Unless they have a long history with massage therapy, many clients don't know the differences between modalities. Some of the modalities overlap techniques or are so subtly different that even massage therapists may get confused or blur the lines between styles. Deep Tissue Massage is probably the least understood. Some clients are under the misconception that deep is a reference to pressure. Using firm pressure does not mean it is a deep tissue massage.
Pressure refers to the amount of force the massage therapist uses during a massage. Firm pressure is exactly that: firm pressure. However, please note that levels of pressure are completely subjective. Firm pressure to one client may feel like medium pressure to another. The massage therapist may use medium or even light pressure and the client could perceive it as firm pressure. This subjectivity is why massage therapists check in with clients during each massage.
Deep references the location of the tissues targeted by the style of massage. The body is assembled in layers. The outermost layer is the skin. The innermost layer is the bones. Anatomically speaking, 'deep' tissue means the tissues closest to the bone. The opposite, or 'superficial' tissue, references the tissues furthest from the bone. Therefore, deep tissue massage focuses specifically on the layers of muscle tissue closest to the bone, with less focus on flow and overall relaxation.
A massage therapist can access the deep muscles by forcing their way through other layers, regardless of any tension, but that will most likely result in a painful massage, both at the time it is received and the next day or two. Brute force is not always an effective tool. The recommended approach for deep tissue massage is to palpate the layers of muscle, from the superficial inward, until the massage therapist can access the deeper muscles with less discomfort.
Massage does not have to hurt to be effective. The body tenses up when in pain, think of it as a self-preservation response. Some techniques may be uncomfortable to receive; however, if the massage hurts to the point where the client tenses up, then massage therapist will be working against the body, not with it, and may actually damage the tissues instead of facilitating healing. Again, this is why massage therapists check in with clients during each massage.
Hopefully that clears up any misconceptions about deep tissue massage. Please share any comments or questions below.