In the US, licensure is the highest level of regulation and this restricts anyone without a license from practicing massage therapy or by calling themselves that protected title. Certification allows only those who meet certain educational criteria to use the protected title and registration only requires a listing of therapists who apply and meet an educational requirement.[123] It is important to note that a massage therapist may be certified, but not licensed. Licensing requirements vary per state, and often require additional criteria be met in addition to attending an accredited massage therapy school and passing a required state specified exam (basically the certification requirements in many states). In the US, most certifications are locally based. However, as of March 2014, some states still do not require a license or a certification.[citation needed] However, this is thought to change eventually as more regulatory bodies governing the profession of massage are established in each state. Furthermore, some states allow license reciprocity where massage therapists who relocate can relatively easily obtain a license in their new state. Not all states provide this option.[124]
Elementary Reflexology™ is a form of reflexology incorporating energy balancing with point specific work. Integrating the ancient art of Ayurvedic reflexology with the modern energetic principles of Polarity, and is based on the concept of the inter-relationship of the five elements: Ether, Air, Fire, Water, and Earth. What sets Elemental Reflexology™ apart is its foundation in the assessment and balancing of these five elements. Elemental Reflexology™ is focused exclusively on the feet, because in polarity, they are the most negative pole in the body-the place where energy is the most dense and tends to crystallize and become blocked. Working on the feet frees up this stagnant energy, allowing it to be released and flow freely throughout the body. This process is suited for all ages and many conditions.

great for the active and the serious athlete. a customized massage to soothe strained muscle groups that may include all aspects of massage determined by each guest’s level of athleticism. massage combined with hot stone, stretching and deep kneading eases tension in tight muscles, stimulating healing and improving recovery time from intensive training and long, stressful days.
Pregnant women should put their reflexology treatments on hold. "There are reflex points that can stimulate uterine contractions," says Colin. "You also don't want to do anything if the foot's already injured or unhappy," so recent foot surgery or plantar fasciitis flares are contraindications. He's also hesitant to work on anyone who isn't a candidate for traditional massage, such as those with blood-pressure issues.
The recognition of reflexology as a specific type of treatment began with Zone Theory, in which the body is divided into 10 vertical zones. Each zone corresponds to fingers and toes all the way up to the top of the head. For example, if you are standing up with your hands on your thighs (palms facing down) the thumbs and great toe would be zone 1. On either side of the body, the index finger and second toe would be zone 2, etc.

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The therapist might use Swedish massage to stimulate circulation of blood and lymph fluids, and trigger point therapy to break down adhesions (knots in the muscles), and stretching to increase the range of motion. Other techniques could include myofascial release, craniosacral therapy, lymphatic drainage and orthopedic assessment. The therapist should also have a good foundation in hydrotherapy modalities including cryotherapy and thermotherapy, which can help with recovery, repair and healing processes.
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).

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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.
In Malaysia, reflexology has been applied widely but without any certification and qualification from the Ministry of Health. Tighter control is needed to overcome this problem. Practitioners who conduct this therapy may not have the accurate knowledge about reflexology and may lead to any contraindication for certain conditions. The government should take serious enforcement about this practice among practitioners who are not certified. Each practitioner must have a proper training. The ministry of education could provide vocational training in the local community colleges throughout Malaysia to upgrade the skills and knowledge of reflexology practitioners.
"Back before we started wearing shoes everywhere, we developed natural stimulus points from the ground [making direct contact] with our feet," Colin says. "By walking and getting that stimuli, we would relieve stress. We don't get that anymore. So the idea of reflexology is going back and mimicking that stimuli to specific points and feeling where that stress sits."
Deep Tissue Massage also has incredible health benefits.  The release of habitually tight muscles relieves chronic pain and speeds the healing of injuries.  Balanced posture improves organ function and athletic performance.  Overall, it relieves the stress and energy drain of chronically tight muscles improving general health and well-being for long term wellness.

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But the relief model is certainly tempting. There are many painful-but-relieving analogies in medicine and biology.15 That’s similar to what good pain in massage feels like, but it’s not the same: no one thinks that lancing a boil or popping a shoulder joint back in is anything but painful while it’s happening.16 And we can’t necessarily take the good pain sensation at face value and assume it means there’s actually going to be a positive outcome. Brains are not all-knowing. Sometimes they see danger where there is none, and sometimes they see help where there is none.

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