Navigating the wild and wacky world of massage therapy can be confusing. There is an incredible array of different types of massage (“modalities”), areas of specialties, and pricing structures. Massage therapists are a creative lot and our practices are often an expression of our focused creativity, tempered with science. Very often, our personalities show through our businesses, the styles we learn and practice, and even in our decor. And in the end, finding the right massage therapist is very often dependent not simply on the end goal of the session or how much we have in our bank accounts, but on a multitude of varying factors. It’s who we feel most comfortable with, and who can ultimately help us reach our goals on the table. Modalities- and how well the therapist uses them- factor strongly into that equation. Modalities, in specifics, can be a very confusing realm.
There are hundreds of modalities and offshoots available. Hundreds. Keeping them straight is difficult for even for the most veteran massage therapist, which is why- eventually- we begin to specialize. Most massage therapists also keep a running log of nearby massage and bodyworkers who specialize in different modalities. Sharing that list with a client- in the form of a referral- is a different story (in my area, massage therapists tend to be hyper- territorial. I’m told that it’s not common in other areas). Most massage therapists though have a good grounding in the basic modalities. These basics vary with geo political area, but most all include Swedish, deep tissue, and some stretching.
This variance of modalities can lead to a little confusion especially when booking a first appointment. After all, each practitioner is an individual and individuals express their art slightly differently, even if they were taught by the same individual. One of the most common areas of confusion is the difference between a firm Swedish and Deep Tissue.
Now I’m a big guy- 6″3, 200 and change and I specialize in athletes and injury rehabilitation. Accessing the deep layer soft tissues is no trick for me. I cannot tell you how many times I’ve had a client come in and request a “deep tissue massage”- only to leave the table unhappy, the taste of lactic acid in their mouths, feeling a little “beat up”, and trying to balance between feeling like a wimp and bolting out of the office as fast as humanly possible.
The first and most important thing to remember is the Swedish massage is a modality. It is comprised of long flowing strokes (“effleurage”), kneading (“petrissage”), friction, stretching, and percussion (“tapotement”). Pressure can vary, depending on the desired outcome, and usually makes use of some sort of oil, lotion or cream.
Deep tissue is none of that. It’s not even the exact opposite. It is, in reality, not a modality at all. It’s an anatomical designation for the layers of soft tissue laying closest to the skeleton. The phrase “Deep Tissue Massage”, though synonymous with hard or heavy pressure during a massage, is not a true modality. Instead it utilizes techniques from other modalities to access the deeper layer structures.
Because of the association with hard pressure though, “Deep Tissue” has lead to many a sore client looking for a more compassionate therapist! Deep tissue work can be exhaustive for the tissues and uncomfortable for the client. The client may experience soreness shortly after the session, or up to 24 hours after. Some people even experience bruising- though, to be fair, if you come away bruised from a massage, your therapist overworked the area. that is to say, some discomfort is expected, but bruising of otherwise healthy tissues should never happen after a massage. I’ve found in my practice that when someone specifically requests a deep tissue massage, they generally mean they don’t want a light touch or “froofy” massage. And that’s cool- I get that. I came to that conclusion many years ago when I tired of losing clients.
Typically, there is a need for deep tissue work. On my table, that usually means an injury of some sort. But all that is discovered during the initial intake and interview. After all, if the cervical multifidi don’t need to be worked, why put yourself (or your client) though it?
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