In the summer of 2009, I attended the Science-Based Medicine conference and The Amazing Meeting 7 in Las Vegas: a huge gathering of skeptics, scientists, and critical thinkers. I was the only alternative health care professional at the conference that I know of. I introduced myself publicly to a couple hundred doctors and scientists as a “skeptical massage therapist.” They were delighted, and for the next four days, skeptics approached me regularly to say, “Hey, that was brave! But massage isn’t quackery, is it?”
In the US, licensure is the highest level of regulation and this restricts anyone without a license from practicing massage therapy or by calling themselves that protected title. Certification allows only those who meet certain educational criteria to use the protected title and registration only requires a listing of therapists who apply and meet an educational requirement.[123] It is important to note that a massage therapist may be certified, but not licensed. Licensing requirements vary per state, and often require additional criteria be met in addition to attending an accredited massage therapy school and passing a required state specified exam (basically the certification requirements in many states). In the US, most certifications are locally based. However, as of March 2014, some states still do not require a license or a certification.[citation needed] However, this is thought to change eventually as more regulatory bodies governing the profession of massage are established in each state. Furthermore, some states allow license reciprocity where massage therapists who relocate can relatively easily obtain a license in their new state. Not all states provide this option.[124] 

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.
Sit comfortably in a chair with your feet on the floor, and close your eyes. Once you are settled and notice your breathing, inhale through your nose for a count of 4, hold it for a count of 7, exhale through your mouth for a count of 8, and repeat. The pace doesn't matter, it should just be something that feels good to you. The key is having the exhale really stretch out much longer than the inhaling. Try and make the exhale smooth and have almost all of the air leave your body. Do it with the counting as long as you need to get the pace down before going to the next step. For me this takes a couple minutes.
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.
Thai massage has been practiced in America since the 1990s when Westerners began practicing it. Thai massage is more commonly found than it used to be at American spas, but you can't find it everywhere for two reasons. First, the spa needs a room with a large, padded mat in order to offer Thai massage. It's easiest if the room is always set up for Thai massage, and yet it is more of a specialty request. It just makes more economic sense to have the room set up with a table for a Swedish massage.
Many training programs are now available throughout the world that require a minimum of 500 hours of basic massage therapy training, in addition to continuing education credits that can require up to another 400–500 hours. (19) Always make sure you’re “in good hands” by first checking that a therapist has proper qualifications and experience, specifically asking about training in NMT, trigger point therapy, sports massage, pain management, myofascial release and orthopedic massage.
Traditionally designed to apply pressure to layers of muscle, tendons and other tissues deep under the skin, deep tissue massage can be very effective in relieving problem areas and is highly therapeutic. Deep tissue massage is generally a modality to consider for athletes as well as the eight-to-five desk job. Muscles easily become tense and deep tissue massage can relieve some chronic patterns of pain and tension, specifically in the back, shoulder and neck areas.  

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1. Take Five. Meditation is a powerful, natural way to reduce stress. If you’ve never tried it, it can seem intimidating—or even a little hokey. It’s actually very easy, though, and it takes only a few minutes to help yourself chill out. Set a timer for five minutes in a quiet space, close your eyes, sit still, and simply take slow, deep breaths. To avoid letting it turn into five minutes of ruminating about your stress, focus on your breath. For example, try breathing in for four counts, holding your breath for seven counts, and then breathing out for eight counts.

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When we're anxious and stressed, it can cause you to take shorter breaths, so by deliberately taking a series of deep ones, you can help increase the supply of oxygen to your brain.This, in turn, stimulates the parasympathetic nervous system, sometimes referred to as the "rest and digest system," because it's the part of the nervous system that slows heart rate, increases intestinal activity, and relaxes certain stomach muscles.
Prenatal massage can be a safe way for women to get a massage during pregnancy. It can help reduce pregnancy body aches, reduce stress, and ease muscle tension. You can get a massage at any time during your pregnancy. However, many facilities, especially in the United States, do not offer massages to women in their first trimester due to the risk of miscarriage during this time.
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).

Most sports massage therapists will wear a white coat or uniform. This projects a professional image. It will also prevent unsightly oil stains on clothes. When you are referred to a massage therapist by a doctor or other qualified person then you should expect their instructions to be carried out to the letter and not added to or altered by the massage therapist.


When you get off the table, your calves may be screaming at you, but don’t get upset and run home to your foam roller, says Denunzio. Soreness is normal and can even help reveal areas of weakness that should receive future attention. Within 48 hours, the tightness should dissipate, and if the massage was administered correctly, you may even feel like you’re in a new body.
Thank you so much for your article The Pressure Question in Massage Therapy. I just read it all. I went for a sports massage two weeks ago as I was recommended to have one as it was suggested it might help with tight calves, a side effect of some other injuries I have. I’ve been for sports massages many, many times before over the years. This one was one of the most painful experiences of my life — when I got home I was almost sick and felt in shock. My right achilles tendon was raging and it’s been bad ever since. It hurt so much when it was done (like someone was sticking knives in) and I kept asking if it was meant to hurt. I wish I’d just stopped the session or objected but I didn’t. It used to be a bad injury that affected me walking for about 6 months so I’m just devastated about this. I can hardly bear to put shoes on and its all this time on. I know there are good practitioners out there but experiences like this just make me want to stay away. I wish I’d gone to a “gentle” one.
I’ve often said that massage therapy research is in its early stages. And after thinking about that more today, I’ve realized it’s worse than that. Massage therapy research is stunted, and not showing signs that it is ready to progress. Some might disagree, and would point to the increasing number of massage therapy studies. (I’ve charted it myself in at least one paper I’ve published, and there is no doubt that the number of papers on the subject is increasing.) But I would counter by noting that there is no discussion in the field. The studies are conducted and published in isolation. They are not often being critiqued, and researchers with different theories and perspectives are not addressing each other in the literature or even at conferences.
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.
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.
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.
In fact, the history of Thai massage is more complex than this legend of a single founder would suggest. Thai massage, like Thai traditional medicine (TTM) more generally, is a combination of influences from Indian, Chinese, Southeast Asian cultural spheres, and traditions of medicine, and the art as it is practiced today is likely to be the product of a 19th-century synthesis of various healing traditions from all over the kingdom.[7] Even today, there is considerable variation from region to region across Thailand, and no single routine or theoretical framework that is universally accepted among healers. 

Massage is reputed to be helpful, and certainly many fibromyalgia patients seek it out (while others avoid it, finding it too intense and exacerbating). Like low back pain, it seems like massage “should” be able to help with fibromyalgia. Surely massage can help soothe the frazzled nerves of a uninjured patient whose primary symptom is pain? And if it can’t, what good is it?

I have been a licensed massage therapist for over 10 years with my ultimate goal being to help others mentally and physically. I am the daughter of a Physical Therapist after all! hehe  Extensive experience working on individuals struggling with depression and/or addiction and they hold a special place in my heart. I am very easy going and non-judgmental, my table is available to those who need to ease up and disconnect. Massages are incredibly beneficial as research proved it could significantly increase one's well-being over time.   Booking a session will come with complimentary aromatherapy to open your senses and promote relaxat ... View Profile
During pregnancy, your body goes through major changes. Pregnancy massage can help with these changes by reducing stress, decreasing arm and leg swelling, and relieving muscle and joint pain. Massage may be particularly helpful during a time when medication and other medical options may be more limited. Using specially designed massage pillows, the massage therapist will help get you into a comfortable position for this type of massage.
Thank you so much for your article The Pressure Question in Massage Therapy. I just read it all. I went for a sports massage two weeks ago as I was recommended to have one as it was suggested it might help with tight calves, a side effect of some other injuries I have. I’ve been for sports massages many, many times before over the years. This one was one of the most painful experiences of my life — when I got home I was almost sick and felt in shock. My right achilles tendon was raging and it’s been bad ever since. It hurt so much when it was done (like someone was sticking knives in) and I kept asking if it was meant to hurt. I wish I’d just stopped the session or objected but I didn’t. It used to be a bad injury that affected me walking for about 6 months so I’m just devastated about this. I can hardly bear to put shoes on and its all this time on. I know there are good practitioners out there but experiences like this just make me want to stay away. I wish I’d gone to a “gentle” one.
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?
Massage is big business in Thailand. It is regulated by the Public Health Ministry. The Commerce and Tourism and Sports Ministries have set a target of 20 billion baht per year to be generated by the spa business, but only 500 of the 2,000 spas nationwide are legally registered with the authorities. The legal difference between a "spa" and a "massage parlour" is unclear. The Federation of Thai Spa Associations (FTSPA) in 2016 urged authorities to clamp down on sexual services being offered at some massage parlours. The FTSPA maintains that influential figures have used legal loopholes to open "pretty spas" or massage parlours where tourists can buy sexual services.[12]
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.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.

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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
Thai Massage is a popular massage therapy that is used for management of conditions such as musculoskeletal pain and fatigue. Thai Massage involves a number of stretching movements that improve body flexibility, joint movement and also improve blood circulation throughout the body. In one study scientists found that Thai Massage showed comparable efficacy as the painkiller ibuprofen in reduction of joint pain caused by osteoarthritis (OA) of the knee.[69]
How to Relax is part of The Mindfulness Essentials series of how-to titles by Zen Master Thich Nhat Hanh, introducing beginners and reminding seasoned practitioners of the essentials of mindfulness practice. Pocket-sized, with original two color illustrations by Jason DeAntonis, How to Relax shows how critical it is to regularly interrupt the hub-bub and routine of our lives to stop, relax mindfully, and recharge.
“Light a candle or two by your bed. Turn off the other lights. Stretch across your bed, taking your time, exaggerating your movements. Feel the cool sheets against your body. Moving slowly, open a book of poetry (or an uplifting…book), and slowly read a page. Allow the wisdom and beauty of what you are reading to enter your mind. Put the book aside. Take a minute to concentrate on the candle flame. Blow out the candle, and curl into peaceful sleep.”
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.
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.
Let go of guilt. Many religious and cultural beliefs instill the value of hard work very deeply. Over time, and increasingly so with the advent of smart technology that keeps us hyper-wired 24/7, many of us have come to believe that being "on-the-go" constantly is the only way to prove our value. Having an unrealistic interpretation of "hard work" will end up wearing you down. Hard work is giving your tasks the attention they deserve at the time they deserve, not letting it bleed into all hours of your day!
1. Take Five. Meditation is a powerful, natural way to reduce stress. If you’ve never tried it, it can seem intimidating—or even a little hokey. It’s actually very easy, though, and it takes only a few minutes to help yourself chill out. Set a timer for five minutes in a quiet space, close your eyes, sit still, and simply take slow, deep breaths. To avoid letting it turn into five minutes of ruminating about your stress, focus on your breath. For example, try breathing in for four counts, holding your breath for seven counts, and then breathing out for eight counts.
Myofascial trigger points — so-called “muscle knots” — are increasingly recognized as a factor in many of the world’s aches and pains. This book-length tutorial focuses on advanced troubleshooting for patients who have failed to get relief from basic tactics, but it’s also ideal for starting beginners on the right foot, and for pros who want to stay current and as science-based as possible. 196 sections inspired by the famous texts of Drs. Travell & Simons, but also much more recent science. Also offered as a free bonus (2-for-1) with the low back, neck, muscle strain, or iliotibial pain tutorials. Buy it now for $19.95 or read the first few sections for free!
“Resonate” in this context means that physical pain may transmogrify into emotional pain and vice versa. Emotional and physical pain readily create and reinforce each other. I assume that catharsis is inherently valuable, and I think that’s a fairly safe assumption. I discuss the relationship between pain and emotions in from many angles in several articles, like Pain is Weird, Pain Relief from Personal Growth, The Anatomy of Vitality, Why Do We Get Sick?, The Art of Bioenergetic Breathing, Insomnia Until it Hurts, and Anxiety & Chronic Pain. Whether catharsis is medically helpful for pain obviously depends on many factors, but it’s certainly possible — just as they can reinforce each other, relief from one may also be coupled to relief from the other. BACK TO TEXT
Good pain. In massage, there is a curious phenomenon widely known as “good pain.” It arises from a sensory contradiction between the sensitivity to pressure and the “instinctive” sense that the pressure is also a source of relief. So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching, and are often described as a “sweet” aching. The best good pain may be such a relief that “pain” isn’t even really the right word.
Some sports massage therapists use myofascial techniques that focus on stretching the fascia, which are connective tissues surrounding muscles, tendons and ligaments in the body. This particular massage technique involves the therapist applying forces in opposing directions which relaxes the tissues. It can help ease pain and increase mobility in the tissues and surrounding muscles.
In this particular study, published in Studies in Health Technology and Informatics, therapeutic massage included techniques of tapping and friction, while DTM used “oblique pressure and a combination of lengthening and cross-fiber strokes.” All sessions were 30 minutes long and preformed daily, and all participants did not receive any other treatments during the course of the study. After 10 days, participants treated with DTM reported significant improvements in pain (lower back pain in this case) compared to those treated with therapeutic massage, based on scores using the Modified Oswestry Low Back Pain Disability Index, Quebec Back Pain Disability Scale and Visual Analog Scales. (4)
Many types of practices are associated with massage and include bodywork, manual therapy, energy medicine, neural mobilization and breathwork. Other names for massage and related practices include hands-on work, body/somatic therapy, and somatic movement education. Body-mind integration techniques stress self-awareness and movement over physical manipulations by a practitioner. Therapies related to movement awareness/education are closer to dance and movement therapies. Massage can also have connections with the New Age movement and alternative medicine as well as holistice philosophies of preventative medical care, as well as being used by mainstream medical practitioners.
Early mobilization and range of motion exercises, for instance, will be taught by competent massage therapists to clients with cervical injuries, because they help people get better faster.2627 In fact, the evidence strongly suggests recovery from nearly any injury or surgery is greatly facilitated by early mobilization. But “massaging with movement” is not “massage therapy,” of course — it’s something that a few well-trained massage therapists prescribe, and only in specific circumstances.
Swedish and deep tissue massages are very similar. The primary difference is the level of pressure involved. If you’re looking for relaxation and relief from tense, tight muscles, Swedish massage is probably right for you. If you’re recovering from an injury, deep tissue massage can be a helpful part of your treatment plan. Feel free to ask questions before you book a massage and to communicate feedback to your therapist during a massage.
Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The word lomilomi also is used for massage in Samoa and East Futuna. In Samoa, it is also known as lolomi and milimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it romiromi and mirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known as popo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.[46]
Connective tissue stimulation. A lot of therapists are keen on stretching connective tissues — tendons, ligaments, and layers of Saran wrap-like tissue called “fascia.” I’m not a huge fan of this style, but certainly it’s a way of generating many potent and novel sensations, which may be inherently valuable to us — another form of touch. Although “improving” the fascia itself is implausible and unproven, perhaps fascial manipulations affect bodies indirectly, just as a sailboat is affected by pulling on its rigging. People have written whole books full of speculation along these lines. So, as long as the sensations are not like skin tearing (that’s an ugly pain for sure), you might choose to tolerate this kind of massage if it seems to be helping you.
The reason the Pressure Question exists is that it’s hard for patients to tell the difference between nasty pain that might be a necessary part of therapy, and ugly pain that is just abusive. Not everything that hurts is therapeutic, but not every therapeutic procedure is painless! How can we tell if an intense massage technique is therapeutic or not?

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When you're in pain, the last thing you want to do is leave the house. But taking the time to connect with people outside of your usual routine can help reduce stress. Try making a regular date with friends or your spouse for some unwind time. Go out for coffee, see a movie or even take a long walk in the park if you're able. Once you make your date, do whatever it takes not to break it.
Good pain. In massage, there is a curious phenomenon widely known as “good pain.” It arises from a sensory contradiction between the sensitivity to pressure and the “instinctive” sense that the pressure is also a source of relief. So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching, and are often described as a “sweet” aching. The best good pain may be such a relief that “pain” isn’t even really the right word.
In massage therapy, so much can be achieved while inflicting only good pain on patients that bad pain must be justified by vivid, quick, and somewhat lasting benefits — which is a high bar to clear. All health care practices must be justified by benefits. As risk and pain and expense increase, the benefits must also. There is simply no point in tolerating — and paying for — painful treatment without an obvious return on the investment.
The significant difference in the two approaches is their effect on these layers. A Swedish technique uses lubricant to glide over the layers – whether that be on a superficial layer (light pressure) or a deeper layer (firm pressure). There may also be kneading of the muscles, vibration or percussion to stimulate the muscles, and passive and/or active joint movements. All of these techniques serve to increase circulation of blood and lymph, soften and relax the tissues, reduce cortisol levels in the body (the stress hormone), and provide a generalized sense of relaxation for the client.
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.
Yes, certainly it is a bit exaggerated. It could be a lot worse — hey, at least it’s got references! But it could be a lot better. Citing single cherry-picked studies to support broad treatment claims is weak sauce, even if the picks are good (and clearly not all of these are). The evidence and claims here that are stronger are also less important … and those that are more clinically important are also less sound.
Ever gone to a county fair, music festival, or conference and envied other people getting chair massages? Passed by the chair massage section in an airport? Or, maybe you're lucky enough to work at a company that offers 15- to 20-minute massages as a regular benefit. Onsite, chair massages are done while you're seated fully clothed in a portable, specially designed chair. They usually involve a massage of your neck, shoulders, back, arms, and hands.
Whether you’re an athlete with a daily high demand placed on your body or recovering from an injury or illness, deep tissue massage likely has some benefits to offer you. Massages have been utilized for thousands of years throughout the world to lower both physical and psychological stress. And today, research continues to show that whether used alone or in conjunction with other treatments, massage therapy is an effective way to help treat common conditions like arthritis, anxiety and chronic lower back pain.
Yes, certainly it is a bit exaggerated. It could be a lot worse — hey, at least it’s got references! But it could be a lot better. Citing single cherry-picked studies to support broad treatment claims is weak sauce, even if the picks are good (and clearly not all of these are). The evidence and claims here that are stronger are also less important … and those that are more clinically important are also less sound.
While this is practically a no-brainer, it’s still important to note that exercising is an excellent way to get rid of stress. Find the type of exercise that suits you and makes you happy doing it. Some people find walking or jogging very relaxing while others like to dance or lift weights. Find a physical exercise that suits you and raise your heart rate around 20-30 minutes every day.  Simple ways to increase exercise are to take the stairs, and park farther away so you have to walk further.  Look for opportunities to walk and move at home, school or on the job.
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.
Accept that sleep is a very important part of life. During sleep, your mind continues learning in ways that are not possible during waking hours. Sleep restores and refreshes your body in myriad ways that cannot happen when you're awake. Do not be tempted to devalue the worth of sleep. Moreover, the alleged ability of some people to thrive on four hours sleep per night is the exception, not the rule — most of us need the six to eight hour sleep cycle for full restoration. Dreaming is an essential part of sleep; you can explore your inner fantasy and have many experiences that you never encounter in the waking world.

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