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Bruising after deep tissue massage – what is acceptable?

Do you have to be bruised for a deep tissue massage to be effective?

By in Blog with 22 Comments

BRUISING AFTER DEEP TISSUE MASSAGE – WHAT IS ACCEPTABLE?

Have you ever been left with bruises after having a deep tissue massage or sports massage? And if so have you thought ‘well that must have done some good’. No pain without gain right?
In my opinion it’s wrong!
I accept there are some cases where some bruising is not avoidable due to medication such as blood thinning drugs that prevent clots, some cancer medication, steroids and Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, however, in my opinion bruising is not the normal outcome of a deep tissue massage.

WHAT CAUSES BRUISING?

Bruises happen when small blood vessels (capillaries) under the skin are broken causing microscopic tears in them, this causes bleeding under the skin that then clots. Bruising typically occurs as a result of an injury to the area such as fall or bump. Some people do bruise more easily than others, especially as you get older as skin gets thinner and women are more prone to bruising than men.

WILL YOU BE BRUISED AFTER A DEEP TISSUE MASSAGE?

If you have a deep tissue massage, or a sports massage, with me I will do my utmost best to make sure that you don’t bruise. I take a detailed medical history and I take into account your age and pain thresholds. I thoroughly warm up the muscles and fascia allowing the fibres to move and be manipulated allowing me to work deep into the underlying areas gradually without causing a trauma to the area, so not to cause bleeding under the skin and bruising. I always advise my clients that I work to a pain threshold of a level 7 on the pain scale, 10 being the highest and ask that they tell me if the pain level exceeds that. I keep checking in with my clients to make sure that they are comfortable and I look out for signs of tension. It has been proven that if the pain level goes above a 7 for a client they are likely to experience tension and stress, so instead of decreasing the levels of the stress hormone cortisol in the system, a painful massage can increase it, restricting healing and leaving the client more tensed then before the massage.

WILL I ENJOY A DEEP TISSUE MASSAGE OR WILL I JUST HAVE TO ENDURE IT?

I make every effort to make sure that you will get some relaxation and enjoyment from your massage with me. That is not to say that I will not work deeply and some of my work may be uncomfortable but I will keep it to levels that you can tolerate. I always include long gliding moves (effleurage) to help move toxins that I release from tense muscles into the circulatory system, aid lymphatic drainage and reduce stress. I have comprehensive training in various techniques such as soft tissues release (STR), myofascial release (connective tissue techniques) and muscle energy techniques (MET) –these techniques are explained in more detail here.
I use all or some of these techniques to adapt my treatment to you as an individual and to your unique case, to make sure you get the maximum benefit. You may still feel some soreness for a couple of days, you may even experience the healing response where you feel washed out and a bit worse initially (only lasts for a few hours) but ultimately you should get great results.

WHEN SHOULD I HAVE A DEEP TISSUE MASSAGE?

If you have tight muscles and are experiencing a lot of tension then a deep tissue massage is probably what you will need. However, I tailor all my massages to the individual and aim to meet my client’s needs so when booking a massage with me you do not need to worry if you have booked the correct type of massage. If, on talking to you and palpating your areas of concern I decide some deep tissue work is required I will let you know and explain what I will do. I will work deeply and in full communication with you to make sure that you are not uncomfortable. I always bring in a relaxation element as well, so even if some of my techniques have not been very comfortable you can rest assured that you will still experience the more pleasant side of massage as well.
My clients have reported great results and many continue with regular massages even after their initial problem has been sorted out, such is the pleasant and relaxing element of my deep tissue massages.

Claire Masser
SMT level 4. Mobile Massage Therapist.

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22 Comments

  1. Melissa says:

    Good post Claire ! I’m a licensed massage therapist I myself and I agree that deeper is not always better and can cause additional problems. People shouldn’t be bruised or overworked on. I too like to customize massages for our clients based on their answers to my questions. Thank you for sharing your information. ?

    • Jorge Tasse says:

      I am a mobile massage therapist as Well And agree on not always more pressure means more benefits. Some of my new clients did not have a massage in years ,some of them never had one and their muscles are like rock. They might not preceive and react to deep tissue massage to those who come for treatment regularly

    • Guy says:

      Hi everyone, ive been reading your article and comments but sincerelly you need to have a more balanced view point on bruising here, not talking about careless bruising. Massage for relaxation is one thing but if your going to work at fixing issues with people such as removing adhesions or restrictions it will always result in some bruising in clients, otherwise your just not getting to the problem, scar tissue traped in layers of fascia fibers especially along the retinacula cuttis superficialis skin ligaments and deeper in the sub cutaneous levels may have scarring and causing joint restricions, to remove these problems will result in bruising for some people that lasts a couple of days. So to say you must avoid bruising then your saying your not willing to get to the core of a clients problem. If you are just a masseuse then thats different your not trained to deal with those type of issues and are there to make someone feel good less stress, then that should have no bruises attached, however some people bruise easily just by a gentle touch, so its not possible to say there never is bruising in any type of massage, but bruising caused by therapist who do deep work and not understanding what there doing but just causing heavy handed bruising is not good for the client or the therapists reputation either. As long as you explain to the client what they can expect from your type of treatment and what will be the end result, I have saved many from having surgery and fixed frozen shoulders, disc bulges, backward sacral torsions, been trained by the best, james waslaski, erik dalton, tom myers, etc etc and have mastered my own skills not rellying just on techniques, a good manual therapist is someone who can help correct and help there clients issues with observing there postural problems and history then correcting them, which will result in some bruising especially when fixations are involved. Cheers

      • Claire says:

        Hi, I appreciate you point of view, however, from my training I see there is another way other than causing bruising. If a client has indicated on their consent form that they bruise easily I would not work deeply as you have suggest, but instead use other techniques such as dry needling which gets to the root of deep related problems far more effectively then working so hard and deep that you cause bruising. If dry needling is not an option, I go down the facial release route, use STR methods or MET’s, gently working in deep so that bruising is not caused. I agree that in some cases bruising may not be avoided in some clients but every effort should be made to avoid it. I am disheartened by the assumption by a lot of therapists, who may not have trained in more recent times, who still find is acceptable to cause bruising citing that it is a necessary evil to be put up with in order to get deep. During my training in level 4 sports massage 4 years ago, we were taught that bruising was not acceptable and we were taught other techniques. So I am sorry, I still do not hold that bruising is acceptable in modern treatments.

  2. Samantha says:

    Hi is it normal for a therapist to bruise you minutes after a massage I hold her to stop but she was practically push me down I was crying dnot was running and she didnt stop this was really put me going back I know swedish massage is ruff.but heck I felt as if my back was being broke she was a big lady to putting her wright high in her elbow she called me a wimp

    • Claire says:

      Hi Samantha, I am shocked to hear about your experience. Swedish Massage is normally a relaxing massage so I would not expect any bruising. In my opinion, a good therapist will work with the client’s own pain tolerances. If you go for a deep tissue or sports massage you will experience some discomfort but the pain should not be more that a 7 on a pain scale of 1 – 10, 10 being the highest. You may feel a little bit sore the following day, but in my opinion, you shouldn’t bruise unless there are other factors involved e.g medication etc. It is sad to think that you have been put off having a massage. All I can advise is that most massage therapists are excellent. So should you look to book another therapist ask them about bruising and pain during massage and find out where they stand on that issue before you book. All the best, Claire

  3. Jon Tibke says:

    Absolutely agree that bruising should not generally happen and you offer good guidance about how to avoid it. We really do need to keep fighting the ‘no pain no gain’ perception of sports massage.
    Not so sure about the release of toxins though. I know we are often taught this, but the science says that the lymphatic system and the kidneys do this. It may be the case that massage stimulates the lymphatic system to some extent. 

    • Claire says:

      Hi, Thanks for your comment! I understand what you are saying about the release of toxins and I think a simple explanation is that massage does stimulate the lymphatic system and massage helps move toxins into the that system, that is my understanding.

  4. This post is really appreciated.

  5. Kath says:

    I am black and blue after a physio session on my right shoulder. I currently have frozen shoulder and have never had anyone leave me so bruised. I was sweating and cringing from the pain. The physio didn’t seem to respond to my reactions. I honestly don’t think bruising a patient is a way to help.  I have had massage previously which was intense but never walked away looking like I have been beaten up. 

    • Claire says:

      Hi Kath, I am sorry to hear of your experience with the physio, I hope you have recovered fully.

    • Jo says:

      Hi Kath – I really related to your comment! I just had a similar experience after a physio session on my frozen shoulder. I had no prior explanation of what to expect, and was only told during it that it may bruise afterwards. And no checking of my pain level during which was definitely above a 7.

  6. Michael J says:

    OMG thank you so much Claire for this insight. I suffered from bruising that lasted more than a week after receiving my deep tissue massage. The DTM I got was a Thai massage. I couldn’t bear the pain when I received the treatment. I asked the therapist does it have to be so painful, and he told me for the best results, it’s best to endure it.

    However, the effect of the massage fulfilled its purpose seeing that I was tension-free for a long time.

    Ultimately, thanks to your article Claire, I will definitely speak up if I can’t handle the pain and know it could possibly cause bruising. I really didn’t like the look of how the majority of my body had bruising.

    • Claire says:

      Thank you for your comment Michael – I am glad my article will help you in the future. I too have suffered the same from Thai massage, and although the muscular effect was ultimately very good despite a week of aching, I felt that mentally I was left a little traumatised!

  7. Michelle Zee says:

    Thank you for sharing about what is involved in a deep tissue massage. I think sometimes people think of deep tissue meaning it has to hurt and that you end up with bruises. Your article clearly articulates that it shouldn’t be the case!

  8. Great post! Thank you for sharing these information. It is really useful for me.

  9. jo says:

    I had encapsulated implants and my massage therapist has been trying to ‘release’ break down some of it because I was in pain, couldn’t wear bras, etc.  HOWEVER, it’s like he took out his frustration of not having results fast enough to push so hard there was a loud pop, which I believe scared him as well as me.  I was very sore after, which was expected, but then looked in the mirror 24 hours later and had a major bruise 1” x 3” under my breast near the original scar from incision.  I’m worried about the damage he may have caused.  it’s not a slight bruise…..it’s dark purple/blue and looks way worse than a broked blood vessel or two.  I worried he burst the implant as well, but right now don’t think he did.  Can my primary care doctor check it for any bleeding or internal damage that could be happening??  or who do I go to?  

    • Claire says:

      I am very sorry to hear about your experience. If you are still concerned you should go and see your doctor to check no damage has been caused to your implants.

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