The significant difference in the two approaches is their effect on these layers. A Swedish technique uses lubricant to glide over the layers – whether that be on a superficial layer (light pressure) or a deeper layer (firm pressure). There may also be kneading of the muscles, vibration or percussion to stimulate the muscles, and passive and/or active joint movements. All of these techniques serve to increase circulation of blood and lymph, soften and relax the tissues, reduce cortisol levels in the body (the stress hormone), and provide a generalized sense of relaxation for the client.

In this particular study, published in Studies in Health Technology and Informatics, therapeutic massage included techniques of tapping and friction, while DTM used “oblique pressure and a combination of lengthening and cross-fiber strokes.” All sessions were 30 minutes long and preformed daily, and all participants did not receive any other treatments during the course of the study. After 10 days, participants treated with DTM reported significant improvements in pain (lower back pain in this case) compared to those treated with therapeutic massage, based on scores using the Modified Oswestry Low Back Pain Disability Index, Quebec Back Pain Disability Scale and Visual Analog Scales. (4)
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Deep tissue massage involves manipulation of the deep layers of tissue in the body, including the fascia and other supportive tissue that make up the muscles and joints. Compared to other popular massage techniques — including Swedish massage or acupressure, which tend to be lighter in pressure and can involve moving the body into certain positions — deep tissue massage is usually slower and firmer. (2)

Couples massage is a good choice when lovers are in the throes of early romance, and can't bear to be apart. They want to share everything, even their massage. Many couples treatments are specifically designed with romance in mind, including time alone in a rose-petal-strewn tub, a bottle of Champagne with strawberries and chocolate, and lounging time by a fire after the treatment. Part of what you are paying for is a time in the room, which works best when it's a beautiful romantic setting. 
No. Bottom line, massage should never hurt if you don’t want it to. Some clients specifically say that they do not want to be in pain, and that should be respected. However, there are certain techniques that might cause discomfort. If the client and therapist communicate and agree on increased pressure, you can incorporate these deeper or more aggressive techniques into the massage. They can cause a little pain at the time, and a little bit of soreness the next day. I like to compare it to how you feel after a good workout. A good Massage Therapist will also be very skilled at warming and softening the tissue layer by layer to decrease the amount of pain felt by the client.

Trigger point massage therapy is specifically designed to alleviate the source of the pain through cycles of isolated pressure and release. ... The results and benefits of trigger point massage are releasing constricted areas in the muscles thus alleviating pain. You can experience a significant decrease in pain after just one treatment. Receiving massage with trigger point therapy on a regular basis can help naturally manage pain and stress from chronic injuries.
A study in the Journal of Alternative and Complementary Medicine found that people's blood pressure fell after a single 45 to 60 minute deep tissue massage. Additionally, a 2010 meta-analysis in the Journal of Clinical Psychiatry found that massage modalities like deep tissue reduce stress hormone levels and heart rate while boosting mood and relaxation by triggering the release of oxytocin and serotonin.
I recommend trying more than one session, because reflexology has cumulative benefits. It’s important the client assesses if this is working for them or not. Depending on the issue or health challenge, I often suggest at least three sessions close together (every week or two weeks), and then we evaluate initial results. Remember, acute conditions tend to balance faster than chronic ones. In other words, the longer you’ve had the issue, the longer it takes to get rid of it.

Pre-event. Pre-event sports massage is given within the four hours preceding an event to improve performance and help decrease injuries. It is used as a supplement to an athlete's warm-up to enhance circulation and reduce excess muscle and mental tension prior to competition. It is normally shorter (10-15 minutes) than a regular conditioning massage, and focuses on warming-up the major muscles to be used, and getting the athlete in a good mental state for competition. It also improves tissue pliability, readying the athlete for top performance. Certain massage techniques can help calm a nervous athlete, and others can be stimulating. Pre-event. Pre-event sports massage is given within the four hours preceding an event to improve performance and help decrease injuries. It is used as a supplement to an athlete's warm-up to enhance circulation and reduce excess muscle and mental tension prior to competition. It is normally shorter (10-15 minutes) than a regular conditioning massage, and focuses on warming-up the major muscles to be used, and getting the athlete in a good mental state for competition. It also improves tissue pliability, readying the athlete for top performance. Certain massage techniques can help calm a nervous athlete, and others can be stimulating.

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Couples massage is a good choice when lovers are in the throes of early romance, and can't bear to be apart. They want to share everything, even their massage. Many couples treatments are specifically designed with romance in mind, including time alone in a rose-petal-strewn tub, a bottle of Champagne with strawberries and chocolate, and lounging time by a fire after the treatment. Part of what you are paying for is a time in the room, which works best when it's a beautiful romantic setting. 
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].

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Swedish massage is the most common massage therapy technique in the United States. (In case you were wondering, Swedish massage is called “classic massage” in Sweden.)   A Swedish massage focuses on overall relaxation, circulation, and physical and mental wellness.  Swedish massage includes gliding, kneading, tapping, stretching, and cross-friction strokes.

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Take it slow. Remember, the inner and outer charts are for people experienced with foot reflexology. Wait until you feel comfortable with the basics before trying to fully understand how to work the inner and outer charts. You may want to meet with a foot reflexology specialist or consider taking classes if you're interested in the inner and outer charts.[11]
In 2015 the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; reflexology was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.[5] Accordingly In 2017 the Australian government named reflexology as a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".[6] 

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The Spa at Norwich Inn, named "Best Destination Spa in New England" in the 70th Anniversary issue of YANKEE Magazine, "Best Resort in Connecticut" by New England Travel & Life, and "Best Day Spa in Connecticut" for 10 consecutive years by readers of Connecticut Magazine, and rated "Best Day Spa for 2015" by readers of Hartford Magazine. The Spa at Norwich Inn is a member of the Historic Hotels of America, a program of the National Trust for Historic Preservation.
Another study compared the effects of foot reflexology, simple massage, and conversation on 130 patients who had undergone abdominal gynecologic surgery under full anesthesia. The patients were asked how they felt, and data were recorded on general condition, pain intensity, movement of the bowels, urination, and sleep, from the day before the operation until until the tenth day afterward. Simple massage turned out to be a relaxing, positive experience, whereas foot reflexology had various effects, some of which were negative. The researchers concluded that foot reflexology is not effective in acute, abdominal postsurgical situations in gynecology and can occasionally trigger abdominal pain [15].

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Recovery. Therapeutic massage helps the body recover from the stresses of strenuous exercise, and facilitates the rebuilding phase of conditioning. The physiological benefits of massage include improved blood and lymph circulation, muscle relaxation, and general relaxation. These, in turn, lead to removal of waste products and better cell nutrition, normalization and greater elasticity of tissues, deactivation of trigger points, and faster healing of injuries. It all adds up to relief from soreness and stiffness, better flexibility, and less potential for future injury.

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Just this past year, the journal Evidence-Based Complementary and Alternative Medicine showed that reflexology not only helped to reduce pain, improve nerve conductivity, and correct thermal and vibration sensitivity concerns, it improved glycemic control — this suggests that someday, perhaps soon, we may learn that this ancient healing art can help prevent or treat type 2 diabetes. (6)
Sports massage has antecedents in earlier periods of history. The ancient Greeks and Romans combined massage and exercise in their athletic training. Various Asian cultures also developed forms of massage for dancers and for students of martial arts . As a formal practice, however, sports massage began in the Soviet Union and Communist bloc countries in the 1960s. Soviet teams were the first to have a massage therapist travel with them and work on their athletes on a regular and ongoing basis. Through sports and cultural exchanges, the concept of sports massage moved to Europe and the United States in the 1970s. Over time the benefits of sports massage became accepted, and sports massage became a part of the training regimen, first of professional athletes, then of college and amateur athletes. Today sports massage is recognized as a specialty by the American Massage Therapy Association.

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While a reflexologist can address specific conditions of the body, they cannot and should not attempt to diagnose disease. In fact, Bill Flocco, the Director of the American Academy of Reflexology, says it can be dangerous to use reflexology to diagnose a condition (see Reference section). This is because the reflex points on the body may already be strained or sore, and they, therefore, won't give a clear read of the body. This breakdown in response can be a result of regular wear rather than an issue with the body system that the point corresponds to.
Later, in the 1930s, a physical therapist, Eunice D. Ingham, explored the direction of the therapy and made the startling discovery that pressure points on the human foot were situated in a mirror image of the corresponding organs of the body with which the respective pressure points were associated. Ingham documented her findings, which formed the basis of reflexology, in Stories the Feet Can Tell, published in 1938. Although Ingham's work in reflexology was inaccurately described as zone therapy by some, there are differences between the two therapies of pressure analgesia. Among the more marked differences, reflexology defines a precise correlation between pressure points and afflicted areas of the body. Furthermore, Ingham divided each foot and hand into 12 respective pressure zones, in contrast to the 10 vertical divisions that encompass the entire body in Fitzgerald's zone therapy.
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.

While this massage is designed to help ease 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.”

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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.
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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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!

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In all cases, such massage techniques are employed in collaboration with other appropriate medical care. For example, encouraging circulation around a bruise, but not directly on it, through the use of compression, cross-fiber techniques or even long, deep strokes is only used after appropriate medical referral and diagnostics indicate that there are no clots formed in the area which may embolize.
For starters, you bear in mind the things described above that tend to cause ugly pain, and you avoid that kind of therapy like the plague. Then you look for some clues that painful pressure is okay. Here are at least three reasons why unpleasantly intense pressure might be therapeutic — “bad pain,” but not ugly. In each of these situations, it might be acceptable to tolerate sensations so intense and painful that the only thing about them that is pleasant is the part where it stops.
At All is Well Massage and SPA, we look forward to helping all of our clients achieve health and tranquility. We are always happy when we can serve more people with a couple’s massage on their journey to a ‘all is well’ life. We invite you to discuss with our massage therapists any concerns or accommodations they may have regarding their couple’s massage.

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