Deep-tissue massage movements involve concentrated strokes, gliding in the direction of the muscle fibers, and focus on areas of localized muscle tension. Knuckle, fist and elbow techniques performed with moderate to heavy pressure constitute the massage. Deep-tissue massage should not be done in an area of the body with fractures, open wounds, blood clots, skin infections, weakened bones or where there has been a recent surgery, according to the Center for Complementary and Alternative Medicine.
Knuckle Technique
Massage therapists often perform a knuckle massage on the muscles along the backbone and around the shoulder blades. A proper knuckle massage technique, according to Art Riggs, certified advanced Rolfer, involves maintaining extended fingers at the joint between the metacarpals and phalanges, keeping your wrist in a neutral position and flexing your elbow. The pressure for the massage stroke is supplied by gravity rather than by muscular effort, Riggs says.
Fist Technique
Massage therapists use fist movements to perform deep-tissue massage on the broad flat muscles of the legs, back and shoulders of a client. For example, fist stroking the calf muscles and iliotibial band are common in deep-tissue massage routines. According to Riggs, the proper mechanics for a fist massage include keeping your palm up, your thumb forward and your arm relatively straight. The force of the stroke should come from your body weight and legs, not your shoulders, says Riggs.
Elbow Technique
Massage therapists use elbow strokes when applying precise pressure to dense areas of muscle tissue. Massaging the piriformis muscle through the gluteal muscles is a common use for the elbow technique. According to Riggs, the technique for providing force during an elbow massage stroke involves using your body weight to pressure the stroke and raising your hand to sharpen the angle at the elbow. To avoid causing pain during an elbow massage, communication between the therapist and client is important.
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