Why It’s Absolutely Okay To See Bruising After A Massage Treatment

Deep tissue massages feel amazing. They relieve stress, lower your blood pressure, rehabilitate muscles, and can help treat chronic pain. It uses firm pressure with slow strokes to reach the deep layers of muscle and fascia and break up scar tissue and muscle knots. After a deep tissue massage, you might feel on cloud nine, but you should also know that bruising after massage treatment is very common.

Like many other women my age, I suffer from migraines. They’re a type of recurring headache with severe throbbing or pulsing, accompanied by nausea, sensitivity to light and sound, and can sometimes be debilitating. I curbed them for a while with over the counter meds and essential oils, but after a few months, even those stopped working. For Christmas one year, I got a gift card to a spa specializing in deep tissue massages. I thought, why not?

The massage therapist was very friendly and walked me through the entire deep tissue massage process since it was my first time. She told me that tense neck and shoulder muscles could lead to migraines and that deep tissue massages release serotonin, promote circulation, relieve muscle tension, and reduce stress. I was so excited to get some relief finally.

My massage therapist was very thorough and told me about the areas of my back, shoulders, and neck she would target. She asked what level of pressure I liked, and I said medium to hard. She started off slowly with light pressure, warming up my muscles and fascia, and advised me to focus on my breathing. Then, she amped up the pressure and used her forearm, elbow, and body weight to dig into my back and shoulders.

She ran her knuckles along the back of my neck, suspending my head with only her thumbs. I could feel the pangs of tension dissipating through my jaw and down my neck. I felt the muscle knots on my back twitch back and forth as she ran her palms over them. She even targeted the muscles on my chest, ones I often forget are there. It felt incredible. It was the most relaxing hour of my life.

Once I got home, I noticed red spots after the massage. I told myself this would go away. They’re just marks from where she had her hands. Then a few hours later, I got a massive headache and started feeling bruising on my neck. It hurt to the touch, so much that even laying down was uncomfortable. The masseuse had told me I would feel sore but not bruised. I was definitely experiencing bruising after a massage treatment.

I had always associated bruising with injury, so when I noticed deep tissue massage bruising on my neck, shoulders, and upper back, I worried that the beautiful, relaxing massage had actually injured me and made things worse. I was scared and Googled: “why does my back feel bruised after a massage?”

The answers I found online were conflicting. Some websites said: “severe bruising after massage is a sign of poor technique,” while others said: “bruising after massage treatment is perfectly normal.” Which was it? I decided to find out for myself.

What Is Bruising?

First, let’s define what bruising is, and what it means. The medical term for bruising is a contusion, which results from an injury that breaks the capillaries beneath the skin and causes red blood cells to leak out. This bleeding beneath the skin is what causes the blue-ish, purple color of bruises. People who are older, anemic, skinny, on certain medications like blood thinners and women are more prone to bruising than others.

A bruise is tender to the touch and feels like a deep, dull pain with any pressure. I first noticed I had bruises because even my purse strap hurt my shoulders. I also noticed that the red spots after the massage had become swollen and puffy. Looking at my back in the mirror, I could clearly tell where I was bruised by the discoloration and swelling. I felt a lot of resistance in my neck and shoulders, and I couldn’t move them without them hurting.

While most bruises are caused by physical injuries, like from a fall, an accident, or muscle sprains, not all bruising is the result of an injury. Bruising could also be caused by stagnant blood. Stagnant blood is known as disharmony in the body because blood is not moving the way it should be. Traditional Chinese medicine theorizes that slowing or pooling of blood is the cause of many diseases. Blood stagnation manifests in several ways, including sharp shooting pains or constant dull pain in one area of the body or many different areas. Symptoms include shoulder pain, upper or lower back pain, sore legs, numb limbs, and stabbing pain in the neck.

Bonus: How to relieve pain after a massage according to my masseuse.

I was surprised to learn that I had most of the symptoms of stagnant blood. Many chronic illnesses, including migraines, are caused by blood deficiency or poor circulation. Significant arterial pressure can trigger migraine attacks and could have been contributing to mine.

Can Deep Tissue Massage Cause Bruising?

Yes, bruising after deep tissue massage is perfectly normal and could actually be a sign that the massage was successful at alleviating your symptoms. Unlike I had initially thought, bruising is not always the result of an injury.

One of the things that the massage therapist had done was to release the stagnated blood in my tissues through stretching, rubbing, and massaging, in addition to having me focus on my breathing. The knots I felt twitch under her palm were actually forms of stagnant blood that caused bruising after a massage treatment.

A knot is made of lymphatic fluid that remains stuck in one place and cannot circulate through the body the way it should. The fluid may build up so much in one knot that the muscles around it become inflamed, which could result in tension, pain, and in my case, migraines.

The lymphatic system is responsible for removing toxins and waste from the body to keep the immune system functioning against pathogens. To do so, it circulates lymph, which is made of white blood cells and proteins, around the body to collect the waste that cells dump out. Unlike blood that circulates with the help of the heart’s pump, the lymphatic system uses muscle contractions to distribute throughout the body. Therefore, if you are less active and don’t exercise enough, there’s more chance for these lymphs to become stuck.

Lymph channels and knots are just beneath the skin’s surface, so you might even get light bruising from self-massage. The weight of a hand stroking upward can help relax the muscles around the knot and allow the lymph to pass through.

However, blood vessels are also just beneath the skin’s surface, so they are easily ruptured with those same motions. In some cases, rupturing blood vessels results in only minor discoloration and swelling, but with more firm pressure, as I had requested, more blood will leak out and cause visible bruising after a massage treatment.

Timeline Of Deep Tissue Massage Bruising

Minor bruises and bruising from a massage can go away in as little as a few days or last up to about two weeks. You can gauge how your bruise is healing by its color and size. This is the progression of bruising after deep tissue massage:

  • Immediately after the massage, you will likely notice red spots where the masseuse applied deep pressure. These red spots are when the blood first leaks out of the vessels.
  • In one to two days, the red spots will turn darker blue and purple. This is a result of the hemoglobin (carrier of oxygen) in your blood.
  • After a week or so, the bruise will start to change colors as your body begins breaking down and reabsorbing the blood. The color will look more green and yellow.
  • In about two weeks, most of the blood will have been reabsorbed, and the bruised area will appear light brown.
  • Finally, after about two weeks (for more minor bruises), the discoloration and swelling will be gone.

It’s important to note your skin color could also affect the appearance of bruising. The darker your skin tone, the darker the bruises will appear. This does not necessarily mean the bruises are more severe, only that they look darker.

When To Be Concerned About Bruising After Massage

After getting a relaxing, stress-relieving, deep tissue massage, the last thing you want to worry about is the after-effects like bruising. Luckily, bruises hardly ever turn dangerous and rarely need medical attention. Let your massage therapist know what medications you’re on beforehand or any medical conditions you may have that could cause heavy bruising.

Nonetheless, it’s important to know the warning signs of a bruise that could need medical attention. Keep an eye out if your bruise:

  • Keeps getting bigger
  • Lasts longer than two weeks
  • Causes the area to go numb
  • Causes you to lose function of that muscle

Final Thoughts

Bruising is often associated with injury, and since injury is the direct opposite of healing, it might scare you to see bruising after massage treatment. I was definitely caught off guard when I noticed bruising after deep tissue massage, but now I know the causes and meaning behind those bruises. So enjoy your next massage treatment, whether it’s deep tissue or not, and go into it with the knowledge that bruising might occur, but it’s just a sign of your body healing from within.

Photo by Andrea Piacquadio, and frank mckenna on Unsplash

Author: P. Sze

P. Sze P. Sze is the founder of TCM Tips and Dragon Acupuncture®. She graduated from the National University of Singapore with a first-class honor in Civil Engineering. S he also holds a master’s degree in Engineering and is the brain behind the innovative TCM products of Dragon Acupuncture®. She is the author of The Beginner's Guide to Auricular Therapy: Application of Ear Seeds (ISBN 978-1520451398) and Facial Gua Sha - Fight the Signs of Aging Naturally and Inexpensively (ISBN 978-1980678922). She has dedicated her life to ensuring that the complex theories behind oriental medicine and the seemingly dangerous techniques that involve needles and fire do not scare you from trying oriental medicine. This is why she writes endlessly about acupressure and its countless health and wellness benefits.

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