Thai massage therapy requires extensive training, and the preeminent place for it is Wat Po in Bangkok. The school offers three certification levels, with the third one alone requiring 800 hours. (Graduates are issued a certificate from the Thailand Ministry of Public Health.) There are numerous programs around the world with solid training as well, but many die-hard therapists make the pilgrimage to Thailand to acquire at least some authentic knowledge base.

In addition there are many professional bodies which have a required minimum standard of education and hold relevant insurance policies including: the Federation of Holistic Therapists (FHT),[112] the Complementary Therapists Association (CThA),[113] and the Complementary Health Professionals (CHP).[114] In contrast to the CNHC these bodies exist to support therapists rather than clients.


Before booking an appointment, ask questions about the therapist’s education and experience, like “What is your training?” “How many years have you been practicing?” and “Do you work frequently with runners?”, suggests Gammal. Seek referrals if possible, and ensure s/he is a licensed massage therapist. Rotenberger recommends a massage therapist specifically trained in orthopedic treatment and assessment, as s/he will know when to refer you to another healthcare professional, in the case that you’re experiencing chronic pain and discomfort not fixable via massage. You can find a reputable practitioner via www.orthomassage.net or www.NeuroMuscular-Reprogramming.com.
This review is called a meta-analysis, which is weird, because “only 1 study met inclusion criteria for intrarater agreement and therefore no meta-analysis was performed.” So it was just a regular old review of 6 studies of how much different experts can agree on the location of myofascial trigger points. Lacking adequate data for statistical pooling, they had to “estimate” an agreement score of 𝛋=0.452 — a rather precise etimate! Of the criteria used to determine the location of trigger points, the most reliable were localized tenderness (.68) and pain recognition (.57). Those are actually decent reliability scores, but the authors conclude that “manual palpation for identification of MTrPs is unreliable.” Based on their estimated scores, this is technically correct but a bit misleading: most attempts to detect pathologies in the body are technically “unreliable,” falling well short of a score of κ=1.0 (perfect agreement), but still much better than κ=0 (coin flipping agreement). 

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?
Just a square (about 1.4 ounces) of the sweet stuff can calm your nerves. Dark chocolate regulates levels of the stress hormone cortisol and stabilizes metabolism Metabolic effects of dark chocolate consumption on energy, gut microbiota, and stress-related metabolism in free-living subjects. Nestle Research Center, Vers-chez-les-Blanc, Lausanne, Switzerland. Journal of Proteome Research 2009;8(12):5568-79..
Pre-event sports massage is done to help prevent serious athletic injury. It helps to warm up the muscles, stretching them and making them flexible for optimal athletic performance. A pre-event massage stimulates the flow of blood and nutrients to the muscles, reduces muscle tension, loosens the muscles, and produces a feeling of psychological readiness.
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“If your hands and fingers start to scream while you're working, you need to modify what you're doing,” says Bykofsky. “Also, if you notice that you’re sore at the end of your work day, Bykofsky also recommends that you “do the things you suggest to your clients: ice, apply something to help, perhaps take an anti-inflammatory, and, the hard one, rest!”  

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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The results are underwhelming. Although they did a little better than just guessing, the results suggest that it’s difficult even for expert examiners to detect the location of neck and back pain by feel. As well, they were only attempting to detect the side of pain. Imagine how much worse their performance would have been if they had had to identify the location more precisely, or if the pain could have been anywhere or nowhere. So they barely passed the easiest possible test, and probably would have failed a harder one and done no better than guessing.

Does massage therapy “work”? What do massage therapists say that they can do for people and their pain, and is there any scientific evidence to support those claims? Massage is a popular treatment for low back pain, neck pain, and tension headaches — can it actually treat them, or does it just pleasantly distract patients and maybe take the edge off? In this article, I examine massage therapy in the light of science — not “objectively,” but fairly.1 I go out of my way to be critical of my former profession — I consider it an ethical duty. Health professionals must be self-critical and critical of each other: that is how we improve.2 And, alas, massage therapists are guilty of an astonishing amount of bullshit.
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.
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Compile a list or collect a box of things that make you feel happy and proud. It may be photos of your friends and loved ones or your pet. It may be memorable items or gifts. Did you go to a concert or movie that you enjoyed?  Add the ticket stub to your collection. Look at your list or pick up items in your collection when you feel anxiety building. Realize that you have a lot to live and fight for in this world.

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I’m on a padded floor mat wearing loose pants and a T-shirt (standard Thai-massage garb) while Pailin Winotaka uses her fingers, palms, elbows, knees, feet, indeed her whole body as ballast, slowly getting me into such familiar yoga positions as “bridge” (a backward arch) and “bow” (on my stomach, reaching back to grab her wrists rather than my own ankles for a deeper stretch). I actually feel taller when she’s done.
Continuing education is important to stay abreast of the evolving field of sports medicine. In addition, sports massage therapists must have a strong understanding of the demands that sports put on the body, both physically and mentally. Because I also train and race, I feel better able to understand body mechanics—including common injuries and performance goals—which gives me the opportunity to communicate and share my experience as well as my skills to help athletes reach their 

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.


For Pietrunti, an interest in sports massage began as part of his military experience. Serving as a Navy Chief Petty Officer where he was a fitness leader at various naval commands, Pietrunti says, “I began to look into corrective exercise to help my sailors and clients with athletic performance and pain management, but I felt that something was missing.”

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.


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.
Completely new to massage? Book your first appointment either well before a race—at least a few weeks out—or wait until the day after. “Just like you wouldn’t test out new socks or shoes on day of race, you shouldn’t experiment with any pre-race bodywork,” says Denunzio. Those who are familiar with massage can benefit from a pre-race rubdown in the seven to two-day window prior to an event. Getting treatment less than 48-hours prior puts all runners—even those who are massage veterans—at risk of race day soreness.
In New Zealand, massage is unregulated. There are two levels of registration with Massage New Zealand, the professional body for massage therapists within New Zealand, although neither of these levels are government recognised. Registration at the Certified Massage Therapist level denotes competency in the practice of relaxation massage. Registration at the Remedial massage therapist denotes competency in the practice of remedial or orthopedic massage. Both levels of registration are defined by agreed minimum competencies and minimum hours.[105]

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..
Spend time with yourself. Stay away from electronics for a bit, play a soft music and lay down, forget all the troubles and think of good and beautiful things. For example: imagine a cozy beautiful fall forest in your mind. Also you may cook your favorite treat or make a cup of tea and read a book or write in your journal things that you love about yourself, your goals, what makes you happy, etc.
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.
Before you can decide which massage style is best for you, you need to ask yourself a question. Do you simply want a massage for relaxation and stress control? Or do you need symptom relief or help with a certain health condition? Before booking a massage, let the therapist know what you're looking for and ask which style the therapist uses. Many use more than one style. Or the therapist may customize your massage, depending on your age, condition, or any special needs or goals you have.

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We often forget to focus on the simplest, shortest (and one of the most restorative) activities available to us: our breath. Yoga teacher Anna Guest-Jelley suggested taking five deep breaths. “As you do, notice the natural pause between your inhale and exhale, and then between your exhale and your next inhale. Your body has a built-in break — how great is that?!”
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)
Lymphatic drainage is an interesting example of a specific massage technique, allegedly good for one thing and not much else: its purpose is to reduce swelling. By reputation, it’s the best treatment option for patients suffering from lymphoedema, a serious complication of mastectomy and other surgical procedures. But it’s also obscure, technical, and practiced by no more than a few hundred therapists globally. It’s not “massage therapy” per se; just a specialized tool that a tiny group of professionals specialize in, some of whom happen to be massage therapists. Oh, and bad news: there’s also recent evidence that it does not work,28 or not nearly as well as we’d like.29

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Trigger points may respond to massage, and that is certainly my impression from three decades of rubbing my own trigger points and trying to help other people with theirs. It’s also what legions of massage therapists believe. But don’t ask science for confirmation — it’s playing hard-to-get here. I get dorky in detail about the science of trigger point massage in the trigger points tutorial, but here’s the bottom line …
Expect to work hard breaking into the sports environment. Get additional training and develop your expertise in orthopedic massage and functional assessment, clinical massage, myofascial work and stretching. Start by getting involved with your AMTA chapters’ Sports Massage Team; this provides excellent hands-on experience and each event looks great on a resume.

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.
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.
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.)
Unsurprisingly, there are almost no comments questioning or challenging anything about the image. Julie Onofrio chimed in with one of the only genuine criticisms: “a few of the things on there are not correct — massage has not been proven to increase endorphins or decrease cortisol.” Agreed: most of the infographer features common scientific myths about massage.

Even if you do yoga, meditate and perform other stress-reducing activities, calm may allude you. Instead of getting a prescription for Xanax, try a natural supplement to relax. There are several herbs you can take in a nice cup of tea that could give you the sedative effect you need during times of hardship. Examples of such herbs are Chamomile, Valerian, and Kava.  Generally, one teaspoon of dried herbs or three tablespoons of fresh herb to one cup of water is a beneficial amount. Most herbs should steep for 5 to 10 minutes.
Panic attacks have certain patterns. Time how long it takes to build up, the duration of the panic attack, how long it takes to calm down and at what point you are finally able to resume your normal activity. It may not be easy doing this, but timing your panic attacks will enable you to have better control over it the next time it happens. You will also be able to tell those around you before an attack occurs, how long it is liable to last, and how they can help you.
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.
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.
Have you ever heard of power poses? These are body movements that increase your confidence and tend to be more powerful than traditional confidence-boosting exercises.  Identify yours and make sure you practice holding that pose throughout the day. Also identify low power poses and remove them from your personal body language. Power poses basically trick your mind and tell it that you’re amazing! This feeds your subconscious mind, and increases your ability to be positive and anxiety-free.
In Japanese, shiatsu means "finger pressure." For shiatsu massage, the therapist uses varied, rhythmic pressure on certain precise points of the body. These points are called acupressure points, and they are believed to be important for the flow of the body's vital energy, called chi. Proponents say shiatsu massage can help relieve blockages at these acupressure points.
Thank you for explaining the difference between a deep tissue massage and a firm pressure massage. The place I go to offers different techniques and I have been wondering what the difference was between those two. Good to know that a deep tissue massage uses very little to no lubricant so the muscles can be hooked and grabbed. That one sounds like a really great option.
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.
The road to intellectual dishonesty is paved with good intentions. When I worked as a therapist, there were times when — confession! — I didn’t bother to explain to a patient that I was selling them a dubious approach to therapy . Sometimes it seemed okay because the atmosphere of experimental treatment was thick already, with a desperate patient who had low expectations and was pretty much there to try anything. But it was still dishonest, and I’m ashamed of those times. After all, if patients were my experimental research subjects, shouldn't I have been paying them?

A short but clear, compelling, and strong critique of cranial osteopathy. As an osteopath himself, Dr. Hartman’s opinion carries considerable weight, and he writes well. He concludes that techniques based on the assumptions of cranial osteopathy “should be dropped from all academic curricula; insurance companies should stop paying for them; and patients should invest their time, money, and health elsewhere.”
Soft tissue techniques employed by sports massage therapists are effective in the management of both acute and chronic injuries. For example, adding lymphatic massage to the "standard care" procedure in the acute stage of injury will improve control of secondary, hypoxic injury and enhance edemous fluid removal throughout the healing cycle. Trigger point techniques reduce the spasms and pain that occur both in the injured and "compensation" muscles. Cross-fiber friction techniques applied during the subacute and maturation phases of healing improve the formation of strong and flexible repair tissue, which is vital in maintaining full pain-free range of motion during rehabilitation.
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“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.” 

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.
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.
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!
According to the American Massage Therapy Association, up to 25 percent of American adults had a massage at least once during 2016-2017. And, they have a wide range of reasons for doing so. More and more people -- especially baby boomers -- recognize the health benefits of massage. They choose from among many massage styles to get relief from symptoms or to heal injuries, to help with certain health conditions, and to promote overall wellness.
Deep Tissue massages are designed to focus on a specific problem, usually something along the lines of chronic muscle pain, limited mobility, tennis elbow, etc. Cathy Wong explains that according to Consumer Reports magazine, at least 34,000 people claimed that Deep Tissue massages were more effective in relieving osteoarthritis pain than physical therapy, chiropractic, acupuncture or over-the-counter drugs. It is also especially effective in easing fibromyalgia pain, usually giving clients an improved range of motion immediately following a treatment.
Adequate recovery is also a major factor in avoiding the over-training syndrome. Over-training is characterized by irritability, apathy, altered appetite, increased frequency of injury, increased resting heart rate, and/or insomnia. It occurs when the body is not allowed to recover adequately between bouts of heavy exercise. Therapeutic massage helps you avoid over-training by facilitating recovery through general relaxation, and its other physiological effects. 
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.
Headaches. Severe headaches and migraines are the second most common pain conditions in the U.S. (15 percent) according to the AAPM, and Everhart says that massage therapy can oftentimes help in these cases. The Migraine Relief Center (MRC) indicates that the reason this modality works is that it eases muscle spasms, improves blood flow and circulation, relieves tension, and increases relaxation. The MRC shares that it is also especially helpful when it comes to tension and vascular headaches.

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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.
Sports massage was developed to help athletes prepare their bodies for optimal performance, recover after a big event, or function well during training. However, contrary to what the name suggests, you don't have to be an athlete to benefit from sports massage. Sports massage emphasizes prevention and healing of injuries to the muscles and tendons and can be beneficial for people with injuries, chronic pain or restricted range of motion.
Full disclosure: I was a Registered Massage Therapist with a busy practice in downtown Vancouver from 2000–2010. Since then, I have made my living writing about musculoskeletal medicine and pain science, with a reputation for a skeptical perspective. This article is biased in the direction of debunking, but I also have a real soft spot for massage therapy, and still make a large percentage of my income from selling a book about trigger point therapy — a popular idea in massage that is maligned by many other skeptics (and with good reason). So I actually have competing, complicated biases. I try to compensate for them by sticking to what the evidence can support, and clearly identifying speculation and experimental therapy for what it is. BACK TO TEXT

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.
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]
Pressure to meet a deadline can be stressful, but acupressure can help release all that tension. Acupressure’s a kind of touch therapy that works by balancing the circulation of fluids and energies in the body. Use the thumb and forefinger to massage the soft area between the thumb and index finger of the other hand. Dab on some lavender oil for extra relaxation.
5. Emerging: the key in this final step is calmly reentering the world. Rather than just stopping this process and jumping back in, focus on going back to what you need to do with the same peace you might have when you wake up from a nice sleep. Just gently getting back into the flow of your day. This should keep your mind and body both staying in a more relaxed and positive state.
Massage is to work and act on the body with pressure. Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device. The purpose of massage is generally for the treatment of body stress or pain. A person who was professionally trained to give massages was traditionally known as a masseur (male) or a masseuse (female), but those titles are outmoded, and carry some negative connotations. In the United States, the title massage therapist has been recognized as a business norm for those who have been professionally trained to give massages.
AD 1776: Jean Joseph Marie Amiot, and Pierre-Martial Cibot, French missionaries in China translate summaries of Huangdi Neijing, including a list of medical plants, exercises and elaborate massage techniques, into the French language, thereby introducing Europe to the highly developed Chinese system of medicine, medical-gymnastics, and medical-massage.[8]
Negative thoughts and feelings usually stay away when you are a good time. Schedule some time with your closest friend(s) or family regularly.  Go out to dinner, listen to music, take a walk or just sit and have a cup of coffee.  The activity is not as important as the shared experience.  Such activities often help you take your mind off your worries!

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