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 How is Neuromuscular different from Deep Tissue Massage? or Isn't Deep Tissue better?

I get asked this a lot and it's a great question as it brings up some relevant issues in modern massage therapy as well. Just like it sounds, using Deep Tissue Massage technique a massage therapist works the muscle tissue by applying heavy pressure to access deeper layers of tissue.

Deep Tissue Massage is described on the menus of most day spas and other massage joints as deep pressure to differentiate it from the lighter Swedish Massage techniques. Though broadly correct this distinction is overly simplistic. There are other massage modalities that affect the deeper layers of tissue without applying near painful pressure (e.g. Myofascial Release and Neuromuscular).

Within a spa setting Deep Tissue massage should be judiciously applied by the Therapist within a full body relaxation massage session. Deep Tissue applied throughout a full body massage is an obsessive misuse of the technique IMO and could easily lead to unintentional bruising and or soreness.

Deep Tissue massage also does not require any additional training aside from the basic massage therapy education available everywhere. In a way this is a strength but also a drawback, and I will tell you why.

Years ago when I was fresh out of massage school, newly licensed and looking for a job I was applying for positions with several prospective employers. Part of the job quest for a massage therapist is giving a demonstration massage (often called a practical) so your potential employer can evaluate your skills. At one spa I applied, the practical part mostly consisted of the manager posing as the client saying, 'Okay, push as hard as you can.' I guess I pushed hard enough, I got the job. Think about it though, this is upside down, it seemed to me one reason I was hired is because I could push hard enough to make it hurt.

In fact, at the time of this writing September of 2021, one of the leading national day spa chains describes deep tissue on their app as, 'DEEP the most heavy-handed of the pressures, involves skilled techniques affecting entire muscle groups & can be painful.'

(Quote is from ME online android app accessed 9.16.21)

An immediate problem presents itself if you follow this all too common perception of what Deep Tissue is — the distinct possibility of unintentionally bruising a client. I have always been uncomfortable with that. Then there's the flip side, some clients want and expect pain, this too makes me uncomfortable but that is grist for another article.

There needs to be some radical rethinking in the Spa/Massage Industry concerning Deep Tissue Massage and client expectations/education in my opinion. Deep Tissue should mean the effect we have as Therapists on the underlying tissue; not just pressing an elbow into a client until they wince.

Deep Tissue as a technique can be effective. I use Deep Tissue myself when needed in session. When performed correctly deep tissue is effective when not overused and below the pain threshold. As for the claim in the quote above it is a '...skilled technique' in the Day-Spa environment, I beg to differ. Most if not all Therapists within the Day-Spa world push as hard as they can to the satisfaction of the client knowing enough from massage school not to cause too much harm. I would not call this technique but rather 'due caution.'

I know I'm sounding really negative about Deep Tissue, this is not my main intention, but I want to present the case that the current urban perception of what Deep Tissue is and or should be is distorted. It's all part of the undying and proven false notion in fitness circles that no pain is no gain. I think part of this is related to the same psychology that if on the bottle of aspirin it says to take two pills many folks will take four.

Back to the original question, forgive the foray down the rabbit hole, but Deep Tissue is really the proverbial elephant in the room in contemporary massage therapy. Perceptions need to change for better client care IMO.

How is Neuromuscular different from Deep Tissue Massage?

Neuromuscular Therapy is a highly technical form of manual therapy that uses precise protocols. Neuromuscular protocols begin to correct muscle dysfunction and pain by removing trigger points, muscle adhesions, and reinforcing myo-skeletal (connective tissue) linkages. Shortened muscle is lengthened, and the muscular sensory receptors are reset. Areas of pain in the surrounding muscles that are affected due to poor biomechanics and compensation are also addressed.

The pressures that are used during Neuromuscular treatments are based on the client’s threshold, contrary to Deep Tissue where no pain is no gain is the accepted standard. This misguided axiom does not apply in Neuromuscular Therapy. During treatment, the client tells me what the proper pressure is based on an upper threshold of nothing beyond a pleasant soreness, or whatever they choose in between. There is no benefit if the pain response is invoked, it only stresses the muscles and nervous system, causing them to tighten up, which is counterproductive.

Neuromuscular treatments focus on the primary and peripheral areas that are involved with painful and restricted motion, but can involve treating a whole myo-skeletal train too. Deep tissue often only focuses on the sore muscle area itself.

Neuromuscular massage requires a lot of additional training beyond that of the traditional massage education and Deep Tissue does not as mentioned above. I was trained by Gary Salinger, the creator of the Body Insight Method of Neuromuscular Therapy which is still considered a groundbreaking holistic therapy.

Another area where Deep Tissue massage and Neuromuscular Therapy part ways is the differing goals between the two modalities. Deep Tissue is generally a one off treatment for relaxation, relief from a heavy workout and/or sedentary lifestyle. Neuromuscular treats the specific condition and/or injury. I have past clients with years of Deep Tissue massages and after their first Neuromuscular Therapy are amazed at the reduction in pain and muscle dysfunction. Just to qualify what I just said, until our habitual patterns are corrected, it is not uncommon for particular dysfunctions to return. Some conditions like scoliosis will always need maintenance treatments and their treatment plans are more involved, including strengthening of muscle groups and stretches for greater relief. At the least, several sessions are needed in order to begin the retraining of muscle trains by lengthening and reinforcing neuro-pathways to achieve long lasting pain relief and improved mobility. Neuromuscular Therapy is sought for healing, not as a sore muscles massage, but it works well for that too.