There are 58 training programs accredited by the Commission for Massage Therapy Accreditation/Approval in the United States. They provide a minimum of 500 hours of massage training. Certified therapists have graduated from these programs and passed the national certification examination for therapeutic massage. They are also required to participate in continuing education programs to keep their skills current.

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While there are numerous benefits to this branch of massage, elementsmassage.com reminds you that it is important to keep your expectations for the treatment reasonable. While Deep Tissue massages use more pressure to reach deeper muscle tissues and often yield immediately noticeable results, asking your therapist to apply more pressure and gritting your way through pain will do more damage than good. If you are in pain, your muscles will begin to contract, making the therapist’s efforts moot. Applying more pressure will not speed up the process. Like any treatment, Deep Tissue massages need time to be effective. Keep in mind that the injury or muscle tension that you are hoping to get resolved has had a great deal of time to form; it will take time to undo the damage. Like any treatment, often the therapy will not be enough; including other changes to your life style, such as exercise, relaxation techniques or working on posture in addition to your massage appointments will help move the process along and help you see faster and longer lasting results.
Diagnosing or treating disease would constitute the practice of medicine and would be illegal for anyone who does not have a professional license to do these things. Although many diagnose and treat disease, I am not aware of any prosecutions. In some states that license massage therapists, unlicensed reflexologists might also be prosecutable for practicing massage therapy without a license [11].

Similar to Thai massage, in a Swedish massage the client’s joints and muscles are compressed and stretched. This can cause an immediate release of energy that might cause the skin to flush. Clients might also experience a few temporary aches as the body readjusts itself, depending on their level of flexibility and any current physical ailments. For example, a person who arrives at a practitioner’s office with an ultra-tight muscle that has been traumatized may experience some pain while the trauma is massaged out and worked through. In massage, areas of stress and pain can act as blockages to the body’s circulation, energy flow, and overall well-being.
The best we can say is that there is some reason to believe that painful pressures on muscles might be therapeutic for some people some of the time. Pretty decisive, eh? This is why it drives me nutters that so many therapists insist that strong pressures are “essential” to achieve “a complete release.” It really isn’t possible to know! It really does depend! Why would anyone pretend to “know”?
Another theory that may also explain how reflexology can produce pain relief is the gate control theory, or, more recently, the neuromatrix theory of pain. This theory suggests that pain is a subjective experience created by your brain. The brain does this in response to the sensory experience of pain, but it can also work independently of sensory input and create pain in response to emotional or cognitive factors. Thus things that influence the brain, such as your mood or external factors like stress can also affect your experience of pain. According to this theory, reflexology may reduce pain by reducing stress and improving mood.

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Information on this website is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this website for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Any third party offering or advertising on this website does not constitute an endorsement by Andrew Weil, M.D. or Healthy Lifestyle Brands.  

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It usually depends on the techniques used. Many massage therapists use a form of Swedish massage, which is often a baseline for practitioners. In a general Swedish massage, your session may start with broad, flowing strokes (effleurage) that will help calm your nervous system and relax exterior muscle tension. As your body becomes relaxed, pressure will gradually be increased to relax specific areas and relieve areas of muscular tension. Often, a light oil or lotion is used to allow your muscles to be massaged without causing excessive friction to the skin. Do not hesitate to ask questions or mention if you feel any discomfort so that the massage therapist can use another approach or technique.

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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
When you get off the table, your calves may be screaming at you, but don’t get upset and run home to your foam roller, says Denunzio. Soreness is normal and can even help reveal areas of weakness that should receive future attention. Within 48 hours, the tightness should dissipate, and if the massage was administered correctly, you may even feel like you’re in a new body.

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Massage techniques also include Petrissage, or kneading, which is designed to release toxins from the muscles by lifting, separating, and rolling them. Gentle pressure is used to compress and relax the tissue and enhance circulation. Another technique, Tapotement, involves tapping the muscles with a percussive stroke. The side of the hand, fingers, or palm may be used to release tension and cramping. Many therapists also incorporate vibration, a later technique, which involves the therapist centering his or her hands on the back of a limb and shaking them briskly for several seconds to release tension, encourage circulation, and help muscles to contract.
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.
Bad pain. Bad pain comes with no obvious, immediate benefits. If there is anything good about it, there is no way to tell from the sensation at the time. Bad pains are usually sharp, burning, or hot. Such pain is usually caused by excessive but harmless pressure. As bad as it feels, it probably won’t hurt you — maybe a little bruising — but there’s also a good chance that it won’t be therapeutic either. The big question about bad pain is whether or not it is ever justified.
Posterior interosseous syndrome. Physiopedia explains that posterior interosseous syndrome is a compression of the posterior interosseous nerve, which is located near the shaft of the humerus and the elbow, that may result in paresis or paralysis of the thumbs and fingers. Though cryotherapy, ultrasound, dry needling, and other modalities often help with this condition, so too does deep tissue work that is focused on the thoracic outlet, pectoralis minor, triceps, brachioradialis, and other surrounding areas.
As part if its function, the independently organized American Reflexology Certification Board (ARCB) certifies the competency of reflexology practitioners on an individual basis. The ARCB does not evaluate schools and teachers. Prerequisites for individual certification include completion of educational requirements and passing a standard qualifying examiniation. Successful candidates receive the title of Board Certified Reflexologist.
The day-to-day weight we carry in the form of stress, tension, or physical injury impacts our mind, body, and spirit, often in profound ways. Massagetique was created to help lift those burdens and encourage people to relax, feel good, and heal. By connecting those in need of healing with a massage provider, we hope to contribute to a healthier, happier, and more peaceful world. Learn More About Massagetique

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People do have clear pressure preferences: they often fire massage therapists who give treatments that are too painful or too fluffy. Pressure that’s fine for you may cause severe pain, emotional distress, “sensory injury” (sensitization) in others, or even physical injury, so pressure should be customized but often isn’t. Brutal massages might be appreciated or even helpful, but most people can’t tell the difference between the kind of pain that might be a necessary part of therapy, and ugly pain that is just abusive and dangerous.

Prenatal massage uses mild pressure similar to Swedish massage. The therapist will focus on areas such as your lower back, hips, and legs. You can be fully or partially undressed depending on your comfort level. During the massage, you’ll either lie on your side or on a specially designed table with a cutout for your belly. If you’ve had pain in your calves or other parts of your leg, see a doctor before you have a massage.


The theory of this course will be delivered in class where the student attendance is compulsory whereas the practice session is home-based study. Diploma course of reflexology from this school covers most aspects needed in reflexology field including professional practices, counselling and communication skills, nutrition and other health modalities, practice management skills, and advanced techniques. This school also provides part-time reflexology course.19
The pressure from Swedish massage is ideal for relieving muscle tension, like the kind that builds up from hunching over a computer all day. This tension can sometimes result in knots: trigger points of extremely tense muscle fibers that form tiny nodules. Massage therapists are trained to feel for these knots, and Swedish-massage techniques are ideal for gently coaxing them away.

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Couples massage takes place in a room that is, at the very least, large enough for two massage tables, which is the typical set-up in a day spa. On the other hand, resort and hotel spas often create elaborate environments where couples can not only have side-by-side spa treatments, but also take a bath together, get pedicures, spend time in a steam shower, or lounge by a fire after the treatment. 
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:
An author found that a patient who afflict multiple sclerosis and choose reflexology as the complementary treatment for a period of time had notable symptom relief. It is measured by considering urinary symptoms, parenthesis, spasticity, and muscle strength as the parameters. All parameters showed a remarkable improvement except for muscle strength.30
According to the theory, the reflexologist's application of pressure to feet, hands, or ears sends a calming message from the peripheral nerves in these extremities to the central nervous system, which in turn signals the body to adjust the tension level. This enhances overall relaxation, brings internal organs and their systems into a state of optimum functioning, and increases blood supply (which brings additional oxygen and nutrients to cells and enhances waste removal). It positively affects the circulatory, respiratory, endocrine, immune, and neuropeptide systems in the body.

Before we take the plunge towards the 4 types, we want you to know that there is a basic reflexology area on every individual’s foot. This chart actually describes all the body parts and major organs of the body having reflex points in the foot. After understanding this chart completely, you will be able to massage by focusing on the specific body part. The basic reflexology foot chart includes the whole body. In addition, you must also keep in mind that the right foot is connected to the right side of the body while the left one is linked to the left side.
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.
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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This short course only takes about 60 min to learn the routine of classic Thai Foot Reflexology, which is originated from Chiang Mai, Thailand, together with an instructor who teaches body mechanics and proper techniques. A basic knowledge of Thai Medicine theory, ancestors, well-known influential figures in Thai healing, and the history of Thai foot reflexology are also taught.20
Normally, it is not a painful treatment but if you feel any sort of pain, you must inform your therapist and they will sort it out for you. The chances of pain can be because of your comfort zone; you may not be seated properly or the angle of your feet is not in its natural position. Additionally, therapist will always give more time to the parts that you have discussed about in the beginning. The painful parts are given more priority and pressure is given to the reflex points of those parts.
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!

Each treatment is designed to provide restoration for your body and mind, and also make you look and feel the best you can. Massage can reduce stress and muscle tension, improve circulation, eliminate stiffness and soreness, boost the immune system, reduce pain and even help control one’s blood pressure. Couples who strive to practice a healthy lifestyle can enjoy these benefits and more together.
Some sports massage therapists use myofascial techniques that focus on stretching the fascia, which are connective tissues surrounding muscles, tendons and ligaments in the body. This particular massage technique involves the therapist applying forces in opposing directions which relaxes the tissues. It can help ease pain and increase mobility in the tissues and surrounding muscles.

A person receiving a deep tissue massage usually lays on the stomach or back in one position, while deep pressure is applied to targeted areas of the body by a trained massage therapist. The massage is beneficial mostly because it helps stimulate blood flow and relieve muscle tension, while at the same time lowering psychological stress and releasing “happy hormones” like serotonin and oxytocin.

The day-to-day weight we carry in the form of stress, tension, or physical injury impacts our mind, body, and spirit, often in profound ways. Massagetique was created to help lift those burdens and encourage people to relax, feel good, and heal. By connecting those in need of healing with a massage provider, we hope to contribute to a healthier, happier, and more peaceful world. Learn More About Massagetique

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Muscles are layered on top of each other and over lap. Some muscles are right on the surface like your rectus abdominis (six pack ab muscles), and some are much deeper in the body like your Psoas muscle (deep hip flexor). So a DTM implies that the therapist is not just working on the superficial musculature, but reaching layers of muscle and fascia (connective tissue) further below the surface.
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]

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A couples massage can make a romantic gesture or gift for a close friend or loved one. During the experience, two therapists work side-by-side to sweep away aches and stresses from both people.. While therapists often use Swedish massage techniques, individual experiences are often customizable. Couples massages are centered on bonding together through relaxation. Book a couples massage near you through one of our deals and enjoy a relaxing afternoon with someone you love.

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Deep-tissue massage helps ease stress and tension, which can have a beneficial effect on blood pressure. People who had a deep-tissue massage saw their systolic pressure drop by an average of 10.4 mm Hg and their diastolic pressure drop an average 5.3 mm Hg, according to a study cited by the University of Maryland Medical Center. Deep-tissue massage can help increase the body's production of serotonin, the hormone that promotes happiness and good feelings.

In all cases, such massage techniques are employed in collaboration with other appropriate medical care. For example, encouraging circulation around a bruise, but not directly on it, through the use of compression, cross-fiber techniques or even long, deep strokes is only used after appropriate medical referral and diagnostics indicate that there are no clots formed in the area which may embolize.
Foot Reflexology massage can be a deeply relaxing and therapeutic modality for those suffering from plantar fasciitis, ankle injuries or even everyday work and play. At Massage Envy, your massage therapist will apply traditional Swedish and sports massage techniques to the foot, calf and upper leg. This will not only help relieve toe pain, ankle pain, plantar fasciitis and common forms of arthritis, but can also decrease stress and anxiety in the entire body. In addition, a variety of stretches can be beneficial. With pain and sensitivity in the foot, heel and calf areas, be sure to communicate your pain levels with your massage therapist during your treatment. It is also a good idea to rest after receiving the reflexology massage.
Until better evidence is published in peer reviewed journals, he remains skeptical of claims that by massaging or applying pressure to specific points on the hands or feet, a reflexologist can alleviate problems in corresponding organs or other systems throughout the body. He has seen no evidence showing that reflexology is effective for pain or any health problems unrelated to the feet and hands. He urges caution with regard to claims that reflexology can cleanse the body of toxins, increase circulation, promote weight loss, or successfully treat earaches, hemorrhoids, emphysema, heart disease, thyroid disorders or any other health condition.
Deep tissue massages are not for everyone, and it’s very important to find a well-trained therapist. If you’re actively healing from surgery, have nerve damage or an existing injury, you’re wearing a cast or brace, or you’re pregnant, then talk to your doctor before seeking a massage therapist. Although it’s rare, massages that are poorly performed can sometimes cause increased pain, inflammation and other complications in high-risk patients. (16)

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A study by an author found that patients who suffered from low back pain usually show good effect in terms of their pain management when they have reflexology as the complementary treatment.25 In this study, the author used VAS scores to indicate the level of pain of the patient. The author added that this complementary treatment can be used as one of the treatment to reduce low back pain but further study on it must be conducted.23
DTM can be useful to those that are recovering from an injury (once the client/patient is out of the acute phase), for athletes, for people with postural strains, or people with chronic pain. Typically there is an area or a few areas where this type of work is needed. For example, a person who has chronic postural pain/tightness from sitting at a computer, might need DTM to their shoulders, chest, and upper back/neck. They likely, do not need DTM on their whole body. Some therapists might disagree with me here, but I rarely think a full-body, DTM, is needed. It can simply be too much. I would rather see a client more often, for less-intense sessions. It is simply more effective. It is the same as Physical Therapy- it is more effective to do it regularly.
Reflexology is sometimes referred to as a massage, but it is not a massage in the typical sense of the word. Massage involves applying pressure over large sections of the body to target the muscular and circulatory systems. Reflexology, on the other hand, focuses on pointed, specific areas of the feet, hands and ears. It can target not only the main body systems that massage affects but also specific organs, like the liver, bladder and kidneys.

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Reflexologists work from maps of predefined pressure points that are located on the hands and feet. These pressure points are reputed to connect directly through the nervous system and affect the bodily organs and glands. The reflexologist manipulates the pressure points according to specific techniques of reflexology therapy. By means of this touching therapy, any part of the body that is the source of pain, illness, or potential debility can be strengthened through the application of pressure at the respective foot or hand location.

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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.
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.
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).

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Diagnosing or treating disease would constitute the practice of medicine and would be illegal for anyone who does not have a professional license to do these things. Although many diagnose and treat disease, I am not aware of any prosecutions. In some states that license massage therapists, unlicensed reflexologists might also be prosecutable for practicing massage therapy without a license [11].
“It is your body, your session, your outcome,” advises Rotenberger. “There’s a fine line between pain and discomfort, and it’s unique to the individual.” What’s more, deep pressure is not the same as deep tissue. It’s a common misconception, Rotenberger explains, and in reality, a therapist that is muscle-specific needs to exert little pressure to be effective. 
Using a wide variety of tools including bands, combs, electricity, hooks, light energy, probes and stainless steel instruments to stimulate various pain-killing responses in the hands and feet, FitzGerald’s work was first brought to the public by Edwin Bowers in his 1915 article, “To stop that toothache, squeeze your toe,” which was published in Everybody’s Magazine. (15)
That is, regardless of all other considerations, a massage therapist must talk to you about pressure, respect your preferences (they are more important than any treatment ideology), and be careful about stumbling into areas that need much less pressure (for comfort) or much more pressure (for satisfaction). Far too many therapists make the mistake of setting a “default” pressure for a client early on, and then using roughly that much pressure everywhere.
Deep tissue massage is best suited for people who engage in highly physical activities, such as running, or those who have an injury or chronic pain. If you have a low pain threshold or are looking for relief of tense muscles, Swedish massage is gentler and may be a better option. Speak to your doctor before trying deep tissue massage if you have an underlying medical condition.

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Sports massage can be an interesting career choice for therapists who want to do it full time. Professional sports teams often have massage therapists on staff to keep athletes' bodies working at their very best. It helps to have a keen interest in anatomy and physiology, advanced training and experience in sports massage, an interest in sports, and a desire to work with athletes.
  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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Deep tissue massage is best suited for people who engage in highly physical activities, such as running, or those who have an injury or chronic pain. If you have a low pain threshold or are looking for relief of tense muscles, Swedish massage is gentler and may be a better option. Speak to your doctor before trying deep tissue massage if you have an underlying medical condition.

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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:


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.

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Certain massage therapists have specialized training in techniques that help treat people with injuries, inflammation, tears and limitations. Although more than one massage session is usually needed to provide relief and see improvements in pain, well-trained therapists can usually recommend practices or stretches for you to try at home that can further help improve healing.
There is absolutely a time and a place for DTM, the problem is that everyone has a different idea of what this means. Some therapists go after deep fascial layers, some therapists think this means trigger point work, and some just increase pressure as much as they can. If the client and therapist don’t have an open dialogue with clear instructions of when ‘enough is enough’, the client can experience a lot of discomfort and we don’t want that.

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With thumb walking you're basically going to be using the little part of, just this joint. Right, so you'll just be doing that. A lot of times people will say to kind of come up and back down. I want to really stress that if you can come down and maintain pressure and just come up a little bit and then back down again. So, you are moving infinitesimal, you're barely moving. You can practice on your forearm here. You're going to be doing that. So you're just inching ahead and again you're not going to pop up. A lot of people when they are teaching that, they pop up, so just be sure not to do that.

Each type of sports massage uses different massage techniques. Effleurage is a light stroking that can be performed with the palms or the thumbs. The pressure and speed is varied depending on the muscle and the desired result. Effleurage increases blood flow to the muscle. Petrissage is a form of two-handed kneading in which both hands pick up the muscle and compress it. This technique loosens tight bunches of muscles. Percussive strokes are blows or strikes on the muscle, often performed with the little fingers. They are used to tone the muscles. Cupping involves percussing or striking the muscles with cupped hands. It stimulates the skin and causes muscle contractions that help tone the muscles. There are variations on all these strokes, such as deep cross-fiber friction to separate muscle fibers and break down scar tissue, and jostling to relieve muscle tension. A good sports massage therapist will combine techniques to achieve the maximum desired result. Sports massage sessions generally last 30-60 minutes.

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