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Deep Tissue Massage (Benefits and Side Effects)

Deep tissue massage has many benefits, such as optimizing post-workout recovery, promoting healing, preventing injuries, and boosting circulation. However, deep tissue massage has some potential side effects as well. Learn how to reduce or eliminate negative side effects so you can get the maximum benefit from your massage therapy session.

A man having a deep tissue massage on his upper back.

When most people think of getting a massage, they think of low lighting, soothing music, and aroma-infused lotions. In other words, they think of relaxation.

They don’t think about a grueling 90-minute session that feels a little like a marathon. While deep tissue massage uses the same relaxing atmosphere and scented oils as other forms of massage, it’s definitely a workout. That’s because, during a deep tissue massage, your body is doing work to repair itself, boost circulation, and reduce inflammation.

In fact, deep tissue massage can be so effective that many people with chronic musculoskeletal conditions swear by it and schedule weekly massage therapy sessions to manage their pain and increase their mobility.

If you’re suffering from ongoing muscle soreness but are nervous about deep tissue massage, you don’t need to be. Deep tissue massage benefits and side effects are well-documented and easy-to-understand. Going into your massage therapy session prepared, knowing what to expect, will ensure that you have a beneficial experience with minimal negative effects.

What is Deep Tissue Massage?

A woman enjoying a deep tissue massage on her back.

Deep tissue massage is much different from other classic forms of massage, such as Swedish massage and Shiatsu massage. While these types of massage focus on general relaxation, the goal of deep tissue massage is to realign the deeper layers of muscle and connective tissue to promote healing.

Yes, this does mean that sometimes deep tissue massage can hurt, but deep tissue massage enthusiasts describe it as a good hurt that lets them know their knots are loosening and their bodies are realigning. If you’re in the middle of a deep tissue massage and you’re hurting in a bad way or feeling uncomfortable, it’s important that you communicate with your therapist. Massage therapists tend to be intuitive, but they aren’t mind readers!

Deep tissue massage uses many of the same techniques as Swedish or Shiatsi massage, but the movements tend to be slower and the pressure is deeper and more sustained. At the beginning of your massage, your therapist will likely apply a lighter all-over pressure to warm up the muscle tissues and ease you into the massage. No one wants an elbow in the back without any warning! Your therapist will then move into specific techniques that are common to deep tissue massages, such as a deep, gliding stroke along the length of a muscle in your leg or a short, intense stroke across the grain of a muscle to break up adhesions and realign muscle fibers.

You may find that your therapist manipulates your body more often, perhaps stretching your arm over your head to get a a better angle on your upper shoulders or twisting your lower body to get a deep stretch on your lower back. Your therapist may also use more than just the hands, leaning into the pressure with his entire forearm or pinpointing a knot next to your spine with her elbow.

Overall, deep tissue massage is much more involved, a physical practice that can have powerful healing effects.

Common Conditions that Can Be Treated With Deep Tissue Massage

A man suffering from lower back pain.

Deep tissue massage works by releasing adhesions in the body’s soft tissues. When you have ongoing muscle soreness or a sports injury, typically there are adhesions between the muscles, tendons, and ligaments. In other words, these tissues are literally adhering to each other, or sticking together in a knot or bundle, rather than sliding over each other the way they’re supposed to.

To make matters worse, these adhesions block blood flow, constrict your movement, and result in chronic pain and inflammation. Generally speaking, deep tissue massage is best for chronic muscle tension, specific injuries (such as tennis elbow), and other chronic aches and pains, including neck, shoulder, and back stiffness. If you have an area of chronic or recurring muscle soreness, you’re a good candidate for deep tissue massage.

Specific injuries and conditions that can benefit from deep tissue massage include:

  • Lower back pain
  • Fibromyalgia
  • Recover from injury (whiplash, falls and sprains, sports injuries)
  • Chronic leg pain or tension
  • Sciatica
  • Tennis elbow
  • Repetitive use injuries (carpal tunnel syndrome, knee pain, plantar fascitis)
  • Osteoarthritis pain
  • Mobility issues
  • Upper back, shoulder, and neck stiffness
  • Piriformis syndrome
  • Post-workout recovery

The Benefits of Deep Tissue Massage

A man having a deep tissue massage on his back.

According to Consumer Reports magazine, deep tissue massage ranks as one of the most effective treatments for relieving osteoarthritis pain and chronic neck and back pain. Overall deep tissue massage was ranked as more effective than physical therapy, exercise, chiropractic, acupuncture, diet, over-the-counter medications, and glucosamine.

The benefits of deep tissue massage are both physical and psychological. Although a deep tissue massage is not purely meant for relaxation, it can promote a general sense of well-being and contentment, especially if your body is properly warmed up before the more intense part of the session begins.

Some specific benefits include:

  • Reduced pain and stiffness. Obviously, this is the main benefit that most people are looking for when they book a deep tissue massage. Maybe you turned your head too quickly and you’ve had a nagging pain in your neck for a week. Perhaps you’ve suffered from lower back pain for years, but now it’s keeping you up at night. Whatever the complaint, deep tissue massage can help relieve these common aches and pains of life. Deep tissue massage activates your muscle and connective tissues, breaks up adhesions and knots, stimulates natural muscle lubricants, and increases circulation to the affected areas. All of these benefits result in reduced inflammation and soothed, limber muscles, especially over time.
  • Increased circulation and faster healing. As knots and adhesions release, blood flows into areas that have been starving for nourishment. This increased circulation promotes faster healing, not only for the muscle fibers themselves but also for all the associated tissues. The skin, tendons, joints, ligaments, and bones will also thank you for booking that massage.
  • Improved mobility. We all know we should stretch, but none of us do it enough. With the rise of desk jobs, our muscle fibers are shortening, which results in chronic back pain, bad posture, and decreased mobility. A good deep tissue massage uses a sustained, gliding pressure to stretch and lengthen your muscles. The result? More flexibility, stronger joints, and better movement in the hips, knees, shoulders, and back.
  • Better posture. As you continue in your massage journey, you may find that you’re sitting and standing taller. The deep stretching and pressure that are the signature of a great deep tissue massage lengthen your muscles and realign your muscle fibers and connective tissues. By doing this, a deep pressure massage also frees your skeletal system to realign itself naturally. Think about it. Your bones can’t realign if they’re all bound up in a perpetually contracted bundle of muscle and tendons. Once that knot is released, however, the bones can get back into the correct position.
  • Injury prevention. You may have noticed by now that all of these benefits are interrelated and build on each other. That’s because the health of your muscles, connective tissues, and bones are so closely related that they’re often referred to in short-hand as one system. The musculoskeletal system. One of the worst parts of modern office culture is all sitting around. As your connective tissues and bones settle into cramped, hunched positions, your mobility decreases and your chance of injury increases. To make matters worse, as knows and adhesions develop and circulation decreases, your bones, in particular, become susceptible to injuries because they aren’t getting the nourishment they need. You can take 100X the daily recommended dose of Calcium and it won’t do a bit of good if the nutrient can’t find its way to your bones. Deep tissue massage can reverse all of these conditions, making your body stronger and more injury-resistant in the process.
  • Stress reduction and mood improvement. When you properly prepare and properly hydrate after a deep tissue massage, all of these benefits can also make you feel less stressed and happier. A good deep tissue massage can also lower your cortisol, or stress hormone, and increase your production of feel-good hormones like serotonin and oxytocin.

All of these beneficial effects of deep tissue massage are well-researched and documented in scientific studies, but it’s important to remember that massage isn’t a magic bullet and it doesn’t work in a vacuum. In other words, you can’t live a completely unhealthy life and expect one massage a month, or even one massage a week, to undo a lifetime of bad choices.

For best results, regular deep tissue massage should be part of a comprehensive health plan that includes other lifestyle modifications such as yoga and stretching, a healthy diet, good sleep hygiene, walking, and other mobility exercises, and relaxation.

The Side Effects of Deep Tissue Massage

A man having a painful massage.

The side effects of deep tissue massage are usually minimal and easy-to-manage, but it’s important to know what to expect so you can manage any of these effects that do come up.

  • Light-headedness. As your massage therapist works out the kinks in your system, your circulation increases. Simultaneously, as you relax into the massage and the atmosphere, your blood pressure drops, which may cause you to feel dizzy when you stand up again. This side effect is one of the most immediately noticeable after a massage, but it’s also the easiest to avoid. Simply don’t stand up too quickly when you’re done. After your therapist leaves, lie still for a few moments. Breathe deeply. Get up as slowly as possible.
  • Ongoing soreness. You get a massage to relieve muscle soreness and tension, only to discover that you have ongoing soreness for a couple days after the massage is over. What gives? Remember that deep tissue massage works by breaking up adhesions between muscle fibers and connective tissues. The immediate result of this is that more lactic acid is released into the muscle fibers, creating a generalized soreness in the muscles. Give it time and drink plenty of water to flush the lactic acid out and the soreness will go away.
  • Ongoing tiredness and flu-like symptoms. A lot of people report a generalized “gross” feeling after a deep tissue massage, and there’s actually a name for this phenomenon. Post Massage Soreness and Malaise (PMSM). Symptoms include tiredness, headaches, stomach issues and nausea, sweating, and congestion. Basically, you feel like you got the flu. Again, these symptoms are usually caused by lactic acid, myoglobin, and other chemicals being released from the muscles during the massage. Drink plenty of water and try to get to bed an hour earlier to sleep off the side effects. If these feelings persist for more than a day or two, you may want to consult your doctor to see if there’s an underlying health issue that makes your body more sensitive to deep tissue massage.
  • Bruising. Unless you bruise very easily or have an underlying blood disorder, you should not bruise after a deep tissue massage. If you do have a blood issue, consult your doctor before beginning a massage regimen to make sure that you’re safe. If you don’t typically bruise easily but you discover bruising after your massage, your therapist went too hard. Ice the area and apply some arnica gel. During your next massage, be sure to ask your therapist to lower the pressure. You shouldn’t injure your blood vessels while trying to heal your other soft tissues.

A woman having a deep tissue massage on her lower back.

Most of these potential side effects are caused by your muscles “spilling their guts” so to speak. When you get a strong massage, your muscles will release lactic acids and other stored and trapped chemicals into your bloodstream, and the increased circulation created by the massage will transport those chemicals throughout your body until they can be filtered out and eliminated by your kidneys.

One of the best ways to avoid or reduce these symptoms is to drink a lot of water and avoid alcohol, coffee, and other dehydrating beverages after your massage. The increased hydration will clear your system of any unwanted guests more quickly and have you on your way to feeling great. The other important way to reduce or eliminate these side effects is to know your limits and take it slow.

While a great deep tissue massage will feel like a lot of work and leave you a little exhausted, you don’t have to beat your body up to achieve the results you’re looking for. Don’t ask your massage therapist to go deeper until you can barely take the pressure. There’s no benefit in pushing a massage to the point of bruising or injury trying to break up a lifetime of knots and tension in one session. Instead, take it slow, breathe deep, and relax into it. You’ll reap more long-term benefits and avoid negative side effects if you are disciplined and regular in your approach rather than finding someone to beat your body up in a brutal “massage” session.

One of the worst things you can do for chronic pain and other conditions is to injure yourself through a strong massage, causing more trauma to your musculoskeletal system, tearing your muscle fibers and connective tissues, and releasing the resulting toxins into your bloodstream. It’s common to feel a little tired and under the weather after a deep tissue massage, and that feeling may last a few hours or even the rest of the day. If you’re feeling like you have a strong case of the flu three days later, then the massage was too much.

In the most severe cases, Post Massage Soreness and Malaise (PMSM)  can result in a dangerous condition known as rhabdomyolysis, which can endanger the kidneys. This is extremely rare, but you should be aware of the possibility and be gentle with your body.

When to Avoid Deep Tissue Massage

A woman having an upper back deep tissue massage.

Although deep tissue massage is generally safe, there are times when you should consult your doctor first, opt for a gentler form of massage, to avoid massages altogether. Since deep tissue massage uses a firmer touch and more pressure, it may not be safe for everyone.

For example, if you have cancer that has spread to the bones or osteoporosis, an aggressive massage could unintentionally cause a hairline fracture, but a Swedish massage may be beneficial. Similarly, if you have a clotting disorder or are taking blood thinners, the increased circulation that is a benefit for most people could create a health problem for you.

Speak to your doctor before scheduling a deep tissue massage if you:

  • Have cancer or are undergoing cancer treatments
  • Have a history of blood clots or have a clotting disorder
  • Are taking blood thinners
  • Have a bleeding disorder
  • Have a heart condition or high blood pressure
  • Have diabetes
  • Are epileptic
  • Have Ehlers Danlos Syndrome
  • Have any other ongoing condition that is already being treated by your doctor

Schedule a gentler form of massage or let your deep tissue massage therapist know to avoid certain areas if you:

  • Are pregnant
  • Have osteoporosis or cancer in the bones
  • Have open cuts or abrasions
  • Have a sunburn
  • Have varicose veins
  • Bruise easily
  • Have undiagnosed lumps

Avoid massage altogether if you: 

  • Are currently running a fever or have the flu
  • Have recently had an operation or have an acute injury
  • Have neuritis or a skin disease

Most of this information is nothing more than common sense. Listen to your body and your doctor as you’re determining what level of massage is right for you, and avoid anything that causes injury or pain.

When done correctly, deep tissue massage literally breathes new life into knotted tissues, releases built-up tension, and increases your overall mobility and well-being. Going into your massage session knowing what to ask for and what to avoid will help you reduce the potential for negative side effects and reap the most benefit from your deep tissue massage.

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