Myofascial trigger points — muscle knots — are a ubiquitous muscular dysfunction, causing most of the aches, pains and stiffness in the world, and complicating virtually every other injury and disease process. A lot of massage is focused on them, directly or indirectly. Massage may be helpful because it relieves the symptoms of muscle knots, or even unties them. (No, not literally.)

Thank you so much for your article The Pressure Question in Massage Therapy. I just read it all. I went for a sports massage two weeks ago as I was recommended to have one as it was suggested it might help with tight calves, a side effect of some other injuries I have. I’ve been for sports massages many, many times before over the years. This one was one of the most painful experiences of my life — when I got home I was almost sick and felt in shock. My right achilles tendon was raging and it’s been bad ever since. It hurt so much when it was done (like someone was sticking knives in) and I kept asking if it was meant to hurt. I wish I’d just stopped the session or objected but I didn’t. It used to be a bad injury that affected me walking for about 6 months so I’m just devastated about this. I can hardly bear to put shoes on and its all this time on. I know there are good practitioners out there but experiences like this just make me want to stay away. I wish I’d gone to a “gentle” one.

It is important to note that the reflexology group only received two months of treatment, whereas the ibuprofen group had two months. In addition to being “associated with more reduction of intensity and duration of menstrual pain in comparison with ibuprofen therapy,” it appeared that reflexology actually promotes healing and not just pain management.

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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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Typically, sports massage therapists hold a certification and maintain licensure. A good option is to become board certified through the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and have an active membership with an association, like AMTA, to keep up to date with industry trends. Exact requirements depend upon the state in which the sports massage therapist practices.

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Swedish massage helps the body heal itself by physically manipulating and stimulating the body’s circulatory and lymphatic systems. This works to energize and help eliminate toxins in the body. Also, through Swedish massage, a high level of relaxation can often be achieved, and this relaxation can help prepare the body to act as an open, receptive vessel in which healing can more rapidly occur.

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Pre-event sports massage is done to help prevent serious athletic injury. It helps to warm up the muscles, stretching them and making them flexible for optimal athletic performance. A pre-event massage stimulates the flow of blood and nutrients to the muscles, reduces muscle tension, loosens the muscles, and produces a feeling of psychological readiness.

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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:
We recently received an email from a representative of Modern Reflexology asking if they could advertise their website on ours and offering to pay. Of course, we don’t accept advertising. But I was puzzled as to why they approached us and what they thought was science-based about reflexology. I was intrigued enough to visit their website to learn what “modern” reflexology was all about. I learned about a lot of specific claims I hadn’t heard before, but I found no science whatsoever. By writing this article, I am in a sense giving them the advertising that they asked for; but it will be negative publicity, not positive. Old adage: Don’t wish too hard for what you want; you might get it.
In reflexology theory, every organ, valve, muscle, etc. that lies within a zone can be accessed via a point or area on the feet or hands. For example, working between toes 2 and 3, or fingers 2 and 3, the eye point is found. These pathways between pressure points and other parts of the body are thought to be connected via the nervous system, as described above.
Research shows that firmer massages with more pressure can result in a significant reduction in arthritis pain compared to lighter massages. Lighter massage tends to be arousing (not relaxing) because often the heart rate goes up. However, with moderate pressure, heart rate usually goes down, and this stimulates relaxation and reduced tension. (13)

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Not everyone should receive a deep tissue massage. Some people simply enjoy the sensation of deeper pressure to their muscles and others prefer a more gentle touch. Someone who has never experienced a massage before may not want to request a deep tissue massage. It is the responsibility of the massage therapist to determine if a deep tissue massage is necessary by way of a thorough health history and evaluation. A massage is only effective when the person on the table is comfortable and relaxed.

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People with serious and long-term medical problems are urged to seek the advice of a physician. Diabetes patients in particular are urged to approach this therapy cautiously. Likewise pregnant women are cautioned emphatically to avoid reflexology during the early phases of pregnancy altogether, as accidentally induced labor and subsequent premature delivery can result from reflexology treatment.
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.
If you are dealing with a serious injury, and don’t have a diagnosis, definitely see a sports doctor. “Massage therapists do not diagnose,” says Denunzio. “It’s not part of our discipline.” And while a therapist can identify and attempt to alleviate any tightness and inflammation in the body, if a problem area doesn’t feel significantly better three days post-massage, you should likely consult a sports doctor then, as well. Once a diagnosis is given, your massage therapist can work with that information and use massage as a helpful tool in recovery.
The foundation course provides the student with comprehensive training to begin working as a Professional Reflexologist. Dedicated students wishing to extend their skills are recommended to continue their studies with our Advanced Reflexology course. The advanced course will expand your knowledge in the specialised areas of this truly effective therapy.
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.

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Hot stone massage is best for people who have muscle pain and tension or who simply want to relax. This type of therapeutic massage is similar to a Swedish massage, only the massage therapist uses heated stones in lieu of or in addition to their hands. It eases muscle tension, improves blood flow, and relieves pain by using heated stones. Hot stone massage may help:

The deepest work in Swedish massage is accomplished with friction, where the therapist works deep into the muscles with the fingers, elbow, or base of the palm. Using circular movements, the therapist works deeply into the muscle, especially in bony areas, to release adhesions that can restrict movement. Friction helps the client to be more flexible, and it also releases deep seated muscle tension.


Those who relate reflexology with massage are mistaken. Even though both of these things have the same technique, it’s in their approaches that they differ from one and another. We can understand this in a better way if we analyze both of them more closely. Massage is the treatment which is carried out by hand to manipulate the soft tissues of the body using techniques like stroking, tapping, kneading and friction, which are done to relax the body muscles.
Finally, a few months ago, I went to Hartford unannounced, and spent a day in Dr. FitzGerald’s offices. I saw patients who had been cured of goiter; I saw throat and ear troubles immediately relieved by Zone Therapy; I saw nasal operations performed without any anesthetic whatever; and — in a dentist’s office — teeth extracted without any anesthetic except the analgesic influence of Zone Therapy.

Referred pain basically just makes trigger point stimulation feel bigger, more important. Press on a small spot … feel it down your entire arm. Wow! Impressive! Even though it’s just a thumb on a trigger point, it feels as though that “itch” is being scratched throughout an entire region. Referred pain amplifies the good pain effect — or the bad pain effect, if the pressure is too intense!

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I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com

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Changes should be implemented immediately instead of in stages, so that patients can go to any reflexology centre without any doubt. The entire centres, spas or even small booth that offer reflexology treatment must obtain a certificate from the Ministry of Health. It is suggested that each centre to have a medical form about patient's details, medical history, and screening form. It is already issued by the Ministry of Health but none of the centres has ever applied.
While a foot massage may feel the same as a reflexology treatment, a reflexologist will work on areas to promote a healing response in the corresponding organs. A massage therapist giving a foot massage will manipulate muscles and other soft tissues to improve circulation, relieve pain, and heal injuries in the area or to induce overall relaxation.

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