“No Pain, No Gain” Doesn’t Belong in Massage: Rethinking Pressure and Pain in Therapeutic Treatments
In a world where intensity is often equated with effectiveness; particularly in fitness and recovery. The phrase “no pain, no gain” has seeped into massage therapy with damaging consequences. Too often, clients associate a “good” massage with one that leaves them wincing, gritting their teeth, or walking out bruised. But let’s make one thing clear: pain is not a benchmark for therapeutic success.
Whether it’s a deep tissue massage, sports massage, or a precision-based release technique, the goal is the same. To restore optimal function, improve circulation, relieve tension, and support the body’s natural healing processes. None of those outcomes require unnecessary pain.
Let’s explore the nuance behind pressure, the purpose of deep tissue and sports massage, and how the body actually responds to pain during a treatment. Supported by science, not myth.
Deep Tissue Massage ≠ Deep Pain
Deep tissue massage has been widely misunderstood. It’s often marketed (and requested) as the kind of massage that “gets in there and breaks it all up” - a phrase that’s as vague as it is misleading. Deep tissue isn’t about aggressive force; it’s about depth of focus, not just depth of pressure.
A 2014 review in the Journal of Bodywork and Movement Therapies describes deep tissue massage as a “structurally oriented” approach that targets deeper layers of fascia and muscle tissue using slow, sustained pressure and skillful engagement with the body’s tension patterns (Weerapong et al., 2014). This requires anatomical precision and sensitivity, not brute force.
When applied correctly, deep tissue work should feel like your therapist is “melting” into the muscles, not forcefully hammering them. The sensation might be intense at times, especially around trigger points or chronically tight areas, but it should still allow the client to breathe, stay present, and relax into the treatment. If you're bracing, holding your breath, or clenching your jaw, you're no longer in a therapeutic state. Your body has shifted into stress mode.
The Importance of Relaxing Into the Work
Massage works best when your nervous system feels safe. That’s why skilled therapists encourage clients to focus on their breath, soften into the table, and remain as still and present as possible. This isn’t just for ambience; it’s biological.
When you’re able to relax and breathe through areas of discomfort, your parasympathetic nervous system (the “rest and digest” side of your autonomic system) activates. Allowing muscles to soften, fascia to release, and blood flow to increase. According to a 2011 study in the Science Translational Medicine Journal, massage actually downregulates inflammatory gene expression in muscle tissue and promotes mitochondrial biogenesis (Crane et al., 2012). Translation? Your body heals faster when it’s in a calm, receptive state.
However, if you're tensing up or resisting pressure, the therapist is effectively trying to work on a “plank of wood.” And there’s little point trying to release muscles that are neurologically locked in protection mode.
Pain in Massage: When It Helps and When It Harms
A common misconception is that pain during massage equates to progress. But scientific literature challenges that.
Pain, especially sharp or breath-holding pain, triggers muscle guarding, a natural protective response. This involuntary contraction can reduce blood flow, increase inflammation, and prolong recovery. As explained by Bialosky et al. (2009) in the Journal of Orthopaedic & Sports Physical Therapy, manual therapy achieves its greatest success through neurophysiological effects. Modulating pain signals, improving sensory feedback, and helping the brain recalibrate the body’s movement and tension patterns.
Put simply: overstimulating the tissue with harsh pressure can override these beneficial neurological responses.
This doesn’t mean massage should always be feather-light. Some discomfort, especially in targeted areas with adhesions or long-standing tension is natural. However, discomfort is different from distress. Your therapist should always work within your tolerance and adjust as needed.
Sports Massage Doesn’t Have to Hurt
Sports massage, in particular, often gets misrepresented as a necessary gauntlet of pain. In reality, it's a highly versatile modality that can be adapted to different phases of training and recovery.
During pre-event treatments, for example, sports massage tends to be more superficial, rhythmic, and stimulating to prime the body for performance. Post-event or recovery treatments, on the other hand, are more restorative and methodical, helping flush out metabolic waste and reduce delayed onset muscle soreness (DOMS).
According to a 2016 study published in BMJ Open Sport & Exercise Medicine, sports massage can reduce perceived fatigue and muscle soreness when applied appropriately, but excessive force may delay recovery by increasing muscle damage or stimulating inflammatory responses (Davis et al., 2016).
The takeaway? A sports massage can be effective without needing to “break” you.
Pain Tolerance and Trauma: A Complex Relationship
Now, let’s talk about something that rarely gets addressed in standard massage education: the neurological and trauma-based underpinnings of pain tolerance.
Some individuals genuinely don’t feel much during massage; even when a therapist is using firm, targeted pressure. This can be due to desensitisation, chronic stress, nervous system dysregulation, or trauma-related disconnection from bodily sensations (often called interoception).
In trauma literature, this phenomenon is known as “hypoalgesia”. A reduced sensitivity to pain, which can occur in people with complex trauma histories or those who’ve learned to suppress bodily cues as a coping mechanism. It doesn’t mean their tissues don’t need care, it often means they need it more, but at a pace and tone their nervous system can tolerate.
If you’ve tried several therapists and still “can’t feel anything,” it may be time to reflect on your body’s relationship with sensation. This is where finding a therapist who understands trauma-informed bodywork becomes essential.
How to Find the Right Pressure for You
Here’s what you should keep in mind as a client:
Communicate openly. Let your therapist know what feels too much, too little, or just right. A skilled therapist will adapt their technique based on your feedback.
Give it time. It may take a few sessions for your body to respond fully, especially if you’re used to chronic stress or poor posture.
Focus on the breath. Breathing through tight areas increases oxygenation, relaxes your nervous system, and helps your therapist work deeper - safely.
Pain is not the goal. Pressure should feel purposeful, not punishing.
Conclusion: Intent Over Intensity
At its best, massage is a conversation between your body and your therapist’s hands. It’s not about who can take the most pressure, nor is it about pushing muscles into submission. It’s about collaboration, awareness, and respecting the body’s thresholds - not just in the tissue, but in the nervous system as well.
If you leave a treatment relaxed, aligned, and breathing easier - that’s the sign of a successful session. Not bruises, agony, or war stories about how “hard” your therapist worked you.
Deep tissue doesn’t mean deep pain.
Sports massage doesn’t require suffering.
And effective therapy never asks you to override your body’s signals.
Instead, it invites you into a space of healing, and that starts with trusting the process, the pressure, and your own capacity to release, not resist.
References:
Bialosky, J. E., Bishop, M. D., & George, S. Z. (2009). Beyond the tissue: A review of the interaction of pain and manual therapy mechanisms. Journal of Orthopaedic & Sports Physical Therapy, 39(9), 618–627.
Crane, J. D., et al. (2012). Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Science Translational Medicine, 4(119), 119ra13.
Davis, H. L., Alabed, S., & Chico, T. J. A. (2016). Effect of sports massage on performance and recovery: A systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 2(1), e000202.
Weerapong, P., Hume, P. A., & Kolt, G. S. (2014). The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Journal of Bodywork and Movement Therapies.
