Quick muscle knot orientation: Muscle knots — myofascial “trigger points” — are a factor in most of the world’s aches and pains. Their biology is still mostly mysterious: conventional wisdom says they are tiny spasms, but they might also be a more pure neurological problem. Regardless, they can cause strong pain that often spreads in confusing patterns, and they grow like weeds around other painful problems and injuries, making them quite interesting and tricky. Although they are well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. For more information about how trigger points might be involved in your own medical history, see PainScience.com’s best-selling tutorial:
AD 1776: Jean Joseph Marie Amiot, and Pierre-Martial Cibot, French missionaries in China translate summaries of Huangdi Neijing, including a list of medical plants, exercises and elaborate massage techniques, into the French language, thereby introducing Europe to the highly developed Chinese system of medicine, medical-gymnastics, and medical-massage.[8]

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Swedish’s Massage Therapy degree program students study both Western and Eastern theories and techniques. Through combined classroom instruction and hands-on practice, our students receive a strong foundation in anatomy and physiology, massage-related pathology, neurology, and kinesiology. Students enrolled in the Massage Therapy program master their skills in our stress reduction and therapeutic clinics and at community service externships.

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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.”
Angie Bolanos has over 13 years of experience in the practice of rehabilitative therapy. She graduated Cum Laude from Syracuse University with a degree in Occupational Therapy and a minor in Psychology. Upon concluding her undergraduate studies, Angie was immediately recruited as an occupational therapist by a large well-established rehabilitation organization in South Florida. Having the natural ability to consistently raise the benchmark, she quickly moved through the ranks holding various administrative rolls amongst various rehabilitation settings.  ... View Profile

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Currently, the learning centre which provides training for reflexology is very limited. Normally anyone interested to learn reflexology will learn about reflexology through apprenticeship. Recently, Stella In, a local Malaysia training centre offers certification of training in reflexology. This institute was established by the Ministry of Tourism Malaysia as one of the centres of excellent which offers spa therapy training, specifically for Malaysian, with full job guarantee at any officially approved spa organizations. This institute offers certified qualification of national/international diploma in reflexology foot massage course. Learning about the body zones, feet reflexes, and reflexology techniques which can improve blood circulation, removal of toxins from body, and help to increase the energy level are offered in this course. The teaching techniques include theory and practical.14

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.
Ergonomic chairs serve a similar function as a massage table. Chairs may be either stationary or portable models. Massage chairs are easier to transport than massage tables, and recipients do not need to disrobe to receive a chair massage. Due to these two factors, chair massage is often performed in settings such as corporate offices, outdoor festivals, shopping malls, and other public locations.
Friction strokes work on deeper muscles than the techniques previously described. The friction technique is a pressure stroke and is the deepest that is used in Swedish massage. The massage therapist applies pressure by placing the weight of his or her body on the flat of the hand and the pads of the thumbs, knuckles, fingers, or the back of the forearms, and then releases the pressure slowly and gently. This movement should be a continuous sliding motion or a group of alternating circular motions.
In another study, researchers took muscle biopsies from participants who had received massage therapy or no treatment for exercise-induced muscle damage. The study showed that massage therapy reduced inflammation and promoted mitochondrial biogenesis in the skeletal muscle. In addition, a review published in the journal “Complementary Therapies in Clinical Practice” revealed that moderate pressure massage reduced depression, anxiety, heart rate, and cortisol levels and altered EEG patterns to indicate a relaxation response.
Reflexology is best for people who are looking to relax or restore their natural energy levels. It’s also a good option if you aren’t comfortable being touched on your entire body. Reflexology uses gentle to firm pressure on different pressure points of the feet, hands, and ears. You can wear loose, comfortable clothing that allows access to your legs.

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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.

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great for the active and the serious athlete. a customized massage to soothe strained muscle groups that may include all aspects of massage determined by each guest’s level of athleticism. massage combined with hot stone, stretching and deep kneading eases tension in tight muscles, stimulating healing and improving recovery time from intensive training and long, stressful days. 

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When you get off the table, your calves may be screaming at you, but don’t get upset and run home to your foam roller, says Denunzio. Soreness is normal and can even help reveal areas of weakness that should receive future attention. Within 48 hours, the tightness should dissipate, and if the massage was administered correctly, you may even feel like you’re in a new body.

The most widely recognized and commonly used category of massage is the Swedish massage. The Swedish massage techniques vary from light to vigorous. Swedish massage uses five styles of strokes. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber or with the fibers) and vibration/shaking. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks. The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitioner Johann Georg Mezger applied the French terms to name the basic strokes. The term “Swedish” massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as “classic massage”.

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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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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.
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)
In addition, while the research remains inconclusive, many massage therapists feel that their techniques can lead to the release of toxins into your bloodstream. Because of this, it's commonly recommended that people receiving a massage drink a lot of water for the remainder of the day to help their liver and pancreas process any excess toxins. Doing so may help you avoid feeling nauseous, fatigued or excessively sore afterward.

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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].
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]
Reflexology, also known as zone therapy, is an alternative medicine involving application of pressure to the feet and hands with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on a pseudoscientific[1] system of zones and reflex areas that purportedly reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body.[2]
Deep tissue massages are not for everyone, and it’s very important to find a well-trained therapist. If you’re actively healing from surgery, have nerve damage or an existing injury, you’re wearing a cast or brace, or you’re pregnant, then talk to your doctor before seeking a massage therapist. Although it’s rare, massages that are poorly performed can sometimes cause increased pain, inflammation and other complications in high-risk patients. (16)
Swedish massage is now gaining acceptance from the medical community as a complementary treatment. Studies have shown that massage can relax the body, decrease blood pressure and heart rate, and reduce stress and depression. It may also provide symptomatic relief for many chronic diseases. Many doctors now prescribe massage therapy as symptomatic treatment for headache , facial pain, carpal tunnel syndrome, arthritis, other chronic and acute conditions, stress, and athletic injuries. Many insurance companies now reimburse patients for prescribed massage therapy. As of 2000, however, Medicare and Medicaid do not pay for this form of alternative treatment.

Massage therapy is also being investigated as an aide to patients with more neuromuscular disorders, such as multiple sclerosis (MS). A Iranian 2013 study published in Clinical Rehabilitation looked at 48 individuals with MS who participated in a five-week massage experiment. They were assigned to one of four groups: massage therapy, exercise therapy, combined massage-exercise therapy and control group.

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In South Africa, massage is regulated, but enforcement is poor. The minimum legal requirement to be able to practice as a professional massage therapist is a 2-year diploma in Therapeutic Massage and registration with The Allied Health Professions Council of SA (AHPCSA). The 2 year qualification includes 240 credits, about 80 case studies, and about 100 hours community service.
According to research done by the American Massage Therapy Association, as of 2012 in the United States there are between 280,000 and 320,000 massage therapists and massage school students.[115] As of 2011, there were more than 300 accredited massage schools and programs in the United States.[116] Most states have licensing requirements that must be met before a practitioner can use the title "massage therapist", and some states and municipalities require a license to practice any form of massage. If a state does not have any massage laws then a practitioner need not apply for a license with the state. However, the practitioner will need to check whether any local or county laws cover massage therapy. Training programs in the US are typically 500–1000 hours in length, and can award a certificate, diploma, or degree depending on the particular school.[117] There are around 1,300 programs training massage therapists in the country and study will often include anatomy and physiology, kinesiology, massage techniques, first aid and CPR, business, ethical and legal issues, and hands on practice along with continuing education requirements if regulated.[10] The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S. and currently (Aug 2012) there are approximately 300 schools that are accredited through this agency.

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Another centre called CEPP Wellness Centre also offers 5 days of training courses on reflexology. The tutors in charge for this short course have the qualification as a professional therapy from International Therapy Examination Council, UK (ITEC) which holds a diploma in aromatherapy and holistic massage. They are very committed in helping participants to get the certificate. During this course, different aspects of reflexology theory such as the anatomy of the feet, including bones and muscles, reflex zones of the feet, and others. This course also applies theory and practical session.

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The Pulsational motions of a Classical massage are done so towards the direction of the heart, with the purpose of relaxing any tense muscles to effectively eradicate any toxins trapped within. Build-up of toxins can lead to severe consequences within a human anatomy particularly within the abdomen if they are not excreted from within the body at a daily basis.


While a typical runner’s sports massage focuses primarily on the legs, Denunzio insists on incorporating upper body work as well. As she explains it, “nobody has perfect form, especially when they’re fatigued” and runners can unknowingly tense their upper bodies when working out, which in turn creates tightness in their arms, shoulders and back. Ideally, those areas should receive a little TLC as well.  
Whether you’re an athlete with a daily high demand placed on your body or recovering from an injury or illness, deep tissue massage likely has some benefits to offer you. Massages have been utilized for thousands of years throughout the world to lower both physical and psychological stress. And today, research continues to show that whether used alone or in conjunction with other treatments, massage therapy is an effective way to help treat common conditions like arthritis, anxiety and chronic lower back pain.
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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Speaking of matching, our service path, The Elements Way®, means that Elements Massage™ studios will match each of you with the massage therapist that can best deliver a great massage based on the needs and requests you provide. During the session, each therapist will check in with each of you to make sure the massage session is exactly what you want.
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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I’ve worked in a variety of exciting environments, including the Salt Lake City Winter Olympics, the Greece Paralympic Summer Games and on the road with the U.S. National Powerlifting Team. Plus, I have worked with collegiate, ABL and WNBA athletes. Currently, I travel with the WTA (Women’s Tennis Association) as part of the sports science and medicine team. In my private clinic, I specialize in orthopedic massage.

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There are many types of massage therapy, from classics like Swedish and deep tissue to more exotic styles like shiatsu. Whether you'd like to branch out a bit or have a health condition or injury, choosing a style of massage can be confusing if you're not quite sure what it involves. Here is a list of the most popular types of massage (including some that may be new to you).

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Trust and pain. Bear in mind that feeling safe is critical to the experience of good pain. Tiny differences in trust and comfort can make the difference between an intense pain being good or bad. Much of the “goodness” of good pain comes from mental context, from knowing that a pain is not dangerous or pointless, that it will not increase suddenly, or anything else yucky or shocking.

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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