The 5 Most Effective Deep Tissue Massage Techniques

Category: Massage
Last updated on: 19/06/2023
Massage therapist applying a deep tissue massage technique to the body

In this post you'll learn about five highly effective techniques used by therapists when performing a deep tissue massage session.

If you're looking for a deep tissue therapist to visit you at your home or hotel room in London, then enter your postcode below:

And if you're interested in how to maximise the benefits of a deep tissue massage at home, check out our related comprehensive guide.

Remedial deep tissue massage is one of the most commonly requested therapy styles in London. The key aim of this type of treatment is to restore health and wellness by targeting damage to muscles and other soft tissues. Special manipulation techniques are used to help relieve pain from injuries such as sprains or strains. This kind of massage is also often recommended if you are seeking some relief and comfort from musculoskeletal issues, which if left untreated can become a serious concern for some patients. 

As a client, you can use the information in this post to find out about some of the most effectual techniques – and then request your therapist include them to better help alleviate your pains. Qualified therapists can use the information here to reference and build upon their existing portfolio of movements to ensure they are performing in line with best practice and standards. 


Facts & Stats:

Deep tissue massage therapist applying oil to client's body⇢ Deep tissue massage is the most popular booked treatment style. Over 62% of customers chose this style in 2020.


⇢ Qualified therapists usually spend 5 – 10 minutes warming up the muscles before they begin to apply more intense pressure. 


⇢ Deep tissue is available as a full body treatment or can be combined with other styles so that the more intense techniques are applied only to specific body parts. 


⇢ Sports and Deep tissue massage are not the same style of treatment, albeit they have many similar aspects.


⇢ It is quite normal for some pain to develop in areas which have been massaged intensively within 24 – 48 hours after the treatment.


⇢ Deep tissue massage can be effective for trigger points, but for even deeper release, some of our London therapists might recommend Myofascial Release Therapy techniques.



Key Benefits of More Intensive Massage Techniques

The techniques used in deep tissue massage can feel incredibly satisfying, whether you are feeling generally run down, suffering from a specific muscle injury or even emotionally bruised.  

The more meaningful touch associated with this style of therapy typically offers the following benefits over other types of less intensive treatment: 

⇢ Nutrient-laden blood is encouraged to circulate around the body to damaged muscles and soft tissue quicker

⇢ A more intense treatment, properly applied, helps customers develop trust in their therapist’s ability sooner, thus helping them to relax earlier on

⇢ Clients report feeling more connected with their therapist as a result of the extra pressure – this brings both physical and mental benefits.

Tension in the body is generally built up over extended periods of time where the body, or mind, have been subjected to excessive stress.   

The techniques used in deep tissue massage can help more quickly release such tension by penetrating further into problem areas and thus more quickly getting to the root cause. Performed correctly, a professionally conducted deep tissue session should also embrace relaxation aspects as part of the overall treatment. Many people therefore book this treatment style as part of a spa day at home. 


Deep Tissue Methods

Many people mistakingly think that all such treatments must be performed only using strong strokes and the more powerful the compression applied, the more effective the treatment. That is not correct. 

Just as applying too little pressure may not effectively deal with the problem, it is also possible to apply excessive power which can have an adverse effect on the muscle. What is most important is that an adequate level of pressure is applied at the correct position - getting both parts right increases the chance of treating the issue being suffered. 

Treatments are usually performed using oil but can also be conducted ‘dry’, that is without any oil or cream. Some practitioners prefer to use powder for stronger and more connected treatments.

If your skin is very oily or hairy, or you simply do not want oily skin after your massage, then powder is a good choice. It also facilitates better friction between the therapist’s hands and your body, thus allowing the level of pressure to be increased and applied more easily.


Technique 1 – Sacrum Push 

This is a simple but highly effective method with which to begin any full-body deep tissue massage.

The massage therapist places one hand on the small of your back, just above your sacrum, and then places their other hand on top of the first. Using their two hands as a balancing support, the therapist will then slowly begin to lean towards you, so that the weight of their body begins to transfer away from their knees or feet and towards their hands. As the angle of leaning towards you is gradually increased, the level of pressure applied to the small of your back increases correspondingly. 

Image showing the sacrum area of lower back highlighted with pain

The pressure is increased steadily until appropriate and then held in place for up to 30 seconds, whilst both client and therapist continue to breath slowly.

The technique delivers a highly satisfying, warm pressure to the core of the body at the base of the spine across the whole sacrum area. You will enjoy an almost immediate sensation of immense comfort that prepares your body for the rest of your treatment. We think this is one of the best ways to begin a deep tissue routine and best when combined with carefully measured breathing. 


This technique employs one of the most important aspects for delivering deep tissue therapy in a safe manner for both parties: appropriate and careful use of the therapist’s body weight to increase the overall force of the massage whilst ensuring your therapist is also able to apply that added pressure without using up too much energy.

Experienced therapists should continuously look for feedback from their client (both verbal and visual) to ensure the level of pressure remains comfortable throughout.

If you do feel any discomfort during a treatment, you should let your therapist know straight away. They will be happy to readjust to a more suitable level and thankful for the honest feedback.


Technique 2 – Elbow Pressure 

In this procedure, the therapists bends their arm to 90 degrees and places their elbow directly over a pressure point on your body. After ensuring the position is accurate, they will very slowly lean in towards you to increase the depth of compression.

Therapist applying firm pressure using elbowPressure is applied gently at first to ensure that the correct trigger point has been located, before being steadily increased. Once the optimum level has been reached, the position is held for between 5 to 10 seconds.

This technique is most commonly applied to aching shoulder muscles, either side of the top of the spine around the scapula area.

It is important to ensure that the force is not misplaced onto bony areas as this can be painful and uncomfortable. The beauty is that the therapist can very effectively increase the strength which is focused directly on to the shoulders all the way up to her own weight, thus satisfying even the most demanding of customers.

It is best to use a slightly rounded elbow position rather than bent fully sharp, so that the technique results in a deep but comfortable movement rather than a painful harsh poke. 

Whilst this method also uses practitioner body weight, the therapist has to be especially careful because much of their body weight is being focused through the small surface area of an elbow tip. 

This is an especially good way of applying intense force whilst not risking damage to the therapist’s own fingers and thumbs. 


Technique 3 – Knuckle Pressure

In a similar approach to the Elbow Pressure technique, this method utilises joints on the therapist’s own body to channel a deeper level of force than might be applied using just the fingertips. 

Knuckles of a deep tissue practitionerYour therapist will form a tight fist with their hand and then progressively push the fist into your body, knuckles first. 

It’s a bit like a slow-motion punch! But without the snap impact aspect. The four knuckles, backed by body weight, are able to relatively easily penetrate the top layer of skin tissue and exert force into the soft tissue below. 

Your therapist may also rock, rotate and roll their fist to further work muscles and ligaments an, loosen built up tension, and encourage better blood circulation around the area being treated. 

This method is usually applied when the client needs more vigorous therapy applied to fleshier parts of the body, such as the buttocks and backs of thighs. 


Technique 4 – Double Finger Press 

Talking about fleshy parts, it is well known that pressure applied using a padded instrument feels more comfortable than that from a sharp or pointy one. 

The softer parts of fingersAccordingly, it is not surprising to learn that people generally prefer therapists to use the softer tips of their fingers, rather than the bony corners of elbows and knuckles. 

However, because of the more delicate nature of outstretched fingers compared to joints, applying intense pressure using the tips of fingers can present somewhat of a challenge for therapists, especially if they are quite slightly built. 

The Double Finger Press method of deep tissue massage provides an effective solution to this issue. Using this technique, the therapist is able to use their fingers to apply more force whilst not damaging their own soft tissue. 

Using a similar approach to the Sacrum Push, the therapist places their two hands, one on top of the other with fingers interclaced and then places this combination on the client’s body. 

By leaning into their interlaced fingers, the therapist is able to apply substantial power into the target muscles spread evenly across all 10 fingers and thumbs at once. 

The double finger press massage technique is often used over the whole body to apply oil and conduct flowing effleurage strokes but with at a deeper and more penetrating level than typically found in Swedish massage. 

Just like the popular double shot of espresso, this method is a double shot of effleurage!



Technique 5 – Thumb Rolls 

The last of our 5 most popular and effective deep tissue techniques are Thumb Rolls. 

This procedure allows your therapist to get quite deep into specific muscle areas and is most commonly applied to tired or slightly strained calf muscles

One of the nicest things about this technique is that it allows the therapist to apply increased force whilst still maintaining an overall soothing style. 

The procedure is usually best applied when you are lying face down with the leg being treated raised slightly above the treatment table or bed. By raising the leg very slightly, the therapist is able to more easily access both the upper and lower sections to perform more thorough therapy.

Just place your feet over a rolled towel or small pillow for an easy and comfortable way of keeping your leg raised through the treatment. The best therapists provide a warmed towel for that added bit of luxury!

Therapist and customer thumbs

Once the legs are correctly positioned, the therapist grips the lower leg with both hands just above the ankle. With thumbs placed centrally over the calf muscle and pointing up towards the heart, the therapist’s fingers are wrapped around the rest of the leg with the tips of the fingers at the shinbone. 

Next comes the thumb rolling. First, the fleshy tip of each thumb is pushed into your skin, deep enough to make a small indent. Then each thumb is moved in an opposing circular fashion – the right hand making clockwise circles, the left moving anti-clockwise. 

If the therapist is performing the movement correctly, both their thumbs should meet at the 12 o’clock position every few seconds. The extent of compression is increased with each circle. 

After several revolutions in the same area, the grip around your leg will be reduced slightly and the therapist will move their hands a little further up your calf. The whole process is then repeated again. 

This routine continues until the whole lower leg muscle has been deeply massaged. When the top is reached, the therapist may move on to the second leg. If however, you have particularly tight muscles, it is quite normal for the same area to be repeat massaged two or three times. This allows for the muscles to be gradually warmed, then massaged steadily deeper until quite intensive compression is being performed and then returning to more gentle movements for the final warm down.

The rolling thumbs approach allows therapists to work on both the gastrocnemius and soleus muscles at the same time. By gripping the whole of the lower leg, it is also possible to squeeze inwards from all angles whilst performing thumb rolling, so that the client benefits from compression massage techniques at the same time.  

If you’ve been out running recently, this is one of the best deep tissue techniques to ensure your calves remain in top shape with efficient muscle regeneration!


Pain During Deep Tissue Massage

Image of man holding his head in pain

Even though your therapist will be applying a stronger force during much of the treatment, a deep tissue massage should not hurt to a degree that you feel repeatedly uncomfortable or in severe pain. In fact many people request a deeper treatment to aid sleep as they need a therapeutic and meaningful touch to fully relax.

It is important to keep an open dialogue with your therapist throughout any treatment to inform them if you feel pain at any moment during your treatment so that it can then be quickly adjusted and you feel comfortable again. 

"No Pain, No Gain"

Most common inaccuracy about deep tissue massage: ‘No pain, no gain’ is not true! Therapists may use any combination of medium, deep and extra-deep pressure strokes depending on the state of the soft tissue being massaged.

You may feel some pain in the 24 – 48 hours after receiving a deep tissue massage using the techniques described above, especially if you do not receive them regularly.

Toxins and built up lactate are encouraged to work their way out of your body and this process can cause moderate levels of pain as it happens.

You should not experience any bruising, unless you are particularly sensitive to touch and any post-treatment pain should be disappear within a day or so.

Drinking plenty of water helps speed up the recovery process and assist the delivery of nutrients to recovering muscles. 


Is Deep Tissue the same as Sports Massage? 

A deep tissue massage session is not the same as a sports massage. Whilst both styles are performed using techniques that exert a higher level of force and use more vigorous strokes than you would find in a typical relaxation style massage, there are some important differences between them.

Both styles do however have a similar goal of seeking to soothe and treat muscle injuries. 

To delve deeper into the differences between these popular styles, read our in-depth comparison between Deep Tissue, Sports and Swedish massages.


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