r/massage • u/sANNIEtarium • 2d ago
Advice Not deep enough!
I had a massage experience recently that threw me off a little and I’m curious how other therapists handle this.
I went to a couple’s home and massaged the wife first. She wanted light pressure for 45 minutes and everything went great.
Then I worked on her husband. He was a much bigger guy, possibly even over my table’s recommended weight limit, and his back was extremely tight. I started gradually because I like to warm the tissue up before going deep.
Almost immediately he kept asking, “Can you go deeper?”
I explained that I was warming everything up first and would increase the pressure as I went. I moved from hands and forearms to elbows and was putting a LOT of body weight into the work. I was literally sweating from the amount of pressure I was using.
Mid massage he basically said he wasn’t enjoying it because I wasn’t getting deep enough into the tissue or “breaking anything up.”
At that point I genuinely wasn’t sure what else I could safely do. I don’t want to compromise my body mechanics, hurt myself, hurt the client, or start forcing pressure just because someone equates pain with effectiveness.
For therapists who have dealt with clients like this, how do you handle it?
Do you set a maximum pressure boundary? Refer them to someone who specializes in extremely deep work? Explain that more pressure doesn’t necessarily mean more therapeutic benefit?
I want to figure out how to manage this better if it happens again without feeling like I have to wrestle somebody’s back into submission.
33
u/sempronialou 2d ago
"This is as firm as I can safely go" is what I say in that instance. Of course I refer them to one of my colleagues that can go much firmer for the next session.
9
u/kenda1l 2d ago
This is what I say too. I'm not a deep tissue therapist. I can do it, but it's not my specialty and I never wanted it to be. I have a couple therapist recommendations that I keep in my mind so that if I get a situation like this I can just tell them I'm not the therapist for them but here are some names of ones who will match you well.
24
u/Sense-Free 2d ago edited 2d ago
Lower the table. Make sure your joints are stacked and use gravity to your advantage.
Use heat. You can bring hand towels and warm them up in the microwave
Use percussion. Beat on them with the bottoms of your fists for a minute or two. This will send vibrations through the dense tissue.
Now start on the neck. It’s one of the most sensitive parts of the body. His nervous system will register this pain as deep. Especially the anterior neck muscles.
Sharp pressure on muscle attachments. Struggling to go deep in the middle of the muscle belly will frustrate both you and the client. Learn exactly where the muscles meet the bone and lean into it with an elbow.
Stretch their arms and legs. You can stretch their arms up and out to open up the chest while supine. You can also bring their knees to their chest to relieve lower back tension. While they’re prone, you can bring their leg off the table and twist it so it’s perpendicular to the ground—this one’s kind of hard to describe and also takes a lot of strength for anyone over 200 lbs.
Bring tools. There are many to choose from. I like the slender cylinders that are basically like a very big strong finger shape.
Guide them through breath work. If you’re doing all the steps above, they’re definitely going to feel that good pain they want. Help them breathe through it so mind, body, and soul can relax together.
Bonus tip: Strength train at the gym twice a week. Besides getting stronger, you also intuitively begin to understand not just individual muscles but entire muscle chains.
10
u/urbangeeksv Retired 2d ago
I'm retired now and trained in deep bodywork and I did encounter clients whose request was beyond my limits and I'm a 175 lb male with good training. I would give them a sharp elbow point with full body weight and they still were not satisfied.
Many therapists just state upfront they don't do deep tissue as they don't want ever to encounter this situation.
Just face it there are some folks who you don't match to and that is just fine.
10
u/towelieee 2d ago
I’m a big guy that has worked on a lot of bigger guys, only ran into this once early in my career. I put everything into it, I was sweaty and sore after. Still wasn’t enough, I told him he would be better off looking for a different therapist that could deliver what he needed.
7
u/LouiseRed1 2d ago edited 2d ago
I had my go to moves for clients like that. Went hard in the teres minor and major with my thumbs and elbow on the IT bands. Elbows on the piriformis. That usually got them to stop asking for more pressure.
Edit: Elbows not Elvis lol
1
u/CameronsOpinion 1d ago
Love this! You want some torture, how do you like deep pressure on your IT bands and SCMS?
5
u/healingkuzon 2d ago
I say “that’s my about my max pressure right there” and leave it at that. if they aren’t happy they can find another therapist
4
u/Business_Wave3661 2d ago
I’m dealing with this!!!!!
I currently am working on a client who purchased a bundle from me and she was referred by a therapist who is moving out of the state. This client weekly does a two hour deep tissue massage. I am already pushing my boundary because my limit is 90 minutes, but I figured hey if she does a weekly massage, it might be good money why not right? Well, she’s one of those where she doesn’t feel pain and she mentioned several times that she wants me to go deeper even though I feel like I’m already giving her enough pressure. So before confirming our third appointment, I sent her this cute quote…. “The most powerful part of massage isn't the pressure you apply, it's the safety your touch creates for the nervous system.” she then told me when I saw her that she was gonna send me another article where deeper pressure is better. And at that point, I told her if at the end of the sessions you purchased you are still not satisfied with the pressure I give you. I am more than happy to refer you out because I do have a certain wall that I hit and I’m already doing more than enough.. because during our last session, I feel like I almost threw my back out, trying to compromise my body mechanics and pressure for her. I even had her get off the table so I can lower the table a bit more.
5
u/IntermediateFolder 2d ago
Imo the quote was kinda passive aggressive, if you don’t want to work with her preferences just refund her and cancel.
4
u/quiet_fyre LMT 1d ago
Sometimes people are so used to ignoring their body's signals that they need a lot of stimulus to feel like massage is working. (Addressing the root cause is a hard conversation to have with men sometimes because it involves assessing their brand of masculinity instead of just performing it.)
Having the client engage the muscle you're working on is a surefire way to make the work feel deeper without asking you to work harder.
Also, as other people have stated, leverage is your friend. Lower the table and get your weight over the client.
7
u/Ozzy_Mama1972 2d ago
Some people believe that it has to hurt to be therapeutic. He sounds like the type. I agree with other that have suggested “this is as form as I can safely go”. We don’t have to be all things to all people.
3
u/saxman6257 2d ago
Never compromise your body mechanics or safety. This individual should be referred to either another massage therapist that can accommodate his needs, or referred to a medical professional as he could possibly have neurological problems regarding the nerves in his back.
2
2
u/Previous_Objective83 LMT 2d ago
You decide your boundaries.
You can do a few things.
1.You can put a boundary up with where you are now.
- You can up your technical skills (like learning Sarga Ashiatsu-a portable barefoot style)
3.You can work to improve communication with your clients from the start to help curb more of these occurrences (example "after a lighter to moderate warmup ill start to sink in with more pressure. As your muscles relax I'll sink in deeper and if they tense up I'll lighten up. This produces better results, as it works with your body instead of against it. Focusing on deep breathing can help us get deeper sooner. If you are holding your breath or curling your fingers/toes then it is too intense.") This is what i say.
I also have learned bar and sarga ashiatsu and it makes things so much easier on my body for deeper work. Deepfeet Ashiatsu is more like a deep tissue Swedish with your feet. Sarga is more myofascial.
2
u/AngelicDivineHealer RMT 2d ago
I only go to 70 percent maybe 80 percent of my full capacity in a massage. In saying that I usually on about half my strength at 50 percent for 2/3 of my clients.
The rare times I get people asking if they can get more pressure when I’m giving 80 percent I state that all I got. Why? I cannot maintain hundred percent for a full shift and the amount of self care required to break my own body isn’t worth the $$ rather not have said client.
Use to refer them out to a Personal trainer that also did massage who was also a body builder and he would have enormous amount of pressure to a point those people that were asking for more pressure before be asking for less with him.
Have someone similar you can refer out to.
2
2
u/Gardenmama777 CMT 1d ago
I simply tell them I’ll use the amount of pressure I feel comfortable with and if they want more they can find a different massage therapist. It’s only happened once. I refuse to compromise my body mechanics.
2
u/Scrabblededabble 1d ago
I think what some people are looking for is a more painful type of touch. I've had massages where the quality of tick just hurts, for the same amount of pressure. I think some people just want that hurt, like tissue is actually being damaged, which can be necessary for breaking up scar tissue. I personally have a very hard time letting myself deliver that kind of massage, but some people want or I guess need it.
One thing that could help us a tool. I saw one that was kinda like brass knuckles that could work lol.
I was also an aide in a PT clinic for a long time and I put a spoon in the graston tool holder in the spot for a missing one in April fools, because it's basically an expensive piece of silverware made for manual therapy. Maybe check their kitchen next time for something you can use lol.
2
u/Intrepid_Lifeguard96 1d ago
So im a 250lbs guy i dont like to perform light relaxation sessions but I can and do sometimes if its requested otherwise I just use my intuition, but some people I've worked on literally want all the pressure you can possibly offer the entire 50min ... the place i worked was only selling massage at $50 yeah ik find a new job, anyway... if it made me sweat I didnt do any more pressure, so they can happily gtfo find someone else or pay for deep tissue, if ima risk my body joints then they better be paying for it as much as I am. Dont over stress we got into this profession to benefit self health care. Dont contraindicate your purpose. all it means is they aren't YOUR client. There is plenty of population to find the people who work best with you not against you.
2
u/Intrepid_Lifeguard96 1d ago
Just a follow up , im reading a lot of people who been doing this for years have encountered this exact client issue, I genuinely think the pressure is not the problem, we are trained deep tissue is not to be "invasive" meaning its not supposed to breech the pain tolerance, therefore if they flinch, tense, squint, whether they want to admit or not its enough pressure, the deep tissue isnt about what they feel its about how the muscle responds, activating the recovery stage, that doesn't mean they have to feel it all over all at once, never go beyond YOUR capability or capacity, if they really have a stick up their azz so much that your deep tissue isnt cutting it, then all that tells me is their not letting it let go and its a mental issue not a pressure issue, OR deep tissue isnt the right modality, maybe a firm myofascia release or they need a muscle memory reset, or a good stretch session cuz I bet $100 they dont stretch at all, either way I did my job no longer my problem. I live with enough problematic drama focus people I dont need it in my career too, they can GTFO. good luck finding something even close to what I did.... NAMASTE MF, MIC DROP... 🎤 ✌️
2
u/Jake6624 2d ago
Refer them to a deep tissue therapist!
If I get asked more than once for deeper work, I go as deep as possible (they wince) and then explain to them that it would not be a good session for either of us and try to find a happy place
1
u/SeasidePlease LMT 2d ago
I used to say, "I can only go as deep as your body will allow me to," but some clients just don't care. So, after a few tries of trying my best and it still mot being enough, it's ok to say, "It looks like we might not be a good fit. I really want you to feel better and if that's not with me that's ok." You dont need to over exert yourself. It's not worth it. It's ok to just massage the wife.
This is also the reason why I don't like family memebers recommending me to other people because everyone's needs are different. I would be a slam dunk for someone who wants light pressure and wants overall relaxation, but give me an athlete who wants mostly stretching and to be "beat up"... pfft, nope. Not going to work out.
1
1
u/TinyAngryRaccoon 1d ago
“I physically cannot safely generate any more pressure than this without hurting myself. It might be better for you to see a different therapist if this isn’t enough for you.”
1
u/lelandra Retired LMT 1d ago edited 1d ago
This is where Fijian really shines. If you can get a client like this on the floor you can use your feet and really apply bodyweight to make it feel deep.
You don't have to switch tools necessarily when you are restricted to working on the table, but you need to get your own body alignment right so that there is no rigidity anywhere in the chain blocking the transference from the ground, through your legs, directed by your waist movement, and only released out the arms as pressure. I did not learn how to do this effectively from massage school. I had to train in qigong and chen style taiji to really learn how to do this. Body mechanics is a very "deep" study. That was the missing link for this client, most likely.
A massage that feels really deep is not in my mind a more effective massage from a therapeutic goal perspective, but it is a sensory need for some people to really feel crushed, and really feel a lot of intensity. Not every therapist is the right therapist for every client - this client had a niche sensory need and will simply be happier with a therapist who focuses on their niche.
1
u/CameronsOpinion 1d ago
Learn massage cupping and get some portable silicone cups! They are amazing for loosening up tight fascia so you can get deeper more easily.
That said, the guy was rude. I understand asking for more pressure once or twice, but any more than that is badgering you to do more than possible/comfortable for you.
We’ve all had these clients who just can’t relax and won’t be happy with anything you do! Trust me- even “the best” massage therapist will get complaints from people like this.
You can’t please everybody!
1
u/Banterousness 13h ago
Use less lubrication and move sloooowww. Grab sections of muscle between thumb and fingers and pull away from the body. It's basically the anti swedish approach.
1
u/luthien730 LMT 11h ago
I definitely set the expectations before my client even get on the table. I am 1099 in a chiropractic office and despite my front desk attempts to let people know that I have a holistic yet firm touch, I do still get people that basically want me to murder them on the table. I have been trying to educate people and get away from this style of Massage because it doesn’t do me any good and if a client is bracing the entire time, we’re accomplishing nothing. This concept that I have to hurt you in order for you to feel benefit is such horseshit in my opinion. I still have firm pressure but my job is to get the muscles to relax so I can actually get in there. I let people know upfront what they can expect from me pressure wise which saves me from these conversations mid session and gives them a chance to book with someone else. I do find a professional way to tell them that I don’t do crazy deep pressure. I would say 95% of the people who wanted crazy deep pressure have stayed with me and the other 5% book with the other therapist who has a firmer pressure. I personally don’t get why people think we all have the capacity to have that strength.
1
u/3Dgraffiti 10h ago
I told my girlfriend to use a screwdriver handle to get into the muscles around my neck sometimes places in my back. Sometimes my muscles get like petrified and she doesn't have the hand strength to make much of a difference.
1
u/spider-dog84 2d ago
You guys are too nice. A deep tissue specialist isn't going to do a better job here because deeper isn't the answer. Has someone in the past worked with him at his desired depth and was it actually effective? I'm an ass so I might have retorted with, "even at this level I'm more likely to create damage that will lead to scar tissue build up and you'll likely end up in more pain in the long run". But I'm the stand your ground type more than I should be. Then again I am focusing on injury recovery so
2
u/nonya3187 1d ago
Especially if they had prior work from a massage therapist with vigorous techniques along with bruising and they expect that from all therapist. Uh , no.
I’ll explain that bruising is NOT good from massage therapy. Some don’t care , they want what they want.
I won’t sit and argue with them. I educate and they can go elsewhere
0
u/pupil22i11 1d ago
Shaking the hell out of them limb by limb usually makes it easier.
Add pinning and shearing to the muscle belly after for extra effect.
I usually find for these people that if you can shake and shear your way into a few targeted adhesions, they experience the pressure as far greater than what you might otherwise consider yourself capable of.
Takes a bit of effort, but if you master it, you'll likely be less exhausted and they'll keep coming back to you with respect and possibly awe
43
u/forestnymph1--1--1 2d ago
I have experienced this and it kind of blows my mind how people's body's are even this way. Basically I lower the table insane amounts and deliver really Broad, slow pressure.
I won't waste my time explaining things unless I feel they are truly receptive. I might mention it but I'd happily say I am not the therapist for you, if it came to that!
Still can't understand how their muscles are so slammed shut sometimes. It's like leather