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?


There are many types of massage therapy, from classics like Swedish and deep tissue to more exotic styles like shiatsu. Whether you'd like to branch out a bit or have a health condition or injury, choosing a style of massage can be confusing if you're not quite sure what it involves. Here is a list of the most popular types of massage (including some that may be new to you).
Sports massage is given within the four hours preceding an event to improve performance and help decrease injuries. It is used as a supplement to an athlete’s warm up, to enhance circulation, and reduce excess muscle and mental tension prior to competition. It is normally shorter (10-15 minutes) than a regular conditioning massage, and focuses on warming up the major muscles to be used and getting the athlete in a good mental state for competition. It also improves tissue pliability, readying the athlete for top performance. Certain massage techniques can help calm a nervous athlete; others can be stimulating. Post-event sports massage is given after a competition and is mainly focused on recovery. It is geared toward reducing muscle spasms and metabolic build-up that occur with vigorous exercise. Recovery after competition involves not only tissue normalization and repair, but also general relaxation and mental calming. A recovery session can range from 15 minutes to 1.5 hours in length. For more, see our Comprehensive Guide to Massage.
These improvements are achieved via a range of techniques. When analyzing and treating a person’s injury or symptoms, a Sport Massage Therapist studies root causes carefully as an injury to one part of the body may be connected to another. Some of these areas can seem strange to work on given the specific case scenario, however a Sport Massage Therapist will explain the reasons to you.

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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)
The therapist may utilize some Swedish techniques to warm up the tissues (kneading, friction, percussion), softening the superficial layers so that he or she can access the deeper ones more easily. Then, with little or no lotion, the therapist utilizes the hard surfaces of their hands and arms — surfaces such as fingers, knuckles, forearms, and elbows — and employs a very slow, sustained type of stroke.

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Finding time for each other, let alone massages, can be difficult for couples with busy schedules. By pairing massage sessions with quality bonding time, couples can accomplish two goals at once and emerge relaxed, refreshed and reconnected. A couple’s massage is a wonderfully relaxing, personal experience. Leave the ‘real world’ behind the walls of Le Reve Rittenhouse Spa.
“If your hands and fingers start to scream while you're working, you need to modify what you're doing,” says Bykofsky. “Also, if you notice that you’re sore at the end of your work day, Bykofsky also recommends that you “do the things you suggest to your clients: ice, apply something to help, perhaps take an anti-inflammatory, and, the hard one, rest!”  

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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.
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.
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Addressing anything from headaches to sinus problems to stomach issues, if sensitivity or tenderness is experienced when certain areas of the foot are stimulated, it usually indicates bodily weaknesses or imbalances within the corresponding organ. With repeated practice of applying pressure and manipulating nerve endings (traditionally in the foot), reflexology can help to clear any channels of blocked energy through moving the flow of blood, nutrients and nerve impulses to ultimately improve overall health and balance. In addition to manipulating the pressure points on the foot, reflexologists sometimes work on the hands or ears to trigger relaxation as well. 

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When you think of a massage, you probably think of soothing music, a gentle brush of hands softly kneading the stress from your shoulders, maybe even of a loved one offering to rub your back after a long day at work. While some massages can be soothing, and rely on gentle touches to work out a client’s stress or anxiety, there are other massages that have a little more grit to them. For example, the Deep Tissue massage, which is very similar in style to the Swedish massage, utilizes some of the same techniques as its much gentler cousin; Deep Tissue massages, however, are designed to focus on the deeper layers of muscle tissues and fascia, the protective layer that surrounds muscles and joints. Working out these harder to reach muscles will require more pressure, making the Deep Tissue massage slightly uncomfortable, gritty and highly effective.
“Runners put so much effort into training, but very few athletes put effort into taking good care of body that helps them perform,” says Gammal, who recommends incorporating regular massage—even if it’s just a 30-minute session once a month—so as to prevent injuries and the overtraining of muscles.  Scheduling mid-training appointments can also reveal places that are tight and places that should be addressed in post-workout stretching. “Massage isn’t a luxury, Gammal says. “It’s an investment.”

My massage therapist has been doing massages for 30 years. He is really aggressive. I thought that I was going to die. The pain was so intense that I honestly feel that it was worse than having children. When the massage was complete, I felt relaxed. When I got home I felt exhausted, like I had been in a major accident. Truthfully I feel like crap. I ache from head to toe, what the heck is this? I feel absolutely horrible. I had a bath before bed and it did help somewhat. But this morning I still feel like hell …
The whole Swedish experience is also a potential stress reliever, which is a benefit unto itself. Plus, it can improve blood flow, delivering more oxygen to cells. A lesser-known benefit—moisturized, glowing skin—results from the application of massage oils. Many therapists prefer to use sweet almond oil because it absorbs slowly into the skin, yet doesn’t leave clients feeling like they’re covered in grease. Other favorite oils include grapeseed (non-greasy, no smell) and jojoba oil (easily absorbed, mixes well with aromatherapy oils).

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A traditional Swedish massage involves the whole body. You will begin on either your back or your stomach and flip over at the halfway point. If you have an area of particular concern, such as a tight neck, you can ask your therapist to spend more time in this area. Depending on your preferences, you can ask your massage therapist to use light, medium, or firm pressure.

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Pregnancy massage is a therapeutic massage tailored specifically to the needs of a pregnant woman’s body. Before having a prenatal massage, always check in with your prenatal care provider and ask if massage therapy will be safe for you and your pregnancy. A pregnancy massage is much more than just an indulgence. The specialized strokes and techniques used to loosen tight muscles, reduce swelling, alleviate pressure, and ease tension provide positive health benefits for both you and your baby. Experts recommend finding a massage therapist who has received additional training on prenatal massage techniques. This is typically a certification above and beyond their standard massage therapy certification and training requirements. During the massage you will likely lie on your side or in a semi-reclined position; these supported poses keep you and the baby comfortable and free from strain or undue pressure. During the massage, the therapist will listen to what body challenges you are experiencing and work to release tension. The massage should be a relaxing and very soothing experience.

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But the relief model is certainly tempting. There are many painful-but-relieving analogies in medicine and biology.15 That’s similar to what good pain in massage feels like, but it’s not the same: no one thinks that lancing a boil or popping a shoulder joint back in is anything but painful while it’s happening.16 And we can’t necessarily take the good pain sensation at face value and assume it means there’s actually going to be a positive outcome. Brains are not all-knowing. Sometimes they see danger where there is none, and sometimes they see help where there is none.

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As for the basics of how it works, foot reflexology simply refers to the reflexes that have been mapped out in the foot. There are many different foot reflexology charts that show where the reflexes are for every part of the body. Although it is like a massage, its principles are entirely different. It is thought that reflexology works through nerve endings, while massage focuses on the muscles and soft tissue of the body. This is where the practice gets its name; it works on the reflexes, not just the skin, muscle, or tissue. It should not be painful, though like in a massage there could be stressed areas of your body that are more tender or uncomfortable. However, the applied pressure to those areas, the less tender they will become.

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When you are looking for massage therapy, be sure to check which type of massage a practitioner can provide. Match that with the benefits you hope to get from the massage session. You may want to chat with several different practitioners to find the one who understands your needs and is used to working with people with similar goals. Be sure also to discuss any allergies, such as to scents or plant oils, so your massage will be relaxing and beneficial without that concern.

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Pain management. If you have a condition like sciatica or osteoarthritis and are suffering from chronic pain as a result, Swedish massage can be an effective method for managing that pain in a natural way. Notify your massage therapist about your pain points, he or she can target those areas and use a stroking motion to improve local circulation and reduce muscle tension.
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)

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Peer-reviewed medical research has shown that the benefits of massage include pain relief, reduced trait anxiety and depression, and temporarily reduced blood pressure, heart rate, and state of anxiety.[80] Additional testing has shown an immediate increase and expedited recovery periods for muscle performance.[81] Theories behind what massage might do include enhanced skeletal muscle regrowth and remodeling,[82] blocking nociception (gate control theory),[83] activating the parasympathetic nervous system, which may stimulate the release of endorphins and serotonin, preventing fibrosis[84] or scar tissue, increasing the flow of lymph, and improving sleep.[10][85]


Massage is the manipulation of soft tissues in the body. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. A person who was professionally trained to give massages was traditionally known as a masseur (male) or a masseuse (female), but those titles are outmoded, and carry some negative connotations. In the United States, the title massage therapist has been recognized as a business norm for those who have been professionally trained to give massages.
Alhough he was a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association at the time, Pietrunti says that he ultimately decided to pursue licensure in massage therapy as well. This provided that missing link while also being “a good way to ‘bridge the gap’ and provide a better service to my clients,” he says.
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In Mexico massage therapists, called "sobadores", combine massage using oil or lotion[102] with a form of acupuncture and faith.[103] Sobadores are used to relieve digestive system problems as well as knee and back pain.[102][103] Many of these therapists work out of the back of a truck, with just a curtain for privacy.[103] By learning additional holistic healer's skills in addition to massage, the practitioner may become a curandero.[104]

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Maintenance sports massage is done at least once a week as a regular part of athletic training programs, although professional athletes who have their own massage therapists may have maintenance massage daily. Maintenance massage increases the flow of blood and nutrients to the muscles. It also keeps the tissues loose so that different layers of muscle slide easily over each other. Maintenance sports massage also helps reduce the development of scar tissue while increasing flexibility and range of motion.
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Reflexology (or foot reflexology) is a therapy based on the principle that there are small and specific areas of innervation in the hands and feet that correspond to specific muscle groups or organs of the body. In this system, the nerve endings in the extremities provide a “map” of the rest of the body. Examples are the base of the little toe representing the ear, or the ball of the foot representing the lung. Through the application of pressure on particular areas of the hands or feet, reflexology is said to promote benefits such as the relaxation of tension, improvement of circulation, and support of normalized function in the related area in the body.

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