“The number one thing therapists should do to protect themselves from injury is avoid doing too much work,” says Bykofsky. She also recommends not over-scheduling, working too many hours, or holding too many deep massage sessions a week. Also, take advantage of other “tools” at your disposal, such as different parts of your hands and arms, using them for leverage to take some of the pressure off your thumbs. 

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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 proper design, control, and intervention protocols of research on reflexology remain debatable. The use of randomized controlled trials (RCTs) is the golden standard in assessing the efficacy of complementary therapies such as reflexology.34 Verhoef et al. have described the challenges when researching complementary therapies: standardization of regimented treatment that limit the individualization of treatment; client's focus on health with restricted roles for disease treatment; ethical issues involving the recruitment and randomization due to participants pre-conceived belief on reflexology; practicality of applying sham reflexology; interference of psychological influence on rapport between patient-provider.35
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:

I want to be part of people’s health program. Providing my professional knowledge, dedication and passion for body/mind wellness Deep Tissue, Swedish, Contemporary Cupping Methods Neuro Muscular Therapy, Prenatal, Labor, postpartum and newborn/infant massage Myoskeletal Therapy Therapeutic Massage and Hydrotherapy Pediatric Massage, “Liddle Kidz” (ADD, ADHD) Touch Therapy for “Liddle Kidz” with Autism (ASD) Karmapa Reiki Master Tian Di Bamboo Massage Hawaiian Lomilomi Massage Trained in Traumatic Incident Resolution Certified Body Practitioner, “Institute for Mind Body Therapy” ... View Profile
Until better evidence is published in peer reviewed journals, he remains skeptical of claims that by massaging or applying pressure to specific points on the hands or feet, a reflexologist can alleviate problems in corresponding organs or other systems throughout the body. He has seen no evidence showing that reflexology is effective for pain or any health problems unrelated to the feet and hands. He urges caution with regard to claims that reflexology can cleanse the body of toxins, increase circulation, promote weight loss, or successfully treat earaches, hemorrhoids, emphysema, heart disease, thyroid disorders or any other health condition.

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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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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).
Maximization of comfort is kept as the primary goal by massage therapists; therefore, a profoundly peaceful environment is observed while most massage periods are extended till an hour at least to deliver optimal comfort efficiently. The combinations of soothing Effleurage, as well as Petrissage strokes, works when merged with a comforting homely environment helps with decreasing Cortisol; the stress hormone present within the anatomy of clients.
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
Now for some benefits that are not supported by research. The ability of sports massage to help the muscles get rid of lactic acid is not supported in research studies. Many researchers feel this is linked to the fact that sports massage does not increase blood flow to muscles. For example, a 2010 study found that blood flow was actually mechanically impeded by massage and that was a possible reason that lactic acid removal was impaired. A quicker recovery after sports massage is not yet supported by the research. Studies do support that active recovery (low-intensity exercise after work-out) is the best method of decreasing the amount of lactic acid that builds up after exercise and speeds recovery.

The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

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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

Cathy Wong explains in her article “Deep Tissue Massage: Everything You Need to Know” on verywell.com that while Deep Tissue massages can be slightly uncomfortable, they have been known to reduce stress hormones and heart rate while releasing oxytocin and serotonin, which allow the client to experience a boost in mood and relaxation. Deep Tissue massages are often used to relieve chronic aches and pain, stiff necks, upper back and lower back pain as well as muscle tightness. Therapists treat such issues by utilizing Deep Tissue massages to break up scar tissue and muscle knots and working out adhesions that might be hindering circulation and limiting movement.
Burmese massage is a full body massage technique that starts from head to toes, drawing on acupuncture, reflexology, and kneading. Signature massage strokes include acupressure using the elbows, quick gentle knocking of acupressure points, and slow kneading of tight muscles. The massage is aimed to improve blood circulation and quality of sleep, while at the same time help to promote better skin quality.
Most deep tissue massages normally focus on major muscle groups — such as the neck or lower back — along with joints and tendons that are susceptible to straining or injuries. Certain areas of the body that tend to tense up in times of stress, including the shoulders, neck and hips, can often benefit the most from this type of deep manipulation. Many people consider “sports massages” to be a form of deep tissue massage, which involves physical treatment primarily to neuromusculoskeletal systems to treat pain and disability, improve muscle recovery and joint mobilization, and prevent injuries.

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DTM can be useful to those that are recovering from an injury (once the client/patient is out of the acute phase), for athletes, for people with postural strains, or people with chronic pain. Typically there is an area or a few areas where this type of work is needed. For example, a person who has chronic postural pain/tightness from sitting at a computer, might need DTM to their shoulders, chest, and upper back/neck. They likely, do not need DTM on their whole body. Some therapists might disagree with me here, but I rarely think a full-body, DTM, is needed. It can simply be too much. I would rather see a client more often, for less-intense sessions. It is simply more effective. It is the same as Physical Therapy- it is more effective to do it regularly.
According to the American Massage Therapy Association, up to 25 percent of American adults had a massage at least once during 2016-2017. And, they have a wide range of reasons for doing so. More and more people -- especially baby boomers -- recognize the health benefits of massage. They choose from among many massage styles to get relief from symptoms or to heal injuries, to help with certain health conditions, and to promote overall wellness.

Esalen or Essalen Swedish Massage is a direct outgrowth of Swedish Massage. It is a product of the Esalen Institute in Big Sur, California. It combines Swedish Massage with acupressure. Its approach is more Asian philosophy than Western. The intent of Esalen Massage is to relax the mind and the body to produce an overall sense of well-being. It does so through slow, rhythmic and even hypnotic strokes. These combine with rocking and stretching movements.

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One difference, however, is that you may not want to drift off the same way you might during a conventional massage. "The only times I run into issues with people not liking their treatment is when they just plop down on the table and go to sleep," Colin says, adding that you should "be honest with your therapist, let them know what your goals and expectations are, and have that conversation."
AD 1878: Dutch massage practitioner Johan Georg Mezger applies French terms to name five basic massage techniques,[13] and coins the phrase "Swedish massage system". These techniques are still known by their French names (effleurage (long, gliding strokes), petrissage (lifting and kneading the muscles), friction (firm, deep, circular rubbing movements), tapotement (brisk tapping or percussive movements), and vibration (rapidly shaking or vibrating specific muscles)).

Like massages, chiropractic care can be beneficial for lowering pain and improving recovery. It’s also been shown to lower stress, headaches and more. One way that chiropractors help treat pain is by lowering mechanical compression and irritation of spinal joints, which can send nerve signals throughout the body that increase inflammation and irritation.

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The researchers also note there are psychological benefits for athletes receiving massages, which other research shows can include improved focus and confidence. Although more research is still needed on a long-term scale, both tissue healing and the psychological effects of massages are areas that seem promising for both professional and recreational athletes.

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Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer ("aleiptes")[27] who would rub their muscles with oil. Pehr Ling's introduction to massage also came about directly as a result of his study of gymnastic movements.
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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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.
Reflexology in Thailand is abundantly offered even at spas, centres, markets, and chair beside the street because it is widely known as one of the most relaxing therapies. Colorado School of Thai Massage offers a short course of reflexology about the fundamental practice of Thai Foot Reflexology. For those who are interested, no bodywork experience required to join this course.

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There is absolutely a time and a place for DTM, the problem is that everyone has a different idea of what this means. Some therapists go after deep fascial layers, some therapists think this means trigger point work, and some just increase pressure as much as they can. If the client and therapist don’t have an open dialogue with clear instructions of when ‘enough is enough’, the client can experience a lot of discomfort and we don’t want that.
Professional massagers use the Effleurage as the initial massage treatment, during a Classical massage primarily to locate, evaluate and assess all tension points present within the client's body. Another reason behind the Effleurage being the initial most massage stroke covering the entire body is to familiarize customers with pressurized massage strokes effectively.

During the 1990s, I observed at least seven foot reflexologists at work during health expositions. In most cases, the process appeared to be an ordinary prolonged foot massage with little communication between the practitioners and their clients. But at one exhibit, the practitioners claimed that they could reduce stress, cleanse the body of toxins, increase circulation, assist in weight loss, and improve the health of organs throughout the body. On another occasion, I underwent a 15-minute session in which the practitioner felt my foot for diagnostic purposes and then massaged it for "therapeutic" purposes. During the previous year, I had had severe shoulder pain caused by an inflamed tendon that was rubbing against a bony surface inside my left shoulder joint. Thorough medical evaluation had determined that the appropriate treatment was arthroscopic surgery in which a drill is used to shave the bony area that was impinging on the tendon. The reflexologist claimed that he could detect the shoulder problem by feeling my left foot, that it was caused by stress, and that pressing on my foot—perhaps for a few sessions—could solve the problem. His "treatment," which lasted about 10 minutes, consisted of massaging the foot and from time to time, pressing hard on the ball of my foot, a procedure that was quite painful. The "treatment," of course, did absolutely nothing to help my shoulder. A few months later, I had the surgery, which cured the problem immediately and permanently.


Reflexology is basically a study of how one part of the human body relates to another part of the body. Reflexology practitioners rely on the reflexes map of the feet and hands to all the internal organs and other human body parts. They believe that by applying the appropriate pressure and massage certain spots on the feet and hands, all other body parts could be energized and rejuvenated. This review aimed to revisit the concept of reflexology and examine its effectiveness, practices, and the training for reflexology practitioners. PubMed, SCOPUS, Google Scholar, and SpringerLink databases were utilized to search the following medical subject headings or keywords: foot massage, reflexology, foot reflexotherapy, reflexological treatment, and zone therapy. The articles published for the last 10 years were included. Previous systematic reviews failed to show concrete evidence for any specific effect of reflexology in any conditions. Due to its non-invasive, non-pharmacological complementary nature, reflexology is widely accepted and anecdotal evidence of positive effect reflexology in a variety of health conditions are available. Adequate training for practitioners is necessary to ensure the consistency of service provided. 

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AD 1878: Dutch massage practitioner Johan Georg Mezger applies French terms to name five basic massage techniques,[13] and coins the phrase "Swedish massage system". These techniques are still known by their French names (effleurage (long, gliding strokes), petrissage (lifting and kneading the muscles), friction (firm, deep, circular rubbing movements), tapotement (brisk tapping or percussive movements), and vibration (rapidly shaking or vibrating specific muscles)).


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If you are a massage therapist, or sports physical therapist, it might be a good idea to explain what a this type of massage will accomplish and what to expect.  At first, a Deep Tissue massage might feel like your typical Swedish massage. First, your therapist will warm up and prepare your muscles by applying light pressure to the areas that require attention. Only after your muscles have been sufficiently prepared will your therapist begin applying specific techniques. The most commonly used strokes in Deep Tissue massages are stripping and friction. Stripping usually involves your therapist applying deep and gliding pressure to the length of your muscle fibers with an elbow, forearm, knuckles or thumbs. Friction, on the other hand, applies pressure across the grain of the muscle in order to relieve adhesions and realign the fibers of the tissue.
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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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Maximization of comfort is kept as the primary goal by massage therapists; therefore, a profoundly peaceful environment is observed while most massage periods are extended till an hour at least to deliver optimal comfort efficiently. The combinations of soothing Effleurage, as well as Petrissage strokes, works when merged with a comforting homely environment helps with decreasing Cortisol; the stress hormone present within the anatomy of clients.
The ultimate massage experience combines a full body massage with additional time spent working on your tired feet. Using an integrative method of Reflexology, the therapist utilizes a whole-hand technique that works with the body meridians, opening pathways for better circulation and stimulation helping to create a calming effect to the whole body, mind, spirit, and soul!

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Swedish massage is a very relaxing and therapeutic style of bodywork. It combines oil or lotion with an array of strokes — such as rolling, kneading, and percussion — to help the body improve its circulation. The benefits of this type of bodywork are wide-ranging and include relief from aches and pains, decreased stress levels in the body, enhanced mental clarity, improved appearance, and greater flexibility.
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]
Changes should be implemented immediately instead of in stages, so that patients can go to any reflexology centre without any doubt. The entire centres, spas or even small booth that offer reflexology treatment must obtain a certificate from the Ministry of Health. It is suggested that each centre to have a medical form about patient's details, medical history, and screening form. It is already issued by the Ministry of Health but none of the centres has ever applied.

Like massages, chiropractic care can be beneficial for lowering pain and improving recovery. It’s also been shown to lower stress, headaches and more. One way that chiropractors help treat pain is by lowering mechanical compression and irritation of spinal joints, which can send nerve signals throughout the body that increase inflammation and irritation.

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