AD 1776: Jean Joseph Marie Amiot, and Pierre-Martial Cibot, French missionaries in China translate summaries of Huangdi Neijing, including a list of medical plants, exercises and elaborate massage techniques, into the French language, thereby introducing Europe to the highly developed Chinese system of medicine, medical-gymnastics, and medical-massage.[8]
In Thailand, Thai massage is officially listed as one of the branches of traditional Thai medicine, recognized and regulated by the government. It is considered to be a medical discipline in its own right and is used for the treatment of a wide variety of ailments and conditions. Massage schools, centers, therapists, and practitioners are increasingly regulated by the Ministries of Education and Public Health in Thailand.[107][108]
“Massage Therapy: Riddled with quackery,” a webpage on QuackWatch.org. Scientifically unsupportable ideas are common among massage therapists, according to Dr. Stephen Barrett. He avoids a blanket condemnation of the profession, conceding that “ordinary massage and the legitimate practice of massage therapy should not be categorized as quackery.” However, “many therapists make claims that go far beyond what massage can accomplish. And even worse, massage therapy schools, publications, and professional groups are an integral part of the deception.” He provides many references to support this view. I agree with almost every detail of the article and wrote a letter of support to Dr. Barrett, which is published as an addendum to it. That said, the article does neglect some nice things that can be said about massage therapy, and it contains a few minor errors. But I applaud the intent and embrace and welcome most of the criticism. I wish it weren’t mostly true, but I believe that it is.
There’s rarely any justification for extremely painful massage, unless it clearly produces a better result than gentler treatment — which is rarely clear!1 It is possible that a few “brutal” deep tissue massages could do the trick where gentler treatment would fail — but there is no way to know this in advance, and massage is expensive stuff. If you’re going to gamble on a treatment, gamble on cheaper and less painful ones.
I think it is more that they are circumspect than pessimistic. Speaking as a scientist, we are very careful to guard against declaring a finding if there is even a small risk of it being a false positive. We never want to say ‘we’ve found something’ and later have it turn out we were wrong when more data comes in. So, I think they are hewing to scientific norms in this regard, and I do not fault them for that; it is important to be careful in science. 

One theory is that muscle knots may be caused by something that goes wrong at the “motor end plate” — where a nerve ending attaches to a muscle cell.9 We don’t know why this happens, or what exactly goes wrong, but there is circumstantial evidence that motor end plates are the “point” in trigger point. That evidence is too complex and controversial to review properly here. It is explored in detail in my book. Some research has suggested that it may actually be possible to physically destroy the motor end plate with strong massage, thereby inactivating the trigger point.10 When it regrows — these are microscopic structures, it doesn’t take them long to heal — the trigger point may be gone.
Most deep tissue massages normally focus on major muscle groups — such as the neck or lower back — along with joints and tendons that are susceptible to straining or injuries. Certain areas of the body that tend to tense up in times of stress, including the shoulders, neck and hips, can often benefit the most from this type of deep manipulation. Many people consider “sports massages” to be a form of deep tissue massage, which involves physical treatment primarily to neuromusculoskeletal systems to treat pain and disability, improve muscle recovery and joint mobilization, and prevent injuries.
Meditation in its purest form involves focusing on one thing to clear your mind. Usually done in a quiet room, it calms the mind and the body — and can get your mind off your pain. Meditation sounds easier than it is, however, and distraction is usually a problem for beginners. Try following a recorded guided meditation, or seek the guidance of an experienced meditation teacher.
Thinking about something other than your stress or your pain can help you feel better. Guided imagery takes us to a happy place, but you don’t need to take a 30-minute journey to get there. When you feel stressed, stop what you are doing and picture yourself doing something relaxing, like taking a bath, swimming in the ocean or resting on a hammock. Imagine the scene as vividly as you can. Go there anytime you need to “escape.”
BC 722-481: Huangdi Neijing is composed during the Chinese Spring and Autumn period. The Nei-jing is a compilation of medical knowledge known up to that date, and is the foundation of Traditional Chinese Medicine. Massage is referred to in 30 different chapters of the Nei Jing. It specifies the use of different massage techniques and how they should be used in the treatment of specific ailments, and injuries. Also known as "The Yellow Emperor's Inner Canon", the text refers to previous medical knowledge from the time of the Yellow Emperor (approx 2700 BC), misleading some into believing the text itself was written during the time of the Yellow Emperor (which would predate written history).[7][8]

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Minty, fruity, or bubble-gum flavor, a stick of gum is a surprisingly quick and easy way to beat stress. Just a few minutes of chewing can actually reduce anxiety and lower cortisol levels Chewing gum alleviates negative mood and reduces cortisol during acute laboratory psychological stress. Scholey, A., Haskell, C., Robertson, B., et al. NICM Collaborative Centre for the Study of Natural Medicines and Neurocognition, Brain Sciences Institute, Swinburne University, Melbourne, Australia. Physiology & Behavior 2009;22(7):304-12..
Massage has been shown to reduce neuromuscular excitability by measuring changes in the Hoffman's reflex (H-reflex) amplitude.[90] A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability.[91] Others explain, "H-reflex is considered to be the electrical analogue of the stretch reflex...and the reduction" is due to a decrease in spinal reflex excitability.[92] Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage.[93] It has been noted that "the receptors activated during massage are specific to the muscle being massaged", as other muscles did not produce a decrease in H-reflex amplitude.[91]

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.


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.

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Relaxing is increasingly difficult in our always-on digital world. This first struck me a couple of years ago when I had to stop exercising after an injury. Exercise had always been my go-to “me-time” activity, and without it I felt totally lost. I recently started again, but having only one means to de-stress now feels very limited and I am not even sure it counts as relaxing – it is quite hard work, and inherently competitive. When I find myself at home with a free evening, I often have no idea what to do and inevitably end up staring emptily at one screen or another for hours, before stumbling off to bed, wondering where the time has gone.
It is important to recognise the difference between good stress and bad stress, life-changing events like getting married, becoming a parent, moving house, starting a new job or starting school can all be stressful events; but these are ultimately good for you – the stress is usually short-lived.  Bad and more dangerous stress is long-term background stress which can be caused by any number of factors including: frustration, overwork, failure or perceived failure as well as more specific life circumstances and illnesses.
The psychoanalyst David Morgan, of the Institute of Psychoanalysis, believes that for many of us this deadening retreat to our screens is both a reason for and a consequence of the fact that we no longer know how to relax and enjoy ourselves. Our screens and what we use them for are all techniques of distraction, he says. “People have got so used to looking for distraction that they actually cannot stand an evening with themselves. It is a way of not seeing oneself, because to have insight into oneself requires mental space, and all these distraction techniques are used as a way of avoiding getting close to the self.”

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So what should runners book instead? Anna Gammal, a massage therapist who works with elite runners at the Boston Marathon each year and also massaged athletes at the 2004 and 2012 Olympics, recommends either a sports massage (i.e. targeted therapeutic treatment for the unique physical and biomechanical needs of athletes) or a myofascial release massage (i.e. the application of gentle, sustained pressure on soft tissue restrictions). Both specifically target muscle release and will help improve flexibility, reduce pain and increase range of motion.
If scientifically unsupportable practices are surprisingly common medical massage therapists, they are close to universal among barely-trained and untrained bodyworkers. Many of them aspire to greater skill, but usually don’t do so by studying orthopedics and physical therapy — a project that could occupy anyone for a lifetime — but instead by increasing their repertoire of certifications in proprietary hands-on techniques, most of which are either silly and/or medically unimportant (i.e. pleasant and harmless, but producing no significant therapeutic effect for any important health problem — hot stone massage would be a good example of this).
Like massages, chiropractic care can be beneficial for lowering pain and improving recovery. It’s also been shown to lower stress, headaches and more. One way that chiropractors help treat pain is by lowering mechanical compression and irritation of spinal joints, which can send nerve signals throughout the body that increase inflammation and irritation.
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“I decided to go into sports massage when I experienced its effects on me as an athlete,” says McElroy. “Despite having no experience as a competitive runner in high school or college, I joined a team and realized I was pretty good. I trained while working full-time and ran my first marathon, missing the Olympic trial qualifying time by 21 seconds.
Sripongngam, T., Eungpinichpong, W., Sirivongs, D., Kanpittaya, J., Tangvoraphonkchai, K., & Chanaboon, S. (2015, October 5). Immediate effects of traditional Thai massage on psychological stress as indicated by salivary alpha-amylase levels in healthy persons. Medical Science Monitor Basic Research, 21, 216–221. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599180/

There’s just no reason to push a client to that “cringe point.” It’s ham-handed, tends to indicate a simplistic “more is better” approach to the work, and simply isn’t needed — that’s not what defines “intensity” in a good massage. Very strong and sastisfying pressure can always be achieved without that edgy, nervous-system-almost-rebelling feeling.
Relaxing is increasingly difficult in our always-on digital world. This first struck me a couple of years ago when I had to stop exercising after an injury. Exercise had always been my go-to “me-time” activity, and without it I felt totally lost. I recently started again, but having only one means to de-stress now feels very limited and I am not even sure it counts as relaxing – it is quite hard work, and inherently competitive. When I find myself at home with a free evening, I often have no idea what to do and inevitably end up staring emptily at one screen or another for hours, before stumbling off to bed, wondering where the time has gone.
But when you take a pill, the side effect is usually unrelated to the problem (i.e. it doesn’t make the problem you’re treating worse), you are generally trading those side effects for some pretty clear benefits, and it’s usually cheap. In manual therapy, most adverse events are backfires — that is, you go for a neck adjustment at the chiropractor, and you come out with more neck pain instead of less. Other data shows this is 25% more likely than if you did nothing at all (see Carlesso). And you pay through the nose for this! Manual therapy is much more expensive than most drug therapy.
Have you ever spent time in the sun during the summer time and felt so happy? That’s because the heat helps reduce anxiety through releasing stress in your brain and muscles. Find ways to warm up regularly and this will have a great effect on your anxiety problem. Use a sauna, go to the beach, dip in a hot tub or spend some time by the fireplace. The warmth will instantly boost your mood.
Think about how easy it is for a baby or small child to fall asleep. We're born with the instinct to relax and sleep when our bodies or minds need a break. Over the years, it becomes necessary to control and even suppress these natural urges to rest, because we must remain alert as we attend school, learn professions, go to work, or care for a family. Many people spend years conditioning themselves to perform well despite feelings of tiredness. While no one would argue that suppressing tiredness can be a necessary skill, it can impair our ability to actually "let go" and relax when we do find the time.
Thai massage, long considered a medical treatment in Thailand, the therapist puts you through a series of stretches that cover the entire body. (That’s why it’s often called lazy man’s yoga.) You lie on a floor mat or on a table wide enough to accommodate the therapist, and you wear loose-fitting clothing (often supplied by the spa), because there’s no way a sheet can stay put during these moves—the therapist might kneel on the back of your legs and pull your arms to arch your back and open your chest, or place her shoulder under your heel to lift your leg and stretch your hamstring. Thai massage also includes deep-pressure point work to stimulate the sen, or the body’s energy pathways.

I doubt that I personally know any skeptical massage therapists who aren’t already there, if they want to be, but I may have readers who qualify. Such skeptics are obviously a rarity in massage therapy, a profession notorious for attracting people with New Age and fringe science beliefs. The kind of people who would happily pay through the nose for tickets to see Deepak Chopra talk and think Mercola.com is a good source of health care information.


Manual therapists routinely claim that their services are much safer and more effective than drug therapies. Yet this data pretty clearly shows that the difference is really not great. Depending on how you look at it, drugs are only a little worse in some ways, or maybe a little better in other ways. But no matter how you slice it, 20-40% is a pretty unpleasant rate of harm — especially at $60–120/hour!
A couple’s massage is a massage that you do with your partner, friend, or family member in the same room. It brings all the benefits of a regular massage and sometimes provides you with access to the spa’s hot tubs, saunas, and other facilities. Other treatments such as pedicures, facials, and body scrubs are sometimes offered as part of a package.

Take a tropical vacation without leaving the desk chair. Use a five-minute break to peel, slice, and bite into a juicy mango, which packs a compound called linalool that helps lower stress levels Stress repression in restrained rats by (R)-(-)-linalool inhalation and gene expression profiling of their whole blood cells. Nakamura, A., Fujiwara, S., Matsumoto, I., et al. Technical Research Center, T Hasegawa Co, ltd, Kawasaki-shi, Japan. Journal of Agricultural and Food Chemistry 2009;57(12):5480-5.. Don’t fret about the juice dripping down your chin—the stress relief is worth the mess.


“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.”
Massage is to work and act on the body with pressure. 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.
Traction is a great example — pulling on the spine. Often used by massage therapists to treat low-back pain and neck pain, it might be an effective technique for a few patients, but I wouldn’t count on it, or advise anyone to spend much money on it. Like many popular therapies, the evidence is a mess.30 The absence of conclusive evidence is significant: if traction worked well, it probably would have shown up clearly by now. If traction works at all, it’s certainly not reliable. I discuss traction in considerable detail in both my neck pain and back pain tutorials.
A short but clear, compelling, and strong critique of cranial osteopathy. As an osteopath himself, Dr. Hartman’s opinion carries considerable weight, and he writes well. He concludes that techniques based on the assumptions of cranial osteopathy “should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.”
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. 

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]
For instance, the average therapist is probably not even able to reliably find trigger points,81 and it is tricky to treat what you can’t find. Even when you have found them, we have no idea if they can actually be treated by any well-known method, none of which has ever been clearly shown to be effective. There are many kinds of treatments for trigger points, and not one of them is much more than an educated guess. And every patient seems to respond differently (for instance, some patients have clear cravings for brutal intensities of treatment that would cripple another patient).
Acupressure [from Latin acus "needle" (see acuity) + pressure (n.)[31]] is a technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in those meridians. Pressure may be applied by fingers, palm, elbow, toes or with various devices.

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