The Wiltshire School

of
Beauty and Holistic Therapy

Diploma in Advanced Massage and

Deep Tissue Techniques

Practitioner’s Training Manual

W: www.wsbht.co.uk E: holistics@wsbht.co.uk
T: 01793 73 77 33 M: 07824 337333
CONTENTS

1. Contact Details

2. Introduction

3. Relevant Anatomy & Physiology

4. Pathologies of the Muscular System

5. Assessment Techniques

6. Deep Tissue Techniques

7. Contra-Indications, Contra-Actions and Aftercare

8. Underpinning Knowledge

9. Results

10. Contact Details

11. Accreditation

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 1. COURSE DETAILS

During this course you will learn techniques that can be used to provide a deep
tissue massage.

You will learn how to:

prepare the client for treatment
assess the client prior to and during the treatment
carry out deep tissue massage techniques
use mechanical massage

You will also study:

benefits of the treatment
related anatomy and physiology
contra-indications
aftercare and contra-actions

Once you have successfully completed your practical training, you will receive
The Wiltshire School of Beauty and Holistic Therapy Diploma in Advanced
Massage and Deep Tissue Techniques, accredited by The Guild of Holistic
Therapists.

Good luck and enjoy!

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 2. DEEP TISSUE MASSAGE INTRODUCTION

A deep tissue massage is not just a firm massage where you apply more pressure,
but instead consists of different techniques that are used to allow the therapist to
work beyond the superficial muscles, usually in a specific area. During your
consultation, it is important to find out as much information as possible, so that
you can concentrate on the right area and to also ascertain if any action makes
the symptom worse.

If a muscle has been injured or is holding tension, due to poor posture, stress or
illness, then adhesions can form. Adhesions are bands of painful, rigid tissue
which can form in muscles, the tendons or ligaments and can lead to poor blood
flow to the area as well as limitation of movement, leading to pain. The purpose
of a deep tissue massage is to release the muscle fibres that have become “stuck”,
in order to remove toxins and to encourage blood to circulate again. It is
important to note that clients should be referred to another professional such as
an Osteopath, a Physiotherapist or Sports Massage therapists if you suspect that
there is an injury that warrants expert advice. Always work within your own
limitations.

The Benefits of Deep Tissue Massage

Deep Tissue Massage has many benefits:

increases the range of motion (ROM) in joints

improves blood flow to muscles
breaks down and reduces adhesions
can aim to improve postural faults
can aim to relieve muscle spasm and tension
improves the distribution of oxygen and nutrients to muscles
reduces stress on other muscle groups which may be overcompensating
loosens the fascia of the muscle

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 3. RELEVANT ANATOMY & PHYSIOLOGY
Muscle Structure

Muscles are classified into three different types, which are skeletal, smooth and
cardiac.

For the purpose of this course, we are mainly going to concentrate on Skeletal
muscle, as smooth muscle is mainly found within hollow organs and cardiac
muscle is found within the heart.

Skeletal muscles, also known as striated due to its appearance, or voluntary due
to its action, are attached to bones and deal with movement. These muscles are
made up of fine, thread like fibres of muscles, containing light and dark bands.
Skeletal muscles can be made to contract and relax by voluntary will. They have
striations due to the actin and myosin fibres and create movement when
contracted. There are over 650 different types of muscles in the human body,
making up nearly half of the body weight.

Muscles have the following properties:

Excitability – the muscle responds to stimuli

Contractibility – the muscle shortens due to a nerve impulse
Extensibility – the muscle can stretch and increase its length by half
Elasticity – the muscle will return to its normal length

Muscles consist mainly of muscle fibres which are held together by fibrous
connective tissue, with numerous blood vessels and nerves penetrating through
them. The muscle fibres are made up of muscle cells, which vary in length and
are rod shaped. The fibres are called myofibrils and they get shorter (contract) in
response to a nerve impulse. The protein strands then slide against each other
when the muscle contracts.

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Each muscle fibre has an individual wrapping of a fine connective tissue called
endomysium, which are then wrapped into bundles called fascicule and are
covered by the perimysium. This is what forms the muscle belly, and has its own
covering called the fascia epimysium. The fascia acts as a “Clingfilm” around
muscles, giving them support and also acts as a pathway for nerves, blood and
lymph vessels.

When a muscle is damaged, fibres become torn and the connective tissue around
the muscle is also damaged. Fluid seeps out of torn fibres, which can cause
localised swelling. This fluid tends to stick the fibres together which causes pain
as the muscle is irritated by the slightest contraction. The fibres stop sliding as
effectively and the fascia gets tighter and begins to constrict the muscle. The
fascia can also become torn and the loss of elasticity can create tissue congestion.
If the body is held in the same position for too long, such as sat at a computer,
then the fascia can easily adapt to that shortened position, and any attempts to
return it to its normal length can be painful. There is then a temptation to
remain in that position, which in turn worsens.

Muscle Shapes

The bundles of fibres within muscles will determine the shape of the muscle. The
commonest muscle fibre arrangements are:

Parallel fibres – these muscles have fibres that run parallel to each other in length
and can sometimes be called strap muscles. These muscles have great endurance
but may not be that strong due to their length. An example would be the
Sternocleidomastoid (SCM).

Circular muscles – these muscles are usually circular in shape and an example
would be the muscles surrounding the mouth and eye.

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Convergent – this is where the muscle fibres converge to an attachment to a
bone. The fibres are arranged to allow maximum force and can sometimes cross
joints which have a large range of movement such as the Pectoralis Major.

Pennate – these are made up of short fibres so the pull is short but also strong,
though the muscle tires easily.

Fusiform – these are sometimes included within the parallel muscle group and
are made up of spindle shaped fibres. A good example is the Biceps Brachii as the
belly is wider than the origin and the insertion.

Muscle Movement

Muscles are only every able to contract or pull. This means they have to work in
groups and even when carrying out an action, do not work alone. A joint,
therefore has to have two or more muscles working together.
As a muscle contracts, the second muscle relaxes, and as this second muscle
contracts, the first muscle relaxes. This is called Antagonistic action as they are
pulling in the opposite direction to each other but without working against each
other. One end of the muscle needs to be fixed, which is known as the origin and
as that muscle contracts, the other end of the muscle moves towards the origin.
The name given to the end of the muscle that moves towards the origin is called
the insertion.

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Muscles of the Back

Name Position Action

Trapezuis Upper back going Moves scapula up, down and back
down to the spine (retracts)
Raises the clavicle
Latissimus Across the back at Used in rowing. Adducts, extends
dorsi the sides and medially rotates the shoulder
joint
Erector spinae Three groups of Extends the spine
muscle which lie Keeps body in an upright position
either side of the
spine from the neck
to the pelvis
Rhomboids Connects the scapula Braces the shoulders
to the vertebra Rotates the scapula

Muscles of the Upper Body

The pectoralis major is the main muscle that covers the front of the chest. It is a
thick, fan shaped muscle which gives the chest its contour. It makes up most of
the males chest shape and lies under the breasts on females. The latissimus dorsi
covers the back of the chest and sides of the abdomen. It adducts, extends and
medially rotates the shoulder joint. The serratus anterior runs around the side
wall of the chest.

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 Name Position Action
Pectoralis Front of chest, under Pulls arms forward and assists
breast rotation of the arm
Deltoids Surrounds shoulders Lifts arms sideways, forwards and
backwards

Muscles of the Arm and Hand

Name Position Action

Biceps Brachii Consists of a long Flexes elbow
and short head. Runs Supinates the forearm and hand
from under the
deltoid to elbow
Triceps Brachii 3 muscles that form Extends the elbow
the back of upper
arm
Brachialis Upper arm, deeper Flexes the elbow
than the biceps
Brachioradialis On the thumb side of Flexes the elbow
the forearm
Flexor Carpi Middle of the Flexes and bends the wrist drawing
Radialis forearm it towards the forearm
Extensors Carpi Little finger side of Extends and straightens the wrist
Radialis the forearm and hand
Thenar muscle Palm of the hand Flexes the thumb and moves it
below the thumb outwards and inwards
Hypothenar Palm of hand below Flexes little finger and moves it
muscle little finger outwards and inwards

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Muscles of the Legs
Name Position
Gluteals 4 muscles, 3 of which
make up the
buttocks
Tensor Fasciae This is the 4th Gluteal
Latae muscle. Runs from
the ileac crest and in-
between the two
layers of the IT band
Hamstrings 3 muscles that run
the back of the thigh
Gastrocnemius Located with the
soleus at the calf of
the leg
Soleus Calf of leg, below the
gastrocnemius and
attaches to the
Achilles tendon
Quadriceps Front of the thigh
extensor Group of four
muscles
Sartorius The longest muscle
in the body, crosses
the front of the thigh
Adductors Group of muscles of
the inner thigh
Abductors Buttocks region and
thigh on the outside
Tibialis anterior Outside of the tibia
at the front of the
lower leg
Action
Used in walking and running
adduction and rotation of the
thigh, and extending the hip
Provides lateral stability to the
knee. Facilitates walking
Flexes and extends the knee
Flexes the knee
Plantar-flexes the foot
Plantar-flexes the foot
Extends the knee, used in kicking
Flexes the knee and hip
Abducts and rotates the femur
Adducts the hip (brings in)
Flexes and rotates the femur
Abducts the hip (takes away) and
rotate the hip
Inverts the foot
Dorsiflexes the foot
Rotates the foot outwards

The main muscles are at the front of the thigh and are called the
quadriceps. They are responsible for extending the knee joint and flexing
the hip.
The Adductors are the group of muscles on the inside of the thigh and
moves the leg in towards the body.
The Abductors are on the outside of the thigh, and moves the hip
outwards. (Remember that the term abduct means to take away).
The hamstrings are located at the rear of the thigh and extends the thigh
and flexes the leg.
Dorsiflexion of the foot is performed by the tibialis anterior .

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Growth and Repair of the Muscles

Muscle hypertrophy is the term used for when a muscle cell grows in size, and the
commonest reason for this is due to exercise, where there will be an increase in
muscle fibre. When a muscle is damaged (torn), the body has to repair it and will
do this by using satellite cells which fuse with the ends of the damaged fibre. If
the damage is constant then the process will repeat itself so that more satellite
cells are used which will create growth of the muscle.

Muscle Tone

Muscle tone refers to the amount of tension or resistance to movement in a

muscle. Muscle tone is what enables us to keep our bodies in a certain position or
posture. A change in muscle tone is what enables us to move. For example, to
bend your arm to brush your teeth, you must shorten (increase the tone of) the
bicep brachii muscles on the front of your arm at the same time you are
lengthening (reducing the tone of) the tricep brachii muscles on the back of your
arm. To complete a movement smoothly, the tone in all muscle groups involved
must be balanced. The brain must send messages to each muscle group to
actively change its resistance.

Tendons and Ligaments

Tendons and ligaments are made up of collagenous tissue with ligaments

attaching bone to bone and tendons attaching muscle to bone. The place where a
muscle attaches to a bone but does not move, is known as the origin. To make
movement occur, the muscles contract, which will pull on the tendons, this then
pulls on the muscles.

Tendons are tough, yet flexible bands of fibrous tissue, which allows movement.
Ligaments are stretchy connective tissue which helps to stabilise the joints. They
control the range of movements of a joint to prevent them from bending the
wrong way. Injuries to both tendons and ligaments are very common, caused
mainly by sporting injuries. It is fairly common for tendons to be stretched or
torn which can be extremely painful. If ligaments are stretched, caused by injury
or excess strain, the joint will become weaker, as the ligaments are unable to
support it.

As discussed, the muscles within our body act when they receive impulses. The
nervous system is the means by which the body co-ordinates bodily systems and
informs the body about any changes in the environment.
The nerves carry brief electro-chemical messages that trigger appropriate
responses in the various parts of the body. The messages (impulses) then react
and will do certain tasks such as make the muscles contract, the glands secrete
and the blood vessels widen or narrow.
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The nervous system is a very complex system in the body but is divided up into
two main parts. The Central Nervous System (CNS) and the Peripheral Nervous
System (PNS).

The CNS

The Central Nervous System consists of the brain and spinal cord. The main
function of this part of the system is to get information from the body and send
out instructions, and to maintain equilibrium in the body. The CNS receives
sensory information from all parts of the body. On receipt of this information,
the CNS analyses the information, and thoughts, emotions and memories are
then generated and stored. The CNS usually responds to nerve impulses by
stimulating muscles or glands, which creates an appropriate response to the
original stimulus such as a change in temperature.

The Peripheral Nervous System

This part of the system is made up of all of the nerves and the wiring. This system
sends the messages from the brain to the rest of the body. The 31 pairs of spinal
nerves are part of the peripheral nervous system.
There are two types of cells in the peripheral nervous system which carries
information to the sensory neuron cells and from the motor neuron cell. Cells of
the sensory nervous system send information to the CNS from internal organs or
from external stimuli. Much of the peripheral nervous system is concerned with
voluntary response, but there are still involuntary responses that are dealt with.

Types of Nerves

Sensory nerves send messages from the muscles to the spinal cord and the brain.
Special sensors in the skin and deep inside the body help people identify if an
object, for example is hot. Sensory nerve damage often results in tingling,
numbness, pain, and extreme sensitivity to touch

Motor nerves enable the brain to stimulate muscle contraction, by sending

impulses from the brain and spinal cord to all of the muscles in the body.
Damage to the motor nerve can lead to muscle weakness, difficulty walking or
moving the arms, cramps and spasms.

Autonomic nerves control involuntary or semi-voluntary functions, such as heart

rate. If the autonomic nerves are damaged, then a person’s heart may beat faster
or slower, and dizziness may occur. In addition, autonomic nerve damage may
result in difficulty swallowing, nausea, vomiting, diarrhoea or constipation,
problems with urination, abnormal pupil size, and sexual dysfunction.

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 4. THE MUSCULAR SYSTEM
When a muscle is relaxed, there is a good flow of blood to the area, but during
contraction, the flow of blood is reduced and therefore waste removal is limited.
This is not a problem if this is occurring during exercise, as the constant
contraction and relaxation allows the blood flow to remain. The problem can
occur if we constantly contract the muscle without it actually moving, such as in
sitting in a poor position, as the blood capillaries can become compressed and
blood flow can be impeded, resulting in an accumulation of waste and a reduction
in the delivery of nutrients and oxygen. Muscles can become fatigued and
become weaker and can result in spasm, eventually creating pain. As the muscles
become shorter, they will eventually pull on the tendons that attach them, which
can result in loss of function and pain. As function gradually deteriorates, an
imbalance can be caused in the muscle group and unless the action or activity
that started the issue in the first place is not stopped, the problem will usually re-
occur, even after treatment.

If a client is presenting with a sharp pain, this can represent inflammation in the
area and massage should not commence until the pain has turned into a dull
sensation.

Causes of Musculo-Skeletal Problems

Very often, the problem will not be noticed for a long time and the symptoms can
be very subtle at first. This can make it difficult to be able to determine the cause
of the problem. However, below are some of the most common causes.

Stress – emotional stress will usually show itself in physical tension, causing tight
muscles and poor posture.

Environment – by looking at the clients lifestyle and occupation, a pattern may

form that could highlight a potential problem. Such activities as walking a dog
which pulls on a lead or carrying heavy bags over the shoulder can often lead to
problems.

Injury – any type of injury will cause the soft tissue to become swollen and may
lead to increased muscle tension or spasm. This can lead to a lack of range of
motion. If you suspect an injury, always refer your client to a professional such
as osteopath, physiotherapist or GP.

Posture – postural problems may be due to bad habits but they may also be due
to postural faults, such as those below:

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Postural Fault Definition

Kyphosis Excessive curvature at the top of the spine, creating a

“hump”
Scoliosis Curvature of the spine to one side, causing the hips to
be misaligned.
Lordosis Inward curve of the lower back, creating a protruding
abdomen.

As a therapist, you are not in the position to diagnose a postural fault but it is
important to recognise that poor flexibility and imbalance may develop and the
muscle groups surrounding will be affected if a postural fault is present.

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 5. ASSESSMENT TECHNIQUES

The assessment process will take a variety of procedures. Firstly there will be a
verbal discussion, completing a consultation form to determine the clients’
lifestyle, medical history and also the presenting problem/s. It is essential, that
during this process, you find out as much information as possible on what seems
to make any muscular pain worse and if you feel that the client needs medical
advice due to the presence of an injury, then to refer them appropriately and do
not treat. As part of your consultation process, below are other ways to carry out
an assessment.

Observation – one of the best ways to observe the client is naturally, because if
you tell someone you are watching them they will unconsciously change their
actions. Watch them as they walk across the room, as they sit down, or reach for
their bag. Do they have an unusual gait, do they appear to have one shoulder
higher than the other etc.

Ideally, ask your client to be dressed in undergarments (shorts/vest), and stand

behind them approximately a metre away.

Imagine they have a plumb line running through the body from head to the feet.
The line should run through the ear, through the shoulder, through the hip and
knee and be in front of the ankle.

Start by looking at the head to see if it is level, use the ears

as a guide.

Do the shoulders sit straight? Check the “key hole” (the

gap between the arms and the body) to see if the gap is
wider on one side. Do the hands hang at the same length?

Look at the belt line of the clients’ underwear to see if level,

this may indicate scoliosis otherwise.

Look at the back of the knees to see if the skin creases are
level. Do the knees turn in or out?

Check for the alignment of the Achilles tendons to see if

there is any thickening of either tendon. Look at the angle
of the feet to see if they are turned in or out.

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Range of Motion (ROM) - Another way to carry out an assessment is to determine
the amount of movement which occurs
without discomfort or pain.

If you are going to carry this out,

demonstrate the movement to your
client beforehand and always carry out
checks on the unaffected side first, so
that you have something to compare it
to, then check for restriction or pain.
This is purely as a guide and should not
be used as a diagnosis, but can help you
understand that muscles may be tight or
restricted in a particular area.

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Palpation – this is the process of feeling with your hands, sometimes before but
definitely during the massage and it is a continual process throughout the
treatment. Palpation will give you feedback on areas where you need to
concentrate on and with lots of experience your fingers will begin to “see” what is
beneath. During palpation, your fingers move the skin over the underlying
tissues so that you are able to determine different textures. This procedure needs
to be carried out very slowly. Below are some of the textures you may feel:

Soft and pliable – this indicates healthy and relaxed soft tissue.

Firm and stringy – will usually be tendons, due to their fibrous nature.

Firm and less resilient – this can indicate thickening of the fascia.

Dip in the contour of the muscle – this can represent a tear in the muscle.

Woody and stringy and may “flick” – can signify adhesions of the fascia.

Firm, gritty and fairly pliable – can indicate recently formed scar tissue.

Firm, solid – can signify mature scar tissue.

Knotty and resistant – this can indicate tension within a muscle.

Fluid – if there is oedema in the soft tissues, the sensation can be soft and
mobile, however if there is excessive fluid then the skin can feel tight, firm
and be painful.

Definitions of Soft Tissue Dysfunction

Adhesions are fibrous bands that form around joints or within the fascia
layers. They are formed from elastic fibres and are usually caused by
inflammation or injury and the release of adhesive glycoprotein’s which
aid the repair process. You may know adhesions as “knots”.

Scar Tissue is the body’s natural response to injury, and its aim is to bring
two ends together, for example in a torn muscle. It is also made of elastic
fibres but also collagen and can be sticky in its early stages, causing the
fibres to adhere together, causing muscle fibres to clump together over
time and preventing the fibres from gliding. Scar tissue can become as
hard as bone, and non-pliable reducing the Range of Motion in a joint.
Generally, the earlier scar tissue is managed, the less damage it will cause.

Fibrosis occurs when excess fibrous connective tissue forms usually due to
tissue damage such as repetitive strain.

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Muscle spasms are a convulsive muscular contraction which can be a
result of tissue damage as the natural response is to contract nearby
muscles. They can also occur if a muscle is overworked or over stretched.
The contraction of the muscle fibres can compress on blood vessels and
with a build up of toxins in the muscle, the nerves can become irritated,
causing pain.

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 6. DEEP TISSUE MASSAGE TECHNIQUES

Before any deep tissue work commences, it is essential that you have warmed up
the area by using plenty of effleurage as you would in a normal massage. You may
find erythema occurring which can be a good indication that there is some
congestion going on.

Deep Stroking can be used within your standard effleurage, using the
palms of your hands with the pressure coming from the heel of the hand
rather than your fingers. Ensure you are not overstretching whilst
performing this move, and you may find it beneficial to lower your couch
to be able to apply pressure from your own body weight. Palpation
should be taking place throughout the treatment, running the length of the
muscle in a slow motion. If you want to start working a little deeper, then
you can re-in force your hand but ensure you are working slowly to
identify any abnormalities in the tissue or muscles. Return to deep
stroking throughout your treatment to encourage the removal of toxins
and to keep the muscles warm.

Petrissage can be used to lift tense muscles, only once you have applied
plenty of deep stroking to the area.

Deep Tissue Frictions can be carried out using the fingers, thumbs, heel of
the hand or even the elbow and can be performed in a number of
directions such as circular or across the muscle (cross fibre friction).
Frictions are ideally used where you suspect scar tissue or adhesions have
formed, though they should not be used if you suspect an acute injury
where there may be inflammation. Return to this technique throughout
your massage rather than spending too long on one area as it can be too
stimulating.

Connective Tissue Manipulation (CTM) is a technique that involves

stretching connective tissue using the soft pads of the fingers to move one
layer of skin on the layer below. This technique is carried out easier if there
is minimal medium being used so it may be necessary to remove any
excess oil beforehand to prevent slip.

Trigger Point Therapy is a technique that finds the “trigger point” within a
muscle, tendon or the fascia that can be hypersensitive and can radiate
pain to other areas of the body. This area can be as small as a pinhead,
and the Trigger Point itself may not necessarily be the area of pain but can
refer to the area where there is injury within a taut band of muscle and can
act as a reference. The Trigger Point area can be congested spots within
muscles, demonstrating restricted blood flow. Working on Trigger Points
can reduce pain and improve circulation to the area. It is important that

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 the cause is investigated as any treatment will only act as a short term
relief if the cause is not removed i.e poor posture.

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Neuromuscular Therapy (NMT) or sometimes called Muscle Release
Technique is an extension of trigger point therapy and is carried out on
thick, knotty areas which are discovered through palpation. Direct
pressure is applied, using either the thumbs or fingers or even elbows,
directly on trigger points to break the cycle of muscular spasm to the area.
Once the area has been identified, ask your client to take a deep breath and
gradually apply pressure as they breathe out until it is just within their
pain tolerance. It is therefore essential that the therapist works with the
client to gauge this, and a scale of 1-10 can be used to determine how much
tolerance a client has. The pressure can be applied for up to 90 seconds if
necessary until the pain begins to ease or the therapist feels an alteration
in the muscle. Once the pain has moved to a dull ache, carry out effleurage
around the area to encourage circulation again. It is more effective to
return to the area later on during the treatment, rather than use NMT for
too long at a time as excess pressure can cause a muscle to go into spasm
which would be counter-productive. If the pain increases rather than
decrease during NMT, then the technique should be stopped immediately
as there may be some inflammation present. NMT works on the theory
that when a muscle is being regularly held in a wrong position and
therefore carries tension, our brain starts to accept this as normal, so that
when we try and correct it, the brain feels as if it is wrong. This is not a
conscious effort but happens through a natural reflex in the central
nervous system. NMT works on a conscious level teaching the central
nervous system that this is not normal and to re-programme it. The
procedure temporarily compresses the blood vessels which supply the
tissue, and when the compression is released, the blood will flow back to
the area, bringing with it nutrients, oxygen and heat, and removing waste
products. The release of endorphins also acts as pain relief.

Cross Fibre Massage runs across the muscle fibres rather than the length
of the muscle and is applied with the pads of the fingers or thumbs
(usually reinforced). This technique is used on localised areas of tense
muscles and can break down scar tissue effectively.

Mechanical Massage can provide a consistent, deep and effective form of

treatment. Many therapists like working this way as it can achieve the
same results in around four minutes to what it would take manually in
fifteen minutes, therefore saving the therapists hands and energy. Many
therapists like working with the equipment as it is also less personal and
maintains a consistent pressure. There are issues that need to be
considered however, such as loss of touch, making it more difficult to find
areas of tension, and also the importance of not using mechanical massage
over a bone or on an endangerment site.

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 7. CONTRA–INDICATIONS, CONTRA- ACTIONS
AND
AFTER CARE

Because you are carrying out a massage, the usual contra-indications will apply,
however there are some specific to Deep Tissue Massage that you need to be
aware of:

Swelling/inflammation – avoid the area if any swelling is evident as this

can demonstrate bleeding from a torn vessel, with tissue fluid leaking into
the surrounding areas.

Working on a recently injured site – avoid the area for 48/72 hours after
an injury.

Redness or discolouration of the skin – this can indicate an infection.

Sharp, knife like pain (acute) – this can indicate inflammation.

Always work within your own limitations. If you are unsure, then always refer to
another professional such as a GP, chiropractor or osteopath.

As with any massage treatment there may be some contra-actions, so it is

important to warn your client of them and to provide the normal aftercare that
you would for a massage treatment.

As you have worked deeper into the muscles than a normal massage treatment,
your client is more likely to feel the after effects!
If you have used NMT, then the area may feel bruised for up to 72 hours
afterwards, and the procedure should not be repeated for 48 hours.

Aftercare
The normal aftercare should apply for a deep tissue massage, but for the client to
get the best from the treatment they should be encouraged to stretch afterwards
and to hold the stretch for around 20 seconds. This will increase flexibility but
will also provide relief for sore muscles.

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 8. UNDERPINNING KNOWLEDGE

Please answer the following questions and send to alliemaisey@wsbht.co.uk

before your training day.

1. What are the benefits of a Deep Tissue Massage to the client?

2. List 3 contra-indications to a Deep Tissue massage.

3. Discuss the advantages and disadvantages of combing mechanical

massage with manual massage.

4. What are the precautions that you need to consider when using
mechanical massagers.

5. What are adhesions and how do they form?

6. In your own words, describe two Deep Massage Techniques.

7. Name and describe one way of carrying out an assessment.

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 9. RESULTS

(Please bring this with you on your assessment session, to be completed and
retained by the tutor)

Student Name________________

Practical evidence

Application of Deep Massage Techniques □

Theory evidence

Completed assignment □

Diploma awarded Yes/No

If no, Action plan

Tutor name______________________________

Tutor signature___________________________

Date___________________________________

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Advanced Massage and Deep Tissue Techniques Training Manual ©
 10. CONTACT DETAILS

CONTACT DETAILS
Head of
Holistics : Allie Maisey

Address : 706 Delta Office Park

Welton Road
Swindon
Wiltshire
SN5 7XS

Telephone : 01793 73 77 33

Mobile : 07824 337333

Email : holistics@wsbht.co.uk

Website : www.wsbht.co.uk

Like us on Facebook or follow @wsbht on twitter

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Diploma in
Advanced Massage and Deep Tissue Techniques Training Manual ©
 11. ACCREDITATION

This course is accredited by:

The Guild of Beauty Therapists

The Guild of Holistic Therapists

WSBHT is registered with UKRPL

UK Register of Learning Providers No: 10027055

Medical Disclaimer
It is advised that you take medical advice if you or any of your clients have a
health problem. Any qualification from WSBHT will not qualify you to advise on
any medical condition or to diagnose a condition.

Liability
WSBHT will accept NO liability for any person for any type of loss or damage
whatsoever resulting from the use of materials within any course held by
WSBHT.

Copyright
All copyright and other intellectual property rights in these materials are owned
by or licensed by WSBHT. Copyright, adapting or other use of all or part of these
materials without written permission of WSBHT is strictly prohibited .

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Diploma in
Advanced Massage and Deep Tissue Techniques Training Manual ©