The reason the Pressure Question exists is that it’s hard for patients to tell the difference between nasty pain that might be a necessary part of therapy, and ugly pain that is just abusive. Not everything that hurts is therapeutic, but not every therapeutic procedure is painless! How can we tell if an intense massage technique is therapeutic or not? 

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Reflexology and acupressure are both "reflex" therapies in that they work with points on one part of the body to affect other parts of the body. While reflexology uses reflexes that are in an orderly arrangement resembling a shape of the human body on the feet, hands, and outer ears, acupressure uses over 800 reflex points that are found along long thin energy lines called meridians that run the length of the entire body.
Whether you’re an athlete with a daily high demand placed on your body or recovering from an injury or illness, deep tissue massage likely has some benefits to offer you. Massages have been utilized for thousands of years throughout the world to lower both physical and psychological stress. And today, research continues to show that whether used alone or in conjunction with other treatments, massage therapy is an effective way to help treat common conditions like arthritis, anxiety and chronic lower back pain.

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"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."
Following injury, and especially if it’s also a very stressful time, inflammation can prevent proper blood flow from reaching damaged tissue and can cut off vital nutrients and oxygen. This can cause toxins to accumulate around damaged tissue, which only increases swelling and pain. Some studies have found that even self-administered massage can help reduce pain associated with plantar fasciitis and other injuries. (10)
When most people think of massage, they think of Swedish. The style takes its name from a 19th-century Swedish physiologist, Per Henrik Ling, whose system of medical gymnastics included massage. Johan Georg Mezger (1838-1909) coined a reduced set of maneuvers and techniques of Dr. Ling’s system as the “Swedish massage” system. Swedish massage is defined by four or five (somewhat familiar) techniques, which have French names: effleurage (stroking), petrissage (kneading), tapotement (rhythmic choppings), and friction (rubbing). Some therapists now incorporate advanced techniques that have rehabilitating effects and stretches for improving your range of motion. But the ultimate goal is relaxation. As the default Western massage, Swedish massage is extremely popular and is simple, soothing touch therapy.
The most widely recognized and commonly used category of massage is the Swedish massage. The Swedish massage techniques vary from light to vigorous.[63] Swedish massage uses five styles of strokes. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber or with the fibers) and vibration/shaking.[64] Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks.[65] The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitioner Johann Georg Mezger applied the French terms to name the basic strokes.[66] The term "Swedish" massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as "classic massage".
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. 

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]
Pain is a stressor in the body system and any injury occurs to any part of the body will cause the whole system to be stressed.1 Endorphin is a body's natural pain-relieving chemical will be released as a response to reflexology. Endorphin teaches the body how to adapt any injuries. Those who practice reflexology in their life believe that healing from any injuries comes from the role of reflexology.3

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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The light-touch, free massages often offered at finish line festivals can help calm the nervous system by allowing the body to commence its natural repair state quicker, explains Rosemarie Rotenberger, an orthopedic massage therapist in Mertztown, Pennsylvania. And  Denunzio says that racers can schedule a recovery-focused sports massage within several hours up to 48 hours after an event, although she recommends massage newbies wait three to four days, as they may be too sore within the first few days fully benefit from (and appreciate) the experience.

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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)
In South Africa, massage is regulated, but enforcement is poor. The minimum legal requirement to be able to practice as a professional massage therapist is a 2-year diploma in Therapeutic Massage and registration with The Allied Health Professions Council of SA (AHPCSA). The 2 year qualification includes 240 credits, about 80 case studies, and about 100 hours community service.
Many people confuse reflexology with massage, Reiki, or acupuncture, but there are essential differences between these therapies.  Massage therapists manipulate larger areas of soft tissue in the body while reflexologists apply pressure to specific points on the feet, hands, and ears.  Unlike either massage or reflexology, Reiki does not involve any physical manipulation or pressure, but instead uses light touch to work with the subtle vibrational field thought to surround the body. Finally, while acupuncture and acupressure, like reflexology, use reflex points on the body to influence other parts of the body, the points are not the same and acupuncture uses points over the entire body.
Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.
Connective tissue stimulation. A lot of therapists are keen on stretching connective tissues — tendons, ligaments, and layers of Saran wrap-like tissue called “fascia.” I’m not a huge fan of this style, but certainly it’s a way of generating many potent and novel sensations, which may be inherently valuable to us — another form of touch. Although “improving” the fascia itself is implausible and unproven, perhaps fascial manipulations affect bodies indirectly, just as a sailboat is affected by pulling on its rigging. People have written whole books full of speculation along these lines. So, as long as the sensations are not like skin tearing (that’s an ugly pain for sure), you might choose to tolerate this kind of massage if it seems to be helping you.

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Empathy: Most people opt for massage therapy because they are in pain or because they are stressed out and need to calm down. As a massage therapist, it is imperative that you are empathetic to the needs of your clients, regardless of your day is going. If you appear or feel anxious or stressed, you are not going to be able to make your client feel calm and relaxed. Create trust with your patients by being personable and communicating effectively. Be receptive to their needs.

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