Neuromuscular therapy is a form of soft tissue manipulation that aims to treat underlying causes of chronic pain involving the muscular and nervous systems. This medically oriented form of massage addresses trigger points (tender muscles points), circulation, nerve compression, postural issues, and biomechanical problems that can be caused by repetitive movement injuries.

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Chronic back pain. The American Academy of Pain Medicine (AAPM) reports that 100 million Americans suffer from chronic pain, with is more than those afflicted with diabetes, coronary heart disease, stroke, and cancer combined. Additionally, back pain is the most common type of pain reported, accounting for 27 percent of all chronic pain cases. It is also the leading cause of disability in Americans who are 45-years-old or younger. Research has found that deep tissue massage can potentially help ease this pain, offering these individuals a chance at a higher quality of life.

Reflexology (or foot reflexology) is a therapy based on the principle that there are small and specific areas of innervation in the hands and feet that correspond to specific muscle groups or organs of the body. In this system, the nerve endings in the extremities provide a “map” of the rest of the body. Examples are the base of the little toe representing the ear, or the ball of the foot representing the lung. Through the application of pressure on particular areas of the hands or feet, reflexology is said to promote benefits such as the relaxation of tension, improvement of circulation, and support of normalized function in the related area in the body.

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)


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)
However, since having the feet or hands rubbed is an enjoyable and relaxing experience for most people, there is little doubt that hand and foot reflexology can promote stress relief and a sense of well being in much the same way as any other form of massage. This therapy may be an especially useful complementary treatment for neuropathy of the legs, feet and toes. It can also be useful for sore hands and feet after a workout, running or taking a long walk.

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Flushing. If massage can “improve” any tissue — unknown — one way it might do it is through simple hydraulics: physically pumping tissue fluids around, and/or stimulating the circulation of blood and lymph. I won’t get into the evidence about it here. Suffice it to say that it might be true, and if it’s true then it may not much matter if the process is uncomfortable. While gentler massage may feel pleasant and satisfying, it is possible that more biological benefits can only be achieved hydraulically — whether it’s comfortable or not. This is even more plausible because of trigger points: it’s likely that the tissue fluids of a trigger point are quite polluted with waste metabolites, and the need for flushing is greater, but it’s especially uncomfortable to squish those polluted patches of tissue.

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Deep tissue massages are usually “cross-grain,” moving against the muscles to relieve aches or pains rather than moving  with them. This can sometimes feel a bit more painful as a result compared to standard “relaxation massages.” However, the pressure involved in deep massages is actually a good thing. It provides many of the benefits that this type of therapeutic massage has to offer. Deep tissue massages also tend to be slower-paced and longer than many other massages, ideally about 1.5 hours long, which gives bodily tissue enough time to warm up and then relax.
The best we can say is that there is some reason to believe that painful pressures on muscles might be therapeutic for some people some of the time. Pretty decisive, eh? This is why it drives me nutters that so many therapists insist that strong pressures are “essential” to achieve “a complete release.” It really isn’t possible to know! It really does depend! Why would anyone pretend to “know”?

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