Why Percussion Therapy for Deep Tissue Massage

Percussion therapy is used in the treatment of soft tissue.

What is Percussion Therapy?

Percussion therapy, also known as tapotement, is a type of massage therapy, treating patients with soft tissue pain. It speeds up the growth of tissues and repairs them by providing strong, concentrated, rapid, short-duration pulses deep into the tissues of the body. It is a therapy in which rapid burst of pressure is applied in concentrated areas of the body so that the short-duration pulses penetrate deep into the tissues. Consequently, blood flow through veins and circulation in the lymphatic system increases, which helps relieve pain, improve function, and increases range of motion.

Also, percussive therapy gently stretches muscles and connective tissue. Consequently, their flexibility and range of movement improves. In addition, the therapy relaxes thickened connective tissue, which helps to break down adhesions and internal scar tissue. By the way, adhesions are bands of painful, rigid tissues in muscles, tendons, and ligaments. Moreover, these adhesions can block blood circulation, cause pain, inflammation, and limit movement.

Finally, it’s a good massage therapy for anyone to recover faster from injuries and surgery.

Vibration and Percussion Therapies

First and foremost, vibration therapy devices produce a back and forth motion across the body’s skin, creating a trembling sensation. In fact, therapy devices produce a piston-like up and down motion on the body’s surface. This motion creates comfortable compression waves that travel to the body’s deepest connective tissues.

When to Use Percussive Therapy

Treating Delayed Onset Muscle Soreness

First and foremost, when parts of your body are subject to unfamiliar or unaccustomed exercise, they may experience pain 24 to 72 hours later. In fact, this pain is caused by tears of microscopic muscle fiber from the unfamiliar or unaccustomed exercise. Especially relevant, this pain is referred to as Delayed Onset Muscle Soreness or DOMS. Most of all, DOMS, which increases risk of injury, has these features:

First, it may be accompanied by muscular pain.

Second, it decreases the intensity of muscle force you can generate.

Third, it reduces range of motion which makes it difficult to absorb the shock of physical activity.

Lastly, it creates discomfort.

Other Reasons

Other reasons for using percussion therapy include:

First, to relieve muscles injured from whiplash, falls, sports injury, tennis elbow, trauma, surgery or disease. Indeed, the contractions created by percussion therapy strengthen muscles. Therefore, it is extremely beneficial for people who can’t participate in physical therapy. Consequently, it is used on patients with partial or full paralysis to stimulate muscles, prevent non-use atrophy, and improving reflex responses in which the nerves respond to stimulation.

Second, to relieve chronic aches and pains

Third, treat a stiff neck

Fourth, treat upper or lower back pain

Fifth, treat tight leg muscles

Or, treat sore shoulders

Also, treat shin splints

Next, treat muscle spasms and cramps

In addition, treat TMJ syndrome

Also, treat bursitis

Or, tendonitis

Next, treat herniated or bulging discs

Also, repetitive strain injury, such as carpal tunnel syndrome

And, sciatica, tennis elbow, or sports injuries

Or, treat osteoarthritis pain. Most noteworthy, according to Consumer Reports magazine, 34,000 people ranked deep tissue massage more effective in relieving osteoarthritis pain than physical therapy, exercise, prescription medications, chiropractic, acupuncture, diet, glucosamine, and over-the-counter drugs.

Next, free adhesions, breaking down scar tissue, and decreasing inflammation that can sometimes follow cosmetic procedures. As a result, it accelerates the healing and recovery time of the patient.

Also, treat fibromyalgia. In fact, deep tissue massage received top ranking for fibromyalgia pain. Indeed, people often notice improved range of motion immediately after a deep tissue massage.

In addition, treat Piriformis syndrome

Or, treat postural problems

Also, treat muscle tension in the hamstrings, glutes, IT band (a multipurpose tendon running down the length of the outer thigh), legs, quadriceps, rhomboids, and upper back

Finally, after a workout or bodybuilding

Benefits of Percussive Therapy

Benefits of percussive therapy include:

First, the therapy relaxes thickened connective tissue

Second, the therapy breaks down adhesions and internal scar tissue present after an injury or surgery

Third, it increases venous and lymphatic circulation. The increased blood circulation brings more oxygen and nutrients to the muscles.

Fourth, percussive therapy relieves lymphatic congestion

Fifth, it elongates muscle fiber which is helpful when there are muscle spasms, stiffness or restrictions. In fact, muscles and fascia relax, thereby preventing future spams from occurring.

Also, the therapy speeds up recovery

Moreover, percussive therapy decreases muscle pain

Also, by relieving stiff joints, the therapy improves range of motion

Next, it reduces muscle soreness

Also, muscle fatigue

In addition, percussive therapy improves muscle tone and balance

And, relieves tight muscles

In addition, the therapy relaxes tense muscles. As a result, stress and anxiety falls.

Lastly, it reduces physical stress placed on bones and joints

People have also reported that deep tissue massage helps with:

First, high blood pressure

Also, limited mobility

Lastly, with lower back pain

Steps to Take After a Deep Tissue Massage

First and foremost, there is usually some stiffness or pain after a deep tissue massage, but it should subside in a day or so. Meanwhile, applying ice to the area after the massage helps.

Also, it's important to drink a lot of plain water after a deep tissue massage. As a result, lactic acid gets flushed out of the tissues. On the other hand, if you don't, you might be sore the next day.

However, even if you do drink water, it's still possible that you might feel some soreness the day after a deep tissue massage. Actually, this just means a lot of waste products were flushed out of the tissues. And, the soreness should go away in a day or so.

Importance of Recovery

No matter how fit you are, if you are looking to lose weight, build strength and fitness or just trying to achieve your physical potential, your body needs rest and time to recover. This recovery process is important because if short changed, the chance of temporary or even permanent injury are severely increased.

How Effective Is The Therapy?

Recent studies show that percussive therapy causes muscle contractions that are up to 30 times more powerful than normal voluntary contractions. As a result, muscle strength increases, while muscle recovery is faster.

Ankylosing Spondylitis

First, a 2017 study in Evidence-Based Complementary and Alternative Medicine looked at Ankylosing Spondylitis, or AS. Moreover, AS is a condition characterized by inflammation in the spine. Furthermore, this inflammation can eventually lead to new bone formation. Also, this bone formation is characterized by certain sections of the spine fuse in a fixed, immobile position.

In this study, the 27 men with AS were split into two groups. First, one group received therapeutic massage to ease lower back pain, improve function, and induce relaxation. By the way, a therapeutic massage is a type of massage that:

First, uses a circular stroking movement made with the palm of the hand

Also, kneads the body

And, uses tapping, where tips of the fingers are used to gently tap the area

Finally, uses friction, where, penetrating pressure is applied through fingertips

Meanwhile, the second group received deep tissue massage designed to alleviate musculoskeletal contributors to the men’s lower back pain. Also, both groups participated in a total of 10 massage sessions.

Next, after the study, the men answered six questions about their fatigue, pain, tenderness, and stiffness. Incidentally, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to evaluate the men’s conditions.

Actually, the deep tissue massage group showed a significantly greater reduction in BASDAI when compared to the therapeutic massage group. Furthermore, they also showed a greater reduction in pain.

However, this isn’t to say that deep tissue massage is better than therapeutic massage. But that different methods are more effective for some conditions than others.


First, a 2014 PLOS One study reported individuals with fibromyalgia sometimes experience immediate beneficial effects in their pain levels. Moreover, many times, this happens within just five weeks of massage therapy. Furthermore, individuals in this study also reported lower levels of anxiety and depression.

Heart and Lungs

Next, a 2008 study on muscle spasm or strain was published in the Journal of Alternative and Complementary Medicine. Meanwhile, blood pressure and heart rate of 263 participants was measured before/after a 45 to 60-minute deep tissue massage. And, the study reported the following after a deep tissue massage:

First, lower systolic and diastolic pressure

Next, heart rates of around 10 beats per minute

Lastly, improved lung function

Low Back Pain

Next, a 2012 study published in Studies in Health Technology looked at chronic low back pain. For the study, the 26 chronic low back pain patients between the ages of 60 and 75 were split into two groups. First, one group of 13 patients, received 30-minute therapeutic massage sessions for a period of 10 days. While, the other group of 13 patients received deep tissue massage for the same 10 days.

Finally, the patients were assessed based on three different scales before and after the study:

Modified Oswestry Low Back Pain Disability Index (ODI)

Quebec Back Pain Disability Scale (QBPD)

Visual Analog Scale (VAS)

And, using the ODI and VAS scales, deep tissue massage was statistically significantly better therapy than therapeutic massage.

Meanwhile, a 2014 study involving 59 participants found that deep tissue massage helped to reduce chronic low back pain. Above all, the study reported that the effects of the massage are similar to taking non-steroidal anti-inflammatory drugs like ibuprofen.

Plantar Fasciitis Pain

Next, a study in Journal of Research in Medical Sciences reports that plantar fasciitis can cause heel pain. In fact, plantar fasciitis appears as the cause in 11 to 15 percent of the cases.

Furthermore, research in April 2014 issue of Manual Therapy reported on how deep tissue massage helps reduce this pain. Indeed, deep tissue massage to posterior calf muscles combined with self-stretching exercises helped reduce plantar fasciitis pain.

This video shows use of percussion therapy to relieve plantar fasciitis.

Range of Motion

First and foremost, scar tissue forms when the body heals after an injury. For example, the most common scars are those from a visible cut.

However, sometimes scars occur deeper in the body, such as when you damage muscles, ligaments or tendons. And, it is this type of scarring that deep tissue massage can help heal. Indeed, the massage can make it easier to move and promote greater range of motion.

Meanwhile, a systematic review and meta-analysis of seven studies with 237 participants was performed in 2017. And, the results were reported in the 2017 Journal of Physical Therapy Science. In fact, analysis showed that massage therapy significantly improved the participant’s shoulders range of motion. Moreover, this was especially true for movements involving flexion and abduction.

What are the Side Effects of the Therapy?

Because deep tissue massage creates more pressure than many of the other types of massages, users may notice some side effects after the session is complete.

First users may notice bruising. Meanwhile, the easiest way to avoid this is to pull back on the pressure and in the case of the massage gun, reduce the speed.

Next, a study published in the Physician and Sports medicine reported an instance of a user developing venous thromboembolism. By the way, venous thromboembolism is a blood clot that forms in the arm, leg, or groin and which travels to the lungs. Incidentally, this blood clot developed after a vigorous deep tissue massage. Therefore, as with bruising, the best prevention is to pull back on the pressure and speed.

Yet another study, published in the Archives of Physical Medicine and Rehabilitation, reported an instance when a user developed spinal accessory neuropathy after a deep tissue massage. As a result of the weakness in the trapezius muscle, the user developed “scapular winging and droopy shoulders”.

Finally, the New England Journal of Medicine reported the case of a 39-year old woman who received a deep tissue massage. Most noteworthy, this massage included the abdomen and right upper quadrant. Meanwhile, within 24 hours she developed abdominal discomfort, nausea, and pain in her right shoulder. In fact, a large hematoma was found in her right hepactic lobe, causing the woman to feel nauseous and have a fever for the following six months. By the way, hepatic hematoma is a painful liver condition.

While these are individual and infrequent cases, it’s important to realize that deep tissue massage can potentially create these unintended consequences.

Set Realistic Expectations

It's important to be realistic about what one deep tissue massage can achieve. First example, muscle knots are small, bump-like areas of muscle that can be painful to the touch. Incidentally, the medical term for muscle knots is myofascial trigger points. Meanwhile, these knots occur when muscle fibers or the bands of connective tissue surrounding or underneath muscles, called fascia, tense and tighten.

Above all, many people may push hard to get rid of all their knots. Regrettably, this just won't happen. Moreover, chronic knots and tension may build up over a lifetime. Therefore, undoing them is best achieved by using the following techniques.

First by regular exercise

Second by improving posture

Third, by changing ways of moving

Fourth, by using relaxation techniques

Finally, with a regular program of massage therapy

When Not to Use Percussion Therapy?

While percussive therapy is safe, there are cases and conditions when it should not be used. For example,

First, with lumbar injuries.

Or, when taking blood thinning medications.

Also, for advanced level of diabetes.

Next, anyone with cardiovascular diseases.

Or, for anyone who is pregnant.

Lastly, anyone with certain types of chronic back pain or injuries.