In ashiatsu, the practitioner uses their feet to deliver treatment. The name comes from the Japanese, ashi for foot and atsu for pressure.[34] This technique typically uses the heel, sesamoid, arch and/or whole plantar surface of foot, and offers large compression, tension and shear forces with less pressure than an elbow, and is ideal for large muscles, such as in thigh, or for long-duration upper trapezius compressions.[35] Other manual therapy techniques using the feet to provide treatment include Keralite, Barefoot Lomi Lomi, Chavutti Thirumal.
“The number one thing therapists should do to protect themselves from injury is avoid doing too much work,” says Bykofsky. She also recommends not over-scheduling, working too many hours, or holding too many deep massage sessions a week. Also, take advantage of other “tools” at your disposal, such as different parts of your hands and arms, using them for leverage to take some of the pressure off your thumbs.
The massages are geared towards athletes and their sports. For instance, working on a runner will require doing a lot of leg work, but the upper body work will be minimal. Moreover, massages will target those areas that tend to become injured. For example, a massage session with a tennis player will involve a forearm massage that is preventive in the development of tennis elbow. If necessary, a whole session could be spent only on important areas, and skip completely muscles that are not overused in a particular sport.
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.
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.”
Sometimes confused with pressure point massage,[10] this involves deactivating trigger points that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (President Kennedy's physician) and David Simons. Trigger points have been photomicrographed and measured electrically[71] and in 2007 a paper was presented showing images of Trigger Points using MRI.[72] These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this technique is different from reflexology, acupressure and pressure point massage.
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.
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.  
People think of massage therapy as a “safe” therapy, and of course it mostly is. But things can go wrong. Serious side effects in massage therapy are rare, however, and common side effects are minor. A 2007 survey of 100 massage patients49 found that 10% of 100 patients receiving massage therapy reported “some minor discomfort” in the day following treatment. This would mainly be a familiar slight soreness that is common after a massage — I’m surprised only 10% reported it. The massage must have been quite gentle.
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.
The therapist uses his or her hands, knees, legs, and feet to move you into a series of yoga-like stretches and also applies deep muscle compression, joint mobilization, and acupressure. Thai massage also utilizes energy work, which, according to ancient Asian culture, treats the subtle energetic field within the body. It corrects blockages, deficiencies, and imbalances in the flow of this energy, which then is believed to improve the client's health. 

Deep-tissue massage can be an effective treatment for injured muscles. Because it facilitates the movement of toxins from the muscles and helps stretch tight or twisted muscle mass, deep-tissue massage can help promote healing. Because massage also helps relax muscles, it can reduce the pain caused by injuries, too. Deep-tissue massage is frequently used to rehabilitate sports injuries.


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.
• If you are spending time with family or friends over the festive period, Nina Grunfeld recommends assigning each person one hour in which they are in charge of the group’s schedule, when they can choose whichever activity they consider most relaxing. “One of my children might decide we all have to play a video game; another will decide we are all going for a walk; another will make us all bake cakes. That way you all get a bit of ‘me-time’, and you can experience someone else’s – and it’s very relaxing not having to make decisions for the whole day,” she says.
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.
A review of nine studies of dubious quality of “myofascial technique” — rubbing and stretching basically — for joint pain and stiffness. Although all the studies showed improved range of motion and reduced pain, most clearly for the jaw, the authors of this review think that there are “a number of threats that challenge the statistical inferences underpinning these findings.” Translation: they think the studies they reviewed are of poor quality and that their conclusions cannot be trusted (garbage in, garbage out). Obviously the science is incomplete, but there are some reasons for optimism here (and it’s not exactly a huge claim that some rubbing and stretching might help a painful, stiff joint).
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.
Trigger points or stress points may also cause muscle soreness and decreased flexibility. These points are specific spots in muscle and tendons which cause pain when pressed, and which may radiate pain to a larger area. They are not bruises, but are thought by some to be small areas of spasm. Trigger points may be caused by sudden trauma (like falling or being hit), or may develop over time from the stress and strain of heavy physical exertion or from repeated use of a particular muscle.
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.
There have been very few studies of pre-event sports massage. In 2018, a rare example of it had a clear negative conclusion,71 echoing the findings of a couple earlier ones.7273 It’s a very small study, but it’s still a useful contribution74 (and it's not actually the first such evidence). Seventeen sprinters were tested with four combinations of massage, dynamic warmup, and an ultrasound placebo and found that “massage decreased 60-meter sprint performance in comparison to the traditional warm-up.”
A satisfying sensation doesn’t necessarily imply successful treatment, unfortunately. Scratching mosquito bites feels great… but it’s not helping them! Trigger points may be like mosquito bites: it may feel terrific to massage those mysterious sensitive spots in soft tissue, but it may not be doing much to actually “release” or resolve them. It may be a purely sensory experience, the satisfaction of dealing with an “itch” that we cannot easily reach on our own.

A traditional Swedish massage involves the whole body. You will begin on either your back or your stomach and flip over at the halfway point. If you have an area of particular concern, such as a tight neck, you can ask your therapist to spend more time in this area. Depending on your preferences, you can ask your massage therapist to use light, medium, or firm pressure.


Really, stop and smell ’em. Certain odors can change our mood, and it’s hard to feel angry or upset with a nose full of roses The impact of natural odors on affective states in humans. Weber, S.T., Heuburger, E. Department of Clinical pharmacy and Diagnostics, University of Vienna, Vienna, Austria. Chemial Senses 2008;33(5):441-7.. Keep a fresh jar of your favorite flowers near your workspace or in the living room, and take a whiff whenever anxiety strikes.
Several mechanisms for deep massage’s natural stress-relieving effects include its ability to dilate blood vessels and also lower activity of the limbic system (including the hypothalamus), which is responsible for autonomic nervous system regulation and cortisol secretion. Massage has been shown to improve relaxation by boosting activity of the parasympathetic nervous system, as measured by heart rate, blood pressure and heart rate variability. (8, 9)
Each of your feet contains 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments. Oh, and the soles of your feet have over 20,000 nerve endings. Researchers believe going barefoot keeps the information highway to your brain open and refreshed, so kick off your shoes, put your feet on the floor, and walk around to feel the full effects.
Everyone I know, including myself, is busy and distracted on an infinite loop. It’s a curious conundrum, considering we’re all armed with more than enough information on how to de-stress. But the “surprising benefits” of exercise, meditation and work-life balance, documented ad nauseam, are beginning to feel like drawn-out humblebrags. Sometimes, they just seem insurmountable. And try as we might to convince ourselves that binge-watching TV helps, I don’t know anyone who feels refreshed after two+ episodes.

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