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Deep Tissue Massage Therapy (DTMT)
Deep Tissue Massage is a type of massage therapy that focuses on realigning deeper layers of muscles & connective tissue. It is especially helpful for chronically tense & overused areas, which can occur anywhere in the body depending on which training regiment the bodybuilder, strength athlete, or fitness enthusiast follows.Some of the same massage strokes are used as traditional massage therapy, but the movement is slower, and the pressure is heavier, allowing for a deeper treatment of the muscles & connective tissues, concentrating on areas of tension, adhesions & pain.
When there is chronic muscle tension or injury, there are usually adhesions (bands of painful & rigid tissue) in skeletal muscles, tendons or ligaments, or a combination thereof. Adhesions can block circulation and cause pain, limited movement, and inflammation. Deep Tissue Massage Therapy works by physically breaking down these adhesions to improve blood circulation & recovery from workouts, relieve pain and restore normal movement, or at least, increase range of motion.
Depending on the type of adhesion or tension, DTMT can be moderate to incredibly painful at times. It’s essential to communicate with your massage therapist during the DTMT session to assess how much pressure can be applied. The therapist can also prepare you for the pain to come when treating areas with many adhesions or scar tissue. Over time, these adhesions & scar tissue will slowly break apart, increasing mobility and allowing the therapist to apply even more force to reach deeper lying tissues during the DTMT sessions. Eventually, treatments will almost become pain-free as all adhesions have been massaged out, and the scar tissue has been broken apart to the point therapy doesn’t hurt anymore. However, this might take months, so you’ll have to suffer through a few painful sessions before it gets better!
Massage therapists may use Fingertips, Knuckles, Hands, Elbows & Forearms during the Deep Tissue Massage Therapy session. You may be asked to breathe deeply and slowly as the massage therapist works on certain tense areas. It is important to drink plenty of water during & after the DTMT session to flush metabolic waste products & toxins from the tissues and body.
NOTE 1: If you take injectable steroids, make sure you inform your massage therapist about the location of injection as they might mistake it for scar tissue, which will lead to a very unpleasant feeling when the therapist attempts to break it apart with force.
NOTE 2: Do not eat a meal within 1 hour of starting your DTMT session as you’ll typically lay on your stomach at the beginning of the session, allowing the therapist to work on your Back. Having undigested food in your stomach, while the therapist is applying force to work through adhesions in your Back, Neck & Triceps, will not be a pleasant experience!
Active Release Technique (ART)
Active Release Technique (ART) treats your body’s soft tissue by combining manipulation with movement. ART focuses on identifying, isolating & targeting the affected areas to break up adhesions & scar tissue. This improves blood circulation and promotes the healing of injuries. ART is recommended on previously injured areas that required surgery for re-attachment, like a (partially) torn Pectoral muscle or Bicep tendon.Similar to DTMT, ART can be used to treat pain & symptoms caused by injury or damage to the Fascia (the fibrous connective tissue that protects & supports muscles and organs), Skeletal Muscle, Tendons & Ligaments. The therapist might use Fingertips, Knuckles, Hands, Elbows & Forearms to improve mobility and break up scar tissue.
Where Active Release Therapy differs from Deep Tissue Massage Therapy is by applying movement against resistance to break up adhesions & scar tissue. You could almost consider ART an invasive treatment (a medical procedure that enters the body), while DTMT is mostly non-invasive as it rarely involves movement of the patient.
The therapist will first identify & assess scar tissue locations, followed by several Active Release Techniques to isolate & target the area. Manipulating it with pressure & movement of involved Muscles, Tendons & Ligaments to break up the scar tissue. Compared to DTMT, this way of therapy is considered to be a lot more painful, as ART involves very precise pressure & movements, especially in injured areas where large amounts of scar tissues have formed during the healing process.
ART can be considered after the patient has broken up most of the adhesions with DTMT, but there’s some lingering scar tissue present in certain areas, which DTMT can’t improve on its own. If the patient has a high pain tolerance, they might resolve most of their issues in 1 or 2 sessions. Successful treatment requires an experienced ART provider as well as good communication from the patient during the art session. ART should only be performed by a certified provider. You can find Certified ART Providers in your area on the ART website:
Certified ART Providers: Find a Provider - Active Release Techniques
Graston Technique
Graston Technique is a patented technique similar to ART, but does not involve hands-on massage therapy. Graston also targets adhesions & improves blood flow but uses handheld instruments to provide tissue mobilization with a specialized form of massage or scraping of the tissue. The Graston Techniques are only practiced by licensed Chiropractors, Osteopathic Physicians, Physical Therapists & Massage Therapists.Graston Technique utilizes 6 tools that are made of stainless steel and concave & convex-shaped. They have rounded edges and are not sharp. The instruments are used to detect areas of injured fibrotic tissue, adhesions & scar tissue and are used to break up these bound areas with pressure.
Using a cross-friction massage, which involves brushing & rubbing against the grain of the scar tissue, the therapist re-introduces small amounts of trauma to the affected area. This process causes temporary inflammation in the area in order to improve blood flow & circulation.
Graston Technique can be considered after the patient has resolved most of their adhesions & scar tissue with DTMT & ART methods, and most of their range of motion has been returned. Since the Graston Technique is more precise compared to ART, it is used to treat areas that ART can’t improve or as maintenance by treating minor adhesions specifically as they occur on the athlete. Graston Technique should only be performed by a certified provider. You can find Certified Graston Technique Providers in your area on the Graston Technique website:
Certified Graston Technique Providers: https://grastontechnique.com/patients/locateaprovider/
The Infamous Lacrosse Ball
The easiest way to give yourself massage treatment in an attempt to break up adhesions & scar tissue is by using a Lacrosse Ball. Simply place the ball on the floor and rest the afflicted area on it, gently rolling around while applying more force with gravity over time. This allows the adhesions or scar tissue to slowly dissipate as you’re rolling & massaging with increased force until you’re almost completely supporting your own body weight on the Lacrosse Ball. This form of massage treatment is also excruciating; hence most bodybuilders, strength athletes, or athletes prefer to use a licensed therapist instead.NOTE: This method isn’t very delicate or precise, but a lot more cost-effective compared to hiring a therapist to perform Deep Tissue Massage Therapy, Active Release, or Graston Technique on you.
