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Should Hands or Elbows be used for deep tissue work?

Deep tissue massage is a type of massage therapy that focuses on realigning deeper layers of muscles and connective tissue (fascia). It is sometimes helpful for chronic aches and pains in contracted areas such as stiff neck and upper back, low back pain, leg muscle tightness, and sore shoulders.

It is generally accepted that deep work using only hands to apply sufficient pressure causes long term harm to the therapist hands, and that the same pressure can be applied with relative ease using the forearms and elbows.