Bruising After Deep Tissue Massage

Massage is an ancient practice that, over the centuries, has evolved into a wide range of techniques. One of the deeper and more intense forms of massage is deep tissue massage. In this technique, your therapist will progress deeper into the layers of your muscle and connective tissue, commonly referred to as fascia, to relieve tension. However, with all the benefits associated with deep tissue massage, there can also be side effects, such as bruising.

Close-up of a woman receiving a deep tissue massage. (Image: Jeffrey Banke/iStock/Getty Images)

Bruising Basics

Bruises, also called muscle contusions, are areas of skin where the damage occurs to underlying muscle fibers or connective tissue, causing bleeding beneath the skin. Since the skin is not broken, the blood spreads out beneath the skin, giving the appearance of black, blue or purple on the surface. The more blood involved, the larger the bruise.

Deep Tissue Pressure

Bruising with deep tissue massage is associated with the pressure your therapist uses on the muscle tissue. In deep tissue, the therapist focuses more on the underlying fascia beneath the muscle, using enough pressure to loosen up areas that have "stuck" together, commonly referred to as "knots." The pressure needed to successfully treat knots can result in the damage necessary to form a bruise. However, it is important to note that not all deep tissue massages end in bruising. Also, deep tissue massage may be slightly uncomfortable at times, but it is a misconception that deep tissue treatments are, or should be, painful. These treatments are meant to reduce pain, not create it.

Easily Bruised

Keep in mind that bruising will be more common if you have easily bruised skin, or you suffer from a condition which leaves your skin prone to bruising. For example, easy bruising becomes more common as you age due to aging capillaries and thinner skin. Blood conditions that cause clotting problems, or the use of medications like blood clotting drugs or corticosteroids, can also make your skin more likely to bruise from a deep tissue massage.

Alternatives

Not all types of massage press as deeply into your muscle tissue. If you have sensitive skin that easily bruises, or if you suffer from a disorder that leaves you susceptible to bruising, consider a lighter massage technique. For example, a Swedish massage typically uses lighter pressure and longer strokes, placing less pressure on areas susceptible to bruising. You can also ask your therapist to use lighter pressure if you're experiencing pain.

Treatment

If you experience bruising from deep tissue massage, apply an ice or cold pack to the bruised skin several times a day for about 48 hours after the bruise occurs. If pain accompanies the bruises, use an over-the-counter pain medication, such as acetaminophen, or a non-steroidal anti-inflammatory like ibuprofen.