Most deep tissue massages normally focus on major muscle groups — such as the neck or lower back — along with joints and tendons that are susceptible to straining or injuries. Certain areas of the body that tend to tense up in times of stress, including the shoulders, neck and hips, can often benefit the most from this type of deep manipulation. Many people consider “sports massages” to be a form of deep tissue massage, which involves physical treatment primarily to neuromusculoskeletal systems to treat pain and disability, improve muscle recovery and joint mobilization, and prevent injuries.

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Some possible justifications for painfully intense massage (these aren’t endorsements) include the destruction of motor end plates to “de-activate” trigger points; somatoemotional release (pain often strongly “resonates” with strong emotions like grief); moving tissue fluids; or just creating a strong, novel sensory experiences (which may have many subtle benefits).
Couples massage takes place in a room that is, at the very least, large enough for two massage tables, which is the typical set-up in a day spa. On the other hand, resort and hotel spas often create elaborate environments where couples can not only have side-by-side spa treatments, but also take a bath together, get pedicures, spend time in a steam shower, or lounge by a fire after the treatment. 
My massage therapist has been doing massages for 30 years. He is really aggressive. I thought that I was going to die. The pain was so intense that I honestly feel that it was worse than having children. When the massage was complete, I felt relaxed. When I got home I felt exhausted, like I had been in a major accident. Truthfully I feel like crap. I ache from head to toe, what the heck is this? I feel absolutely horrible. I had a bath before bed and it did help somewhat. But this morning I still feel like hell …
Interestingly, many patients and therapists swear by massage as a way to reduce constipation or digestive upset, since the increased circulatory benefits and relaxation of the abdominal and lower back muscles can help relieve symptoms. In fact, a 2014 study from the British journal Nursing Standard highlights a number of the ways abdominal massage encouraging muscle contraction, nudging the gut to move things along.

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