FAQ: What is the “Right” Pressure?

Massage therapists ask you about the pressure during a session.  However, if you are still new in massage, you might not know exactly what the “right” pressure should be.  As I wrote in “FAQ: No Pain, No Gain,” some people believe that a massage should give them “good pain,” so to speak, to be effective.  It shouldn’t.

You might think massage therapists should know what pressure is right for you.  Yes, and no.  They do have a good idea based on how your tissue feels like, so they can adjust their pressure accordingly.  However, how your tissue feels like (e.g. tightness) isn’t always a good indication because it is you, who feel it, not your tissue.  You can be very sensitive to touch and can’t stand any deep pressure even if you have tight muscles.  On the other hand, your tissue isn’t tight, but you feel it tense and want stronger pressure.  The perception is relative.  

Another issue is the approach of each massage therapist varies as I mentioned in “Art of Pressure” and “FAQ: Is Deep Tissue Massage painful?”  On top of that, what each of them expects their clients to feel is also different.  I understand that you trust your therapist’s judgment and go along with “not-so-sure-feeling” believing it might do you good in the end.  Or, you just thought that’s what was supposed to feel like. 

I have an embarrassing story when I received a “deep tissue” massage after I became a massage therapist.  The massage was vigorous all the way through, and the pressure was strong, but I thought it was not hurting, and I couldn’t bring myself to tell the therapist to lighten up.  I thought she should know what she was doing.  The outcome was miserable.  I felt “energized” right after the session, but then my body started to get sore everywhere and got even a bruise on that day.  I ended up with pain that I didn’t even have.  I realized our definitions of a “deep tissue” massage were completely different.

You, as a client, should be in charge of what feels right for you.  Trust your “first perception.” (In my case, the pressure was “strong.”)  I remembered that one of the instructors at my massage school said “if you are thinking about pressure during the session, it is probably too much.”  

FAQ: Is Deep Tissue Massage painful?

Some people want to get Swedish Massage to relax, and some love Deep Tissue Massage to feel that their body is surely worked on.  Whatever you choose, all massage is “therapeutic” in the sense that massage influences and promotes your well-being.  

Deep Tissue Massage (I call it Connective Tissue Therapy) seems to be regarded as a somewhat painful method opposed to Swedish Massage.  However, the Connective Tissue Therapy I learned is not intended to push hard or cause pain.  As I explained about fascia and the cornstarch experiment in the previous post “Fascia (Connective Tissue),” I sink in to the tissue slowly only to the degree that the tissue allows me (read about my techniques).  It may not turn out to be “deep” depending on the condition of the tissue, but it is all effective as the superficial fascia still has an effect on the deep fascia.  The work is intended to allow the restricted or dehydrated fascia to become softer and more supple.  The Connective Tissue Therapy invites you to be aware of your body and provides a unique opportunity to discover yourself.  You could experience deeper relaxation because of the slower pace.

Ask your massage therapist first what their “Deep Tissue Massage” is like.  Since massage techniques, methods, and approaches are not clearly defined unless they are registered such as Rolfing®, “Deep Tissue Massage” can be quite different depending on the therapist.  And also, it may be called “Connective Tissue Massage/Therapy,” ”Myofascial Massage,” or something else.  It's important to find one you like, whatever is called.

If you like Deep Tissue Massage, read "No Pain, No Gain?"

FAQ: No Pain, No Gain?

“No pain, no gain” is the phrase most frequently heard from clients.  I also believed it, and I liked deep tissue massage before going to massage school.  The first challenging idea for me at school was “A massage doesn’t have to hurt.”  I also explained other changes while at school in the post “A Holistic Approach.”

I found many websites by massage therapists that “No pain, no gain” is a myth, and others express some pain is necessary.  I agree with the latter because it really depends on the condition and the goal of a massage.  If a massage is for a rehabilitation purpose, the pain is not required to get better.  However, if the pain is caused by trigger points, it is necessary to feel the pain especially in the beginning.  Even if treated on trigger points, the pain level shouldn’t exceed the client’s pain threshold.  Tracking the client’s non-verbal cues such as frowning, flickering, and clenching is very important for the therapist.  In addition, the therapist should respect the tissue and know how deep, how fast and how much pressure the tissue can withstand. 

Some of you have high tolerance for pain and also believe “No pain, no gain,” so even if it’s uncomfortably painful, you may not tell your therapist.  If you are not sure about how much pain is reasonable, check to see if you can keep breathing normally.  If your breathing stops frequently, I would guess you are enduring the pain too much.  If you can’t relax, your muscles keep contracted and tight, so a painful massage may not help the condition.  Another guideline can be a pain level of 7 or less on a scale of 1 (no pain) to 10 (unbearable).

Again, it really depends on your condition and the goal of your massage, so good communication between you and your therapist before and during the session is very important.  Don’t stick to “No pain, no gain”!

FAQ: Should I take off my underwear?

This is probably the first question you may have before you get a massage for the first time.  I always tell my clients to undress to their level of comfort.  This means, if you are not comfortable taking off your bras, you can leave them on.  Massage sessions are for your comfort, which is more important for your relaxation than my convenience.  I can work around any garments left on.  I have worked on a lady with a tank top or undershirt.    

It is true, however, without undershirt or bras on, I can apply smooth, continuous gliding strokes to the body, which would feel more relaxing, if you are comfortable.  I get permission from clients to unhook the bras only when I work on the back, and put them back.  However, if you are not comfortable with this request, you should say no.  

Regarding underpants, I don’t mind if they are on or not.  Male clients tend to keep them on maybe because they don't want to embarrass me, but I am professional, so I won't be uncomfortable.  If clients wear boxers or briefs, I ask them to pull them up toward the hip bone when I work on their upper legs.  Without underpants on, I can apply continuous strokes up to the top of the thighbone and the buttocks to be able to address low back pain, sciatica, knee pain, and tight quadriceps, hamstrings, and IT bands (a thick band on the side of your thighs).  

When clients, whom I have seen some time, have sciatica or low back pain, and I think it will be more beneficial for them to receive work on their buttocks without underwear, I explain it to them and make sure if it will be totally comfortable for them.  I recommend you try without underpants on next time if you are completely comfortable with the idea.  

You might also want to read the related post "FAQ: Does a massage therapist work on my buttocks?" and watch the video. 

FYI - Draping is required in the state of Florida, so even if you are without underwear, the gluteal (buttock) cleft must be covered all the time, and only one side of the buttocks is undraped at a time.