Balance Blog

May 16th

Deep Pressure: Does Massage Have to be Painful to be Effective?

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One of the most popular forms of massage is deep tissue massage.  In my practice, I’ve encountered a large number of massage clients who have learned that in order for it to be effective; a deep tissue massage must be painful.  Fortunately, this is not the case!

Deep Massage is a modality developed by David Lauterstein, writer, massage therapist and owner of the Lauterstein-Conway Massage School in Austin, Texas.  David writes, “The idea is there are many ways to deeply affect a person—heavy pressure is just one way—not necessarily the best. The key is to find the best way to touch the person in order have a deep, positive, and long-lasting therapeutic benefit.” (

The most effective way to address pain due to old injuries, accidents, surgeries, etc, is for the muscles to be relaxed during the massage.  I’ve also encountered the belief that by using heavy pressure, a massage therapist can force tight muscles to relax.  In reality, relaxing the muscles is the job of the nervous system. Heavy, painful pressure can engage the client’s sympathetic nervous system – the body’s response to pain and danger.  Everything gets ready for fight or flight, including tensing of the muscles.  Imagine your fingers passing through sand to find a shell.  Now imagine trying to pass your hands through a brick wall.  Sand = relaxed nervous system; brick wall = fight or flight, too much pressure.   When a client is able to enter into a trusting, relaxed state, the muscles release.  The body allows the therapist entrance.   Heavy pressure on a brick wall is simply not therapeutic!

Deep pressure does have its place in massage. When the muscles are relaxed and good connection and communication is established between client and therapist, pressure can be added gradually.  The goal here is for the therapist and client to find the pressure that comes just up against your tolerance – maybe, in some cases, uncomfortable pressure, but not beyond what you can handle.   This is the key: does the pressure being used engage your fight or flight response?  Here’s another way to gauge it: is it painful enough for your fists to clench, for you to have to hold your breath to get through it, for the muscles being manipulated to tighten up reflexively?  If the answer is yes, the pressure is too deep. If you can breathe through the discomfort and maintain relaxed muscles, this is the best possible place for the deepest healing to happen for injuries and other chronic pain in soft tissues.

Here’s a final word from David Lauterstein on the benefit of the Deep Massage method:  “Deep tissue works from outside in and therefore may be more temporary in its effect. Deep Massage works from inside out, stimulating the nervous system’s ability to relax. Therefore it usually results in more thorough, longer-lasting relaxation as well as deeper pain relief, and postural benefit.”

To learn more about David Lauterstein and Deep Massage, click here .  You can also purchase David’s book, the Deep Massage Book, here.

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