No question: actually boosting performance would be a big deal, a humungous deal! But the cited evidence doesn’t remotely substantiate such a mighty claim. Even if we take that evidence at face value, it’s a huge and oversimplified reach to conclude that “a little increased range of motion” constitutes a meaningful effect on athletic performance as a whole. I can increase my ROM with a few seconds of stretching, too … and stretching does not enhance performance (look it up).
Certain massage therapists have specialized training in techniques that help treat people with injuries, inflammation, tears and limitations. Although more than one massage session is usually needed to provide relief and see improvements in pain, well-trained therapists can usually recommend practices or stretches for you to try at home that can further help improve healing.
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.
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]

Practice meditation, or try rejoicing, meditative prayer. This is the process of clearing your mind by focusing on a specific thought, place, word(s), color or object. To meditate, sit (kneel or lie) in a comfortable position and think (or pray) about one specific thing. It may take upwards of ten minutes in order to completely clear your mind, but that is normal.

Before booking an appointment, ask questions about the therapist’s education and experience, like “What is your training?” “How many years have you been practicing?” and “Do you work frequently with runners?”, suggests Gammal. Seek referrals if possible, and ensure s/he is a licensed massage therapist. Rotenberger recommends a massage therapist specifically trained in orthopedic treatment and assessment, as s/he will know when to refer you to another healthcare professional, in the case that you’re experiencing chronic pain and discomfort not fixable via massage. You can find a reputable practitioner via www.orthomassage.net or www.NeuroMuscular-Reprogramming.com.

We all have different goals and challenges in life; therefore it’s highly important that we create our own life motto to keep us on track. This mantra will focus your mind and stop you from being anxious and overwhelmed when life throws you yet another curve ball. Identify your challenges, weaknesses and goals so you can craft your own personal mantra.
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?!”
Kicking back in front of one screen or another does have its place, says Andrew – but it depends how you do it. “Sometimes people describe not being engaged in what they’re looking at – totally zoning out, not knowing what they’ve done for the last half-hour,” she says. “You can view this almost as dissociation, periods of time when your mind is so exhausted and overwhelmed it takes itself out of the situation. That’s unlikely to be nourishing in any way.” Maybe that is why, after I have spent an evening staring emptily at Twitter, or dropping off in front of the TV – less Netflix and chill, more Netflix and nap – I wake up feeling as if I have eaten a load of junk food. I have confused feeling brain-dead with feeling relaxed.
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.
Massage is a profoundly valuable service regardless of what specific effects it does or does not have on pain, tissues, or pathologies. A pleasant, relaxing experience may have any number of minor therapeutic benefits, such as bringing your blood pressure down. However, the subtler benefits of massage extend well beyond that, into the territory of emotional and psychological benefits that are virtually impossible to define or measure — and surprisingly potent.
The most widely recognized and commonly used category of massage is the Swedish massage. The Swedish massage techniques vary from light to vigorous.[63] Swedish massage uses five styles of strokes. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber or with the fibers) and vibration/shaking.[64] Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks.[65] The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitioner Johann Georg Mezger applied the French terms to name the basic strokes.[66] The term "Swedish" massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as "classic massage". 

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I’ve worked in a variety of exciting environments, including the Salt Lake City Winter Olympics, the Greece Paralympic Summer Games and on the road with the U.S. National Powerlifting Team. Plus, I have worked with collegiate, ABL and WNBA athletes. Currently, I travel with the WTA (Women’s Tennis Association) as part of the sports science and medicine team. In my private clinic, I specialize in orthopedic massage.
The results are underwhelming. Although they did a little better than just guessing, the results suggest that it’s difficult even for expert examiners to detect the location of neck and back pain by feel. As well, they were only attempting to detect the side of pain. Imagine how much worse their performance would have been if they had had to identify the location more precisely, or if the pain could have been anywhere or nowhere. So they barely passed the easiest possible test, and probably would have failed a harder one and done no better than guessing.
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!
According to the American Massage Therapy Association, up to 25 percent of American adults had a massage at least once during 2016-2017. And, they have a wide range of reasons for doing so. More and more people -- especially baby boomers -- recognize the health benefits of massage. They choose from among many massage styles to get relief from symptoms or to heal injuries, to help with certain health conditions, and to promote overall wellness.
The titles masseur and masseuse (the feminine form of the word masseur) have a long and colorful history related to massage. Both terms were used to describe men and women, respectively, who provided massage in exchange for payment. But these terms, especially masseuse, were hijacked by irreputable women operating under the guise of “massage,” beginning in the 1950s.  Over the past 30-plus years, massage professionals have worked to help get laws enacted that protect titles that reflect their training and professional standards. Today, state laws protect titles including massage therapist, massage practitioner and massage technician.  Still, the words masseuse and masseur live on as ways of describing the kind of touch not practiced by educated massage professionals.  ‘"Masseur is to massage therapist as stewardess is to flight attendant,’”   

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Deep Tissue massages are designed to focus on a specific problem, usually something along the lines of chronic muscle pain, limited mobility, tennis elbow, etc. Cathy Wong explains that according to Consumer Reports magazine, at least 34,000 people claimed that Deep Tissue massages were more effective in relieving osteoarthritis pain than physical therapy, chiropractic, acupuncture or over-the-counter drugs. It is also especially effective in easing fibromyalgia pain, usually giving clients an improved range of motion immediately following a treatment.
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.
This review is somewhat novel in that it includes some Chinese research, but it doesn’t really help. The introduction curiously boasts that “traditional Chinese massage is one of the most ancient massage therapies,” but there is not enough distinctive about Chinese massage that makes it worthy of any focus, and massage is ancient in every culture. This weird, prominently placed statement is a red flag: biased interpretation ahead! (And only one study of traditional Chinese massage made it passed the selection criteria anyway.)
Trigger points may respond to massage, and that is certainly my impression from three decades of rubbing my own trigger points and trying to help other people with theirs. It’s also what legions of massage therapists believe. But don’t ask science for confirmation — it’s playing hard-to-get here. I get dorky in detail about the science of trigger point massage in the trigger points tutorial, but here’s the bottom line …
Leave the past behind, and think of what you can do in the future to put those memories to rest. It may help to do a physical action to lay that memory to rest, or to let your mind let it go. Get a chalkboard and draw the memory, or write, on it, then ritualistically erase it, knowing it wil leave your mind as it leaves the chalkboard. Or, write it on a piece of paper, and throw it into a fire to be consumed, thus eradicating it from your mind.
Many students at my school were actually angry that things like therapeutic touch were even being taught. I recall some heated debates between skeptical students and more “open-minded” instructors and school officials. It may surprise you to hear that I was not one of the skeptics back in those days — it was only just starting for me then. BACK TO TEXT
The following relaxation process is all about taking steps to change your physiology when you are tense, anxious, or angry. This is basically done by shifting attention and taking control of breathing as a way to jump-start the parasympathetic nervous system. There is no magic, just basic steps (some that you already do) that should result in you feeling more relaxed, quickly. I encourage you to practice doing the full sequence at least once a day for two weeks during times of lower tension before you start using it in more urgent situations. Additionally, there is no set amount of time that this takes. It could last as little as a minute or two, or go on as long as you like.
Sit back, or lie down. Close your eyes. Imagine a serene beach, a green forest, or a nice breeze. Allow yourself to indulge in seeing a whole picture of peace – whatever that is. Give yourself bonus points for imagining the delightful sounds and scents of your favorite location. You’ll be giving yourself a small escape – a mini-midday vacay. And it can have a wonderful effect on your peace of mind.
For many years the best review of the science that was available, by Furlan et al., had a cautiously optimistic conclusion, declaring that “massage is beneficial.”37 But then, in 2015, Furlan et al. added another dozen studies to the pool of data, and actually changed their tune: now they have “very little confidence that massage is an effective treatment for LBP.”38 And nor should they. Although there are scraps of good news, the evidence damns massage with faint praise — just like all other “promising” back pain treatments.
“The ritual process brings us renewed balance, empowerment, energy and comfort,” writes Jennifer Louden in her book The Woman’s Comfort Book: A Self-Nurturing Guide for Restoring Balance in Your Life. This gives you a specific time to focus on nurturing yourself and your needs. The key, according to Louden, in creating a daily ritual is repetition. Here’s an example from the book:
During the 1930s and 1940s massage's influence decreased as a result of medical advancements of the time, while in the 1970s massage's influence grew once again with a notable rise among athletes.[10] Until the 1970s, nurses used massage to reduce pain and aid sleep.[22] The massage therapy industry is continuously increasing. In 2009, U.S. consumers spent between $4 and $6 billion on visits to massage therapists.[23] In 2015, research estimates that massage therapy was a $12.1 billion industry.[24]
If exercising feels to much like a chore then how about enjoying some guilt-free time with your friends? In ‘Play it Away’, author Charlie Hoehn explains how spending 30 minutes each day on any outdoor activity with your friends may actually be the key when trying to cure anxiety. He even created a Pinterest board with all sorts of activity ideas you can try out.

Massage is not a detox treatment. If anything, it’s the opposite! Post-massage soreness and malaise (PMSM) is probably caused by mild rhabdomyolysis (“rhabdo”). True rhabdo is a medical emergency caused by muscle crush injuries. But milder stresses cause milder rhabdo — even just intense exercise can do it. And massage! We know this from a good formal case study, several informal ones, common exertional rhabdo, and the similarities between PMSM and ordinary exercise soreness. A rhabdo cocktail of waste metabolites and by-products of tissue damage is probably why we feel cruddy after any intense biological stress or trauma — but they can’t be “flushed” away by massage (or by drinking water). See Poisoned by Massage: Rather than being DE-toxifying, deep tissue massage can probably cause a slightly toxic situation in the body. BACK TO TEXT
If exercising feels to much like a chore then how about enjoying some guilt-free time with your friends? In ‘Play it Away’, author Charlie Hoehn explains how spending 30 minutes each day on any outdoor activity with your friends may actually be the key when trying to cure anxiety. He even created a Pinterest board with all sorts of activity ideas you can try out. 

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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.”

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:

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The therapist uses his or her hands, knees, legs, and feet to move you into a series of yoga-like stretches and also applies deep muscle compression, joint mobilization, and acupressure. Thai massage also utilizes energy work, which, according to ancient Asian culture, treats the subtle energetic field within the body. It corrects blockages, deficiencies, and imbalances in the flow of this energy, which then is believed to improve the client's health. 
"If you walk in the door decompressed, it gives you a jump-start for the rest of the evening," says productivity expert Julie Morgenstern, author of Time Management from the Inside Out ($15; amazon.com). Do you take public transportation home? Resist the siren call of email and try a meditation app, such as Insight Timer, Calm, or Stop, Breathe & Think (all free on iTunes and Google Play). "Call a friend or loved one, listen to music—any activity that breaks you out of your normal train of thought should help," says Morgenstern. "One client found it effective to set his relaxation intentions on his way home from work. He'd tell himself, 'I want to enjoy cooking with my partner and make sure so-and-so does homework, but I'll ask in a gentle way,' and so on."
Wiltshire et al subjected 12 people to intense hand-gripping exercises to boost blood levels of lactic acid and other waste products of muscle physiology. Then they measured those substances with and without the subjects receiving basic sports massage. Their data showed that massage significantly “impairs lactic acid and hydrogen ion removal from muscle following strenuous exercise by mechanically impeding blood flow.”

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And, as many critics have pointed out, massage is a super expensive way to relax. On average, professional massage therapists charge about a buck a minute — vastly more than millions of people can afford on a regular basis. This economic perspective is often completely ignored in discussions of whether or not massage works. It probably does … but does it work well enough for the price? A nap is also quite relaxing, and a lot cheaper. If massage is to be considered a more cost-effective treatment for any medical problem than napping, we really must establish that it does more — quite a lot more — than just mellow people out. 

It is frequently asserted that massage therapy (MT) reduces cortisol levels, and that this mechanism is the cause of MT benefits including relief from anxiety, depression, and pain, but reviews of MT research are not in agreement on the existence or magnitude of such a cortisol reduction effect, or the likelihood that it plays such a causative role. A definitive quantitative review of MT's effect on cortisol would be of value to MT research and practice.
I love the simple yet profound way that Thich Nhat Hanh writes. This book lead me to numerous insights into my own process and has helped me to relax and be kinder to myself and others. I have studied tai chi for years and all of my teachers have stressed the value of relaxing, often stating that it is the most important principle. This book has helped me to apply this principle to all of me: body, mind and spirt. Relaxing is the key to living a more full life with greater mindfulness, loving kindness and energy.
Plantar fasciitis. According to the JAMA Network, plantar fasciitis occurs when the fibrous band on the bottom of the foot becomes irritated and inflamed, causing pain in the heel and arch areas. The Pacific College of Oriental Medicine further indicates that deep tissue massage can be an effective treatment for this particular condition as it helps “release the muscle tension, break scar tissue, and lead to its elimination.”

It is hard to study what you can’t define … and it is extremely difficult to define massage precisely. Many possible questions arise! What kind of massage therapy? What methods? Could a combination of methods be effective where another combination fails? How well trained is the therapist? Are “advanced” techniques better than relaxation and Swedish techniques? Or maybe the basics are the basics because they really work? How much massage therapy? Could five sessions succeed where two would fail? Is one appointment “massage therapy,” or does it really need more? Could nine sessions actually be better still? Or perhaps counterproductive? Can anything be done with short sessions, or are long ones needed? If massage works, how much of the benefit can be attributed to non-massage elements like bedside manner, relaxation, and reassurance? How much do those factors define massage? What if massage didn’t work at all, or very poorly, without them? Would that mean “massage” works because it’s a great way of delivering a nice experience? Or that nice experiences “work” and the massage is irrelevant? What if massage therapy of a certain type for a specific condition was only effective 20% of the time? 60%? 80%? At what point is it “worth a shot”? (And worth the expense?)
This step may seem silly or obvious, but when we are anxious, tense, or angry, we are almost never paying attention to our immediate surroundings. Instead, we are usually consumed with our thoughts or feelings related to things that are not present where we are. Orienting allows us to start relaxing by recognizing our immediate surroundings, which are hopefully calm, stable, and safe.
The approval of skeptics doesn’t mean that massage “works,” and they may actually be giving massage more credit than it deserves. At TAM7, I repeatedly explained to horrified skeptics — who were trying to give me the benefit of the doubt — that my colleagues routinely either sell or endorse virtually every imaginable form of alternative health care, including the silliest: ear candling, crystal therapy, iridology, gong therapy (look it up!) … you name it, there’s a goofy therapy that many massage therapists “believe” in.

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Deep Tissue massages are designed to focus on a specific problem, usually something along the lines of chronic muscle pain, limited mobility, tennis elbow, etc. Cathy Wong explains that according to Consumer Reports magazine, at least 34,000 people claimed that Deep Tissue massages were more effective in relieving osteoarthritis pain than physical therapy, chiropractic, acupuncture or over-the-counter drugs. It is also especially effective in easing fibromyalgia pain, usually giving clients an improved range of motion immediately following a treatment.
Massage is a profoundly valuable service regardless of what specific effects it does or does not have on pain, tissues, or pathologies. A pleasant, relaxing experience may have any number of minor therapeutic benefits, such as bringing your blood pressure down. However, the subtler benefits of massage extend well beyond that, into the territory of emotional and psychological benefits that are virtually impossible to define or measure — and surprisingly potent.
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This may be the first ever scientific test of friction massage for tendinitis. In 1989 (when I was graduating from high school!), “No clinical trials, either controlled or uncontrolled, reporting the effectiveness of friction massage could be found.” From the conclusion: “This study does not support the notion that either deep friction massage or phonophoresis are superior to ultrasound in the treatment of lateral epicondylitis at the elbow.”
Trigger points may respond to massage, and that is certainly my impression from three decades of rubbing my own trigger points and trying to help other people with theirs. It’s also what legions of massage therapists believe. But don’t ask science for confirmation — it’s playing hard-to-get here. I get dorky in detail about the science of trigger point massage in the trigger points tutorial, but here’s the bottom line …
Massage used in the medical field includes decongestive therapy used for lymphedema[10] which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT.[52] However, it is less effective than management of SVT with medications.[53]
In the Thai language it is usually called nuat phaen thai (Thai: นวดแผนไทย; lit. 'Thai-style massage') or nuat phaen boran (Thai: นวดแผนโบราณ, IPA: [nûət pʰɛ̌ːn boːraːn]; lit. 'ancient-style massage'), though its formal name is nuat thai (Thai: นวดไทย, lit. 'Thai massage') according to the Traditional Thai Medical Professions Act, BE 2556 (2013).[1]
Combine these with the 4,146 active players in the NFL (National Football League) MLB (Major League Baseball), NBA (National Basketball Association), NHL (National Hockey League) and MLS (Major League Soccer); the 244 Olympic athletes on Team USA who competed in the 2018 Winter Games; and all of the “weekend warriors” who play sports on a more sporadic basis and this represents a huge number of individuals who rely on their bodies to consistently perform at higher levels.
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Several mechanisms for deep massage’s natural stress-relieving effects include its ability to dilate blood vessels and also lower activity of the limbic system (including the hypothalamus), which is responsible for autonomic nervous system regulation and cortisol secretion. Massage has been shown to improve relaxation by boosting activity of the parasympathetic nervous system, as measured by heart rate, blood pressure and heart rate variability. (8, 9)
Wat Pho, the center of Thai medicine and massage for centuries, opened the Wat Pho Thai Traditional Medical and Massage School in 1955 on the temple grounds, the first such school approved by the Thai Ministry of Education. Wat Pho offers four basic courses of Thai medicine: Thai massage, Thai midwife-nurse, Thai pharmacy, and Thai medical practice.[8]
Deep tissue massage is a focused, therapeutic massage that targets muscle knots (also known as "adhesions") and specific problem areas in the deeper layers of muscle and connective tissue. Using deliberate, slow strokes or friction across the grain of the muscle, the therapist addresses chronic tight or painful muscles, repetitive strain, postural problems, or injuries.
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It is hard to study what you can’t define … and it is extremely difficult to define massage precisely. Many possible questions arise! What kind of massage therapy? What methods? Could a combination of methods be effective where another combination fails? How well trained is the therapist? Are “advanced” techniques better than relaxation and Swedish techniques? Or maybe the basics are the basics because they really work? How much massage therapy? Could five sessions succeed where two would fail? Is one appointment “massage therapy,” or does it really need more? Could nine sessions actually be better still? Or perhaps counterproductive? Can anything be done with short sessions, or are long ones needed? If massage works, how much of the benefit can be attributed to non-massage elements like bedside manner, relaxation, and reassurance? How much do those factors define massage? What if massage didn’t work at all, or very poorly, without them? Would that mean “massage” works because it’s a great way of delivering a nice experience? Or that nice experiences “work” and the massage is irrelevant? What if massage therapy of a certain type for a specific condition was only effective 20% of the time? 60%? 80%? At what point is it “worth a shot”? (And worth the expense?)
Have you ever smiled even when you were feeling bad? That’s highly unlikely. Make yourself to smile more. Make a mental file of people, places, and things that make you smile.  Pull something out of this mental file when you are feeling overwhelmed.  The positive energy will transfer to your surroundings and echo back to you. In this study participants demonstrated that forcing a smile resulted in feeling more relaxed and an overall greater positive attitude.
The standard type of massage offered in most clinics, gyms, spas, and wellness centers, Swedish massage is virtually synonymous with massage therapy. Swedish massage is based on the Western concepts of anatomy and physiology, compared to the energy-centric style more common in Asian forms of massage. Using lotion or oil, massage therapists typically begin with broad general strokes and then transition to specific strokes to address problem areas.
But logistics, economics, and devilish details get in the way. Not many scientists are interested in studying massage, while massage therapists don’t have scientific training. It’s an expensive and overwhelming challenge for a massage therapist to make room in their career for some research — few do it, and hardly any have ever done it well. Even when they do, you’d be amazed how hard it is to even find 100 people with the same problem, so studies of that size are almost never done: instead you get studies of 20 or 30 patients, which isn’t generally enough to prove much. Another challenge is that “massage” can mean so many things that it’s hard to know what is even really being studied (lack of standardization of treatment).4
This study compared the effects of massage and minimal exercise therapy on poor circulation (venous insufficiency) in post-menopausal women. Superficially it looks like a good news story for massage, and in some ways it is. Massage did have a statistically significant positive effect and seems to have “increased circulation” in one sense (something I have often called a myth). But there’s a lot to consider here.

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