day...Believe me they found it very interesting.. lol They seemed very interested in my explanations of why I do what I do.. or how I handle a situation, or anything to do with massage....cause its like way different from what they were learning. It lasted an hour or more I think? The advanced class ....It was cool.. They would ask me questions on anything they wanted about massage.. And then I answered.. So now they are interested in paying me to give a seminar..Not the school, but the students. Very casual.. no tests. Not telling anyone there how to do it..I just tell them what I do and how I think.... Thats all.. NO CE credits. Just tell people what I know.. They can do whatever they want with it.. lol Its fun for me...
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Today Ive got six hours of massage work..I have to shower here in a min. and get ready.. Its a trip..They all have their reasons for getting a massage...Its a trippy job Gary..Only real advice is not to think too much..I know that sounds crazy but like here is an example... No matter what your client tells you.. I want deep tissue...I dont like deep tissue.. I just want to relax.. can you work on my low back, but dont press too hard...You can press as hard as you like...or whatever they say..All they are really saying is. I WANT A GOOD MASSAGE. lol And a lot of what a good massage is...The right pressure.. Thats it...Just simple stuff like that.. It really can be simple.. The hard part is peoples belief systems.. People think reality differently.. Jesus means something completely different to a Muslim then to a Catholic.. its the people part that is the most challenging.. For me anyway.. They have belief systems.. Damn its so hard to say what I want to say in here.. lol I can talk it much better. lol Lets see..learning is interesting..But most people dont really learn... They just accumulate information.. But thats just a dull mind from my point of view.. That accumulates.. Lets say uhm you want to know about oak trees.. So you go to wickopidia Study text books..Know everything about an oak tree.. And when you walk by one.. you point and say .. There is an Oak tree.. and you start telling people about it.. You seem smart to them.. But if you really want to know an oak tree.. You walk up to it without any preconceived notion or idea.. You just look at it without thinking.. You get up close and feel it.. smell it,,maybe even taste it.. No thinking.. Nothing to remember.. Just look.. Then you will really know an oak tree.. Not sure if that makes sense...But thats how I look at massage.. and its helped me. lol Gary,, have fun learning..Most people look at massage with a fact they have learned..That just leads to belief systems.. Like they look at religion. Ok gotta go... lol
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Nyema, this 1-10 thing: your 10 may be another person's 1, right? It's a subjective judgment, and it's overlooking the ego factor--you know, people not wanting to be perceived to be a wimp. When I'm on the table and asked, How's the pressure, even if I can feel a bone cracking, I automatically reply "It's okay." Many if not most people do, I think. So, I believe that Gordon is right. Not that you are wrong. Lacking his experience, MTS have to rely on arbitrary scales of pain. Just keep in mind that rating pain without clinical instruments is subjective rating and not to be considered perfectly reliable 100% of the time. Sometimes you have to educate a client that they may not need what they want. To this point I've had only 14 clients in our school clinic, and one of those was a frigging masochist who squealed with delight when anyone else would be jumping off the table and cursing about the pain.
Gordon J. Wallis said:
Gordon J. Wallis said:
Regardless of what kind of pressure a client tells me they want... What they are really saying is I want a really good massage. Then I explain to them what a healing massage feels like..It feels really freakin good...It can be really sore but it always has to feel so good you hardly want it to stop. I dont know any number for that? Its not about keeping pain at a certain level. I dont think? .That sounds painful not good..its gotta feel good..a good massage.. Once you get that pressure, its just a matter of how long too work the area..Thats kind of the hard part..If you over do it... You can cause some post massage sorness..So you explain that possibility to your client..So they understand how to get a massage. I dont even think numbers.. They would moan and say OH That FEELS Sore but REally Good.. You can think the way you think...Im just telling you what I do..Thats all.. lol Really.
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 Lolita Knight on
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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 Knightkristi 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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Well my busy day just dwindled to almost nothing. lol My first two appointments just never showed up.. So three hours gone right there...My last one cancelled. The only one I have is a lady for a two hour massage...She has never had a massage in her life...lol So no way Im going to work on her for two hours...So my total day went from six hours to maybe one...lol Another hard lesson for you new people too learn..No money today.. oh well... I could use the break...Oh Gary, if you read this...You might want to think about ClaspKnife Reflex..
Gordon J. Wallis said:
Today Ive got six hours of massage work..I have to shower here in a min. and get ready.. Its a trip..They all have their reasons for getting a massage...Its a trippy job Gary..Only real advice is not to think too much..I know that sounds crazy but like here is an example... No matter what your client tells you.. I want deep tissue...I dont like deep tissue.. I just want to relax.. can you work on my low back, but dont press too hard...You can press as hard as you like...or whatever they say..All they are really saying is. I WANT A GOOD MASSAGE. lol And a lot of what a good massage is...The right pressure.. Thats it...Just simple stuff like that.. It really can be simple.. The hard part is peoples belief systems.. People think reality differently.. Jesus means something completely different to a Muslim then to a Catholic.. its the people part that is the most challenging.. For me anyway.. They have belief systems.. Damn its so hard to say what I want to say in here.. lol I can talk it much better. lol Lets see..learning is interesting..But most people dont really learn... They just accumulate information.. But thats just a dull mind from my point of view.. That accumulates.. Lets say uhm you want to know about oak trees.. So you go to wickopidia Study text books..Know everything about an oak tree.. And when you walk by one.. you point and say .. There is an Oak tree.. and you start telling people about it.. You seem smart to them.. But if you really want to know an oak tree.. You walk up to it without any preconceived notion or idea.. You just look at it without thinking.. You get up close and feel it.. smell it,,maybe even taste it.. No thinking.. Nothing to remember.. Just look.. Then you will really know an oak tree.. Not sure if that makes sense...But thats how I look at massage.. and its helped me. lol Gary,, have fun learning..Most people look at massage with a fact they have learned..That just leads to belief systems.. Like they look at religion. Ok gotta go... lol
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