Therapeutic and Deep Tissue Massage Techniques
Domain 6 examines focused work for specific complaints: trigger points, adhesions, restricted fascia, and guarded tissue, always within a safe and consented plan.
Core rules and concepts
- Treat with a purpose. Palpate for tissue texture, tenderness, and referral patterns, then choose ischemic compression, cross-fiber friction, myofascial release, or active-assisted stretching.
- Ischemic compression is applied gradually and held for roughly 30-90 seconds while the client breathes and the tissue releases. Stop if pain increases sharply or numbness appears.
- Work within a pain score the client can tolerate, commonly around 5-7 out of 10, and reassess during the session. Deep tissue does not mean bruising.
- Avoid the carotid artery, sciatic nerve, ulnar nerve at the elbow, femoral triangle, kidneys, and bony prominences. Never work over an undiagnosed lump.
- Expect soreness for 24-48 hours and tell the client so. Reassess range of motion and pain after treatment.
Worked example
An office worker has a tight upper trapezius with pain referring toward the temple. Reasoning: this fits a trigger point referral pattern. Apply gradual ischemic compression to the taut band, keep pressure below the client's tolerance limit, avoid the anterior neck and carotid, then add active-assisted stretch and posture advice. Recheck pain and rotation after treatment.
Traps
"No pain, no gain," pressing on the carotid or a nerve, treating undiagnosed pain with deep pressure, and failing to reassess. Another trap is documenting deep tissue work when the session was actually general relaxation.