Because Thai massage is done fully clothed, some people recommend it if you feel uncomfortable with the nudity. However, Thai massage is not the best choice for first-time spa-goers. Why? First, you're going to be lying on a futon with a therapist crouched over you, pressing on your legs, just to start. They might use the weight of their body to move your body into various positions to achieve passive stretching. 

Massage has been shown to reduce neuromuscular excitability by measuring changes in the Hoffman's reflex (H-reflex) amplitude.[90] A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability.[91] Others explain, "H-reflex is considered to be the electrical analogue of the stretch reflex...and the reduction" is due to a decrease in spinal reflex excitability.[92] Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage.[93] It has been noted that "the receptors activated during massage are specific to the muscle being massaged", as other muscles did not produce a decrease in H-reflex amplitude.[91]
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!
About “tendinitis” versus “tendonitis”: Both spellings are considered acceptable these days, but the first is technically correct and more formal, while the second is an old misspelling that has only achieved respectability through popular use. The word is based on the Latin “tendo” which has a genitive singular form of tendinis, and a combining form that is therefore tendin. (Source: Stedmans Electronic Medical Dictionary.) BACK TO TEXT
An urge to continually tidy up the house or yard may be a response to chaos all around you. According to Brigid Schulte, director of the Better Life Lab at the Washington, D.C., think tank New America and author of Overwhelmed ($10; amazon.com), "When you're strapped at work and stretched at home, having things in order can seemingly restore equilibrium." All together now: Yes. This. One sane way to tame that life-is-out-of-control feeling: Quit scattering tasks among your calendar, notepads, emails, sticky notes, and memory. Says Morgenstern, "Decide on a single, reliable system, and it will help turn off the ticker tape of to-dos in your brain."
An Indian physician named Shivago Kumar Bhucca, a contemporary of the Buddha, is often credited with developing Thai massage. The impetus was to give monks and nuns the flexibility to sit for long hours in meditation. Whatever its genesis, massage was considered such a crucial aspect of medical treatment in Thailand that until the early 20th century, the Thai Department of Health included an official massage division. Thai massage is based on releasing blockages along ten lines of energy called sen, which are similar to the meridians of traditional Chinese medicine. The technique incorporates stroking and kneading of muscles, manipulation of joints, and pressure applied to specific points in order to balance the body’s four elements—earth, water, fire, and air. But there’s also rocking, breathing, and lots of stretching—Thai massage is often referred to as “lazy yoga.”
While there are numerous benefits to this branch of massage, elementsmassage.com reminds you that it is important to keep your expectations for the treatment reasonable. While Deep Tissue massages use more pressure to reach deeper muscle tissues and often yield immediately noticeable results, asking your therapist to apply more pressure and gritting your way through pain will do more damage than good. If you are in pain, your muscles will begin to contract, making the therapist’s efforts moot. Applying more pressure will not speed up the process. Like any treatment, Deep Tissue massages need time to be effective. Keep in mind that the injury or muscle tension that you are hoping to get resolved has had a great deal of time to form; it will take time to undo the damage. Like any treatment, often the therapy will not be enough; including other changes to your life style, such as exercise, relaxation techniques or working on posture in addition to your massage appointments will help move the process along and help you see faster and longer lasting results.
In any case, the whole notion that you want or need to get rid of lactic acid in the first place is just bogus. Lactic acid is not the cause of muscle pain at any time except the immediate aftermath of intense exercise (and probably not even then). Research has shown that muscle fatigue and the “burn” that you feel as you exercise intensely is probably caused by calcium physiology, not an accumulation of lactic acid.67 In particular, lactic acid does not cause soreness the day after exercise — yet another myth, and a particularly bad one that will just not die!68
That is, regardless of all other considerations, a massage therapist must talk to you about pressure, respect your preferences (they are more important than any treatment ideology), and be careful about stumbling into areas that need much less pressure (for comfort) or much more pressure (for satisfaction). Far too many therapists make the mistake of setting a “default” pressure for a client early on, and then using roughly that much pressure everywhere.
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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There are a few “medical” massage therapists out there with some training in orthopedics and rehabilitation. My education in massage therapy here in British Columbia, Canada, was three years long — the longest massage therapy training program in the world. There are also a few other places with two-year programs. A massage therapist with this level of education is certainly the kind that patients should seek out if they want massage as a treatment.

Deep Tissue massages are among the most effective forms of massage therapy available to clients. If you are interested furthering your massage therapy education or pursuing a career in wellness, it is important to have this technique firmly under your belt. Fremont College offers an extensive program in massage therapy, sports therapy education and physical therapy education. Take a look at our programs page for a more detailed description of the courses and degrees we offer!


Over time, deep-tissue massage therapy can help break up and eventually erase scar tissue in the body. It does this by improving lymphatic circulation and drainage to improve flexibility and range of motion in the affected area. Scar tissue is often associated with ongoing pain and stiffness, so deep-tissue massage can improve these symptoms. Massage therapy is often recommended for people who are recovering from surgery.

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.


“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.”

Tests of overall effectiveness (clinical trials) are not difficult to cook up in principle: just take a hundred people with a certain kind of problem, give some kind of reasonably appropriate massage to fifty of them, give a neutral treatment to the other fifty, record the results, and report them. It’s not perfect, but it doesn’t have to be perfect to detect what should be a reasonably strong effect — if those massaged 50 people aren’t better off, how good can massage be? A great deal more precision is required to answer exactly what kind of massage works how well for what — more on that in a moment — but in broad strokes, it’s not a difficult problem. Not in principle. BACK TO TEXT

The belief of long-term pain-relief as the benefit of short-term agony from massage therapy is a common mistake many make. We think relief will come from a massage therapist digging and crushing our muscles for an entire massage session of an hour or longer. Fortunately at Elements Massage™ studios, your massage session is customized to exactly what you want, proper pressure in the desired area, to ensure your massage provides the relief you are seeking.
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
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

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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]
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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