Another alarmingly common example is the sensation of skin tearing. This has been inflicted on me personally on at least three occasions, and not by poorly trained therapists — quite the opposite, the perpetrators were all well-trained massage therapists doing a kind of “fascial release” therapy that they clearly thought of as an “advanced” technique.7

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For starters, you bear in mind the things described above that tend to cause ugly pain, and you avoid that kind of therapy like the plague. Then you look for some clues that painful pressure is okay. Here are at least three reasons why unpleasantly intense pressure might be therapeutic — “bad pain,” but not ugly. In each of these situations, it might be acceptable to tolerate sensations so intense and painful that the only thing about them that is pleasant is the part where it stops.
Whenever athletes exercise heavily, their muscles suffer microtraumas. Small amounts of swelling occur in the muscle because of tiny tears. Post-event sports massage helps reduce the swelling caused by microtraumas; loosens tired, stiff muscles; helps maintain flexibility; promotes blood flow to the muscle to remove lactic acid and waste build-up; and reduces cramping. In addition, post-event massage helps speed the athlete's recovery time and alleviates pulls, strains, and soreness.
Ugly pain in massage therapy is, by my definition, never okay. Ugly pain is often caused by things that are not going to offer even minimal, delayed benefits, and may even be dangerous. It’s important to be able to spot ugly pain for what it is and completely eliminate it from any therapy you’re receiving. What kinds of handling may cause “ugly” pain?
Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The word lomilomi also is used for massage in Samoa and East Futuna. In Samoa, it is also known as lolomi and milimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it romiromi and mirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known as popo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.[46]
Reflexologists posit that the blockage of an energy field, invisible life force, or Qi, can prevent healing. Another tenet of reflexology is the belief that practitioners can relieve stress and pain in other parts of the body through the manipulation of the feet. One claimed explanation is that the pressure received in the feet may send signals that 'balance' the nervous system or release chemicals such as endorphins that reduce stress and pain. These hypotheses are rejected by the medical community, who cite a lack of scientific evidence and the well-tested germ theory of disease.[9]
Another study compared the effects of foot reflexology, simple massage, and conversation on 130 patients who had undergone abdominal gynecologic surgery under full anesthesia. The patients were asked how they felt, and data were recorded on general condition, pain intensity, movement of the bowels, urination, and sleep, from the day before the operation until until the tenth day afterward. Simple massage turned out to be a relaxing, positive experience, whereas foot reflexology had various effects, some of which were negative. The researchers concluded that foot reflexology is not effective in acute, abdominal postsurgical situations in gynecology and can occasionally trigger abdominal pain [15].
According to the Neuromuscular Therapy Center, NMT is one type of deep massage technique that focuses on applying manual therapy to soft tissue with “quasi-static pressure” in order to stimulate skeletal striated muscle. (17) In addition to massaging a painful or inflamed muscle, the area around the affected muscle that normally supports it is also massaged in order to release tension. NMT therapists often focus on several factors that can add to muscle or tissue dysfunctions, including joint pathologies, postural positioning, disruptive habits of use, nutritional components, emotional well-being, allergies and neurotoxins.
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.
Research shows that firmer massages with more pressure can result in a significant reduction in arthritis pain compared to lighter massages. Lighter massage tends to be arousing (not relaxing) because often the heart rate goes up. However, with moderate pressure, heart rate usually goes down, and this stimulates relaxation and reduced tension. (13)
Connective tissue stimulation. A lot of therapists are keen on stretching connective tissues — tendons, ligaments, and layers of Saran wrap-like tissue called “fascia.” I’m not a huge fan of this style, but certainly it’s a way of generating many potent and novel sensations, which may be inherently valuable to us — another form of touch. Although “improving” the fascia itself is implausible and unproven, perhaps fascial manipulations affect bodies indirectly, just as a sailboat is affected by pulling on its rigging. People have written whole books full of speculation along these lines. So, as long as the sensations are not like skin tearing (that’s an ugly pain for sure), you might choose to tolerate this kind of massage if it seems to be helping you.
Typically, sports massage therapists hold a certification and maintain licensure. A good option is to become board certified through the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and have an active membership with an association, like AMTA, to keep up to date with industry trends. Exact requirements depend upon the state in which the sports massage therapist practices.

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Excell within you! I keep that in mind all the time. When you enjoy whatever you are doing, certain magic occurs, certain energy flows through your hand or your word; and serendipity appears (that unexpected fantastic results). Me and Armando, my husband, we make a great team as we are both massage therapist; I also teach yoga, reiki, and meditation and Armando is also a personal trainer.  We love service others to create harmony and balance physically, mentally and spiritually, so we can help each others to deal with daily life challenges and reach goals.  ... View Profile

What to do: The easiest way to do this is with a dryer, golf or any small, hard ball you have at home. Press down on the ball along the inner edge of the middle part of the foot. This relaxes stomach and improves circulation in this area. Stimulating the middle of the foot opens the energy pathways to the organs related to digestion, like the stomach, colon and intestines. This helps blood flow and circulation to these organs and can help alleviate digestive issues.

I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com


The literature on reflexology is only beginning to emerge since early 1990. Several methodological shortcomings in the previous studies of reflexology safety and efficacy are worth mentioning. Firstly, the number and the methods of reflexology treatment given are not standardized. Furthermore, most studies have small sample size (around 20 participants).

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Before booking an appointment, ask questions about the therapist’s education and experience, like “What is your training?” “How many years have you been practicing?” and “Do you work frequently with runners?”, suggests Gammal. Seek referrals if possible, and ensure s/he is a licensed massage therapist. Rotenberger recommends a massage therapist specifically trained in orthopedic treatment and assessment, as s/he will know when to refer you to another healthcare professional, in the case that you’re experiencing chronic pain and discomfort not fixable via massage. You can find a reputable practitioner via www.orthomassage.net or www.NeuroMuscular-Reprogramming.com.
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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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