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!

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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.
Structural Integration's aim is to unwind the strain patterns in the body's myofascial system, restoring it to its natural balance, alignment, length, and ease. This is accomplished by hands-on manipulation, coupled with movement re-education. There are about 15 schools of Structural Integration as recognized by the International Association of Structural Integration,[60] including the Dr. Ida Rolf Institute (with the brand Rolfing), Hellerwork, Guild for Structural Integration, Aston Patterning,[8] Soma,[61] and Kinesis Myofascial Integration.[62]
This seems like a fairly straightforward bit of good-news science about stretching. It’s not a surprising idea that movement would have some systemic regulatory effects (motion is lotion, use it or lose it), but it’s nice to see some corroboration of that common sensical notion, and it’s also nice to know that perhaps just stretching did this (to the extent we can learn anything from a single study). If true, it makes for nice evidence to support a general stretching habit, yoga, mobilizations, really any kind of “massaging with movement,” and probably even massage itself.
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]
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.
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. 

It takes just a minute to drip some lavender, tea tree, or another essential oil into your palm and inhale. The soothing scents may help send stress and anxiety packing by stimulating smell receptors in the nose that connect to the part of the brain that regulates emotions Essential oils and anxiolytic aromatherapy. Setzer, W.N. Department of Chemistry, University of Alabama in Huntsville, Alabama. Natural Product Communications 2009;4(9):1305-16..
If you are dealing with a serious injury, and don’t have a diagnosis, definitely see a sports doctor. “Massage therapists do not diagnose,” says Denunzio. “It’s not part of our discipline.” And while a therapist can identify and attempt to alleviate any tightness and inflammation in the body, if a problem area doesn’t feel significantly better three days post-massage, you should likely consult a sports doctor then, as well. Once a diagnosis is given, your massage therapist can work with that information and use massage as a helpful tool in recovery.

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.
No need to go on a retreat to the mountains—five minutes of peace is all it takes to reap the benefits of meditation. There’s evidence that just two quick bouts of silent meditation per day can relieve stress and depression A Randomized, Controlled Trial of Meditation for Work Stress, Anxiety and Depressed Mood in Full-Time Workers. Manocha, R., Black, D., Sarris, J., Stough, C., et al. Discipline of Psychiatry, Sydney Medical School, Royal North Shore Hospital, Sydney University, St. Leonards, Australia. Evidence-basedcomplimentary and alternative medicine. Epub 2011.. Find a comfortable spot in a quiet place, concentrate on your breath, and feel those anxieties start to disappear.

The constipation claim is another good example of something that’s probably as clinically trivial as it is certain. Who the hell thinks, “I haven’t had a crap in days: I guess I’d better buy a professional massage!” (I might rub my own belly.) In ten years working as an RMT, I think I did that kind of abdominal massage maybe a half dozen times — demand for the service was rather low. I’ve been writing about the science of massage even longer, and this is literally the first time the word “constipation” has ever appeared on this website — because who cares?
Life gets a lot easier when you plan out your day. Get a head start by waking up 10 minutes earlier.  Then, create a rough plan in your mind about how you plan to spend your day.  Sometimes it is helpful to jot down a list and take it with you.  Check off each event as you finish it and then you’ll have a feeling of accomplishment at the end of the day.
And yet some medical benefits are plausible despite the lack of evidence. For instance, many apparently successful treatments may be due to the effects of pressure on “muscle knots,” which are a likely factor in many common pain problems, but poorly understood (and difficult to treat). And regardless, the effects on mood and mental health are so profound that patients can’t really lose — it’s a valuable service whether it “works” for pain or not.
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.

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We often forget to focus on the simplest, shortest (and one of the most restorative) activities available to us: our breath. Yoga teacher Anna Guest-Jelley suggested taking five deep breaths. “As you do, notice the natural pause between your inhale and exhale, and then between your exhale and your next inhale. Your body has a built-in break — how great is that?!”
Find the right massage therapist. Look for a therapist who specifically identifies the massage type you’re interested in as part of their practice and background. If necessary, look for someone trained to treat a particular condition, such as sports injuries, fibromyalgia, arthritis, or pregnancy. Also check if the therapist is licensed or certified according to state requirements.
There have been very few studies of pre-event sports massage. In 2018, a rare example of it had a clear negative conclusion,71 echoing the findings of a couple earlier ones.7273 It’s a very small study, but it’s still a useful contribution74 (and it's not actually the first such evidence). Seventeen sprinters were tested with four combinations of massage, dynamic warmup, and an ultrasound placebo and found that “massage decreased 60-meter sprint performance in comparison to the traditional warm-up.”
“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.”
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.
There are a lot of relaxation techniques out there that we can all learn and practice. However, I have found that many of my clients (and myself) struggle with the way these are presented, and they also have problems motivating themselves to use them. In response to that, I researched the types of relaxation techniques that have the most research support, and I developed a five-step sequence that anyone can do to feel more relaxed in minutes, minus the new-age vibes.
Anxious? Just squeeze, release, and repeat. Progressive relaxation involves tensing the muscles in one body part at a time to achieve a state of calm Effects of progressive relaxation on anxiety and quality of life in female students: a non-randomized control trial. Dehghan-Nayeri, N., Adib-Hajbaghery, M. Tehran University of Medical Sciences, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran, Iran. Complementary Therapies in Medicine 2011;19(4):194-200.. The method (also used by actors) is a great way to help fall asleep.

Training and certification standards for massage therapists are all over the map, and most practitioners have barely scratched the surface of musculoskeletal medicine. The profession is rife with pseudoscience like crank theories about the causes of pain, the myth that massage detoxifies, or that painfully “deep tissue” massage is needed to “release” tissues (which is stressful or even harmful for many patients).


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 …
A 2014 Chinese review of studies by Li et al48 is a good example of what a shabby state massage therapy research is in. Let me be clear up front: I don’t think this paper actually proves anything one way or the other. I think it’s straightforwardly inconclusive. It has a positive sounding conclusion that isn’t really justified and there are major caveats. But it doesn’t mean that I wouldn’t go get me some massage if I had fibromyalgia. I probably would! But that’s another story. This is about the science, so here goes:
“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.
Sports massage can be an interesting career choice for therapists who want to do it full time. Professional sports teams often have massage therapists on staff to keep athletes' bodies working at their very best. It helps to have a keen interest in anatomy and physiology, advanced training and experience in sports massage, an interest in sports, and a desire to work with athletes.

Develop an invisible shield between yourself and stressed folk. This is really a visualization technique, in which you imagine that you are cocooned against the negative vibes of overly stressed people around you. See their behavior and attitudes for what they are, recognize what their stress is doing to them but refuse to let this penetrate your shield.
Bastian B, Jetten J, Hornsey MJ, Leknes S. The Positive Consequences of Pain: A Biopsychosocial Approach. Pers Soc Psychol Rev. 2014 Apr;18(3):256–279. PubMed #24727972. Bastian et al. write about “pain’s capacity to produce positive consequences, thereby decoupling the experience of pain from the experience of suffering” — pain’s silver linings, basically. BACK TO TEXT
There are a few “medical” massage therapists out there with some training in orthopedics and rehabilitation. My education in massage therapy here in British Columbia, Canada, was three years long — the longest massage therapy training program in the world. There are also a few other places with two-year programs. A massage therapist with this level of education is certainly the kind that patients should seek out if they want massage as a treatment.
Traditional Thai massage uses no oils or lotions. The recipient remains clothed during a treatment. There is constant body contact between the giver and receiver, but rather than rubbing on muscles, the body is compressed, pulled, stretched and rocked. Thai stretches are often very similar to yoga poses. Back walking may be performed during a Thai massage as well.
Posterior interosseous syndrome. Physiopedia explains that posterior interosseous syndrome is a compression of the posterior interosseous nerve, which is located near the shaft of the humerus and the elbow, that may result in paresis or paralysis of the thumbs and fingers. Though cryotherapy, ultrasound, dry needling, and other modalities often help with this condition, so too does deep tissue work that is focused on the thoracic outlet, pectoralis minor, triceps, brachioradialis, and other surrounding areas.
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. 
Negative thoughts and feelings usually stay away when you are a good time. Schedule some time with your closest friend(s) or family regularly.  Go out to dinner, listen to music, take a walk or just sit and have a cup of coffee.  The activity is not as important as the shared experience.  Such activities often help you take your mind off your worries! 

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