Permission Joseph E. Muscolino. Advanced Treatment Techniques for the Manual Therapist: Neck (2013).

Neck Deep Pressure Massage: Step by Step – Engage the Tissues

Being able to feel tissue tension barrier is the one most crucial aspect for a clinical orthopedic manual therapist performing deep pressure massage. From a mechanical standpoint, it is only pressure beyond the tissue tension barrier that effects therapeutic change (this is not necessarily true neurally).

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.