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.

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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.
Superior communication skills: Massage therapy is not just about using your massage skills to improve a client’s physical condition. As a therapist, you must be able to clearly and effectively communicate with them to make sure you are being receptive to their needs and creating a comfortable environment for them. Massage therapy appointments should begin with a consultation that discusses what the client expects from you and what you can help provide. It is important that you discuss any health issues clients might have or if they are experiencing pain or discomfort in any part of their body. This will help determine the types of massage techniques you can use during the session.
In another study, researchers took muscle biopsies from participants who had received massage therapy or no treatment for exercise-induced muscle damage. The study showed that massage therapy reduced inflammation and promoted mitochondrial biogenesis in the skeletal muscle. In addition, a review published in the journal “Complementary Therapies in Clinical Practice” revealed that moderate pressure massage reduced depression, anxiety, heart rate, and cortisol levels and altered EEG patterns to indicate a relaxation response.
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.
Forty-three states, the District of Columbia and five Canadian provinces currently offer some type of credential to professionals in the massage and bodywork field—usually licensure, certification or registration.[79][118] Thirty-eight states and the District of Columbia require some type of licensing for massage therapists.[119] In the US, 39 states use the National Certification Board for Therapeutic Massage and Bodywork's certification program as a basis for granting licenses either by rule or statute.[120] The National Board grants the designation Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). There are two tests available and one can become certified through a portfolio process with equivalent training and experience.[121] Between 10% and 20% of towns or counties regulate the profession.[97] The National Certification offered by the NCBTMB does not mean that someone can practice massage in any state.[122] These local regulations can range from prohibition on opposite sex massage, fingerprinting and venereal checks from a doctor, to prohibition on house calls because of concern regarding sale of sexual services.[97][123]
The study involved 263 volunteers with an average age of 48.5. Overall muscle spasm/muscle strain was described as either moderate or severe for each patient prior to treatments, which consisted of a massage between 45–60 minutes in duration. Results demonstrated an average systolic pressure reduction of 10.4 mm/Hg, a diastolic pressure reduction of 5.3 mm/Hg, a mean arterial pressure reduction of 7.0 mm/Hg and an average heart rate reduction of 10.8 beats per minute following massage treatment. (6)
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.

Practices resembling reflexology may have existed in previous historical periods. Similar practices have been documented in the histories of China and Egypt.[9] Reflexology was introduced to the United States in 1913 by William H. Fitzgerald, M.D. (1872–1942), an ear, nose, and throat specialist, and Edwin F. Bowers. Fitzgerald claimed that applying pressure had an anesthetic effect on other areas of the body.[16][17] It was modified in the 1930s and 1940s by Eunice D. Ingham (1889–1974), a nurse and physiotherapist.[18][19] Ingham claimed that the feet and hands were especially sensitive, and mapped the entire body into "reflexes" on the feet, renaming "zone therapy" reflexology.[20] "Modern reflexologists use Ingham's methods, or similar techniques developed by the reflexologist Laura Norman."[9]


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.
Sports massage is a good option if you have a repetitive use injury to a muscle, such as what you may get from playing a sport. It’s also a good option if you’re prone to injuries because it can be used to help prevent sports injuries. You may also use sports massage to increase flexibility and performance. Additionally, sports massage can be used to relieve pain, anxiety, and muscle tension.

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The pressure used during a Swedish massage therapy help to relax the muscles and relieve all of the tension that has built up. The touch of the skin also helps to relax the person and to clear their mind of anything that might be bothering them. Therapists suggest a Swedish massage to anyone who is feeling run down or suffering from mild depression.


Hepatic hematoma. Hepatic hematoma is a painful liver condition, which The New England Journal of Medicine says has been instigated by deep tissue massage. In this case, a 39-year-old woman received a deep tissue massage, which included the abdomen and right upper quadrant. Within 24 hours, she developed abdominal discomfort, nausea, and pain in her right shoulder. A large hematoma was found in her right hepactic lobe, causing the woman to feel nauseous and have a fever for the following six months.
The pathways postulated by reflexologists have not been anatomically demonstrated; and it is safe to assume that they do not exist. Similar rationales are used employed by iridologists (who imagine that eye markings represent disease throughout the body) and auricular acupuncturists who "map" body organs on the ear (a homunculus in the fetal position). The methodology is similar in both of these; and some commentators consider pressing on "acupuncture points" on the ear or elsewhere to be forms of reflexology, but most people refer to that as acupressure ("acupuncture without needles). The Reflexology Research Web site displays charts for foot and hand reflexology. The fees I have seen advertised have ranged from $35 to $100 per session.
Post-event massage is usually given 1–2 hours after the competition is over in order to give dilated blood vessels a chance to return to their normal condition. Post-event massage is light and gentle in order not to damage already stressed muscles. The goal is to speed up removal of toxic waste products and reduce swelling. Very light effleurage will decrease swelling while light petrissage will help clear away toxins and relieve tense, stiff muscles. Post-event massage can be self-administered on some parts of the body, such as the legs.
As for the commonly held belief that extra liquids are needed post-massage: that’s a myth, explains Gammal. “Massage does not release or flush out any toxins from the body, which means it won’t dehydrate you. Massage helps with recovery from lactic acid but doesn’t get rid of lactic acid.” Post-massage, you can just resume your normal hydration habits.

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The Couples Massage at Le Reve Rittenhouse Day Spa is Philadelphia’s romantic escape for couples wishing privacy to enjoy each other’s company while indulging in Gourmet Chocolates and sipping on sparkling Champagne in a calming, relaxing atmosphere. Le Reve Rittenhouse Day Spa offers luxurious couples massage packages. Some couples enjoy being together every minute of the day. Others prefer going their own way, then meeting for special experiences. Either way, a romantic couple’s massage makes a wonderful gift. The gift might be for a big event like a wedding or anniversary. It might be a reminder that, even with the arrival of a new baby or with the departure of a new graduate, time spent together is still important. Surprise your partner with a trip to the best spa in Philadelphia for a rejuvenating Couples Massage. To find the best spa for couples massage in Philadelphia, look no further, Le Reve Rittenhouse Day Spa is here to satisfy your wishes.

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Reflexology is a practice in which different amounts of pressure are applied to specific points on the feet or hands. These points are believed to match up with certain other parts of the body. Reflexology is claimed to cause relaxation and healing in those parts of the body, but this has not been proven. In a study funded by the National Cancer Institute, women with advanced breast cancer who received reflexology treatments showed improvement in a few symptoms, such as shortness of breath, but not others, such as nausea or pain. In this study, reflexology was safe even for the most fragile patients.
There are many systems of reflexology, some with very different approaches and points. This is the system we use the most. The therapist will use many of the points below during your session. If you are interested in self care between visits, feel free to ask your therapist how to apply pressure to certain points at home, and how often you should do so.
It’s just a theory: no one knows if this is actually effective.11 However, it may explain why so many massage patients report a “gets a bit worse before it gets much better” response to quite painful treatments: motor end plates are (painfully) destroyed by strong pressures, and then that tissue is quite sensitive and a bit weak as it heals over a day or two … and then you finally feel much better after that!
...It is very important to ALWAYS speak up and let your therapist know if you need the pressure to be corrected, (i.e. if you need them to lighten up because it is too deep, or to apply more because it is not deep enough). Most everyone needs more pressure in some areas and less in others. This occurs because muscle tissue that contains Trigger Points is more sensitive to pressure and can be tender to the touch.

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REAL MASSAGE TECHNIQUES, FOR COUPLES. Most couples don’t have the patience to give a 60-minute massage. It’s a long time, a lot of massage strokes to remember and to the novice, its a lot of stress on your hands – this is best left to the professional. Most of us couples just want to know how to give great back rubs. MELT teaches you how to give a 5-minute, 15-minute and epic 30-minute back rub without a sore thumb in sight. It’s delicious!
Post-event sports massage is given after a competition and is mainly concerned with recovery. It is geared toward reducing the 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 might be 15 minutes to 11/2 hours in length. Post-event sports massage is given after a competition and is mainly concerned with recovery. It is geared toward reducing the 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 might be 15 minutes to 11/2 hours in length. 

Research published in the Journal of Sports Medicine and Physical Fitness reported findings of a positive trend for deep tissue massages in regard to improved athletic recovery and performance. The most beneficial type of deep tissue massage for athletes is considered to be “sports massage,” which is commonly performed prior to athletic events to help warm the body and prevent injuries or immediately after to improve recovery.
In Germany massage is regulated by the government on a federal and national level. Only someone who has completed 3,200 hours of training (theoretical and practical) can use the professional title "Masseur und Medizinischer Bademeister" or Medical Masseur and Spa Therapist. This person can prolong his training depending on the length of professional experience to a Physiotherapist (1 year to 18 months additional training). The Masseur is trained in Classical Massage, Myofascial Massage, Exercise and Movement Therapy. During the training they will study: Anatomy, Physiology, Pathology, Gynecology, Podiatry, Psychiatry, Psychology, Surgery, and probably most importantly Dermiatry and Orthopedics. They are trained in Electrotherapy, and Hydrotherapy. Hydrotherapy includes: Kneipp, Wraps, underwater Massage, therapeutic washing, Sauna and Steambath. A small part of their training will include special forms of massage which are decided by the local college, for example: Foot reflex zone massage, Thai Massage etc. Finally a graduate is allowed to treat patients under the direction of a doctor. He is regulated by the professional body which regulates Physiotherapists. This includes the restriction on advertising and oath of confidentiality to clients.[citation needed]

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While this massage is designed to help ease the 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.”

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.


BC 500 Jīvaka Komarabhācca, also known as Shivago Komarpaj, the founder of Traditional Thai massage (Nuad Boran) and Thai medicine.[citation needed] According to the Pāli Buddhist Canon, Jivaka was Shakyamuni Buddha's physician.[citation needed] He codified a healing system that combines acupressure, reflexology, and assisted yoga postures.[citation needed] Traditional Thai massage is generally based on a combination of Indian and Chinese traditions of medicine. Jivaka is known today as "Father Doctor" in Thailand.[citation needed]

A typical reflexology session runs from thirty to sixty minutes. Shoes and socks are removed, and the client is made comfortable, usually by sitting or reclining. Some reflexologists offer a foot bath at the beginning of the session, however, no lotions or oils are used. Pressure is applied in thumb-and-finger “walking” patterns, resulting in gentle stretching and massaging of specific zones of the hands and feet that are thought to correspond to body organs. Simple self-care instructions may be discussed at the completion of the session.
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.

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]


According to the National Center for Complementary and Integrative Health (NCCIH), this includes individuals with bleeding disorders, low blood platelet counts, or those who are taking blood thinning medications. When these types of conditions are present, the NCCIH indicates that a sports massage with deep tissue work is generally not recommended.

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For example, I worked on the Indiana Sports Massage Team starting in 1989, as well as the NCAA Swimming & Diving Championships and National Championships. I coordinated massage for the 1992 Olympic Trials and was on the 1996 Olympic Massage Team for the Atlanta Olympics—the first time massage therapy was part of the medical staff for the Olympics. These were all volunteer positions, but I loved it!

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