Deep tissue massages are not for everyone, and it’s very important to find a well-trained therapist. If you’re actively healing from surgery, have nerve damage or an existing injury, you’re wearing a cast or brace, or you’re pregnant, then talk to your doctor before seeking a massage therapist. Although it’s rare, massages that are poorly performed can sometimes cause increased pain, inflammation and other complications in high-risk patients. (16)

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The physiological effects are a bit of a moot point: if the pressure doesn’t suit you, you’re not likely to continue with the therapy. The exception is the patient who is willing to put up with intense pain long enough to find out if there appears to be a therapeutic effect afterwards, which there may be. But that judgement call is often made without much knowledge of whether or not the pain is really justified. BACK TO TEXT

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It’s important to be open with your massage therapist about the level of pressure and discomfort you wish to endure. This may be different for certain areas and throughout the massage, feel free to communicate with your massage therapist before and during the massage. Some massage therapists find pain to be counterproductive to the process and expect you to speak up if the pain is too much.


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.
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.

Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.[47][48][49]
Not everyone should receive a deep tissue massage. Some people simply enjoy the sensation of deeper pressure to their muscles and others prefer a more gentle touch. Someone who has never experienced a massage before may not want to request a deep tissue massage. It is the responsibility of the massage therapist to determine if a deep tissue massage is necessary by way of a thorough health history and evaluation. A massage is only effective when the person on the table is comfortable and relaxed.

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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.
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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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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Massage may be an appropriate technique for helping certain sports injuries, especially muscle injuries, to heal. When treating an injury, however, it is best to seek advice from a qualified sports therapist or a specialist in sports medicine before performing any massage. Certain ligament and joint injuries that need immobilization and expert attention may be aggravated by massage.

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Reflexology also known as "zone therapy", is an alternative medicine involving application of pressure to the feet and hands with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on a pseudoscientific[57] system of zones and reflex areas that purportedly reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body.[58]

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Some readers may not get this joke. It’s a reference to Pulp Fiction; it means, “I’m so sick of hearing about ‘release’ I might shoot the next person who says it.” The term has reached annoying buzzword status when paired with faddish excitement about fascia. While many therapists may find the frustration hard to understand, many professionals really are that fed up with hearing about fascia in general & release in particular.
More technically and most seriously, massage research is plagued by a “stark statistical error”: the error of reporting statistical significance of the wrong thing, or the wrong comparison.5 Dr. Christopher A. Moyer is a psychologist and a rare example of a real scientist — someone trained and expert in research methodology — who has chosen to focus on massage therapy:
4. Coaching: once you have the breathing pace down, keep doing it while you move to this step. The key here is giving yourself positive, reassuring, and calm messages, rather than continuing with the tense, anxious, and angry thoughts. When I do this, I think things like "I can get through this. It will be OK. I can handle whatever happens. I am going to calmly do my best." Everyone will have a different way of doing this, and some people like to imagine this in the voice of someone they care about, or with the image of that person telling them those things. Keep doing this along with the breathing until you feel sufficiently ready to reconnect with what you were doing.
Manipulative approaches to naturally treating pain and other health problems have been utilized for over 3,000 years, dating back to Ancient Egyptian and Chinese civilizations. Pressure massages were used to improve “Qi” (life force or energy), detox the body and promote better liver function — which today can be explained through the process of activating the lymphatic system.
Beyonce, Blondie, or the Biebster, sometimes belting out the lyrics to a favorite tune makes everything seem all right. If you’re in a public place (that isn’t the opera), just listening to music can be a quick fix for a bad mood Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. Knight, W.E., Rickard, N.S. Monash University, Victoria, Australia. Journal of Music Therapy 2001;38(4):254-72.. Classical music can be especially relaxing right before bedtime.
Sports massage is a good option if you have a repetitive use injury to a muscle, such as what you may get from playing a sport. It’s also a good option if you’re prone to injuries because it can be used to help prevent sports injuries. You may also use sports massage to increase flexibility and performance. Additionally, sports massage can be used to relieve pain, anxiety, and muscle tension.
We offer our patients chiropractic, massage and acupuncture all under one roof. All injuries are treated from a whole-body approach. We focus on first reducing pain by taking pressure off of the inflamed muscle, disc or vertebra with an adjustment and release the surrounding muscles with stretching, myofascial release, graston or ART. Once pain levels have decreased, we correct muscle imablances and strengthen weak muscles with a customized physical therapy plan. Most patients enjoy periodic treatment sessions to maintain their health at an optimum level. ... View Profile
Massage may be an appropriate technique for helping certain sports injuries, especially muscle injuries, to heal. When treating an injury, however, it is best to seek advice from a qualified sports therapist or a specialist in sports medicine before performing any massage. Certain ligament and joint injuries that need immobilization and expert attention may be aggravated by massage.

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Disconnect. Put the phone back down, shut the email folder, walk away. Whenever you feel like making an instantaneous reply in anger to someone who has raised your ire, don't act on it. When we feel angry and stressed, we are more likely to read sinister interpretations into our interactions and if we act on them, our self-righteous anger can be self-fulfilling when the person responds negatively. Sleep on your angry missive and practice the relaxation techniques outlined here.

“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.
Most of us have dealt with financial stress at some point. Debt can easily become overwhelming and become a major contributor to feelings of low self-esteem and hopelessness.  Organize your finances by tracking your expenses. Cut down unnecessary expenses. Create a budget for every week or month. Spend your money wisely and make a workable plan to pay your debt.  Try to save a little of every paycheck.
Bio-medicine.org reports: “Nerve signals that tell the brain that we are being slowly stroked on the skin have their own specialised nerve fibres in the skin. The discovery may explain why touching the skin can relieve pain.” This discovery is important to touch therapies, of course. It strongly implies that neurological responses to touch have considerable complexity.
The psychoanalyst David Morgan, of the Institute of Psychoanalysis, believes that for many of us this deadening retreat to our screens is both a reason for and a consequence of the fact that we no longer know how to relax and enjoy ourselves. Our screens and what we use them for are all techniques of distraction, he says. “People have got so used to looking for distraction that they actually cannot stand an evening with themselves. It is a way of not seeing oneself, because to have insight into oneself requires mental space, and all these distraction techniques are used as a way of avoiding getting close to the self.”

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!
Your brain listens to you. So talk to yourself even though you may not feel completely convinced on what you are talking about.  Like affirmations, you can trick the brain into believing positive things and what works for you. This ‘fake it until you make it’ tactic takes a while to get used to, but could prove to be very beneficial in the long run.
Massage detoxifies or flushes lactic acid from your muscles. Detoxification myths are among the most embarrassing of all massage myths. “Detoxification” sounds good and means little or nothing. There are such things as toxins in the world, but not only is massage unable to “flush” any that matter from the body, it likely produces a mildly toxic state known as rhabdomyolysis.58 But if you challenge massage therapists to name a “toxin” that they are “flushing,” most will name lactic acid, not rhabdomyolysis. And again, the truth is ironically the reverse of to the myth: evidence has actually shown that massage interferes with lactic acid elimination. See the lactic acid section below.
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. 

A licensed, traditional massage practitioner is required to complete at least 800 hours training.[2] Massage therapists must acquire a professional license and must register at the Public Health Ministry's Department of Health Service Support (HSS). To qualify for a license, therapists must be trained in courses created by the HSS. The standard courses are provided free. Alternatively, students can go to one of the 181 schools nationwide approved to train therapists using standard HSS courses.[3]
This study evaluated the effectiveness of a 15-min. on-site massage while seated in a chair on reducing stress as indicated by blood pressure. 52 employed participants' blood pressures were measured before and after a 15-min. massage at work. Analysis showed a significant reduction in participants' systolic and diastolic blood pressure after receiving the massage although there was no control group.
Craniosacral therapy is another classic example — popular for decades, it is a touch therapy, not “massage,” and it has never enjoyed any respect from the majority of doctors or scientists. It has even been criticized by many alternative health professionals.36 And yet it is sold with overconfidence by countless manual therapists as though it were proven effective. 

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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.

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Burmese massage is a full body massage technique that starts from head to toes, drawing on acupuncture, reflexology, and kneading. Signature massage strokes include acupressure using the elbows, quick gentle knocking of acupressure points, and slow kneading of tight muscles. The massage is aimed to improve blood circulation and quality of sleep, while at the same time help to promote better skin quality.
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.

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.
Typically, sports massage therapists hold a certification and maintain licensure. A good option is to become board certified through the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and have an active membership with an association, like AMTA, to keep up to date with industry trends. Exact requirements depend upon the state in which the sports massage therapist practices.
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.
Like massages, chiropractic care can be beneficial for lowering pain and improving recovery. It’s also been shown to lower stress, headaches and more. One way that chiropractors help treat pain is by lowering mechanical compression and irritation of spinal joints, which can send nerve signals throughout the body that increase inflammation and irritation.

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Wake up and smell the latte. Just the odor of coffee can help reduce stress hormones—no sipping required Effects of coffee bean aroma on the rat brain stressed by sleep deprivation: a selected transcript- and 2D gel-based proteome analysis. Seo, H.S., Hirano, M., Shibato, J. Department of Food and Nutrition, College of Human Ecology, Seoul National University, South Korea. Journal of Agricultural and Food Chemistry 2008;56(12):4665-73.. (Just be sure not to burn the tip of your nose.)


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!

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The first thing to examine is if your lifestyle is interfering with your ability to relax. We all get stressed out now and again, but a bad work environment, fights at home, money problems, and even clutter around you can keep you constantly on "high alert." It's hard to relax when something's constantly nagging at you—whether it's at the back of your mind or you're well aware of the stressors.

PS Ingraham. Central Sensitization in Chronic Pain: Pain itself can change how pain works, resulting in more pain with less provocation. PainScience.com. 5428 words. Pain itself often modifies the way the central nervous system works, so that a patient actually becomes more sensitive and gets more pain with less provocation. This is called “central sensitization.” (And there’s peripheral sensitization too.) Sensitized patients are not only more sensitive to things that should hurt, but also to ordinary touch and pressure as well. Their pain also “echoes,” fading more slowly than in other people. BACK TO TEXT
There is so much uncertainty that it is fair and reasonable to ask if we can really say much of anything about massage based on such incomplete and imperfect evidence. We can, in fact, but it all must be done with our eyes wide open and a lot of qualifiers and hedging of bets. We can’t be certain of anything … but we can certainly be informed by the evidence so far.
Specialized massage tables and chairs are used to position recipients during massages. A typical commercial massage table has an easily cleaned, heavily padded surface, and a horseshoe-shaped head support that allows the client to breathe easily while lying face down and can be stationary or portable, while home versions are often lighter weight or designed to fold away easily. An orthopedic pillow or bolster can be used to correct body positioning.

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In regulated provinces massage therapists are known as Registered Massage Therapists, in Canada only four provinces regulate massage therapy:[96] British Columbia, Ontario, Newfoundland and Labrador, and New Brunswick.[97] Regulated provinces have, since 2012, established inter-jurisdiction competency standards.[98][96] Quebec is not provincially regulated. Massage therapists may obtain a certification with one of various associations operating. There is the Professional Association of Specialized Massage Therapists of Quebec, also named Mon Réseau Plus, which represents 6,300 massage therapists (including orthotherapists, naturotherapists and others), the Quebec Federation of massage therapists (FMQ), and the Association québécoise des thérapeutes naturels; however, none of these are regulated by provincial law.

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To put it bluntly, it’s not clear that massage has any musculoskeletal benefits at all. It probably does, but mostly quite temporary and highly unpredictable. There’s not nearly enough science, and therapists are hopelessly biased assessing their own efficacy. See Does Massage Therapy Work? A review of the science of massage therapy … such as it is. BACK TO TEXT

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You may also have your own unique trouble spots, perhaps from past injuries. A massage therapist can pay special attention to these areas, monitor them for developing problems, and help keep them in good condition. An experienced massage therapist can also compliment treatment received from other health care professionals for various injuries. You may also have your own unique trouble spots, perhaps from past injuries. A massage therapist can pay special attention to these areas, monitor them for developing problems, and help keep them in good condition. An experienced massage therapist can also compliment treatment received from other health care professionals for various injuries. 
All that pretension! All those assumptions and lovely-sounding structural theories. All those expensive technique workshops those therapists went to, and all the extra money they charge real patients for their “expertise” to help pay off their investment in the workshops. It all added up to … nothing. They could have done relaxation massage instead and their patients would have been just as well off.
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.

First, start by reducing or eliminating anything that causes these images to appear in the first place, like scary movies or websites. To help get the images out of your mind, relax and do some breathing exercises. Picture yourself in a calming place while breathing deeply and slowly. You could also try distracting yourself by reading. This can be especially effective if you read a book without pictures since your brain can focus on creating images for the story.
Pre-event. Pre-event sports massage is given within the four hours preceding an event to improve performance and help decrease injuries. It is used as a supplement to an athlete's warm-up to enhance circulation and reduce excess muscle and mental tension prior to competition. It is normally shorter (10-15 minutes) than a regular conditioning massage, and focuses on warming-up the major muscles to be used, and getting the athlete in a good mental state for competition. It also improves tissue pliability, readying the athlete for top performance. Certain massage techniques can help calm a nervous athlete, and others can be stimulating. Pre-event. Pre-event sports massage is given within the four hours preceding an event to improve performance and help decrease injuries. It is used as a supplement to an athlete's warm-up to enhance circulation and reduce excess muscle and mental tension prior to competition. It is normally shorter (10-15 minutes) than a regular conditioning massage, and focuses on warming-up the major muscles to be used, and getting the athlete in a good mental state for competition. It also improves tissue pliability, readying the athlete for top performance. Certain massage techniques can help calm a nervous athlete, and others can be stimulating.
Have you ever splashed cold water on your face and felt instantly refreshed? There’s a good reason for that because cold water helps with heart palpitations by making your system “reboot”. It’s a trick that you can apply a few times a day to keep yourself refreshed and stress-free and whenever you are feeling overwhelmed.  It will also wake you up if you are too sleepy!
If you’re going to unwind or just to work out the kinks, make sure you find the right massage for your needs. Often they can be customized to address any concerns you may have and to make the massage perfect for you. Wear what feels comfortable to get the most out of your experience and be sure to speak up about what feels good and what doesn’t - this experience is all about you! Find out what type of massage is right for you in our comprehensive guide.

Massage may be an appropriate technique for helping certain sports injuries, especially muscle injuries, to heal. When treating an injury, however, it is best to seek advice from a qualified sports therapist or a specialist in sports medicine before performing any massage. Certain ligament and joint injuries that need immobilization and expert attention may be aggravated by massage.
Some possible justifications for painfully intense massage (these aren’t endorsements) include the destruction of motor end plates to “de-activate” trigger points; somatoemotional release (pain often strongly “resonates” with strong emotions like grief); moving tissue fluids; or just creating a strong, novel sensory experiences (which may have many subtle benefits).
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.  

Lactic acid is not a dead-end, “bad” metabolic waste product, and it does not cause post-exercise soreness. This is a pernicious and seemingly un-killable myth. It originated with “one of the classic mistakes in the history of science,” according to George Brooks, a Berkley physiologist. I will not give the myth any further air time here. See Gina Kolata’s clear overview in the New York Times, or a concise professional summary by Robergs in Experimental Phsyiology. For a deeper and geekier, but excellent read, see Dr. Goodwin’s entertaining rant about the prevalence of the lactate myth in the 2012 summer Olympics coverage. BACK TO TEXT

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The therapist might use Swedish massage to stimulate circulation of blood and lymph fluids, and trigger point therapy to break down adhesions (knots in the muscles), and stretching to increase the range of motion. Other techniques could include myofascial release, craniosacral therapy, lymphatic drainage and orthopedic assessment. The therapist should also have a good foundation in hydrotherapy modalities including cryotherapy and thermotherapy, which can help with recovery, repair and healing processes.
Another alarmingly common example is the sensation of skin tearing. This has been inflicted on me personally on at least three occasions, and not by poorly trained therapists — quite the opposite, the perpetrators were all well-trained massage therapists doing a kind of “fascial release” therapy that they clearly thought of as an “advanced” technique.7
Well, all living creatures have what’s known as fight or flight responses. Fight or flight can be triggered when you’re forced to respond to environmental stressors and your default biophysical reactions kick in to get you out of harm’s way (or what you perceive as harm’s way). Interestingly, your epithelial and endothelial cells – that’s right, even your tiny cells – enact fight or flight when they’re up against environmental stressors.1

Trigger point masssage is still 100% experimental. It has rarely been directly tested and it has never been done well (and never for back pain specifically, which is probably of the greatest interest).78 If you squint optimistically, you could call the best of the evidence “promising.” You could say that where there’s smoke, there’s fire. But it’s like the smoke from last night’s campfire — more of a smokey smell than a smoke where any fire might be hiding. Dial up even a mild cynical impulse, and the evidence collectively looks more like a damning failure to produce any clearly good news.


Unfortunately, such massage therapists are quite rare. Most are poorly trained and uncertified. Most work in spas or resorts and on cruise ships, doing treatments that are infamously fluffy and skin deep, with little therapeutic value other than the comfort of a quiet hour of touching (even though many patients find skin-deep massage to be more annoying than anything else). Most of these therapists are earnest and view themselves as medical semi-professionals, despite their comparative lack of training. It’s actually inappropriate to call them “therapists” at all, and in some places (here) it’s actually illegal — they have to use terms like “bodyworker” or “masseuse.”

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