Thank you so much for your article The Pressure Question in Massage Therapy. I just read it all. I went for a sports massage two weeks ago as I was recommended to have one as it was suggested it might help with tight calves, a side effect of some other injuries I have. I’ve been for sports massages many, many times before over the years. This one was one of the most painful experiences of my life — when I got home I was almost sick and felt in shock. My right achilles tendon was raging and it’s been bad ever since. It hurt so much when it was done (like someone was sticking knives in) and I kept asking if it was meant to hurt. I wish I’d just stopped the session or objected but I didn’t. It used to be a bad injury that affected me walking for about 6 months so I’m just devastated about this. I can hardly bear to put shoes on and its all this time on. I know there are good practitioners out there but experiences like this just make me want to stay away. I wish I’d gone to a “gentle” one.

Massage is used for hygienic, prophylactic, and therapeutic purposes and in athletic training. Hygienic massage improves the health and is a way of taking care of the body. It prevents excessive deposit of fats and salts and helps maintain the figure. For hygienic purposes, general massage is most often administered. One of the forms of hygienic massage is cosmetic massage, which is done to prevent wrinkling of the skin and to smooth out blemishes on the face and neck. In athletic training, massage helps maintain athletic form, combat fatigue, and restore strength after strenuous muscular work. There are several types of athletic massage, including preparatory, training, and restorative massage. Self-massage is used for hygienic purposes, in combination with morning calisthenics and aquatic exercises. Sometimes it is prescribed for therapeutic purposes (for example, in the treatment of contusions and sprains).


AD 1150: Evidence of massage abortion, involving the application of pressure to the pregnant abdomen, can be found in one of the bas reliefs decorating the temple of Angkor Wat in Cambodia. It depicts a demon performing such an abortion upon a woman who has been sent to the underworld. This is the oldest known visual representation of abortion.[12]
Plantar fasciitis. According to the JAMA Network, plantar fasciitis occurs when the fibrous band on the bottom of the foot becomes irritated and inflamed, causing pain in the heel and arch areas. The Pacific College of Oriental Medicine further indicates that deep tissue massage can be an effective treatment for this particular condition as it helps “release the muscle tension, break scar tissue, and lead to its elimination.”
The study involved 263 volunteers with an average age of 48.5. Overall muscle spasm/muscle strain was described as either moderate or severe for each patient prior to treatments, which consisted of a massage between 45–60 minutes in duration. Results demonstrated an average systolic pressure reduction of 10.4 mm/Hg, a diastolic pressure reduction of 5.3 mm/Hg, a mean arterial pressure reduction of 7.0 mm/Hg and an average heart rate reduction of 10.8 beats per minute following massage treatment. (6)

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Most of us can't afford to jet off to Burgundy with our beau for a romantic getaway, but the luxe rooms inside the Plaza Hotel's spa is the next best thing. The dark-wood-paneled enclave allows you to channel a French vineyard with its wine-infused treatments. Couples should choose the Divine Love Ritual package ($650 per couple), which includes both a 50-minute customized massage and facial. The signature facial uses products derived from red wine—resveratrol and polyphenols—to help maintain skin’s elasticity and brighten the complexion. Hop onto the adjacent massage tables for 50-minute toning rubdowns designed to promote circulation, then wind down on the leather couches inside the wine lounge while sipping a glass of bordeaux from Caudalie’s family vineyard ($10-$15) and nibble on an assortment of fromage ($18-$25).
Several mechanisms for deep massage’s natural stress-relieving effects include its ability to dilate blood vessels and also lower activity of the limbic system (including the hypothalamus), which is responsible for autonomic nervous system regulation and cortisol secretion. Massage has been shown to improve relaxation by boosting activity of the parasympathetic nervous system, as measured by heart rate, blood pressure and heart rate variability. (8, 9)
The price of a couples massage depends on the spa, the amount of time, and the amenities. Generally, it is the cost of a regular massage, times two. Sometimes you can add on private time. For instance, Aspira the Spa at The Osthoff Resort in Wisconsin offers couples massage at $135 per person for 50-minutes. Couples can enjoy an additional hour of time alone together in the spacious suite, equipped with a master shower, whirlpool bath, stone fireplace, and sofa, for $50 per person. At some spas, the package might include private time and amenities like Champagne, which sends the price higher.
Completely new to massage? Book your first appointment either well before a race—at least a few weeks out—or wait until the day after. “Just like you wouldn’t test out new socks or shoes on day of race, you shouldn’t experiment with any pre-race bodywork,” says Denunzio. Those who are familiar with massage can benefit from a pre-race rubdown in the seven to two-day window prior to an event. Getting treatment less than 48-hours prior puts all runners—even those who are massage veterans—at risk of race day soreness.
Massage in China is an extremely popular therapy, the city of Shanghai alone playing host to over 1500 foot massage centers while there are more than 3000 in Shenzhen. It is one of the biggest service industries in China with workers in Shanghai numbering in the tens of thousands.[17] The average rate of pay for a worker in the massage industry in China is over 10000 yuan per month, making it among the highest paid jobs in China’s service sector.[18] China’s massage parlors are frequently linked to the sex industry and the government has taken a number of measures in recent times to curb prostitution and the spread of disease. In a nationwide crackdown known as the yellow sweep ("Yellow" in Mandarin Chinese refers to sexual activities or pornographic content), limitations on the design and operation of massage parlors have been placed, going so far as requiring identification from customers who visit massage establishments late at night and logging their visits with the local police.[19][20]
The benefits of a sports massage are numerous: improved flexibility, reduced risk of injury, and a boosted circulatory system, just to name a few. But bodywork isn’t a one-size-fits all tool, and there are certain things to consider before booking an appointment. Here, three runner-trusted massage therapists impart important pre-massage knowledge.  

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In New York City, couples massage serves as a way to escape—even if you can’t get out of the city. Most of the best spas in NYC will give pairs the option to receive massages together, lying prostrate side by side and enjoying amenities like wine or supplemental services. For example, at Spa Castle NYC, couples can retire to private rooms where massage therapists will knead their sore muscles with soothing Swedish or deep-tissue strokes or use hot stones to break up tension caused by couples arguing over how to load the dishwasher correctly.

A study conducted by the National Center for Complementary and Alternative Medicine, and published in The New York Times, found that volunteers who received a 45-minute Swedish massage experienced significant decreases in levels of the stress hormone cortisol, as well as arginine vasopressin-a hormone that can lead to increases in cortisol. Volunteers also had increases in the number of lymphocytes, white blood cells that are part of the immune system, and a boost in the immune cells that may help fight colds and the flu.


Knowing what to expect before, during and after your massage can enhance the benefits you experience. Before the session, Debbe will want to understand your health history and your treatment goals. It is important that you let Debbe know if you have any allergies or specific injuries that you wish to address or avoid. Debbe, with feedback from you, will note your concern areas and mark the desired intensity of treatment on your first visit. She will stimulate and relax the connective tissues that form the underlying foundation of your muscular tissues. After receiving regular deep tissue massages, you may experience a dramatic decrease in your level of muscle tension and pain, as well as lowered blood pressure levels.

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When you’re hungry, you need to eat. You’ll feel fine for a while, but you’re going to get hungry again later. Massage is a similar principal. You’ll feel the effects from a massage almost immediately. The rush of positive endorphins and the newness of your extended range of motion will likely carry on for a few days. Like with most things, you’re going to need to come back to maintain the positive after effects. 
Since reflexology is not recognized by law, no formal training is required to practice reflexology or call oneself a reflexologist. However, some nurses and massage therapists offer reflexology as part of their licensed practice. Some courses are accredited for continuing education for nurses and massage therapists. The most widely publicized training source is probably the International Institute of Reflexology, of St. Petersburg, Florida, which claims to have 25,000 members worldwide [9]. Its seminar on the "Original Ingham Method of Foot Reflexology" are taught by Ingham's nephew, Dwight Byers. Its "Certified Member" status requires 200 hours of instruction plus passage of written and practical tests. As far as I know, this certification process has neither legal nor medical recognition. The Institute's Web site states:

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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.
That is, regardless of all other considerations, a massage therapist must talk to you about pressure, respect your preferences (they are more important than any treatment ideology), and be careful about stumbling into areas that need much less pressure (for comfort) or much more pressure (for satisfaction). Far too many therapists make the mistake of setting a “default” pressure for a client early on, and then using roughly that much pressure everywhere.

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Many people confuse reflexology with massage, Reiki, or acupuncture, but there are essential differences between these therapies.  Massage therapists manipulate larger areas of soft tissue in the body while reflexologists apply pressure to specific points on the feet, hands, and ears.  Unlike either massage or reflexology, Reiki does not involve any physical manipulation or pressure, but instead uses light touch to work with the subtle vibrational field thought to surround the body. Finally, while acupuncture and acupressure, like reflexology, use reflex points on the body to influence other parts of the body, the points are not the same and acupuncture uses points over the entire body.

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Many clients see the benefit of different modalities and choose to incorporate massage therapy into their health and wellness plans by enrolling in the Elements Wellness Program™. Members of the Elements Wellness Program™ receive discounted massage therapy on a regular basis from the nation’s highest-rated massage provider. Our studios offer the highest-rated massage because we make the massage about you, the client.

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We offer our patients chiropractic, massage and acupuncture all under one roof. All injuries are treated from a whole-body approach. We focus on first reducing pain by taking pressure off of the inflamed muscle, disc or vertebra with an adjustment and release the surrounding muscles with stretching, myofascial release, graston or ART. Once pain levels have decreased, we correct muscle imablances and strengthen weak muscles with a customized physical therapy plan. Most patients enjoy periodic treatment sessions to maintain their health at an optimum level. ... View Profile

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As a teacher, a nationally-certified practitioner and Reiki Master who works in many therapeutic styles, you can have confidence that you found someone with a reputation for “getting in there” without hurting you.  I'm generous with my time because it takes patience to achieve healing. I love what I do. I specialize in a fusion of therapeutic modalities. These include Shiatsu, Acupressure, Cranio-Sacral Therapy, Cupping, traditional Swedish Massage, Reflexology, Reiki, and other forms of Energy Healing. ... View Profile

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Reflexology is an alternative medicine system that claims to treat internal organs by pressing on designated spots on the feet and hands; there is no anatomical connection between those organs and those spots. Systematic reviews in 2009 and 2011 found no convincing evidence that reflexology is an effective treatment for any medical condition. Quackwatch and the NCAHF agree that reflexology is a form of massage that may help patients relax and feel better temporarily, but that has no other health benefits. Our own Mark Crislip said, “The great majority of studies demonstrate reflexology had no effects that could not be replicated by picking fleas off your mate…And it has no anatomic or physiologic justification.”
Posterior interosseous syndrome. Physiopedia explains that posterior interosseous syndrome is a compression of the posterior interosseous nerve, which is located near the shaft of the humerus and the elbow, that may result in paresis or paralysis of the thumbs and fingers. Though cryotherapy, ultrasound, dry needling, and other modalities often help with this condition, so too does deep tissue work that is focused on the thoracic outlet, pectoralis minor, triceps, brachioradialis, and other surrounding areas.
The main purpose of Swedish massage is to increase the oxygen flow in the blood and release toxins from the muscles. Swedish massage shortens recovery time from muscular strain by flushing the tissues of lactic acid, uric acid, and other metabolic wastes. It increases circulation without increasing heart load. It stretches the ligaments and tendons keeping them supple and pliable.
Clients interested in experiencing Swedish massage should seek out a reputable massage therapist to explore it. Often it takes several visits to multiple therapists to find one who is a good match with the client. Like other massage modalities, this form is most effective when undertaken at least once a month, although once every two weeks is a more therapeutically useful interval. Clients should remember to communicate clearly with the therapist for a productive session.
In regulated provinces massage therapists are known as Registered Massage Therapists, in Canada only four provinces regulate massage therapy:[96] British Columbia, Ontario, Newfoundland and Labrador, and New Brunswick.[97] Regulated provinces have, since 2012, established inter-jurisdiction competency standards.[98][96] Quebec is not provincially regulated. Massage therapists may obtain a certification with one of various associations operating. There is the Professional Association of Specialized Massage Therapists of Quebec, also named Mon Réseau Plus, which represents 6,300 massage therapists (including orthotherapists, naturotherapists and others), the Quebec Federation of massage therapists (FMQ), and the Association québécoise des thérapeutes naturels; however, none of these are regulated by provincial law.
Deep tissue massages are often utilized following injuries to help break up newly forming scar tissue that can make recovery more difficult and lead to stiffness. Massage has been shown to help reduce inflammation and muscle spasms by stimulating blood flow, loosening up muscles to allow for more oxygen and also helping reduce the nervous system’s automatic stress response.
Diagnosing or treating disease would constitute the practice of medicine and would be illegal for anyone who does not have a professional license to do these things. Although many diagnose and treat disease, I am not aware of any prosecutions. In some states that license massage therapists, unlicensed reflexologists might also be prosecutable for practicing massage therapy without a license [11].

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You can usually choose which type of massage you’d like to receive, and you and your partner can each get a different type of massage depending on your preference and the offerings at the spa. Your partner and you will be on tables side-by-side, and you’ll each have your own massage therapist working on your body. You can talk during the massage if you wish. 

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Sometimes you're not intimate partners, just traveling with someone you don't get to see often enough — a sister, mom or best friend — and you want to spend as much time together as possible. All of these scenarios are fine, really, because you make the rules up. If you want to talk to each other during the massage, you can. If you want to quietly commune, that's good, too. The therapists will follow your lead.
As for the commonly held belief that extra liquids are needed post-massage: that’s a myth, explains Gammal. “Massage does not release or flush out any toxins from the body, which means it won’t dehydrate you. Massage helps with recovery from lactic acid but doesn’t get rid of lactic acid.” Post-massage, you can just resume your normal hydration habits.
Massage is the manipulation of soft tissues in the body. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. A person who was professionally trained to give massages was traditionally known as a masseur (male) or a masseuse (female), but those titles are outmoded, and carry some negative connotations. In the United States, the title massage therapist has been recognized as a business norm for those who have been professionally trained to give massages.
Many people confuse reflexology with massage, Reiki, or acupuncture, but there are essential differences between these therapies.  Massage therapists manipulate larger areas of soft tissue in the body while reflexologists apply pressure to specific points on the feet, hands, and ears.  Unlike either massage or reflexology, Reiki does not involve any physical manipulation or pressure, but instead uses light touch to work with the subtle vibrational field thought to surround the body. Finally, while acupuncture and acupressure, like reflexology, use reflex points on the body to influence other parts of the body, the points are not the same and acupuncture uses points over the entire body.

Thank you so much for your article The Pressure Question in Massage Therapy. I just read it all. I went for a sports massage two weeks ago as I was recommended to have one as it was suggested it might help with tight calves, a side effect of some other injuries I have. I’ve been for sports massages many, many times before over the years. This one was one of the most painful experiences of my life — when I got home I was almost sick and felt in shock. My right achilles tendon was raging and it’s been bad ever since. It hurt so much when it was done (like someone was sticking knives in) and I kept asking if it was meant to hurt. I wish I’d just stopped the session or objected but I didn’t. It used to be a bad injury that affected me walking for about 6 months so I’m just devastated about this. I can hardly bear to put shoes on and its all this time on. I know there are good practitioners out there but experiences like this just make me want to stay away. I wish I’d gone to a “gentle” one.

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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).
Massage used in the medical field includes decongestive therapy used for lymphedema[10] which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT.[52] However, it is less effective than management of SVT with medications.[53]
The underlying theory behind reflexology is that there are certain points or "reflex areas" on the feet and hands that are connected energetically to specific organs and body parts through energy channels in the body. By applying pressure to reflex areas, a reflexologist is said to remove energy blockages and promote health in the related body area.

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Each massage session at Elements Massage™ is meant to achieve the same objectives, be therapeutic and relaxing. When a client requests a Swedish massage at an Elements Massage studio, they also have the benefit of requesting aspects of other modalities as well, such as deep tissue massage or hot stone massage. Rather than keep each massage session limited to one particular modality, Elements Massage studios customize each massage to the client’s needs and blend modalities to ensure a truly personalized session.
The massages are geared towards athletes and their sports. For instance, working on a runner will require doing a lot of leg work, but the upper body work will be minimal. Moreover, massages will target those areas that tend to become injured. For example, a massage session with a tennis player will involve a forearm massage that is preventive in the development of tennis elbow. If necessary, a whole session could be spent only on important areas, and skip completely muscles that are not overused in a particular sport.

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