Alhough he was a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association at the time, Pietrunti says that he ultimately decided to pursue licensure in massage therapy as well. This provided that missing link while also being “a good way to ‘bridge the gap’ and provide a better service to my clients,” he says.
With no lotion or oil to cause sliding, it becomes possible to fully get a hold of the shortened fascia; this is necessary in order to lengthen it. Slow, sustained strokes are what can change this tissue from a short, hardened state to a lengthened, fluid state. The process is not unlike stretching salt water taffy. You’ve got to get a hold of it, warm it up, and work it very slowly. The work may sometimes be intense, eliciting moderate discomfort as old adhesions and chronic dysfunctional patterns are altered. But that leads to a much more fluid, easy sense in the body.
There’s just no reason to push a client to that “cringe point.” It’s ham-handed, tends to indicate a simplistic “more is better” approach to the work, and simply isn’t needed — that’s not what defines “intensity” in a good massage. Very strong and sastisfying pressure can always be achieved without that edgy, nervous-system-almost-rebelling feeling.
Inflammation caused by chronic stress and muscle tension can lead to worsened overall health, longer recovery time, reduced immune function and cardiovascular problems, such as high blood pressure. Studies have found that massage therapy can help lower cortisol levels and even boost production of the hormone called oxytocin, which relaxes the body and has soothing effects. (7) Oxytocin is the primary hormone responsible for sustaining social bonds in humans and increasing motivation for cooperative behaviors, which is why it’s often called the “cuddle hormone” and known to be released during hugs, birth, social bonding and from touch.

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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

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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:
Swedish massage helps the body heal itself by physically manipulating and stimulating the body’s circulatory and lymphatic systems. This works to energize and help eliminate toxins in the body. Also, through Swedish massage, a high level of relaxation can often be achieved, and this relaxation can help prepare the body to act as an open, receptive vessel in which healing can more rapidly occur.

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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 statistic has showed that there are more than 5000 registered reflexology centres in Malaysia. Currently, reflexology is a big industry in Malaysia with a huge unexploited potential for tourism and human capital, especially for disabled people. Owing to that, Ministry of Health has published the good practice guidelines for reflexology in 2011 to strengthen and govern its operations.2 Different use of reflexology and the effect of reflexology are listed below:
Phussapa Thai Massage School also offers reflexology training course. The educational systems available for this course are basically the theory, practice, and examination. This institution has the authorization from Thai Ministry of Education. The main curriculum included in this course is the general subject of reflexology such as the history of foot massage, basic knowledge of reflexology map, safe and proper foot massage, necessary equipment, and advice after session. For the practice session, a full session of one-hour foot massage and cool down massage is taught. The examination will be in written and practice format. After the completion of whole school course, the certificate will be issued.22
Again, if somebody is you know, really anxious or feeling stressed out, that diaphragm line, the solar plexus point, which is right here, and the adrenal gland reflex are really powerful. And the last point is the press and slide with Dr. Manzanares. This is if you really want to get deep and you don't want to miss any points within there. So you're going to actually press down, you lean in, and you just slide a little bit and check in with your person, make sure you're not hurting them. You know, you want to kind of kick into it a place of parasympathetic, you know, relaxation. If you go beyond that, it's not serve going to them. So, again you press in and then you go up. Press in and slide and there will be continual pressure.
Learn about qi and other conceptsAnother 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.

An aromatherapy massage is a Swedish massage with scented plant oils (known as essential oils) added to the massage oil. Extracted from flowers and other plant parts, essential oils offer a pleasing scent and are believed to have healing properties. Lavender and rose, for instance, are known to promote relaxation. Although oils may be selected to address specific needs, the therapist typically uses pre-blended oils to relax, energize, or uplift.

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Some sports massage therapists use myofascial techniques that focus on stretching the fascia, which are connective tissues surrounding muscles, tendons and ligaments in the body. This particular massage technique involves the therapist applying forces in opposing directions which relaxes the tissues. It can help ease pain and increase mobility in the tissues and surrounding muscles.
Traditionally designed to apply pressure to layers of muscle, tendons and other tissues deep under the skin, deep tissue massage can be very effective in relieving problem areas and is highly therapeutic. Deep tissue massage is generally a modality to consider for athletes as well as the eight-to-five desk job. Muscles easily become tense and deep tissue massage can relieve some chronic patterns of pain and tension, specifically in the back, shoulder and neck areas.  
People with serious and long-term medical problems are urged to seek the advice of a physician. Diabetes patients in particular are urged to approach this therapy cautiously. Likewise pregnant women are cautioned emphatically to avoid reflexology during the early phases of pregnancy altogether, as accidentally induced labor and subsequent premature delivery can result from reflexology treatment.
Beyond the feel-good effects of the treatment, the practice and purpose go deeper than the skin and muscles by taking specific reflex points on the foot to induce a healing response in corresponding organs and areas of the body, as seen in the chart to the left. Kneading the soft fleshy ball of the foot, pulling on the toes, tracing around the heel and pushing deep into the arch are just a few of the many small, intense movements you’ll experience during a reflexology treatment.
Prenatal massage uses mild pressure similar to Swedish massage. The therapist will focus on areas such as your lower back, hips, and legs. You can be fully or partially undressed depending on your comfort level. During the massage, you’ll either lie on your side or on a specially designed table with a cutout for your belly. If you’ve had pain in your calves or other parts of your leg, see a doctor before you have a massage.
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!
A couple’s massage is a massage that you do with your partner, friend, or family member in the same room. It brings all the benefits of a regular massage and sometimes provides you with access to the spa’s hot tubs, saunas, and other facilities. Other treatments such as pedicures, facials, and body scrubs are sometimes offered as part of a package.
Combine these with the 4,146 active players in the NFL (National Football League) MLB (Major League Baseball), NBA (National Basketball Association), NHL (National Hockey League) and MLS (Major League Soccer); the 244 Olympic athletes on Team USA who competed in the 2018 Winter Games; and all of the “weekend warriors” who play sports on a more sporadic basis and this represents a huge number of individuals who rely on their bodies to consistently perform at higher levels.
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.

Reflexology practitioners and the professional association have advocated that reflexology is effective for general well-being maintenance and treatment of chronic diseases such as strokes, musculoskeletal disorders, and stress. Due to its soothing massage and non-drug complementary nature, reflexology is widely accepted by general public. Yet, numerous systematic reviews confirmed that strong evidence of the positive effects of reflexology postintervention are lacking despite plenty reported small-scale trial and anecdotal evidence of reflexology for some common ailments. Adequate training of practitioners and reflexology programme accreditation are to ensure correct and consistent services are provided. 

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