Those are probably some of the most commonly asked questions and discussed topics among massage therapists and with their clients. It seems everyone wants deep pressure, or thinks they should. The “no pain, no gain” adage in our society runs deep. In my experience, many clients seem to believe “if I am not feeling something intense, nothing is happening with my body.”
There is an incredible range of pressure options and effectiveness in massage. Sometimes, deeper pressure is very effective, especially when eased into. Sometimes, too much pressure can increase tension, and the muscles effectively spit the massage therapist right out. How, then, does the massage therapist decide on how much pressure to use and when?
Here are four factors I take into account in choosing an amount of pressure to use during massage with my clients:
1. What the client wants (or thinks they want!) When people ask for deep pressure or deep tissue massage (which is simply getting to the deeper muscles beneath the superficial ones) I will do my best to accommodate that request. Similarly, if a client just wants to relax, I will not go into deep, although I will look for opportunities to be as effective as possible with some pressure that is well received.
2. I watch how the body responds I always ease my way into the body with warm up strokes. I believe that I have to earn the respect from the client’s body to go in deeper. I will check in with the client on the amount of pressure, both verbally and by checking for non-verbal cues. I watch all their reactions, from a bodily standpoint (of relaxation, breathing, and relinquishing into the massage vs. tensing up), their facial expressions (peaceful, relaxed, relieved, vs. grimacing in pain), and what they say or express through words or sounds. I will back off if it seems too much, or go in deeper if I am welcomed. This happens throughout the massage, as each new area usually requests and accepts a different amount of pressure.
3. I continually gage “what is the benefit of going deeper vs. trying other methods of release?” Sometimes, deeper isn’t better, as the same result can be achieved with less intensity (through the use of range of motion or joint manipulation, for example). I have had massages where I came away much more sore than I wanted, and that soreness lasted for days. Some residual muscle tension, a feeling of having been “worked”, is usually fine, often very effective in fact. It’s finding the balance of what is enough and what is too much.
4. I take into account such things as Resting Tone in the body, pain tolerance, and the clients goals with massage. Working with athletes, for instance, it is often necessary to go in deeper, in order to even have an effect on a well-toned body. Similarly, a person with a very high pain tolerance may not register firm pressure as painful, but only as therapeutic. As long as there are not pain medications involved to dull awareness of pain, I will usually work with a person more deeply who has a higher pain tolerance and requests deep work. And again, I will always take into account what the client’s goals for massage therapy are. Are they recovering from an athletic endeavor? Getting prepared for one? Just looking to relax?
The bottom line? For me, amount of pressure in massage is similar to partner dancing. You take a step, you see how your partner responds and what their body does. If it’s too quick or too much, you back off or slow down. If your moves are welcomed and the response is fluid and graceful, then you can up the complexity of moves or amount of interaction to bring it to a deeper level. Each dance is different, each partner is different, as is each massage and each client. It’s the continual assessment and awareness of what is going on in the moment that allows for the process unfolding in a satisfactory and therapeutic manner. It is my hope with all of my massages to reach the place where the client comes away with the feeling that the amount of pressure was “just right”.