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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 Gary W Addis, LMT on
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"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."
Now that you've mentioned the layering as maybe the problem, it seems so obvious.
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Permalink Reply by Alyson C Schlobohm on
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Lucianna, I really enjoyed reading your response. You brought up a lot of very valid points. I know that sometimes lighter touch is better, it's just hard to explain that to clients at times. A lot of my clients come to me - and refer me to their friends and family - because of my DT work. It's hard to explain to someone that wants a lot of pressure that sometimes less is more - it's a Catch 22!
Gary, LOL. I do think emotional stress had a huge part of it. She was moving in with her fiance and getting married all in one week (a holiday weekend nonetheless). I emailed and spoke with her and offered to do a "relaxation massage", but this was yesterday, the DAY before her wedding, and I was SO nervous of further irritating the muscles that I warned her of this. I'm actually not sure it would have been beneficial at that point - has anyone had experience DECREASING soreness with a massage? Every time I've been sore from a new workout I've been unable to coordinate with MY Massage Therapist. I really wanted to help her and I offered her the best advice I could - light stretching, light movement/rotation of the areas affected, a hot/bath or shower, tons of water, etc. - but we both agreed that another Massage was perhaps not the best answer.
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Permalink Reply by Gordon J. Wallis on
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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.
Gary W Addis said:
"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."
Now that you've mentioned the layering as maybe the problem, it seems so obvious.
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Permalink Reply by Massage Gnome on
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I have read through about half of the responses here and I can tell you that it has many parts to consider. I have been doing massage therapy professionally for 7 years now and here is what I have found. I don't work well with numbers so what I tell my clients is if my pressure makes you squirm or hurt or you cannot breathe through it then let me know because it is too hard. Then watch for non-verbal cues such as foot wiggling, finger twitches and the like. Sometimes people will not tell you because another therapist has told them to "just deal with it or you won't get better" Sadly as this is not correct. Hydration of the person when they come into the massage. I try to make every client sit and sip some water when they arrive because people are typically dehydrated all the time from drinking pop and coffee or nothing at all. Second, deep tissue means something different to each person's body. How much effort it takes to get "deep" can vary so on one person you may feel like you are killing your arms to get what they need and the next person you are using just your finger tips to get to the deeper layers. The Deep Tissue style means that you are focusing in on the individual muscles to release them (kinda like a flowing trigger point) You aren't using Effleurage and pushing harder( as Therese points out below). This is a misconception that is common in our industry. Make sure your client gets more water before they leave and you tell them that they must increase the amount of water they drink in a day. Most will say they get enough but really they only drink 1 or 2 glasses of water and then use caffeine rich drinks the rest of the day. If you have a client you feel may get stiff (or just tell all your clients) have them informed to use an ice pack on any areas that feel tender or stiffen later. Apply for 15 minutes and then stop. Repeat if needed. If you follow the above information, your clients will be completely prepared and know what to expect and even if they get a little sore, they will come and see you again. Last, yes as others have stated, pay attention to duration. Never press for more than 30 seconds in one area (I think I go for 10-15 and if it won't budge, try another technique like friction or another angle) you can cause ischemic tissue (damage).
Hope this helps.
MG
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I can tell you how bodybuilders get rid of soreness: they go to the gym and get the blood flowing. Actually, weight lifters and other serious athletes welcome the onset of soreness-- it is a symptom of the beginning of recovery. For many years MTs and other healtcare pros believed that soreness was a result of lactic acid buildup. Pro athletes knew better instinctively that it had to be the result of micro tears in tissue due to stress that lead to growth. Always after a hard workout, the day after, I'd get sore in the worked muscles, on the fourth day there'd be just a smidgen of soreness left, just in time to work that bodypart again.
Funny, ain't it, that some folks who demand bone-crushing pressure during a massage will whimper about a little insignificant soreness a day or two later.
Alyson Schlobohm said:
Lucianna, I really enjoyed reading your response. You brought up a lot of very valid points. I know that sometimes lighter touch is better, it's just hard to explain that to clients at times. A lot of my clients come to me - and refer me to their friends and family - because of my DT work. It's hard to explain to someone that wants a lot of pressure that sometimes less is more - it's a Catch 22!
Gary, LOL. I do think emotional stress had a huge part of it. She was moving in with her fiance and getting married all in one week (a holiday weekend nonetheless). I emailed and spoke with her and offered to do a "relaxation massage", but this was yesterday, the DAY before her wedding, and I was SO nervous of further irritating the muscles that I warned her of this. I'm actually not sure it would have been beneficial at that point - has anyone had experience DECREASING soreness with a massage? Every time I've been sore from a new workout I've been unable to coordinate with MY Massage Therapist. I really wanted to help her and I offered her the best advice I could - light stretching, light movement/rotation of the areas affected, a hot/bath or shower, tons of water, etc. - but we both agreed that another Massage was perhaps not the best answer.
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Permalink Reply by Boris Prilutsky on
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Hi Gary.
I believe we all got little bit off the topic. I mean if one after receiving massage will experience increase level of pain as a reaction then it is positive phenomena. But injury by vigorous pressure application is unacceptable. I'm strongly believe that at this discussion first we should come to conclusions that traumatizing vigorous pressure has nothing to do with therapy by means of massage. In cases of trauma/contusions, post massage pains having different origins than offset muscle soreness and can initiate developments of difficult painful pathology.speaking on offset muscle soreness. Most likely you will work with some professional teams therefore,I would recommend to view of offset muscle soreness as a significant phenomenon that can and must be prevented.
I hope this article will provide information on the subject.
Best wishes.
Boris
http://medicalmassage-edu.com/article_details.php?bn_id=32
Gary W Addis said:
I can tell you how bodybuilders get rid of soreness: they go to the gym and get the blood flowing. Actually, weight lifters and other serious athletes welcome the onset of soreness-- it is a symptom of the beginning of recovery. For many years MTs and other healtcare pros believed that soreness was a result of lactic acid buildup. Pro athletes knew better instinctively that it had to be the result of micro tears in tissue due to stress that lead to growth. Always after a hard workout, the day after, I'd get sore in the worked muscles, on the fourth day there'd be just a smidgen of soreness left, just in time to work that bodypart again.
Funny, ain't it, that some folks who demand bone-crushing pressure during a massage will whimper about a little insignificant soreness a day or two later.
Alyson Schlobohm said:
Lucianna, I really enjoyed reading your response. You brought up a lot of very valid points. I know that sometimes lighter touch is better, it's just hard to explain that to clients at times. A lot of my clients come to me - and refer me to their friends and family - because of my DT work. It's hard to explain to someone that wants a lot of pressure that sometimes less is more - it's a Catch 22!
Gary, LOL. I do think emotional stress had a huge part of it. She was moving in with her fiance and getting married all in one week (a holiday weekend nonetheless). I emailed and spoke with her and offered to do a "relaxation massage", but this was yesterday, the DAY before her wedding, and I was SO nervous of further irritating the muscles that I warned her of this. I'm actually not sure it would have been beneficial at that point - has anyone had experience DECREASING soreness with a massage? Every time I've been sore from a new workout I've been unable to coordinate with MY Massage Therapist. I really wanted to help her and I offered her the best advice I could - light stretching, light movement/rotation of the areas affected, a hot/bath or shower, tons of water, etc. - but we both agreed that another Massage was perhaps not the best answer.
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Permalink Reply by Therese Schwartz on
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Alyson, I had a client come on Thursday evening and then again Friday morning. I don't usually do that but she's driving an hour and a half to come to me (and staying with her sister, also one of my clients). After Thursday night and some significant Myofascial Release work on her left glutes and hamstrings she was sore the next day because I'd worked some additional areas over the previous session 2 weeks ago. I had already planned on doing entirely different things on Friday but when she said she was sore I changed tactics again. I did a massage with the specific intent of relieving the soreness she felt. I was painstaking with my pressure and intent - I REALLY wanted her to feel great and not sore. She felt better when I was done! So I think it can be done that you can decrease soreness with massage.
That being said, I think you did the right thing with the bride-to-be. I also thought of the emotional angle when I read your post earlier in the week (how many days have there been in this week? I've lost count!). Keep doing what you know to be right for your friends and clients and you will do brilliantly!
Alyson Schlobohm said:Lucianna, I really enjoyed reading your response. You brought up a lot of very valid points. I know that sometimes lighter touch is better, it's just hard to explain that to clients at times. A lot of my clients come to me - and refer me to their friends and family - because of my DT work. It's hard to explain to someone that wants a lot of pressure that sometimes less is more - it's a Catch 22!
Gary, LOL. I do think emotional stress had a huge part of it. She was moving in with her fiance and getting married all in one week (a holiday weekend nonetheless). I emailed and spoke with her and offered to do a "relaxation massage", but this was yesterday, the DAY before her wedding, and I was SO nervous of further irritating the muscles that I warned her of this. I'm actually not sure it would have been beneficial at that point - has anyone had experience DECREASING soreness with a massage? Every time I've been sore from a new workout I've been unable to coordinate with MY Massage Therapist. I really wanted to help her and I offered her the best advice I could - light stretching, light movement/rotation of the areas affected, a hot/bath or shower, tons of water, etc. - but we both agreed that another Massage was perhaps not the best answer.
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Hey everyone, I just want to put it out there that this discussion is amazing! I am so excited to hear about how all of you work on people. In my town most of the MT's were trained at the same school and everyone decided to run with brutal DT. I tried it but hated it, especially when I started taking CranioSacral Therapy classes and found out what 5 grams of pressure can do! I gave up on the DT I was taught as soon as I could.
Gordon, I think I've said this to you before but I totally agree with you about throwing out what we are taught in school. I only use about 10% of it at this point. And like Gordon I don't want to brag on myself or come across like I know everything because I don't but I do have someone willing to drive an hour and a half each way every week because of what I can do...that wouldn't happen if I'd kept doing what I was taught.
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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 Daniel Cohen on
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Gary you already have a lot of knowledge to use in massage. You have history to apply and from what you say you learned. Take what you learned about your body behind the wheel and apply it. You know what a pulled shoulder is like, or a numb leg and much else. You know how you got it and how it felt. Do I have that right? Best wishes on your new career. You're going to like the next 20 years.
As for kickin' back to enjoy some Joe with you and Gordon, can I join you guys some day when it happens down the road?
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Daniel, it is good to hear from you.., it has been awhile since we talked. I'd love to sit with you guys and listen to war stories! This quarter my favorite class is NMT. The textbook is Davies' Trigger Point Therapy Workbook; I'm already making good use of it. Got it Thursday night and I've spent the last two days (and nights) getting familiar with my new best friend. Talking about my new career, I'm like a kid in a candy store. I devour everything I can find out about each new modality as if it were a new flavor of ice cream.
My friends, y'all are welcome on the MS Gulf Coast any time. I'm too old and too married to chase women and party wild, but we can find some things to do!
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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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