Massage Pressure Levels

Written by Shawn White, LMT

In this article, you will learn about massage pressure levels and how you can provide the perfect level of pressure.

What are the best massage pressure levels to use? Many massage therapists claim that firm pressure is the most beneficial, while others argue that soft pressure is the most effective. The actual answer is whatever feels good.

Pressure is subjective. The kinetic force you believe you are applying is likely not the same as what someone perceives they are receiving. The concepts of light, medium, and firm massage pressure levels are abstract ideas. Understanding them, especially as a novice, is a fool’s errand.

It takes years of experience and careful observation to effectively quantify massage pressure levels in a manner that is both helpful and accurate. Fortunately, pressure is not about the amount of kinetic force we apply; instead, it is the techniques we use and our ability to communicate.

Demystifying Firm Pressure

Deep Tissue vs Firm Pressure

The nomenclature of the massage industry is not well defined. Deep tissue is one of many terms that have several different definitions depending on who you are talking to. Some massage therapists believe it means firm pressure, while others consider it to be ‘really firm’ pressure. Other practitioners describe it as a modality, while still others describe it as a method.

These varying professional opinions create a rat’s nest for the public to navigate. How are they expected to know what deep and firm pressure is if we, as professionals, cannot agree on a single definition?

As licensed professionals, it is our responsibility to provide an ethical, safe, and effective massage experience that addresses our clients’ needs and concerns.

MTBOK

Attempts have been made to codify the terminology of our industry. In 2011, the MTBOK was created to help the industry adopt a collection of definitions for the terms used by our industry. This was stewarded by the American Massage Therapy Association, Associated Bodywork & Massage Professionals, Alliance for Massage Therapy Education, Federation of State Massage Therapy Boards, Massage Therapy Foundation, and National Certification Board for Therapeutic Massage and Bodywork.

The researchers included prominent and influential members of the massage community, such as, Bryan Fong, LMT, MBA, NCTMB; Megan E. Lavery, LMT, CZB, NCTMB; Kevin Pierce, LMT, MBA; Susan G. Salvo, BEd, LMT, NTS, CI, NCTMB; Steven Schenkman, BS, LMT; Dawn M. Schmidt, BS, LMT; JoEllen Sefton, Michael Shea, PhD, LMT; and Chip Hines, MS, PMP, LMT, NCTMB.

Although great work was invested in the research and development of the MTBOK, it received mixed reviews from the professional body and was not adopted by the industry.

Deciphering What Someone Wants

Rather than attempting to change how thousands of massage therapists define deep tissue, I focus on understanding what the client wants. Many of the methods and theories I use are irrelevant to the client, because all they want are results. To help them experience the relief they need, I must know what they want. This is achieved by asking them questions.

When someone tells you they want firm pressure, it tends to mean one of three things:

1. I don’t want to experience feather touch.
2. I want it to hurt so good.
3. Somewhere deep in my muscles I hurt and it is driving me crazy. It is a place I cannot reach, so I need you to get it for me. I don’t care how much kinetic force you need to apply to get there, or how much it hurts in the process, just please find that place and push on it.

Kinetic Force vs Perceived Pressure

What does it mean when people request firm pressure? On the surface, we may assume they want to feel a tremendous degree of kinetic force pressed into their body. In most instances this is not the case, generally speaking the vast majority of the people who ask for firm pressure want it to feel good.

If you are someone who enjoys light to medium massage pressure levels, you may wonder how firm pressure can be pleasurable. There exists a sensation called hurts-so-good. You have probably felt it before; it is a sensation that hurts yet feels good at the same time. It usually accompanies a deeply satisfying release of tension. People who schedule deep tissue massages are searching for this kind of experience. They want to feel their aches and pains float away, and they know the ‘hurts-so-good’ sensation will provide them with the relief they need.

Accomplishing this kind of sensory experience is not about pressure. Instead, it requires advanced techniques and communication. There are ways to create the perception of firm massage pressure levels without using a lot of force.

Communicate

How can someone know whether they are using an appropriate amount of pressure? The most effective way to identify the pressure we are applying is by asking how it feels. We must actively request information from the person we are massaging to gain insight into their unique experience. No matter how experienced or empathetic you are, you cannot know what someone is thinking or feeling unless they share it with you.

Experiment with Massage Pressure Levels

When you combine communication with hands-on experimentation, you will discover that you can achieve a myriad of massage pressure levels with minimal exertion. When practicing, take the time to explore and feel each soft tissue structure of the body. Ask your partner how each technique feels as you investigate with your hands. Some of the best techniques are discovered through exploratory palpation.

When Someone Asks For More Than You Can Give

As massage therapists we want to help people who are hurting, but when someone wants more pressure than we can provide it causes quite the pickle. Do we offer more pressure than we want to give, or do we say no? A therapist’s maximum pressure is limited by their strength, endurance, techniques, discipline and knowledge. Whether you are a student, therapist, or a regular Joe you must know your maximum pressure. Additionally, you must have the will and personal boundaries to remain within your range. Using more kinetic force than is safe for your body will lead to injury. If you hurt yourself when trying to help someone else, you won’t be able to help anyone anymore. If you find yourself in a situation where a client is asking, or demanding more pressure than you can give, don’t try to provide it.

I often say that when we perform a massage we should help the client feel like they are the center of the universe. If this is true, shouldn’t we give them everything they want, even if it is more kinetic force than I can safely deliver? No. When performing a massage you should never hurt yourself to help someone else. Helping someone feel like the center of the universe does not entail compromising yourself. Helping someone feel like the center of the universe is the willful action of giving someone your undivided focused attention, it is not catering to their every whim. As a massage therapist it is your responsibility to provide a safe and ethical experience, for you and your client.

At some point in your career you will be confronted by someone who will try to bully you into providing firmer pressure than you feel comfortable giving. It is going to be a very uncomfortable experience. You will probably succumb to their demands and afterward you will be angry at them and yourself for doing it.  When this happens I want you to reflect on the situation. Most people will be angrier at the client than themselves. If this is you, I want you to reverse that focus.

Ask yourself what you could have done differently. What might you have said that would have put an end to the conversation before your boundaries were crossed? Did you let them know you were at your maximum pressure? Prior to the start of the session did you tell them you are not a firm pressure massage therapist? Maybe it wasn’t what you said, but your tone? Could they have detected weakness in your voice and leveraged it to dominate you with their will. If they dominated you, it doesn’t make it right, I’d say it’s was quite the jerk move on their part. But, if it happened once, someone else is going to try it again in the future, so you need to develop the skills to stand your ground and protect yourself.

Reflect on the situation, but don’t dwell on it. Learn what you can from it and move on. When your heart looks back on the circumstance process it through a lens of love. Be kind to them and yourself. You are both June bugs bumbling blindly through the night. Mistakes were made, but you learn from them, and it made you a better massage therapist.

You Must Have Secure Personal Boundaries

You must have strong boundaries as a massage therapist. Enforcing them can be challenging, but the more you stand your ground the easier it becomes. The key to developing your personal boundaries is through reflection. This applies to all aspects of our life. Think about the situation that challenged your boundaries. We all tend to search for ways to blame someone else for why we felt so uncomfortable when our boundaries were tested, stop doing this. Instead, look for how you failed and think of ways you could do better next time.

When you enforce your boundaries be communicative, make them obvious, and be clear when you define them. If no one knows what your boundaries are, they will break them by accident. This doesn’t mean you need to scream them at everyone you meet. Many personal boundaries can be established by how you act, speak, and appear. Be kind and firm when you enforce them, you don’t have to be mean, crude or offensive to protect your boundaries.

Know Your Boundaries

Know your boundaries. What is the maximum level of pressure you are willing to provide? How long will you provide this pressure? Do you charge more for that degree of pressure? How much energy does it take to provide that level of pressure, and will it reduce the number of massages you can perform in a day and week?

Some people are naturally strong, their hands are like a vice grip and they are known for being able to really get in there. As a male massage therapist people assume I give firm pressure in my massages, I can, but I prefer not to. Many men build their career around their natural strength, I have not. My greatest strength is my brain and I use it in every session. I’d rather use a smart technique that feels good and uses almost no energy, than apply a tremendous amount of pressure that causes pain, and uses a lot of energy. If you like using firm pressure, use it, but be mindful of its application and your maximums because everyone has them.

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