Permission Joseph E. Muscolino. Manual Therapy for the Low Back and Pelvis - A Clinical Orthopedic Approach (2013).

Deep Pressure Massage to the Low Back – Choosing the Treatment Contact

When working the low back, a good strategy is to begin with a smaller treatment contact such as thumb or finger pads to assess and begin treatment of the lumbar region, and then switch to a larger contact such as the palm or elbow to deliver deeper pressure.

Permission Joseph E. Muscolino. Manual Therapy for the Low Back and Pelvis - A Clinical Orthopedic Approach (2013).

Deep Pressure Massage to the Low Back – Tissue Tension Barrier

Being able to feel tissue tension barriers is the one most important hands-on skill that an orthopedic manual therapist needs. Clinical orthopedic manual therapy (massage and stretching) only effects change if we reach tissue tension and then apply slightly more force beyond it.