Massage therapy and deep tissue massage
Neck and back massage for pain relief
As you will soon see, it is simple, easy and effective to self-administer or guide someone who is helping you with either massage therapy or deep tissue massage. This discussion will be all you need to get started doing therapeutic massage that is good enough to give you needed relief. It is almost always helpful to apply these basic massage principles, but if after trying to help yourself at home you are not satisfied with the results of your efforts, you can always contact a local professional office to help you out. Either way, doing the kind of basic at-home massage that I will describe in this article will help your back or neck pain 99% of time.
There are many styles and types of massage, and sometimes the names that are used to describe them will overlap and be confusing. Regardless of what the style of massage is called, for most types of self-massage to be effective for pain control and to speed healing of an acute or chronic problem the massage must do only two simple things to be effective:
- Increase blood circulation in the area to move blood into and out of the area better than it was before the massage
- Apply pressure to areas of muscle that are contracted
When using massage for acute or chronic neck and back pain, or pain associated with arthritis, disc bulging or piriformis syndrome, there is little risk of aggravating these problems by using self-administered massage therapy and much to be gained. You will only know for sure once you have tried.
Most people in pain will instinctively place their hand on the area to stroke and rub the tissue gently to make it feel better; it is a comforting and natural thing to do. There is even a very large and well-established organization of nurses who perform and teach what they call “therapeutic touch.” Therapeutic touch is practiced in hospitals and doctor’s offices all over the world, and it is intended to provide pain reducing and healing benefit simply by gently touching the skin over an area of disease and pain. The benefit of therapeutic touch is explained as a transfer of subtle healing energy from one person to another. Everyone has experienced at some time the comforting sensation of being given a warm and loving touch.
It seems that no matter the technique, or the hand strength or skill level used, just rubbing, stroking and applying some pressure in and around the painful area will help relieve pain to some degree, by at least a small or even a great degree of pain relief. If you closely follow the instructions in this article you will increase the benefits you are able to provide for yourself, or guide the person who is trying to help you, by knowing a few important things about massaging the problem area. You can be assured your discomfort will be reduced by a greater or lesser amount depended on how deeply, thoroughly and skillfully the massage is delivered.
As you will soon see, it is not difficult to self-administer or guide someone who is helping to give you a fundamental type of massage therapy or deep tissue massage. This discussion will be all you need to get started doing therapeutic massage that is good enough to give you needed relief. It is almost always helpful to apply these basic massage principles; if after trying to help yourself at home you are not satisfied with the results of your efforts, you can always contact a local professional office to help you out. Either way your back or neck pain will be helped.
What is massage therapy?
Massage therapy is also known as Swedish massage; it is the most common style or type of massage in the United States. Massage therapy is easily recognized by the use of long, smooth strokes with the hands that tend to be directed not too deeply down into the tissue. In massage therapy tissue kneading, pressing, pulling, compression, rolling and squeezing movements are focused on superficial layers of muscle in and around the general region of the chief complaint, aided by the use of massage oil or lotion.
Massage therapy tends to feel comforting and pleasant because of the relatively light gliding and gentle compression that is used, and promotes a sense of well-being and relaxation. Only slight soreness or pain might be briefly experienced when passing over especially sensitive tissue areas; if this happens, simply lighten up a bit over that area.
The friction and pressure of massage therapy improves local and general blood and lymphatic circulation, and this in turn increases oxygen and tissue nutrients into the area being worked, as well as increases the removal of tissue toxins. All these effects create a more favorable environment that will result in reduction of muscle tension and pain, increased flexibility and mobility of joints, and flushing the area of lactic acid and the cellular byproducts of inflammation and tissue healing, all of which further reduces pain and stiffness of muscles and joints.
People use massage therapy for a variety of health problems:
- Acute and chronic back pain
- Muscle conditions such as spasms, strains and sprains
- Chronic inflammation that is seen in arthritis and tendinitis
- Stress relief
- Hypertension or elevated blood pressure
- Headaches and migraines
- Edema or acute swelling of tissue as occurs after sprains, fractures or surgery
- Repetitive strain injury, such as carpal tunnel syndrome
- Circulatory and respiratory problems
- Post-injury and post surgical rehabilitation
Precautions and restrictions with massage therapy:
- Presence of infectious skin disease, bruised or inflamed skin, rash, hives, insect bites, tumors, abdominal hernia, recent fracture and open wounds
- Immediately after surgery, or chemotherapy or radiation treatment for cancer, unless recommended by a doctor
- Tendency toward blood clots which could becomes dislodged
- Heart disease.
- Pregnancy, except when massage provided by a massage therapist certified in pregnancy massage
How to do self-massage therapy and deep tissue massage
Basic method for massage therapy:
- Warm the room where the massage therapy will be provided
- Remove clothing from the area that will be given massage therapy
- Lie on a comfortable surface so you can relax, and position yourself so the area being massaged is easily reached
- Lie on one or more towels if there is a reason to think massage oil will run down skin and onto surface
- Apply a liberal amount of massage oil (mineral oil, hand lotion, moisturizing lotion, or even olive oil can be used) to the area that will be massaged
- Using the open palms and hands, apply a variety of light to moderately firm strokes and gliding movements to the area of complaint, in the general direction toward the heart
- Using the forearms, elbows and knuckles, pass lightly and carefully over the area of complaint
- Roll, knead, bunch and otherwise compress the superficial tissue of the area of complaint
- Never use so much force or pressure that pain is created, or that the tissue becomes more than just a little pink. If someone is doing massage therapy for you, they must understand that no added benefit occurs by using heavy force or deep pressure that is painful. You must communicate with the person doing the massage therapy about any discomfort you might feel and they must agree to reduce their force and technique so that the work is not painful.
10. Rest after each massage therapy session for at least 15 minutes, and drink a few large glasses of water within the hour after the session is over.
What is deep tissue massage?
Deep tissue massage is a slower, deeper and more aggressive style of massage than massage therapy (Swedish massage). Deep tissue massage is recognized by the use of constant pressure that often goes straight down into the tissue or short strokes that are delivered with a greater amount of compression force, as well as the use of elbow tips, knuckles and various rigid tools to apply heavier pressure than is used in other styles of massage. This massage tends to be more uncomfortable to receive since it is directed deeper into the body and toward tissue that tends to be more sensitive to begin with.
Deep tissue therapy is ideally suited for chronically tense and contracted body areas such as stiff necks, sore shoulders, low back tightness, hip and upper thigh pain like sciatica. It is very effective where there is chronic muscle tension or after an old injury that has been slow to improve. In these cases there are usually complex and widespread bands of painful, rigid soft tissue fibers (adhesions) that develop between muscle layers, as well as tendons, and ligaments. The presence of the adhesion interspersed within normal tissue will interfere with loc al blood and lymphatic fluid circulation, cause pain, limit movement by contracting muscles and around joints, as well as act as a source of ongoing inflammation. Deep tissue massage physically breaks down these adhesions to restore circulation and normal movement and reduce pain.
The idea of deep tissue massage is not to provoke pain, although that can certainly happen; the idea is to work with sensitive tissue in spite of the fact it can hurt, in an effort to over-stimulate or fatigue the tissue by the pressure that is being applied and in spite of the pain. When this is done the pain/spasm/pain/spasm cycle is so completely interrupted that the tissue no longer holds the painful contraction that causes so much pain and limited movement.
The pain of deep tissue massage can be easily controlled or reduced to a tolerable level by reducing the amount of force applied to the deeper tissue, although not so much that no pain is felt. No greater pressure and force should be applied in a deep tissue massage than can be tolerated by the individual; a reasonable and acceptable level of pain is maintained so that the best level of tissue change and improvement can result. Since tissue response, meaning relaxation and normalization of painful, tight, shortened and contracted soft tissue tends to be in direct relationship to the force applied to the abnormal tissue, the goal of deep tissue massage is to use as much force as possible while still being able to tolerate the pain that is felt by the individual receiving the massage.
Deep tissue massage tends to feel uncomfortable and tolerably unpleasant when it is done to greatest effectiveness; it can certainly be done so it is not uncomfortable and not at all unpleasant, but then it tends to be less effective. The usual force that is used tends to promote a feeling of overall body fatigue and sense of body weightlessness at the end of a well-delivered massage session. By slowly building up pressure force and allowing the individual to get accustomed to the sense of pressure and stay relaxed while feeling the pain that develops, a greater amount of therapeutic benefit can be earned. Moderate to marked muscle and tissue soreness can commonly remain for an hour to a day or two days afterward when deep tissue massage is done correctly.
For someone who is doing a self-therapy using deep tissue massage, or for someone who is doing this work on another person, it is critically important to note that the pain that is experienced during and after deep tissue massage is not felt because of the use of abusive or overly rough pressure; the pain is not felt because of brutal force or unkind and unnecessarily forceful work that is performed. The pain is primarily experienced due to the very sensitive nature of the abnormally tight and contracted soft tissue. When this keenly tender, shortened and nodular tissue is contacted by a deeply applied force the pain can be considerable. If this same force is applied just as deeply and just as aggressively to normal, healthy and non-contracted tissue it would result in little to no discomfort at all. It is not heavy force that creates the pain response; the pain is a function of abnormally tight, irritable and sensitive tissue being provoked by a reasonable amount of force – that can hurt a lot.
All of the benefits, indications, contra-indications for deep tissue massage are the same as those listed for Swedish massage therapy, plus two additional warnings:
- If you have a heart condition or elevated blood pressure a deep tissue massage might not be safe for you. If you decide to attempt to use deep tissue massage anyway it should be so reduced and modified that your heart rate is not appreciably increased because of pain.
- If you feel so much discomfort that you are being taken beyond your pain tolerance limit, the person doing the deep tissue massage must agree to stop or reduce the force and technique at your first notification that you wish them to reduce or stop what they are doing. When you say stop, they must immediately stop.
Basic method for deep tissue massage:
- Warm the room where the massage therapy will be provided
- Remove clothing from the area that will be given massage therapy
- Lie on a comfortable surface so you are able to relax and position yourself so the area being massaged is easily reached
- Lie on one or more towels if there is a reason to think massage oil will run down skin and onto surface. With deep tissue massage the use of oil or lotion is less important because there is considerably less tissue friction and stroking being used, although a small amount can be helpful.
- Apply massage oil (mineral oil, hand lotion, moisturizing lotion, or even olive oil can be used) to the area that will be massaged
- Using the tip of the thumb, any of the knuckles, the tip of the bent elbow, any clean tool that has a firm broad edge (see below), deeply apply a light to moderate amount of force to the area of complaint
- When a nodular and very sensitive area is found, continue to remain on that specific area until the pain is lessened or the area begins to soften. This can take from 15 seconds to several minutes
- While maintaining light to moderate pressure on the sensitive area it can be helpful to move the contact point of the elbow, thumb tip, knuckle or tool very slightly in a small circular or up/down or crosswise pattern to coax the tissue to loosen and become less painful.
- Never use so much force or pressure that intolerable pain is created.
10. Seldom does the tissue become more than temporarily pink because so little surface friction is applied; most force is applied directly downward
11. You must communicate with the person doing the massage therapy if you feel that you cannot tolerate the pain that is being generated.
12. Do not do deep tissue massage into the abdomen, and definitely not into the midline of the abdomen, and never on the abdomen of a pregnant woman.
13. Rest after each deep tissue massage session for at least 15 minutes, and drink a few large glasses of water within the hour after the session is over.
Deep tissue massage for hard-to-reach areas
It is possible to give yourself a deep tissue massage on the lower back, mid- and upper back or back of the shoulders where your hands cannot reach. All you must do is to find a ball and lie on top of it so that your area of complaint is in contact with the ball. By slowly moving the body around it is possible to thoroughly explore . probe and massage that part of the body indirectly with the ball that is between you and the surface you are resting on. If the pressure and force is too painful or does not go down deep enough to reach the tender areas you wish to treat with deep tissue massage, there are several simple things you can change to alter the force and depth of penetration to get the deep tissue massage exactly like you want it. You can:
- Change the size of the ball – a larger diameter will penetrate less deeply and be more tolerable; a smaller the diameter will penetrate more deeply and reach the more sensitive tissue for a better deep tissue massage
- Change the hardness of the ball – a softer ball will penetrate less deeply and be more tolerable; a harder ball will penetrate more deeply and reach the more sensitive tissue for a better deep tissue massage
- Change the firmness of the surface you are lying on – a softer surface (couch cushions) will allow for a less deep and be more tolerable massage; a harder surface (floor) will allow for greater penetration and a stronger deep tissue massage
- By trying a different ball (golf ball, tennis ball, base ball, child’s rubber ball, volley ball, etc.) used against different surfaces (wooden floor, carpeted floor, bed mattress, couch cushions, etc.) a wide variety of deep tissue massage can be performed. Experiment until you find the right combination that allows you to do it just right for you.
There are tools to deliver a deep tissue massage that are made specifically for that purpose. They can be bought online, or you can find things in your own home that are just as effective and a lot less expensive. Common things around the home that can be used to provide a deep tissue massage:
- Knuckle of a sharply bent finger or thumb
- End of sharply bent elbow
- Eraser end of a pencil
- Rounded end of a fork or spoon handle
- Rounded end of broom handle that has been cut off at 4-5 inches
- Rounded end of a screwdriver handle
- End of a lipstick or lip balm container
- Edge of a silver dollar or a large button of a similar size
If you want to use massage therapy
- Do not use massage therapy in place of a visit to your family doctor or specialist
- Discuss massage therapy with your doctor and ask her advice. Ask for a referral since many doctors now send patients for this kind of care
- Inform your health care providers about all complementary and alternative medicine procedures you use; keep all your doctors informed about what you are doing for your health care. This will ensure coordinated and safe care.