How to get serious pressure in a massage

February 17, 2021 1:40 AM

My upper back and shoulders muscles are basically one big knot of tension and as a results I get headaches that make it hard to work. The only thing that helps is a massage with *very* strong pressure. Like calling it a massage is inaccurate – what I need is for someone to put their weight into pressing into my muscles hard and repeatedly. The problem? I've gone for two massages and I just can't get the masseuse to use enough pressure.

I purposely booked at sports massage places thinking they would be more about working on issues than relaxation. And I say very explicitly both before and during the massage that I want a lot/more pressure and to work on the knots in my shoulders. But both times it wound up feeling more like rubbing than anything, and there was no improvement. What works for me isn't extraordinary, and my husband can do it, but it is definitely work so I'd like to pay someone to help! I'm a small and not sporty middle-aged woman and I wonder if that makes them hesitant? Any advice on best terms to express what I need? Or would it be better to see a physical therapist? Do they do massages? Help me get rid of these miserable knots!

posted by abecedarium radiolarium to Health & Fitness (22 answers total)

As a curveball idea, have you considered a massage gun? I bought one recently (the $100 kind, not the $500 kind) and the bullet head attachment in particular is really good for getting deep pressure into back and shoulder knots. For the price of roughly one massage or PT/osteo appointment in my area, my upper back and shoulders now feel considerably looser after a couple of weeks of using this thing every 2-3 days.

Another idea might be to consider the body type of the masseuse - while I try not to discriminate against service providers based on size or gender, I've had much deeper massages from a larger older male masseuse compared to smaller/younger women. I've heard that size and strength shouldn't matter if the practitioner has been trained well and knows what they're doing, but I also know that some of the best massages I've ever had came from an enormous dude in his 60s.

Probably more important than that, though, is finding someone who actually takes feedback about what you want. The worst massage I ever had was at a fancy spa where I accidentally chose a less-deep type of massage, which ended up being such light touch that it was ticklish beyond the point where I could stand it. When I finally pointed this out to the masseuse, her response was basically, "well you should have picked a deeper type of massage when you booked". A good masseuse for me is one that's open to feedback on how I prefer to be massaged, not one who's sticking to the "rules" of the type of massage I booked.

And re: your question about whether it would be better to see a physical therapist, my experience (in the UK) has been that while they will do some bodywork on you, their practice tends to be focused around teaching you to move in ways that make any physical problems you're having less likely to reoccur. If you want mostly ideas for stretching or other movements you should be doing to free yourself up with maybe 5-10mins of massage if they think it's appropriate, but sometimes none if they think you're likely to get better results from doing the exercises they've suggested, then PT might be right for you.

I've also found sports massage to be a bit closer to this approach than traditional massage (here it often means "sports in sense that the way you move your body is important" rather than "sports in the sense of practitioners with lots of experience pummeling extremely muscular sportspeople"), so you might have better luck booking a deep tissue massage with a traditional rather than a sports masseuse and seeing if that gets you closer to the type of massage you're looking for.
posted by terretu at 2:29 AM on February 17, 2021 [5 favorites]

In my experience Thai massage therapists (at my usual place, tiny middle-aged ladies, so not body type dependent) are delighted to bear down their entire body weight on you in strong and painful ways. This may involve walking on you, but by Jove, your shoulders will be knot-free. Just stock up on ibuprofen, because if you give them free reign on your back, it may be a big bruise for a few days.
posted by I claim sanctuary at 2:44 AM on February 17, 2021 [16 favorites]

Slightly tangential answer but it's helped me so much I felt I should mention it: I had something like this issue with a fairly specific area of my upper back and something that really helped me was to get one of these "peanut" massagers and watch a couple of youtube videos on how to use it.
To start with it was really uncomfortable to use - I had to gingerly lie on it with cushions around me to manage the pressure, but over time I can really use my bodyweight to press into exactly the parts of the muscles and joints that feel locked.
posted by crocomancer at 2:51 AM on February 17, 2021 [2 favorites]

When you book, ask the reservationist for a recommendation for a specific person.

Also: you can do some of this yourself with the help of a wonderful invention called a Thera-Cane.
posted by amtho at 3:28 AM on February 17, 2021 [2 favorites]

Note: You can also make a peanut by putting two tennis balls in a sock - I have a home made one and it’s great, really sorted out a recent bout of mid/upper back soreness that I had.
posted by penguin pie at 3:28 AM on February 17, 2021 [4 favorites]

I came here to say Thai massage as well. For me it’s the only massage that really works on the pressure points and relieving aches. I have to be wincing in pain at some point during it for me to think it’s been effective.
posted by Jubey at 4:14 AM on February 17, 2021 [2 favorites]

Are you booking a massage, or are you booking something like a deep tissue massage? I like a lot of pressure as well, and I have had some luck with the deep tissue massage. You might also have luck with trigger point massage. This type of massage will often hurt or leave you very bruised, so it's not the standard, and I do think it is more strenuous and requires the right person.

I haven't had Thai massage, but now I want to!
posted by needlegrrl at 4:19 AM on February 17, 2021 [5 favorites]

My experience with sports masseurs has been that they typically go easy in the first session, and have only exerted more force (and caused more pain) in subsequent sessions once we know each other a bit better. Perhaps from their perspective, they get people saying 'use a lot of pressure' and then some of them get upset when they do?

So, my suggestion would be to go back to one of the specific masseurs that you've already tried, if you thought they were otherwise receptive to what you needed. The good masseurs I've been to have been very communicative, and we've essentially been talking about the treatment, the levels of pressure, and so on throughout.
posted by siskin at 4:24 AM on February 17, 2021 [3 favorites]

In the before times (pre covid) I got deep tissue massage once a month to keep my pain levels manageable. I tried a couple practioners before I found one that I was comfortable with and felt I could work with to get the intensity of massage that I wanted. My registered massage therapist (RMT) is also trained as a athletic therapist, and gave me stretches/strengthening exercises the first day I went. He did take a couple sessions to get to the level of intensity I wanted. As I understand it from him, he wanted to slowly dial up the intensity as a new client in our first couple sessions to see how my body reacted (ie, to avoid inadvertently cause more tension by going too deep too fast). Now that we are comfortable with each other, he uses a variety of positions and tools to help me with my knots (similar to Thai massage as I understand it?) and can really go to town. On preview, I like the suggestions above to reach out to reach out to someone you have tried and see i they would be receptive to having a discussion about a treatment plan and how to achieve the results you are looking for.
posted by snowysoul at 5:58 AM on February 17, 2021 [4 favorites]

I've found that booking either a deep tissue massage with a freelancer who runs an independent practice (specifically not someone operates out of a spa that also does lots of beauty treatments) or a Thai massage at a place that specializes in Thai massages is most likely to get me a very firm and knot-relieving massage. The downside of going with independent practices is that it's a little harder to find someone and they typically expect regular clients instead of one-off bookings, but the upside is that I've found it somewhat easier to work with them on my specific goals.

A few notes about Thai massages if you've never tried one: they're traditionally done fully clothed and involve some yoga-ish manipulation of the body. Many places will give you appropriate clothing to change into, but to be safe show up wearing clothing you would be comfortable doing yoga in if you don't know what their policies are. It's also pretty common for them to be curtained-off areas of the same room vs. drywall separated rooms, so if privacy is important to you ask about the room situation before booking.
posted by A Blue Moon at 6:51 AM on February 17, 2021 [1 favorite]

As a bigger person who also likes a massage where they elbow my spine until they're tired, I have had the best experiences with Chinese massage places -- I was waiting for my iPhone to be fixed, walked by a Chinese chair massage place and the guy put so much exertion into my spine that he stopped trying to sell me more time he was so tired. My back hadn't felt that good in years. The caveat is that I'm a larger person and there seems to be an unspoken assumption that I want a lot of force.

I have also honestly had good experiences with the car buffer the Wirecutter recommended instead of a massage gun.

I have also used a lacrosse ball on the floor that I then roll around on top of, but when I told my physical therapist that she said "And you do that to yourself willingly?" So that might be a bit much for most people.
posted by Comrade_robot at 7:11 AM on February 17, 2021 [3 favorites]

agree the best pressure I've ever gotten was from older male providers. But also, those $100 (mine was $60) massage guns do help a lot. It's different from a real massage obviously, but they increase circulation so much that it really helps with loosening and healing inflammation. They're shaped so you an easily get at your own shoulders, and I can even get my thoracic spine, albeit at an angle.

one PT practice I used to go to had a massage guy on staff and he was fantastic. Very focused and results-oriented, obviously not a "relaxing" sort of experience. Might be worth asking the PT practices near you.
posted by fingersandtoes at 7:22 AM on February 17, 2021 [2 favorites]

sounds like what you're looking for is active release therapy. i have seen RMTs who do this, but also something chiropractors may do. i would describe like slow motion deep tissue massage. it's also often more participatory than regular massage: i would be asked to breathe in/out at certain times with the release. hope you find what you need.
posted by tamarack at 7:29 AM on February 17, 2021 [2 favorites]

As another idea, definitely try foam rolling your upper back. The effect is totally different from a massage gun. Nothing I’ve tried has ever helped as much as this. Part of it is freeing up your thoracic spine to move backward and part is the weight of your own body pulling those muscles up up up. It’s heaven.
posted by HotToddy at 7:39 AM on February 17, 2021 [4 favorites]

What you want is a special form of massage called ART, active release therapy. My provider is a tiny Japanese woman. It’s not the size or the strength of the therapist that can get you what you need, it’s the technique!
posted by matildaben at 9:19 AM on February 17, 2021 [1 favorite]

The firmer version of the Beastie Ball may also be of help until you can find someone.
posted by praemunire at 9:19 AM on February 17, 2021 [1 favorite]

My case is similar to yours, and I've gotten the most benefit by going to a sports chiropractor (link to example) I was skeptical of chiropractors but my shoulders and neck hurt less often and with less intensity. Massage therapists aren't medically oriented in the same way. I've gotten many massages over the years and there was only *one* who approached what my sports chiropractor has been able to do.
posted by emkelley at 9:52 AM on February 17, 2021 [1 favorite]

Be careful with the serious pressure. I have a high pain tolerance. A masseuse gave me serious pressure for a stubborn knot once and now I have scar tissue there.
posted by aniola at 1:20 PM on February 17, 2021 [2 favorites]

Echoing working with one person who you get to know - rolfing, sports massage, deep tissue- the style is not as important as the built trust so they can go deep and they know you wont later complain to management. A physical therapist might be just the solution for long term success - they can pin point the misbehaving muscles and teach you ways to reduce them tightening again.

But "very hard" pressure can create problems that can lead to injury. Especially the type of injury you are describing - very hard muscles that return no matter how hard you just pressed.

Just a general suggestion - you might want to try CALM or a sports magnesium powder. Very hard muscles are often under hydrated. I hope you feel better soon.
posted by mutt.cyberspace at 5:32 PM on February 17, 2021 [2 favorites]

I love a Thai massage, which does a lot more stretching. But if I want to get my knots out I get Tui Na Chinese massage at a non-fancy place or Korean spa.
posted by Bunglegirl at 7:51 PM on February 17, 2021 [1 favorite]

You need to find the right massage therapist. Mine is a physical therapist by education and career, who does massage therapy on the side for bonus money. He is a man, keeps fit and is strong. That counts when you want that deep tissue work. Keep looking, you will find the right person for the task.
Also, buy a lacrosse ball. Super hard, baseball sized ball. You can put it on the floor and do spot work on yourself. Lay on the floor with the ball on your target area, roll it around. It helps.
Figure out what stretching helps your affected area, then do it everyday, multiple times a day.
Take a look at your work situation. If you are sitting at a computer for long hours, maybe you need to make some adjustments to your desk environment.
posted by a3matrix at 7:32 AM on February 18, 2021 [1 favorite]

I think what you are really looking for is: "deep tissue" massage and "myofascial release".
You may also want to search for "trigger point" massage or "acupressure".
Agreed with some others above that Thai massage can be quite deep on certain points, but it is also a very full-body massage that involves more movement as well.
posted by itsflyable at 11:13 PM on February 18, 2021 [1 favorite]