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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There are 58 training programs accredited by the Commission for Massage Therapy Accreditation/Approval in the United States. They provide a minimum of 500 hours of massage training. Certified therapists have graduated from these programs and passed the national certification examination for therapeutic massage. They are also required to participate in continuing education programs to keep their skills current.
The first study I know of was supervised by William T. Jarvis, Ph.D., a professor who taught research methods to graduate students at Loma Linda University. Using questionnaires, 70 subjects were asked to state whether they had had health problems during the previous two years in any of 43 anatomical areas. These data were then compared with the findings of a reflexologist as recorded on a report form. The results did not differ from what would be expected by blind guessing. To prevent the reflexologist from asking questions or observing subtle clues, the experimental subjects were asked to remain silent and a curtain was placed so that their feet were the only part of their body visible to the reflexologist [12].
“Good pain” is at the heart of the pressure question: a strange, potent sensory paradox that many people actually seek out as the goal of therapy, consciously or unconciously. Either it isn’t literally painful (just intense), or it’s painful but desired anyway because of relief or belief: an actual biological relief or at least the belief that there is one. But it’s important to note that not all satisfying, relieving sensations are genuinely helpful (e.g. scratching a mosquito bite).

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.  


The purpose of the practice of massage is to enhance the general health and well-being of the recipient. ‘Massage’ is used as a general term to describe manual manipulation of the muscles and joints to help relieve pain and stress in the body. This generalized term can be broken down into many subcategories such as: deep tissue, trigger point, prenatal/pregnancy massage, hot stone, sports massage, Thai massage, myofascial release, lymphatic drainage, crainiosacral, lomilomi, shiatsu, reflexology, Hellerwork, looyen work, polarity therapy, tui na, and connective tissue massage, just to name a few.

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Stroke is the condition where the blood supply to the brain is interrupted because of some reasons that may cause many health problems.27 It usually occurs due to blood vessels ruptures. Many patients have tried reflexology as the alternative therapy in order to recover from strokes. The practitioners believe that pressure that they exerted on a particular point on reflex areas may induce a positive outcome and physical changes to the body.28
Recovery. Therapeutic massage helps the body recover from the stresses of strenuous exercise, and facilitates the rebuilding phase of conditioning. The physiological benefits of massage include improved blood and lymph circulation, muscle relaxation, and general relaxation. These, in turn, lead to removal of waste products and better cell nutrition, normalization and greater elasticity of tissues, deactivation of trigger points, and faster healing of injuries. It all adds up to relief from soreness and stiffness, better flexibility, and less potential for future injury.
In all cases, such massage techniques are employed in collaboration with other appropriate medical care. For example, encouraging circulation around a bruise, but not directly on it, through the use of compression, cross-fiber techniques or even long, deep strokes is only used after appropriate medical referral and diagnostics indicate that there are no clots formed in the area which may embolize.
The best we can say is that there is some reason to believe that painful pressures on muscles might be therapeutic for some people some of the time. Pretty decisive, eh? This is why it drives me nutters that so many therapists insist that strong pressures are “essential” to achieve “a complete release.” It really isn’t possible to know! It really does depend! Why would anyone pretend to “know”?
In addition to my private practice, I work with patients at the Initiative for Women with Disabilities (IWD) at NYU Medical’s Hospital for Joint Diseases. Many of the patients I see are dealing with issues such as chronic pain, fibromyalgia, multiple sclerosis, cerebral palsy, and rheumatoid arthritis, and find reflexology a beneficial way to incorporate integrative therapies into their treatment.
This innovative healing technique uses warm salt crystal stones to ground and balance the body's electromagnetic field, central nervous system, and meridians. Salt crystals come from an ancient primal sea beneath the Himalayan Mountains. These crystals are then carved by hand into massage stones that gently soothe away an accumulation of stress, tension, and pollutants.
A dry-water massage table uses jets of water to perform the massage of the client's muscles. These tables differ from a Vichy shower in that the client usually stays dry. Two common types are one in which the client lies on a waterbed-like mattress which contains warm water and jets of water and air bubbles and one in which the client lies on a foam pad and is covered by a plastic sheet and is then sprayed by jets of warm water, similar to a Vichy shower.[77] The first type is sometimes seen available for use in malls and shopping centers for a small fee.

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In “bodywork,” as practiced at Haven, painful physical manipulations are just one part of a package of techniques explicitly designed to evoke and provoke emotional expression and vitality. While a participant lies on the ground breathing hard, two facilitators may be applying extremely painful pressures to key points in the body, deliberately pushing the participant well outside of his or her comfort zone. This may launch people out of emotional ruts (fairly dramatically), relieving intense emotional denial and suppression, and leading to vivid insights and profound new body awareness. BACK TO TEXT
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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.
Deep Tissue massage is much more muscle-tissue focused. Specifically for pain relief, deep tissue massages are characterized by much deeper pressure. They’re great for removing knots and breaking up scar tissue, making them a favorite of athletes, as well as those who do manual labor like heavy lifting, farming or repair work. Unlike the Swedish massage that just works on the top layer of muscle, a deep tissue massage works through to get to the deeper layers of muscle tissue.

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