Friction strokes work on deeper muscles than the techniques previously described. The friction technique is a pressure stroke and is the deepest that is used in Swedish massage. The massage therapist applies pressure by placing the weight of his or her body on the flat of the hand and the pads of the thumbs, knuckles, fingers, or the back of the forearms, and then releases the pressure slowly and gently. This movement should be a continuous sliding motion or a group of alternating circular motions.

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Massage therapy involves rubbing muscles and joints of the body, generally to relieve tension. When it comes to Swedish massage versus deep tissue massage, they are similar but with defining differences, as the pressures and techniques help to differentiate between massage methods. Swedish massage is most commonly offered and utilizes a firm pressure on muscles. Five primary strokes encompass Swedish massage to increase blood flow, ease muscular tension, and reduce stress response.

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.

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Previous research has showed that reflexology can reduce the peripheral neuropathy of a patient who suffers from type 2 diabetes mellitus.31 76 patients ranged from 40–79 years old were listed from public health centres in Busan City. Tactile response to monofilament and intensity of the symptoms of peripheral neuropathy were used as the variable outcomes in this study. Tingling sensation and pain were reduced and tactile was more sensitive to 10 g force monofilament.32 The author added that the reflexology can be used as one of the interventions for encouraging foot care in patients who have diabetes mellitus.32 It also can be measured based on glycaemic control and nerve conductivity which show improvement with reflexology.31

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Swedish massage is rooted in Western practices of anatomy and physiology. To perform this type of massage, licensed therapists apply an arsenal of pressure styles that include stroking, kneading, striking, rubbing, and vibrations. Using massage oil to help their strokes glide, they focus the pressure along the muscles that run the length of the body.

The proper design, control, and intervention protocols of research on reflexology remain debatable. The use of randomized controlled trials (RCTs) is the golden standard in assessing the efficacy of complementary therapies such as reflexology.34 Verhoef et al. have described the challenges when researching complementary therapies: standardization of regimented treatment that limit the individualization of treatment; client's focus on health with restricted roles for disease treatment; ethical issues involving the recruitment and randomization due to participants pre-conceived belief on reflexology; practicality of applying sham reflexology; interference of psychological influence on rapport between patient-provider.35


Many training programs are now available throughout the world that require a minimum of 500 hours of basic massage therapy training, in addition to continuing education credits that can require up to another 400–500 hours. (19) Always make sure you’re “in good hands” by first checking that a therapist has proper qualifications and experience, specifically asking about training in NMT, trigger point therapy, sports massage, pain management, myofascial release and orthopedic massage.

I’ve worked in a variety of exciting environments, including the Salt Lake City Winter Olympics, the Greece Paralympic Summer Games and on the road with the U.S. National Powerlifting Team. Plus, I have worked with collegiate, ABL and WNBA athletes. Currently, I travel with the WTA (Women’s Tennis Association) as part of the sports science and medicine team. In my private clinic, I specialize in orthopedic massage.

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