Trust and pain. Bear in mind that feeling safe is critical to the experience of good pain. Tiny differences in trust and comfort can make the difference between an intense pain being good or bad. Much of the “goodness” of good pain comes from mental context, from knowing that a pain is not dangerous or pointless, that it will not increase suddenly, or anything else yucky or shocking.
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?)

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. 

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
AD 1878: Dutch massage practitioner Johan Georg Mezger applies French terms to name five basic massage techniques,[13] and coins the phrase "Swedish massage system". These techniques are still known by their French names (effleurage (long, gliding strokes), petrissage (lifting and kneading the muscles), friction (firm, deep, circular rubbing movements), tapotement (brisk tapping or percussive movements), and vibration (rapidly shaking or vibrating specific muscles)).
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.
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Standing up for a quick stretch can relieve muscle tension and help us relax during a stressful workday Muscle stretching as an alternative relaxation training procedure. Carlson, C.R., Collins, F.R. Jr., Nitz, A.J, et al. University of Kentucky. Journal of behavior therapy and experimental psychiatry 1990;21(1): 29-38.. Why not try a shoulder roll-out or a chest-opening stretch right from the desk chair?
I love this series by Thich Nhat Hanh. Great size and good for gifting, as its a small, compact book. I bought it to give to my dad but ending up holding on to it for a while to read myself! Very easy to read and great mantras and thoughts inside. Good intro for mindfulness for anyone not familiar with the author's other works. I am not a fan of 'how to' books but I am hooked on this series. Highly recommend.

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Scientists theorize that things in our environment compete for the brain's attention. Essentially, the brain can only focus on a certain amount of input at once. Focusing on sensations other than tension and pain, or even introducing new sensations, can "close the gate" to pain. The pain doesn't go away, it just drops into the background.  De-stress and counteract the downward pain spiral with these eight relaxation tips.

“It is your body, your session, your outcome,” advises Rotenberger. “There’s a fine line between pain and discomfort, and it’s unique to the individual.” What’s more, deep pressure is not the same as deep tissue. It’s a common misconception, Rotenberger explains, and in reality, a therapist that is muscle-specific needs to exert little pressure to be effective. 
If you are a massage therapist, or sports physical therapist, it might be a good idea to explain what a this type of massage will accomplish and what to expect.  At first, a Deep Tissue massage might feel like your typical Swedish massage. First, your therapist will warm up and prepare your muscles by applying light pressure to the areas that require attention. Only after your muscles have been sufficiently prepared will your therapist begin applying specific techniques. The most commonly used strokes in Deep Tissue massages are stripping and friction. Stripping usually involves your therapist applying deep and gliding pressure to the length of your muscle fibers with an elbow, forearm, knuckles or thumbs. Friction, on the other hand, applies pressure across the grain of the muscle in order to relieve adhesions and realign the fibers of the tissue.
Another interesting indirect example: stretching massages muscles with movement, and so it may feel good for some of the same reasons and share some of the same benefits. And indeed a 2011 study of simple, static stretching showed a clear, good effect on heart rate regulation13 — just from pulling on muscles, which may not be very different from pushing on them. It’s not much of a leap to guess that rubbing soft tissues could also have systematic regulatory effects.
With no lotion or oil to cause sliding, it becomes possible to fully get a hold of the shortened fascia; this is necessary in order to lengthen it. Slow, sustained strokes are what can change this tissue from a short, hardened state to a lengthened, fluid state. The process is not unlike stretching salt water taffy. You’ve got to get a hold of it, warm it up, and work it very slowly. The work may sometimes be intense, eliciting moderate discomfort as old adhesions and chronic dysfunctional patterns are altered. But that leads to a much more fluid, easy sense in the body.
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.

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.
Aquatic bodywork comprises a diverse set of massage and bodywork forms performed in water. This includes land-based forms performed in water (e.g., Aquatic Craniosacral Therapy, Aquatic Myofascial Release Therapy, etc.), as well as forms specific to warm water pools (e.g., Aquatic Integration, Dolphin Dance, Healing Dance, Jahara technique, WaterDance, Watsu).[33]
Here comes the sun—and some stress relief. If it’s a sunny day, head outside for an easy way to lift your spirits. Bright light can be an effective treatment for people who suffer from depression, and can even cheer up otherwise healthy folks Randomized trial of physical exercise alone or combined with bright light on mood and health-related quality of life. Partonen, T., Leppamaki, S., Hurme, J., et al. Department of Psychiatry, University of Helsinki, Finland. Psychological Medicine 1998;28(6):1359-64..
In a world where the only thing news sites are non-stop talking about are crime, corruption, economic breakdown, and the end of the world,  you realize that exposing yourself to this on a daily basis is the same as planting seeds of fear and anxiousness. Try and limit the time that you spend watching the news or browsing on social media, and focus your time and energy on things that will help you get forward and appreciate who you really are without you having to worry about the future.

Sam Homola, DC, a chiropractic “heretic” and author of Inside Chiropractic: A patient’s guide, writes, “We … know that massage may be as effective as cervical manipulation in relieving tension headache.” (p147) Dr. Homola is extremely critical not only of chiropractic, but of many other alternative health care practices as well, and he clearly does not tolerate irrational claims of therapeutic efficacy. And yet he is content to make this positive statement about massage therapy. That constitutes a good endorsement!


Our body and mind need sleep in order to rest and refresh. Sleep deprivation is one of the primary causes of anxiety. An average person requires eight hours of sleep every day. When your brain is sleep deprived, it may not be able to respond to emotional events appropriately. Go to bed early and make sure that you get seven to nine hours of sleep every night to maintain a healthy mind.
Post-event sports massage is given after a competition and is mainly concerned with recovery. It is geared toward reducing the muscle spasms and metabolic build-up that occur with vigorous exercise. Recovery after competition involves not only tissue normalization and repair, but also general relaxation and mental calming. A recovery session might be 15 minutes to 11/2 hours in length. Post-event sports massage is given after a competition and is mainly concerned with recovery. It is geared toward reducing the muscle spasms and metabolic build-up that occur with vigorous exercise. Recovery after competition involves not only tissue normalization and repair, but also general relaxation and mental calming. A recovery session might be 15 minutes to 11/2 hours in length. 

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.


Athletes tend to know their bodies fairly well, so information presented to the therapist seems to be better. Compared to the general client, the athlete is also in good shape and is concerned about getting back to the field of play as soon as possible. Some athletes have an obsessive compulsive behavior about their sport. This generally makes them very compliant with the therapists’ recommendations. 
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]

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Most other evidence about massage benefits is indirect and/or so weak it’s meaningless. For instance, there are a few scraps of evidence — not nearly enough, but better than nothing — that rubbing and stretching soft tissue can reduce joint pain and stiffness.8 (Note that stiffness is a symptom, a sensation of discomfort with movement that may or may not involve any actually limited movement. See Why Do Muscles Feel Stiff and Tight?.)
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
“I drew habitually growing up and minored in art in college, but when I graduated, my practice began to slip away. Because I’m rusty now, I get a sort of performance anxiety about the whole thing, so I try to do it in as casual a manner as possible. I typically call a friend who I’ve been neglecting or put music on, get out a pad and doodle. (A really satisfying pen works best. It has to feel like velvety-butter.) I let my pen do all sorts of weird things: make strange shapes, draw people I don’t know who don’t have hands. There are no rules, no expectations of perfection, no product to produce. And when I’m done with it, I’m done with it. It’s very un-precious and so, so relaxing.”
You don’t have to run in order to get a runner’s high. All forms of exercise, including yoga and walking, can ease depression and anxiety by helping the brain release feel-good chemicals and by giving your body a chance to practice dealing with stress. You can go for a quick walk around the block, take the stairs up and down a few flights, or do some stretching exercises like head rolls and shoulder shrugs.

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.


About footnotes. There are 85 footnotes in this document. Click to make them pop up without losing your place. There are two types: more interesting extra content,1Footnotes with more interesting and/or fun extra content are bold and blue, while dry footnotes (citations and such) are lightweight and gray. Type ESC to close footnotes, or re-click the number.
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.

We are creatures of habit and pattern, a strong property of the way the human nervous system functions. Every time we experience something, we are more likely to experience it the same way again in the future, because perception and sensation are so strongly built on expectations, especially threat assessment. That is, we tend to see and feel what we expect to see and feel, and we are particularly prone to expecting the worst (as a survival strategy). If our expectations are negative and fearful—as they often are, because life is harsh, and trauma is common—that then colours our experiences quite a bit. This is a very important principle in chronic pain, which routinely involves “central sensitization,” the brain-driven tendency to overreact to noxious stimuli — the ultimate clinically relevant example of a “sensory rut.” BACK TO TEXT
This review of 35 tests of treatments for delayed onset muscle soreness (DOMS) is strongly consistent with my own past interpretations of the research: basically, nothing works. Massage is “slightly effective” but “its mean effect was too small to be of clinical relevance.” The evidence for cryotherapy, stretching, and low-intensity exercise is not promising, but technically still inconclusive: more study needed.

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Yet kicking back is hardly an unproductive activity; experts say that it keeps us healthy and happy. And research shows that regular de-stressing can help ward off heart disease and obesity, act as a buffer against depression, and even boost immunity against colds. Plus, when you're calm, you perform tasks smarter and more efficiently, leaving you with time to—wait for it—relax. Check out these strategies and inspiration for R in R: relaxing in reality.
Massage-StLouis.com [Internet]. Sanvito A. How Does Massage Work?; 2016 December 31 [cited 17 Feb 28]. While the skin is indeed “the surface of the brain,” there are of course many sensory receptors in deep tissues as well. Massage therapy mainly interacts with the nervous system via the skin, which is extremely richly innervated, and the importance of this is often underestimated or discounted entirely … but it’s not limited to that. For instance, I’ve always particularly loved having my joints moved passively, which creates a flood of proprioception — movement/position sensation — that my brain didn’t initiate, which feels weird in a delicious way. BACK TO TEXT

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.
Low back pain is a huge health problem, and massage therapists claim to get good results when treating low-back pain. Indeed, low back treatments are the bread and butter of the profession. I’d guess that about 70% of massage purchases are for back pain. The amount of money that patients around the world spend on massage for back pain must be simply huge, at least in the tens of millions annually, and probably much more. As with chiropractic care, massage therapists might not have much of a business model if people didn’t have low back pain.
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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This study showed that “massage may have immediately beneficial effects on pain and mood among patients with advanced cancer” and that it didn’t do much more than simple touch … but they both helped. This is both a scientific blow for massage therapy and a nice validation at the same time. It doesn’t say much for the ability of trained therapists to do any more for a cancer patient than a compassionate nurse can. But it also reinforces the reassuring idea that any kind of touch is therapeutic, and that skill may not be a critical factor in the value of massage therapy to some patients. (Over the years, I’ve seen many amateurs who could give excellent massages simply by virtue of their empathy and attentiveness. Could massage “skill” be mostly just an extension of social skills? Might be.)
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]

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.
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.
Although a lot of Bastian 2014 is certainly relevant to the concept of “good pain,” strictly speaking I don’t think they are writing about the good pain paradox, which is defined by simultaneous pleasure and pain. They are writing about pleasure following pain (relief from pain). This is more comfortable scientific ground: it’s pretty straightforward that relief from pain might be “associated with positive consequences” or lead to “activation of the brain’s reward circuitry,” for instance. Lance a boil, then feel better, right? Of course. But that’s definitely not what we mean by “good pain” in massage. BACK TO TEXT

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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).
On the road with the WTA is intense but energizing! I have traveled to Paris, Madrid, Istanbul, Monterrey, Acapulco as well as sites in the U.S. The day generally begins at about 7:00am with breakfast, followed by a team meeting. On the first day, we cover every player as well as their individual needs before and after a match. We arrive onsite in the training room one hour prior to play—work can include anything from a quick warm up of a shoulder to cutting tape for an athlete to prepping sports drinks or ice and towels.
Massage gives you an endorphin rush. The word “endorphin” reached buzzword status a few years back and is now often invoked carelessly. Endorphins are a class of neuropeptides that act on the nervous system to reduce pain and increase euphoria. But although massage therapy may reduce pain by a variety of mechanisms, it probably doesn’t do it by putting more endorphins into the bloodstream.62 And, yet again, it wouldn’t be that big a deal even if it were true. Like relaxation, endorphins are good, but they can only do so much — at best, such an effect would mostly just explain the pleasantness of massage itself. 

AD 1150: Evidence of massage abortion, involving the application of pressure to the pregnant abdomen, can be found in one of the bas reliefs decorating the temple of Angkor Wat in Cambodia. It depicts a demon performing such an abortion upon a woman who has been sent to the underworld. This is the oldest known visual representation of abortion.[12]


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.

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“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.
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.
Deep tissue massages are often utilized following injuries to help break up newly forming scar tissue that can make recovery more difficult and lead to stiffness. Massage has been shown to help reduce inflammation and muscle spasms by stimulating blood flow, loosening up muscles to allow for more oxygen and also helping reduce the nervous system’s automatic stress response.
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.

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