Quick muscle knot orientation: Muscle knots — myofascial “trigger points” — are a factor in most of the world’s aches and pains. Their biology is still mostly mysterious: conventional wisdom says they are tiny spasms, but they might also be a more pure neurological problem. Regardless, they can cause strong pain that often spreads in confusing patterns, and they grow like weeds around other painful problems and injuries, making them quite interesting and tricky. Although they are well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. For more information about how trigger points might be involved in your own medical history, see PainScience.com’s best-selling tutorial:


Trust and pain. Bear in mind that feeling safe is critical to the experience of good pain. Tiny differences in trust and comfort can make the difference between an intense pain being good or bad. Much of the “goodness” of good pain comes from mental context, from knowing that a pain is not dangerous or pointless, that it will not increase suddenly, or anything else yucky or shocking.
Sheets and wrappings of connective tissue called fascia are considered an exciting frontier in massage therapy. Supposedly fascia can get tight and needs to be “released.” However, key examples of research either fail to support fascial therapy or actually undermine it — for instance, fascia is too tough to actually change. Fascia enthusiasm seems to be a fad. For more information, see Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties. BACK TO TEXT
Headaches. Severe headaches and migraines are the second most common pain conditions in the U.S. (15 percent) according to the AAPM, and Everhart says that massage therapy can oftentimes help in these cases. The Migraine Relief Center (MRC) indicates that the reason this modality works is that it eases muscle spasms, improves blood flow and circulation, relieves tension, and increases relaxation. The MRC shares that it is also especially helpful when it comes to tension and vascular headaches.

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The University of Maryland Medical Center reports that deep-tissue massage is more effective and affordable for relieving chronic pain than conventional medical remedies. Because deep-tissue massage increases the flow of blood through through the body, it helps reduce the inflammation that causes pain. Deep-tissue massage can also help alleviate muscle tension that is often a side effect of chronic pain by loosening the tight tissue clusters.
Trigger points or stress points may also cause muscle soreness and decreased flexibility. These points are specific spots in muscle and tendons which cause pain when pressed, and which may radiate pain to a larger area. They are not bruises, but are thought by some to be small areas of spasm. Trigger points may be caused by sudden trauma (like falling or being hit), or may develop over time from the stress and strain of heavy physical exertion or from repeated use of a particular muscle.

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When the body is experiencing pain, it reacts with tension. During a deep tissue massage, discomfort is normal and will be felt if there are inconsistencies within the tissues. Discomfort is described as a "good hurt", the kind that feels good at the same time. On the other hand, pain can be described as being uncomfortable and not tolerated well by the body.
One risk is clearly neurological and complex: some people are basically sitting ducks for the well-documented and nasty phenomenon of “central sensitization,” and indeed may already be in pain and seeking help because of it. A strong massage can severely aggravate that situation, with long term and extremely unfortunate consequences. It’s rare, but it happens. The typical clinical scenario here is a gung-ho under-trained therapist over-treating someone in, say, the early stages of fibromyalgia. Bad, bad, bad.
Expect to work hard breaking into the sports environment. Get additional training and develop your expertise in orthopedic massage and functional assessment, clinical massage, myofascial work and stretching. Start by getting involved with your AMTA chapters’ Sports Massage Team; this provides excellent hands-on experience and each event looks great on a resume.

For instance, I tried a new young massage therapist. He introduced a pain scale right away, and asked me to use it to define an intensity I was comfortable with — a 5 out 10, say — and then actually used that scale to check with me quite a few times throughout an hour treatment. He also responded with clear adjustments to his technique when I reported that we were under or over the target I’d set. Great work! BACK TO TEXT

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Emmanuelle is a certified reflexologist, and a member of the Reflexology Association of America (RAA). She has practiced reflexology for five years, including three years in Paris.  She has studied anatomy, physiology and reflexology, and have been certified in two schools: Action Reflexo Formation (www.action-reflexo.com) with a Traditional Chinese Medicine approach focused on the systemic relation between organs, and is also certified in Reflex Therapy Total Faure Alderson, Ingham Method, focused on the cranial-sacral balance. She participates in post-graduate trainings to enhance her practice.  She practices reflexology with specific processes of manual pressure on feet areas. These areas include  7,200  nervous points located on your feet. The pressure points activate the general nervous network of your body connected through these points and areas. The process will stimulate healing and have a balancing effect on the systems, including the digestive system, hormonal system, cardio-vascular system, and lymphatic system.  Reflexology can address many imbalances, like sleeping problems, stress, puberty, menopause, weight and digestive problems, and recovery after surgery.  In addition to a deep functional relaxation and release of the tensions, the process will promote long-term health.

Whenever athletes exercise heavily, their muscles suffer microtraumas. Small amounts of swelling occur in the muscle because of tiny tears. Post-event sports massage helps reduce the swelling caused by microtraumas; loosens tired, stiff muscles; helps maintain flexibility; promotes blood flow to the muscle to remove lactic acid and waste build-up; and reduces cramping. In addition, post-event massage helps speed the athlete's recovery time and alleviates pulls, strains, and soreness.

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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.

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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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Shiatsu (literally, "finger pressure") is an ancient technique from Japan. It combines gentle stretches with finger pressure to work on different pressure points. The idea is to fix imbalances in the flow of energy in your body. Although there's no concrete evidence of Shiatsu's use as a healing method, people who have had this massage still report stress and pain relief. About.com's Alternative Medicine site says:

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Anyone who routinely stretches their physical limits through movement such as running, cycling, hiking, swimming, dancing, tennis and other racquet sports, strength training and aerobics can benefit from a massage. There are others who does strenuous activities in a day that is not normally classified as exercise. Examples are mothers with small children, gardeners, and others who use their bodies strenuously in their work.
How are NMT and Sports Massage treatments different from a basic massage Treatment? While each system uses a hands-on approach to soft tissue manipulation, NMT and Sports Massage are extremely specific. Like massage therapy, NMT and Sports Massage address the muscle bellies, but they also go to work with the entire length of the muscle from origin to insertion. Instead of a general approach, Sports Massage identifies postural and biomechanical distortions that are involved with pain patterns. These systems also go on to strategically manipulate specific soft tissue components to facilitate structural change and balance.
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

A good massage therapist will never force pressure into the muscle. They will continue to apply pressure until the muscle pushes back against them. The muscle will then slowly begin to release and allow the therapist to move along it. The pressure used should not be painful, but should walk a fine line between pleasurable release of tension and a pain-blocking response from the body (tensing up).


One of the many benefits of sports massage is the prevention of delayed onset muscle soreness or DOMS. According to a report by American College of Sports Medicine, this condition typically begins 12 to 24 hours after the strenuous exercise is finished. DOMS sufferers may experience the most pain between 24 and 72 hours after the physical activity is done. Sports massage therapy prevents DOMS by encouraging blood flow throughout the body, thus preventing muscle fatigue.

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Inter- and intra-event massage is given between events or in time-outs to help athletes recover from the preceding activity, and prepare for the activity coming up. It is also short, and focuses on the major muscles stressed in the activity. Inter- and intra-event massage is given between events or in time-outs to help athletes recover from the preceding activity, and prepare for the activity coming up. It is also short, and focuses on the major muscles stressed in the activity. 
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.
Several mechanisms for deep massage’s natural stress-relieving effects include its ability to dilate blood vessels and also lower activity of the limbic system (including the hypothalamus), which is responsible for autonomic nervous system regulation and cortisol secretion. Massage has been shown to improve relaxation by boosting activity of the parasympathetic nervous system, as measured by heart rate, blood pressure and heart rate variability. (8, 9)
Deep tissue massage is best for giving attention to certain painful, stiff "trouble spots" in your body. The massage therapist uses slow, deliberate strokes that focus pressure on layers of muscles, tendons, or other tissues deep under your skin. Though less rhythmic than other types of massage, deep tissue massage may be therapeutic -- relieving chronic patterns of tension and helping with muscle injuries, such as back sprain.
Upon entering the suite, you are surrounded by aromatic therapy that will envelop you in a sense of relaxation. Our aphrodisiac oil will stimulate your sensuality and feeling of togetherness that will enhance your spiritual connection. A couple’s massage is a wonderfully relaxing, personal experience. During the session, two people receive massages at the same time and in the same room from two different therapists.
The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. We do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication or have a medical condition. 

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Another institute that offers a short course of reflexology is Karisma Institute which is a specialist training institute. This institute is registered with the Ministry of Human Resource and Ministry of Tourism Malaysia. This institute offers many courses that are geared towards meeting the market needs. For those who registered as participants at this institute, they are supplied with registration kits which consist of foot reflexology book, reflexology zone poster, massage cream, and towel. This institute offers 10% lecture class on theory and 90% practical session with demonstration. The overall contents of this short course are introduction to reflexology, human physiology, organs function, consultation, treatment, and entrepreneurship.16

In Australia, Melbourne Polytechnic offers reflexology course for the students and accredited with Diploma of Reflexology. In this course, students will learn the skills to assess and treat the body, supporting its search for natural balance and well-being. It also includes how to develop specific skills in reflexology techniques, learn to provide clients with basic dietary guidance, and learn the necessary health terminology about chronic disease. The qualification from this institute is valid for the membership of national organization such as the Reflexology Association of Australia and also can be used for further studies in complementary medicine.


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.

  Consider the possibilities of reflexology: Connecting with others using reflexology as you help them be well; Taking control of your own well-being using reflexology; Helping your family members or friends through difficult times of health problems with reflexology; Developing a career of hands-on work with others in the field of reflexology. Fond family memories, […]

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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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