Massage techniques also include Petrissage, or kneading, which is designed to release toxins from the muscles by lifting, separating, and rolling them. Gentle pressure is used to compress and relax the tissue and enhance circulation. Another technique, Tapotement, involves tapping the muscles with a percussive stroke. The side of the hand, fingers, or palm may be used to release tension and cramping. Many therapists also incorporate vibration, a later technique, which involves the therapist centering his or her hands on the back of a limb and shaking them briskly for several seconds to release tension, encourage circulation, and help muscles to contract.
Deep tissue massage is best for giving attention to certain painful, stiff "trouble spots" in your body. The massage therapist uses slow, deliberate strokes that focus pressure on layers of muscles, tendons, or other tissues deep under your skin. Though less rhythmic than other types of massage, deep tissue massage may be therapeutic -- relieving chronic patterns of tension and helping with muscle injuries, such as back sprain.
During most full-body massages the expectation is you’ll be undressed. Your massage therapist will ask you to undress for your massage while they wait outside. It’s up to you whether or not to keep your underwear on. Your massage therapist will drape a sheet over your body, which they will pull back and adjust as they work their way around. You will be covered most of the time.
Massage has been shown to reduce neuromuscular excitability by measuring changes in the Hoffman's reflex (H-reflex) amplitude. A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability. Others explain, "H-reflex is considered to be the electrical analogue of the stretch reflex...and the reduction" is due to a decrease in spinal reflex excitability. Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage. It has been noted that "the receptors activated during massage are specific to the muscle being massaged", as other muscles did not produce a decrease in H-reflex amplitude.
A 2004 systematic review found single applications of massage therapy "reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level", while "multiple applications reduced delayed assessment of pain", and found improvements in anxiety and depression similar to effects of psychotherapy. A subsequent systematic review published in 2008 found that there is little evidence supporting the use of massage therapy for depression in high quality studies from randomized controlled trials.