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)

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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:
Some possible justifications for painfully intense massage (these aren’t endorsements) include the destruction of motor end plates to “de-activate” trigger points; somatoemotional release (pain often strongly “resonates” with strong emotions like grief); moving tissue fluids; or just creating a strong, novel sensory experiences (which may have many subtle benefits).

Due to the harsher pressure of this technique, there are certain individuals who should seek pain relief elsewhere. Deep Tissue massages can be dangerous for clients who have blood clots, as the pressure and movements might cause the clots to be dislodged. If you have had blood clots in the past, currently have blood clots or are at risk of forming blood clots, you should consult a doctor before pursuing a Deep Tissue massage. If you are currently recovering from recent surgery, chemotherapy, radiation or are suffering from osteoporosis you too should speak with a doctor before experimenting with Deep Tissue massages. As this is particularly high-pressure massage, you should not allow rashes, wounds, tumors, hernias, etc. to be massaged directly. Expecting mothers should also avoid Deep Tissue massages; instead, ask your doctor about therapists that specialize in pregnancy massage techniques.


Several mechanisms for deep massage’s natural stress-relieving effects include its ability to dilate blood vessels and also lower activity of the limbic system (including the hypothalamus), which is responsible for autonomic nervous system regulation and cortisol secretion. Massage has been shown to improve relaxation by boosting activity of the parasympathetic nervous system, as measured by heart rate, blood pressure and heart rate variability. (8, 9)
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.
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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Stroking in smooth movements, kneading to loosen muscles, rubbing or friction with the practitioner using both hands back and forth in opposite directions, and striking (tapping or chopping the body with fingers or hands) are all used in combination. These movements help relax the body, increase circulation, and improve drainage in the lymphatic system.
Neck pain. Neck pain is tied with headaches as the second most common pain experienced by adult Americans (also 15 percent), and massage can typically help with this too. For instance, a systematic review and meta-analysis published in 2014 in Evidence-Based Complementary and Alternative Medicine analyzed 15 studies and found that there was “moderate evidence” that massage therapy helped provide relief.
Some possible justifications for painfully intense massage (these aren’t endorsements) include the destruction of motor end plates to “de-activate” trigger points; somatoemotional release (pain often strongly “resonates” with strong emotions like grief); moving tissue fluids; or just creating a strong, novel sensory experiences (which may have many subtle benefits).
Carrying the weight of the world on your shoulders? Are your feet tired from the balancing act of life? This targeted massage concentrates on the areas that harbor stress and melt it away. A lingering head, neck and shoulder massage is followed by a tension-reducing foot massage using hot stones. Note: You will be on your back for this entire treatment.

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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.

In Germany massage is regulated by the government on a federal and national level. Only someone who has completed 3,200 hours of training (theoretical and practical) can use the professional title "Masseur und Medizinischer Bademeister" or Medical Masseur and Spa Therapist. This person can prolong his training depending on the length of professional experience to a Physiotherapist (1 year to 18 months additional training). The Masseur is trained in Classical Massage, Myofascial Massage, Exercise and Movement Therapy. During the training they will study: Anatomy, Physiology, Pathology, Gynecology, Podiatry, Psychiatry, Psychology, Surgery, and probably most importantly Dermiatry and Orthopedics. They are trained in Electrotherapy, and Hydrotherapy. Hydrotherapy includes: Kneipp, Wraps, underwater Massage, therapeutic washing, Sauna and Steambath. A small part of their training will include special forms of massage which are decided by the local college, for example: Foot reflex zone massage, Thai Massage etc. Finally a graduate is allowed to treat patients under the direction of a doctor. He is regulated by the professional body which regulates Physiotherapists. This includes the restriction on advertising and oath of confidentiality to clients.[citation needed]

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In Japanese, shiatsu means "finger pressure." For shiatsu massage, the therapist uses varied, rhythmic pressure on certain precise points of the body. These points are called acupressure points, and they are believed to be important for the flow of the body's vital energy, called chi. Proponents say shiatsu massage can help relieve blockages at these acupressure points.

Inter- and intra-event massage is given between events or in time-outs to help athletes recover from the preceding activity, and prepare for the activity coming up. It is also short, and focuses on the major muscles stressed in the activity. Inter- and intra-event massage is given between events or in time-outs to help athletes recover from the preceding activity, and prepare for the activity coming up. It is also short, and focuses on the major muscles stressed in the activity. 
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For example, I worked on the Indiana Sports Massage Team starting in 1989, as well as the NCAA Swimming & Diving Championships and National Championships. I coordinated massage for the 1992 Olympic Trials and was on the 1996 Olympic Massage Team for the Atlanta Olympics—the first time massage therapy was part of the medical staff for the Olympics. These were all volunteer positions, but I loved it!
Before you and your partner book your appointment, be sure to brush up on your spa etiquette. For many, a couples massage may be your significant other’s first visit to the spa. And while a trip to the spa should be a relaxing experience, if it’s your first spa-going encounter, it can be anything but if you don’t know what to expect. To calm those nerves, note the following spa protocol tips: For many, nudity may very well be the most nerve-wracking aspect of spa-going. Bear in mind, though, that maintaining guest modesty is a key priority for most therapists in the U.S. Male or female therapist? It’s your call. Spas make every effort to accommodate guest wishes in this regard, but it’s recommended to make advance reservations, particularly during peak hours. Speak up (if you wish). Couples can feel free to converse during their massage, or stay silent. It’s entirely your preference. For more on Couples Massage, see our guide. 

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Massage of Chinese Medicine is known as An Mo (按摩, pressing and rubbing) or Qigong Massage, and is the foundation of Japan's Anma. Categories include Pu Tong An Mo (general massage), Tui Na An Mo (pushing and grasping massage), Dian Xue An Mo (cavity pressing massage), and Qi An Mo (energy massage). Tui na (推拿) focuses on pushing, stretching, and kneading muscles, and Zhi Ya (指壓) focuses on pinching and pressing at acupressure points. Technique such as friction and vibration are used as well.[70]
Myofascial trigger points — muscle knots — are a ubiquitous muscular dysfunction, causing most of the aches, pains and stiffness in the world, and complicating virtually every other injury and disease process. A lot of massage is focused on them, directly or indirectly. Massage may be helpful because it relieves the symptoms of muscle knots, or even unties them. (No, not literally.)
A satisfying sensation doesn’t necessarily imply successful treatment, unfortunately. Scratching mosquito bites feels great… but it’s not helping them! Trigger points may be like mosquito bites: it may feel terrific to massage those mysterious sensitive spots in soft tissue, but it may not be doing much to actually “release” or resolve them. It may be a purely sensory experience, the satisfaction of dealing with an “itch” that we cannot easily reach on our own.

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A satisfying sensation doesn’t necessarily imply successful treatment, unfortunately. Scratching mosquito bites feels great… but it’s not helping them! Trigger points may be like mosquito bites: it may feel terrific to massage those mysterious sensitive spots in soft tissue, but it may not be doing much to actually “release” or resolve them. It may be a purely sensory experience, the satisfaction of dealing with an “itch” that we cannot easily reach on our own.

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The whole Swedish experience is also a potential stress reliever, which is a benefit unto itself. Plus, it can improve blood flow, delivering more oxygen to cells. A lesser-known benefit—moisturized, glowing skin—results from the application of massage oils. Many therapists prefer to use sweet almond oil because it absorbs slowly into the skin, yet doesn’t leave clients feeling like they’re covered in grease. Other favorite oils include grapeseed (non-greasy, no smell) and jojoba oil (easily absorbed, mixes well with aromatherapy oils).
Another theory that may also explain how reflexology can produce pain relief is the gate control theory, or, more recently, the neuromatrix theory of pain. This theory suggests that pain is a subjective experience created by your brain. The brain does this in response to the sensory experience of pain, but it can also work independently of sensory input and create pain in response to emotional or cognitive factors. Thus things that influence the brain, such as your mood or external factors like stress can also affect your experience of pain. According to this theory, reflexology may reduce pain by reducing stress and improving mood.

Posterior interosseous syndrome. Physiopedia explains that posterior interosseous syndrome is a compression of the posterior interosseous nerve, which is located near the shaft of the humerus and the elbow, that may result in paresis or paralysis of the thumbs and fingers. Though cryotherapy, ultrasound, dry needling, and other modalities often help with this condition, so too does deep tissue work that is focused on the thoracic outlet, pectoralis minor, triceps, brachioradialis, and other surrounding areas.

When most people think of massage, they think of Swedish. The style takes its name from a 19th-century Swedish physiologist, Per Henrik Ling, whose system of medical gymnastics included massage. Johan Georg Mezger (1838-1909) coined a reduced set of maneuvers and techniques of Dr. Ling’s system as the “Swedish massage” system. Swedish massage is defined by four or five (somewhat familiar) techniques, which have French names: effleurage (stroking), petrissage (kneading), tapotement (rhythmic choppings), and friction (rubbing). Some therapists now incorporate advanced techniques that have rehabilitating effects and stretches for improving your range of motion. But the ultimate goal is relaxation. As the default Western massage, Swedish massage is extremely popular and is simple, soothing touch therapy.


Sports Massage can be characterized two ways: pre-activity and post-activity massage. Pre-activity uses dynamic stretching to allow the connective tissue to work through a full range of motion, thereby reducing possible injury. Post-activity massage focuses on recovering the muscle tissue that may have been impacted doing the particular sport. It involves long strokes to flush out the toxins that causes soreness in the muscles and joints. 
Both these massages sound fantastic! I would take a Swedish Massage anytime, as I would also take a Deep Tissue Massage anytime as well. I am constantly stressed with mundane life issues, so there’s Swedish massage for me, and definitely would take the Deep Tissue Massage because of working out and exercising. I’ll have to set up a time to meet with massage therapist soon!
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!
Pain is a stressor in the body system and any injury occurs to any part of the body will cause the whole system to be stressed.1 Endorphin is a body's natural pain-relieving chemical will be released as a response to reflexology. Endorphin teaches the body how to adapt any injuries. Those who practice reflexology in their life believe that healing from any injuries comes from the role of reflexology.3

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Referred pain spreads the goodness. Undoubtedly another reason that massage pain can feel good is the phenomenon of referred sensation. If you stimulate internal tissues anywhere in the body, muscle or otherwise, the brain really has trouble telling quite where the sensation is coming from. When you press hard enough on your muscles, particularly on sensitive trigger points, the pain is often experienced as though it originated from a much broader area.

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While this massage is designed to help ease the pain, you might experience discomfort during your appointment, especially when your therapist is applying pressure to a problem area. It is best to speak up and let your therapist know if the discomfort becomes painful; even though the Deep Tissue massage is meant to apply more pressure, pain does not mean that the massage is working. You might also experience some soreness and stiffness; this is perfectly normal and should subside within 24 hours. ElementsMassage.com recommends that you drink a lot of water in order to flush out the lactic acid that will have accumulated in the tissues; this may ease some of the soreness. Bruising after your massage may also occur; keep in mind that your therapist was applying more pressure in order to reach your troubled areas, light bruising is normal. Cathy Wong also points out that “case reports have reported venous thromboembolism, spinal accessory neuropathy, hepatic hematoma, and posterior interosseous syndrome after deep tissue massage.”

Cancer. Used as a complement to traditional, Western medicine, massage can promote relaxation and reduce cancer symptoms or side effects of treatment. It may help reduce pain, swelling, fatigue, nausea, or depression, for example, or improve the function of your immune system. However, there are specific areas that a massage therapist should avoid in a cancer patient, as well as times when massage should be avoided altogether. Talk to your doctor before getting massage therapy if you have cancer.
Bastian B, Jetten J, Hornsey MJ, Leknes S. The Positive Consequences of Pain: A Biopsychosocial Approach. Pers Soc Psychol Rev. 2014 Apr;18(3):256–279. PubMed #24727972. Bastian et al. write about “pain’s capacity to produce positive consequences, thereby decoupling the experience of pain from the experience of suffering” — pain’s silver linings, basically. BACK TO TEXT
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.

Pumping - The stroking movements in massage suck fluid through blood vessels and lymph vessels. By increasing the pressure in front of the stroke, a vacuum is created behind. This is especially important in tight or damaged muscle tissue as a tight muscle will squeeze blood out like a sponge, depriving the tissues of vital nutrients and energy to repair.

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Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.[47][48][49]
The main professionals that provide therapeutic massage are massage therapists, athletic trainers, physical therapists and practitioners of many traditional Chinese and other eastern medicines. Massage practitioners work in a variety of medical settings and may travel to private residences or businesses.[10] Contraindications to massage include deep vein thrombosis, bleeding disorders or taking blood thinners such as Warfarin, damaged blood vessels, weakened bones from cancer, osteoporosis, or fractures, and fever.[10]
Enhance your Swedish massage with psammo therapy, the ancient art of heated sand. The gentle and deeply affecting warmth of the Bavarian quartz and Persian salt provides physical and mental relaxation while stimulating the metabolism. It also has a purifying effect. This service is beneficial for arthritis, fibromyalgia and muscle and joint pain. It also aids sleep.
People who suffer from the following conditions or disorders should consult a physician before participating in a sports massage: acute infectious disease; aneurysm; heavy bruising; cancer ; hernia; high blood pressure; inflammation due to tissue damage; osteoporosis ; phlebitis ; varicose veins ; and certain skin conditions. Individuals who are intoxicated are not good candidates for sports massage.
The light-touch, free massages often offered at finish line festivals can help calm the nervous system by allowing the body to commence its natural repair state quicker, explains Rosemarie Rotenberger, an orthopedic massage therapist in Mertztown, Pennsylvania. And  Denunzio says that racers can schedule a recovery-focused sports massage within several hours up to 48 hours after an event, although she recommends massage newbies wait three to four days, as they may be too sore within the first few days fully benefit from (and appreciate) the experience.
At certain times during the massage, you may feel some discomfort or even some pain as the massage therapist works on areas where there are adhesions or scar tissue. Pain isn't necessarily good, and it's not a sign that the massage will be effective. In fact, your body may tense up in response to pain, making it harder for the therapist to reach deeper muscles.

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Sports Massage is a no-nonsense massage that helps stretch tight muscles, stimulates inactive muscles and improves soft tissue condition. Sports Massage will help you move your body more freely with more flexibility and in time can improve your posture. As the name suggests it is popular with athletes, as it enhances performance, assists recovery and prevents injury – benefits we can all enjoy.
As we age, our nerve endings become less sensitive in many parts of our body, particularly in our extremities. That being said, reflexology has been connected with stimulating more than 7,000 different nerve endings in a single session, thereby increasing their function and reactivity. Opening and cleaning out neural pathways can help improve functionality and flexibility in many areas around the body. Neural pathways are like muscles, so it is good to work them once in a while to keep them sharp!
For theory session, the teaching includes principle of reflexology, physiological effect of reflexology, various reflex points of the feet, chart theory, zones and cross reflexes, relationship of reflex points to body organs, using reflexology for health and complementary treatment as well as contraindications to reflexology. On the other hand, for practical session, the teaching includes the methods to examine the feet, good hygiene practice, and arrangement of treatment sessions, treatment practicality, assessment and documentation of the client's treatment, consultation as well as individualization of client's conditions.15

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