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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Beyond the feel-good effects of the treatment, the practice and purpose go deeper than the skin and muscles by taking specific reflex points on the foot to induce a healing response in corresponding organs and areas of the body, as seen in the chart to the left. Kneading the soft fleshy ball of the foot, pulling on the toes, tracing around the heel and pushing deep into the arch are just a few of the many small, intense movements you’ll experience during a reflexology treatment.

Due to the harsher pressure of this technique, there are certain individuals who should seek pain relief elsewhere. Deep Tissue massages can be dangerous for clients who have blood clots, as the pressure and movements might cause the clots to be dislodged. If you have had blood clots in the past, currently have blood clots or are at risk of forming blood clots, you should consult a doctor before pursuing a Deep Tissue massage. If you are currently recovering from recent surgery, chemotherapy, radiation or are suffering from osteoporosis you too should speak with a doctor before experimenting with Deep Tissue massages. As this is particularly high-pressure massage, you should not allow rashes, wounds, tumors, hernias, etc. to be massaged directly. Expecting mothers should also avoid Deep Tissue massages; instead, ask your doctor about therapists that specialize in pregnancy massage techniques.
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:

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]


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.
According to research done by the American Massage Therapy Association, as of 2012 in the United States there are between 280,000 and 320,000 massage therapists and massage school students.[115] As of 2011, there were more than 300 accredited massage schools and programs in the United States.[116] Most states have licensing requirements that must be met before a practitioner can use the title "massage therapist", and some states and municipalities require a license to practice any form of massage. If a state does not have any massage laws then a practitioner need not apply for a license with the state. However, the practitioner will need to check whether any local or county laws cover massage therapy. Training programs in the US are typically 500–1000 hours in length, and can award a certificate, diploma, or degree depending on the particular school.[117] There are around 1,300 programs training massage therapists in the country and study will often include anatomy and physiology, kinesiology, massage techniques, first aid and CPR, business, ethical and legal issues, and hands on practice along with continuing education requirements if regulated.[10] The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S. and currently (Aug 2012) there are approximately 300 schools that are accredited through this agency.
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.

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These deep tissue techniques are for the enthusiastic couple that have already aced their way through all the previous techniques. If you want to take your massage to the next level, this is it. Here, we introduce massage techniques using thumbs (aka your secret weapon) and also some deep kneading techniques. Both are an integral part of any advanced massage routine.
Friction strokes work on deeper muscles than the techniques previously described. The friction technique is a pressure stroke and is the deepest that is used in Swedish massage. The massage therapist applies pressure by placing the weight of his or her body on the flat of the hand and the pads of the thumbs, knuckles, fingers, or the back of the forearms, and then releases the pressure slowly and gently. This movement should be a continuous sliding motion or a group of alternating circular motions.
In Myanmar, massage is unregulated.[101] However, it is necessary to apply for a spa license with the government to operate a massage parlour in major cities such as Yangon. Blind and visually impaired people can become masseurs, but they are not issued licenses. There are a few professional spa training schools in Myanmar but these training centers are not accredited by the government.[citation needed]

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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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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.
Ayurvedic Massage is known as Abhyangam in Sanskrit. According to the Ayurvedic Classics Abhayngam is an important dincharya (Daily Regimen) that is needed for maintaining a healthy lifestyle. The massage technique used during Ayurvedic Massage aims to stimulate the lymphatic system. Practitioners claim that benefits of regular Ayurvedic Massage include pain relief, reduction of fatigue, improved immune system, and improved longevity.[36]

Adequate recovery is also a major factor in avoiding the over-training syndrome. Over-training is characterized by irritability, apathy, altered appetite, increased frequency of injury, increased resting heart rate, and/or insomnia. It occurs when the body is not allowed to recover adequately between bouts of heavy exercise. Therapeutic massage helps you avoid over-training by facilitating recovery through general relaxation, and its other physiological effects. 

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]


Shoulder pain. A 2017 study published in the Journal of Physical Therapy Science reports that shoulder pain is one of the most common musculoskeletal disorders, affecting as many as 66.7 percent of the population. The study goes on to say that massage therapy can often help reduce this type of pain, sometimes in a matter of days, though 36 sessions appeared to offer the greatest level of relief.
Pre-event massage is given shortly before an athlete competes. It consists mainly of brisk effleurage to stimulate and warm the muscles and petrissage to help muscles move fluidly and to reduce muscle tension. Effleurage is generally a relaxing stroke , but when done briskly it is stimulating. As the massage progresses, the pressure increases as the massage therapist uses percussive strokes and cupping to stimulate the muscles to contract and flex. The part of the body being massaged varies from sport to sport, although leg and back muscles are common targets for this type of massage.

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Reflexology also known as "zone therapy", is an alternative medicine involving application of pressure to the feet and hands with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on a pseudoscientific[57] system of zones and reflex areas that purportedly reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body.[58]
With possible benefits such as improved fitness endurance and performance, increased flexibility and recovery time, and injury prevention, sports massage is way more than just a massage for athletes! Traditionally, sports massage is a deep tissue massage that targets the deepest layers of muscle in order to stimulate blood flow. It is best done before or after the event as a means to later restore or rehabilitate. For more, see our Comprehensive Guide to Massage.

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Another study compared the effects of foot reflexology, simple massage, and conversation on 130 patients who had undergone abdominal gynecologic surgery under full anesthesia. The patients were asked how they felt, and data were recorded on general condition, pain intensity, movement of the bowels, urination, and sleep, from the day before the operation until until the tenth day afterward. Simple massage turned out to be a relaxing, positive experience, whereas foot reflexology had various effects, some of which were negative. The researchers concluded that foot reflexology is not effective in acute, abdominal postsurgical situations in gynecology and can occasionally trigger abdominal pain [15].
Thai massage – or Nuat Thai – combines both physical and energetic aspects. It is a deep, full-body massage progressing from the feet up, and focusing on sen or energy lines throughout the body, with the aim of clearing blockages in these lines, and thus stimulating the flow of blood and lymph throughout the body. It draws on yoga, acupressure and reflexology.
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.

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Massage is hindered from reaching the gold standard of scientific research, which includes placebo-controlled and double blind clinical trials.[86][87] Developing a "sham" manual therapy for massage would be difficult since even light touch massage could not be assumed to be completely devoid of effects on the subject.[86] It would also be difficult to find a subject that would not notice that they were getting less of a massage, and it would be impossible to blind the therapist.[86] Massage can employ randomized controlled trials, which are published in peer reviewed medical journals.[86] This type of study could increase the credibility of the profession because it displays that purported therapeutic effects are reproducible.[87]


The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

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There are several types of massage that focus on different parts of the body or healing approaches. Massage is the practice of rubbing and kneading the body using the hands. During a massage, a massage therapist will apply gentle or strong pressure to the muscles and joints of the body to ease pain and tension. A massage therapist is a person trained in giving massages.

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Neck pain. Neck pain is tied with headaches as the second most common pain experienced by adult Americans (also 15 percent), and massage can typically help with this too. For instance, a systematic review and meta-analysis published in 2014 in Evidence-Based Complementary and Alternative Medicine analyzed 15 studies and found that there was “moderate evidence” that massage therapy helped provide relief.

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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)

Reflexology, also known as zone therapy, is an alternative medicine involving application of pressure to the feet and hands with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on a pseudoscientific[1] system of zones and reflex areas that purportedly reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body.[2]
Practiced for centuries by Thai monks, and forming a central component of Thai medicine, Thai massage is believed to have originated over 2,500 years ago in India. Originally developed by Jivaka Kumar Bhaccha, the physician to Siddhartha Gautama - the Buddha - more than 2,500 years ago in India. The technique made its way to Thailand, where the original Ayurvedic techniques became combined with principles from traditional Chinese medicine. Read more about how having a Thai massage benefits you and your health.

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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.

Inflammation caused by chronic stress and muscle tension can lead to worsened overall health, longer recovery time, reduced immune function and cardiovascular problems, such as high blood pressure. Studies have found that massage therapy can help lower cortisol levels and even boost production of the hormone called oxytocin, which relaxes the body and has soothing effects. (7) Oxytocin is the primary hormone responsible for sustaining social bonds in humans and increasing motivation for cooperative behaviors, which is why it’s often called the “cuddle hormone” and known to be released during hugs, birth, social bonding and from touch.
In regulated provinces massage therapists are known as Registered Massage Therapists, in Canada only four provinces regulate massage therapy:[96] British Columbia, Ontario, Newfoundland and Labrador, and New Brunswick.[97] Regulated provinces have, since 2012, established inter-jurisdiction competency standards.[98][96] Quebec is not provincially regulated. Massage therapists may obtain a certification with one of various associations operating. There is the Professional Association of Specialized Massage Therapists of Quebec, also named Mon Réseau Plus, which represents 6,300 massage therapists (including orthotherapists, naturotherapists and others), the Quebec Federation of massage therapists (FMQ), and the Association québécoise des thérapeutes naturels; however, none of these are regulated by provincial law.

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