In Malaysia, reflexology has been applied widely but without any certification and qualification from the Ministry of Health. Tighter control is needed to overcome this problem. Practitioners who conduct this therapy may not have the accurate knowledge about reflexology and may lead to any contraindication for certain conditions. The government should take serious enforcement about this practice among practitioners who are not certified. Each practitioner must have a proper training. The ministry of education could provide vocational training in the local community colleges throughout Malaysia to upgrade the skills and knowledge of reflexology practitioners.
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.
A good massage therapist will never force pressure into the muscle. They will continue to apply pressure until the muscle pushes back against them. The muscle will then slowly begin to release and allow the therapist to move along it. The pressure used should not be painful, but should walk a fine line between pleasurable release of tension and a pain-blocking response from the body (tensing up).

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