Takeaway: Fascia is continuous throughout the body. When you engage it superficially by pushing on it, lifting it, lengthening it, etc., it affects the areas to which it extends without having to engage deeper tissues. 

There’s a common misconception among clients and therapists that deep work is necessary to address specific areas of tension and/or pain and that anything less has minimal effect and will not create lasting change. 
In recent months, my clients (primarily new ones) have begun asking for sessions that do not involve deep-tissue work, including some version of the statement, “I know I have a lot of knots to work out, but what I really need is to just relax.” This communicates a belief that it’s an either/or situation—either you get therapeutic work or you get to relax.
What makes clients think they can’t have both? Do therapists know how to offer sessions that address specific concerns without having to dive into the deeper tissue layers? Are therapists aware of, and educating their clients on, how impactful superficial work is (and simple relaxation, for that matter)?
When a person (be it a client or therapist) holds a belief—in this case, that the effects of superficial work don’t reach beyond the surface—they become an obstacle to receiving the true benefits and effects of the work. The goal, then, is to illuminate the inaccuracy of these beliefs so clients can receive therapeutic effects without enduring an approach they are not comfortable with.

What is Superficial Massage?

Let’s start by ensuring we are on the same page about what superficial massage/bodywork is. Generally speaking, superficial massage refers to the application of techniques that engage only the outermost layers of tissue—specifically the skin. There are considerations to make when engaging the tissue at this level.

When clients report they were dissatisfied with a previous superficial massage, they often refer to the treatment as “fluffy.” When I ask them to describe what that felt like, nearly every person makes a gesture that depicts very light touch only to the outermost layer of the skin. In other words, the touch does not engage the deepest skin layer—the hypodermis or superficial fascia. While there are some benefits to this approach, it might not be quite what clients are asking for when they request lighter pressure. Often, they still want to feel further tissue engagement rather than just feather-light strokes. Of course, this is all dependent on the client, and it is important to ask questions like, “Is this the kind of pressure you’re looking for?” and then demonstrate on their forearm before they even get on the table. 
In addition, if there are concerns clients wish to have addressed, such as tension, restriction, or pain, sometimes therapists believe they cannot create change without sinking beyond the superficial fascia. This couldn’t be further from the truth.

How to Go Deep Superficially

So, how do we offer a superficial massage session that meets each of these wants and needs? Can we go deep without going deep? Yes, we can.

Engage Superficial Fascia

Most teachers of myofascial techniques recommend priming or releasing the superficial layers of tissue before going deeper. There are several reasons for this.
First, it begins the process of differentiating layers of tissue. Often when an area of fascia is bound up, the superficial layer sticks to what is beneath. When you release the outermost layer, the process of unbinding the underlying tissue begins. Even if you don’t intend to go any deeper, you can still cause a therapeutic effect with this release alone.
Second, since fascia is continuous throughout the body (in other words, it extends throughout the body in a wholly connected sheet), when you engage it by pushing on it, lifting it, lengthening it, etc., it affects the areas to which it extends. I once saw this demonstrated with the use of a balloon. If you have a balloon filled with water and you pinch one side of it, you can see a stretch throughout the entire balloon (even as far as the opposite side). One pinch affects the whole. It is the same with fascia. Superficial fascia connects to and affects deep fascia. This is especially true for areas where there are dense bands or sheets of connective tissue, such as the iliotibial band and the thoracolumbar aponeurosis. Although these structures appear to sit superficially, the complexity and depth to which they extend is both fascinating and powerful to understand and can greatly inform your intent when you are attempting to go deep via a superficial approach. Studying current theories in fascial research is well worth the investment of time to recognize the ripple effect of one shift within these tissues.
Third, in areas of the superficial fascia where nerves, blood vessels, and lymph vessels penetrate, there can be a thickening in the tissue that causes the flow of fluid and currents to be impeded. By gently manipulating these superficial areas with clear purpose, stagnation can be reduced and flow can be restored, causing a widespread effect. In addition, because fascia is now understood to be highly concentrated with specialized sensory receptors that have direct links to the autonomic nervous system, approaches such as slow, multidirectional stretching and gentle compression can cause a decrease in sympathetic tone, heart and respiratory rate, and blood pressure, even when indirectly contacted through manipulation of the superficial fascia (remember, it is connected to the deep stuff!).

Incorporate Gentle Stretching and Breathwork

Often overlooked are the potent practices of stretching and breathwork. When you wish to access deeper tissues but need to keep your hands in the superficial layers, put the body to work for itself. Applying gentle, passive stretching is soothing and relaxing while it reaches deep into and around the joints. When you rhythmically incorporate breathwork with this movement, you support balance between the sympathetic and parasympathetic responses. 
A great way to perform this is to ask your client to inhale before the stretch, exhale on the stretch, and inhale again on the release. Then, have them exhale again for a second round of stretch and inhale on the release. Repeat in very slow, rhythmic cycles (not quick and bouncy, which can injure tissues).

Tap into Intent

Perhaps the most notable aspect of any type of bodywork is intent. When you center yourself in the present moment and focus on what is under your hands, you can facilitate deep work without ever contacting deeper tissues. This is why knowing anatomy, physiology, and kinesiology is so important. With an understanding of how parts of the whole relate to and interact with each other superficially and deeply, you can move superficial tissue strategically while also contacting what lies beneath by placing it in your mind’s eye and holding a vision of cause and effect. 
Add to this a focus on quality of touch—in other words, what is being conveyed through your hands. When you embody an intent of loving kindness, of seeing and honoring a client’s state of being, of silently communicating safety, respect, care, and support for the body’s natural desire to sustain life, you reach places in the body that can’t be reached any other way.

Practice

Offering superficial massage is a skill that requires practice. While some think it is easier than deep-tissue massage, I find it more challenging—primarily because of the keen focus and restraint that is involved with maintaining just the right depth. Not too much, not too little. 
Find an acquaintance whose tissues are healthy and practice recognizing the difference between gliding across the skin versus engaging the superficial fascia. Then, sink just below into muscle tissue, feeling the difference in the qualities of fascia versus muscle. Even though this practice is taught early in massage and bodywork training, it is valuable to return to it to re-hone skills you might have stopped using. It makes for a much more complex practitioner.

Deepen Your Learning

Although this overview only scratches the surface, my hope is it will inspire you to deepen your learning of what is beneath your hands and the many ways you can access more than you may realize.