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]
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.
Flushing. If massage can “improve” any tissue — unknown — one way it might do it is through simple hydraulics: physically pumping tissue fluids around, and/or stimulating the circulation of blood and lymph. I won’t get into the evidence about it here. Suffice it to say that it might be true, and if it’s true then it may not much matter if the process is uncomfortable. While gentler massage may feel pleasant and satisfying, it is possible that more biological benefits can only be achieved hydraulically — whether it’s comfortable or not. This is even more plausible because of trigger points: it’s likely that the tissue fluids of a trigger point are quite polluted with waste metabolites, and the need for flushing is greater, but it’s especially uncomfortable to squish those polluted patches of tissue.
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.
Pregnant women should put their reflexology treatments on hold. "There are reflex points that can stimulate uterine contractions," says Colin. "You also don't want to do anything if the foot's already injured or unhappy," so recent foot surgery or plantar fasciitis flares are contraindications. He's also hesitant to work on anyone who isn't a candidate for traditional massage, such as those with blood-pressure issues.
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.

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There is not necessarily a hard line between these two techniques, and many sessions often incorporate both depending on your needs. It is usually the case that not all the muscles in your body need deep tissue techniques applied. Rather than being overly concerned with choosing the “right” session, make sure you communicate to your therapist the goals for your session so that he or she can customize the right blend of techniques for you. One massage style is often the foundation of the session, with other techniques used as needed. Due to the slow pace of deep tissue massage it is necessary to schedule a 90-minute session if you would like your full body addressed. Use these guidelines for communication based on your primary goal for the session:
Biomechanical stimulation (BMS) is a term generally used for localised biomechanical oscillation methods, whereby local muscle groups are stimulated directly or via the associated tendons by means of special hand held mechanical vibration devices. Biomechanical oscillation therapy and training is offered in a variety of areas such as competitive sports,[37] fitness, rehabilitation,[38] medicine,[39] prevention, beauty, and used to improve performance of the muscles and to improve coordination and balance. It is often used in the Myofascial trigger point therapy concept to invoke reciprocal inhibition within the musculoskeletal system. Beneficial effects from this type of stimulation have been found to exist, the efficacy of the BMS Matrix therapy was proven in an independent study.[40] carried out by TÜV-Süd which was commissioned by German health insurer BKK Gesundheit.

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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At certain times during the massage, you may feel some discomfort or even some pain as the massage therapist works on areas where there are adhesions or scar tissue. Pain isn't necessarily good, and it's not a sign that the massage will be effective. In fact, your body may tense up in response to pain, making it harder for the therapist to reach deeper muscles.


No. Bottom line, massage should never hurt if you don’t want it to. Some clients specifically say that they do not want to be in pain, and that should be respected. However, there are certain techniques that might cause discomfort. If the client and therapist communicate and agree on increased pressure, you can incorporate these deeper or more aggressive techniques into the massage. They can cause a little pain at the time, and a little bit of soreness the next day. I like to compare it to how you feel after a good workout. A good Massage Therapist will also be very skilled at warming and softening the tissue layer by layer to decrease the amount of pain felt by the client.
Middle-Ages: Medical knowledge, including that of massage, made its way from Rome to Persia in the Middle Ages.[citation needed] Many of Galen's manuscripts, for instance, were collected and translated by Hunayn ibn Ishaq in the 9th century. Later in the 11th century copies were translated back into Latin, and again in the 15th and 16th centuries, when they helped enlighten European scholars as to the achievements of the Ancient Greeks. This renewal of the Galenic tradition during the Renaissance played a very important part in the rise of modern science.
One difference, however, is that you may not want to drift off the same way you might during a conventional massage. "The only times I run into issues with people not liking their treatment is when they just plop down on the table and go to sleep," Colin says, adding that you should "be honest with your therapist, let them know what your goals and expectations are, and have that conversation."
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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.”
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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Deep Tissue massage is much more muscle-tissue focused. Specifically for pain relief, deep tissue massages are characterized by much deeper pressure. They’re great for removing knots and breaking up scar tissue, making them a favorite of athletes, as well as those who do manual labor like heavy lifting, farming or repair work. Unlike the Swedish massage that just works on the top layer of muscle, a deep tissue massage works through to get to the deeper layers of muscle tissue.

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Like having your feet worked on? The therapist uses finger pressure and techniques such as kneading and rubbing to promote relaxation and healing in the body. Reflexology is based on "reflex areas" on the hands and feet, whose energy is believed to be connected to organs and other body parts. By applying pressure to the reflex points, the reflexologist can balance your nervous system and stimulate endorphins, the body's natural pleasure response, which reduces stress and discomfort.


A sports massage is typically a combination of several massage techniques that are tailored to your affected muscle groups based on the activities that you do. A properly administered sports massage can help flush the lactic acid out of your body. There are two types of sports massages that can benefit triathletes depending on when you schedule your appointment and your race schedule.
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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Once play begins, the massages start. Players can sign up for 30, 60 or 90 minutes of specific massage. If not scheduled for a massage session, massage therapists work in the training room doing spot treatments, warm ups or flushes, and even paperwork. It is not uncommon in the middle of the week to have a few days that go until 12:00 am or later. It is intense, but the days fly by and it is tremendously exciting.

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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:

Thai massage works your entire body. It's one of the most invigorating types of massages, as the therapist rigorously manipulates your body, moving it into yoga-like stretches. (It's sometimes referred to as "Yoga for the lazy".) The therapist uses every part of his or her body—hands, knees, legs, and feet—to not only stretch you but also apply pressure on your muscles and loosen your joints. You might even get walked on! This type of massage is both energizing and, at times, relaxing.
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Ever gone to a county fair, music festival, or conference and envied other people getting chair massages? Passed by the chair massage section in an airport? Or, maybe you're lucky enough to work at a company that offers 15- to 20-minute massages as a regular benefit. Onsite, chair massages are done while you're seated fully clothed in a portable, specially designed chair. They usually involve a massage of your neck, shoulders, back, arms, and hands.
If you feel that you would benefit from experiencing a Deep Tissue massage, do some research into local spas around you that offer the treatment. Make sure that your therapist is certified and has been trained in this technique. As always, check with your doctor before giving this massage a try. Be sure to share your concerns with your therapist, go into detail as to what has brought you in to seek the treatment and do not be afraid to speak up if the pressure becomes too uncomfortable. Remember, more pain does not mean the massage is working.
One risk is clearly neurological and complex: some people are basically sitting ducks for the well-documented and nasty phenomenon of “central sensitization,” and indeed may already be in pain and seeking help because of it. A strong massage can severely aggravate that situation, with long term and extremely unfortunate consequences. It’s rare, but it happens. The typical clinical scenario here is a gung-ho under-trained therapist over-treating someone in, say, the early stages of fibromyalgia. Bad, bad, bad.

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Reflexology is based on an absurd theory and has not been demonstrated to influence the course of any illness. Done gently, reflexology is a form of foot massage that may help people relax temporarily. Whether that is worth $35 to $100 per session or is more effective than ordinary (noncommercial) foot massage is a matter of individual choice. Claims that reflexology is effective for diagnosing or treating disease should be ignored. Such claims could lead to delay of necessary medical care or to unnecessary medical testing of people who are worried about reflexology findings.

Challenges include breaking into the sports arena. Often, massage is not viewed as a primary service. If you do get in with a team or individual, the travel schedule can be daunting; long hours, little sleep, and being away from your family and business can be really difficult. Finally, the work can be very physically challenging. This can take a toll on the massage therapist, so exceptional body mechanics and self-care are essential.


One risk is clearly neurological and complex: some people are basically sitting ducks for the well-documented and nasty phenomenon of “central sensitization,” and indeed may already be in pain and seeking help because of it. A strong massage can severely aggravate that situation, with long term and extremely unfortunate consequences. It’s rare, but it happens. The typical clinical scenario here is a gung-ho under-trained therapist over-treating someone in, say, the early stages of fibromyalgia. Bad, bad, bad.

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Many types of practices are associated with massage and include bodywork, manual therapy, energy medicine, neural mobilization and breathwork. Other names for massage and related practices include hands-on work, body/somatic therapy, and somatic movement education. Body-mind integration techniques stress self-awareness and movement over physical manipulations by a practitioner. Therapies related to movement awareness/education are closer to dance and movement therapies. Massage can also have connections with the New Age movement and alternative medicine as well as holistice philosophies of preventative medical care, as well as being used by mainstream medical practitioners.
“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.”

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