Quick muscle knot orientation: Muscle knots — myofascial “trigger points” — are a factor in most of the world’s aches and pains. Their biology is still mostly mysterious: conventional wisdom says they are tiny spasms, but they might also be a more pure neurological problem. Regardless, they can cause strong pain that often spreads in confusing patterns, and they grow like weeds around other painful problems and injuries, making them quite interesting and tricky. Although they are well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. For more information about how trigger points might be involved in your own medical history, see PainScience.com’s best-selling tutorial:
Leave the past behind, and think of what you can do in the future to put those memories to rest. It may help to do a physical action to lay that memory to rest, or to let your mind let it go. Get a chalkboard and draw the memory, or write, on it, then ritualistically erase it, knowing it wil leave your mind as it leaves the chalkboard. Or, write it on a piece of paper, and throw it into a fire to be consumed, thus eradicating it from your mind.
Make your own positive affirmations and repeat them outloud.  Often. Tell yourself that you are strong. Tell yourself that you are safe and that you will get through this. Positive affirmations have been proven to work in a few different ways. Knowing something is one thing, but actually hearing it time and time again from within yourself will result in a boost to your confidence. Make sure to join our 30-day affirmation challenge to get started!
The recipient wears loose, comfortable clothing and lies on a mat or firm mattress on the floor. In Thailand, a dozen or so subjects may be receiving massage simultaneously in one large room. The true ancient style of the massage requires that the massage be performed solo with just the giver and receiver. The receiver will be positioned in a variety of yoga-like positions during the course of the massage, that is also combined with deep static and rhythmic pressures.

I stayed there as the administrator and an instructor for five years after I graduated, and during that period of time, I could not possibly even name all the things I went through. I had a lot of psychic readings. I availed myself of EFT (Emotional Freedom Technique), an invention of Dr. Mercola, [sic]84 which basically consists of tapping on meridian points in order to relieve emotional negativity, food cravings, and pain. I tried Aura Soma, which is described as “color healing.” I got tuned up with tuning forks, and crystal bowls. I participated in one workshop called Matterspeak, which consisted of sitting around chanting random words, letters, and numbers for 8 hours, as in   “1263supercalifragilisti789.” I don’t remember what the purpose of that was and frankly doubt that it had any purpose, other than to enrich the teacher’s pocketbook. If memory serves, she had “channeled” that information from the Atlanteans. I also used the chi machines, the detox foot baths and pads, biofeedback and all kinds of computer programs designed to balance your body, mind and spirit, and most New Agey-sounding things in existence at the time. If it was out there, I tried it. All kinds of “healers” came and went through the school.


Get up off your chair and walk around the desk. Take a quick but deliberate walk to the water cooler and drink a sip of water. This will help increase circulation and get your body moving more during the day. It can be calming to break up the tension that can come from sitting in one place especially since we spend so much time in front of screens!
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So what should runners book instead? Anna Gammal, a massage therapist who works with elite runners at the Boston Marathon each year and also massaged athletes at the 2004 and 2012 Olympics, recommends either a sports massage (i.e. targeted therapeutic treatment for the unique physical and biomechanical needs of athletes) or a myofascial release massage (i.e. the application of gentle, sustained pressure on soft tissue restrictions). Both specifically target muscle release and will help improve flexibility, reduce pain and increase range of motion.

Job’s body: a handbook for bodywork, a book by Deane Juhan. amazon.com If you can manage the density of the language, Job’s Body is thick with creative insights into physiology and healing. Perhaps too many of them, and perhaps too creative — but very stimulating! Juhan tries to explain why bodyworkers often seem so uncannily effective. This is a job that certainly needed doing. In trying to explain bodywork, Job’s Body is a philosophical introduction to the science of the human body — a physiology textbook with a heart. Many chapters are devoted to pure science — just barely accessible to the hard-reading layperson, and mainly offering perspective for the health care professional. Still more chapters are devoted to pure philosophy. Juhan frequently dares to ask (and answer) the hardest questions in the health sciences: why and so what? I took a workshop with Juhan many years later. I’m sorry to say that he seemed cocky and jaded. My main impression was that he was bored and had drunk to much of his own Kool-Aid. And the introductory chapters of this book do a better job of explaining some of the possible subtle benefits of massage therapy than anything else I’ve ever read. Read an excerpt.
This seems like a fairly straightforward bit of good-news science about stretching. It’s not a surprising idea that movement would have some systemic regulatory effects (motion is lotion, use it or lose it), but it’s nice to see some corroboration of that common sensical notion, and it’s also nice to know that perhaps just stretching did this (to the extent we can learn anything from a single study). If true, it makes for nice evidence to support a general stretching habit, yoga, mobilizations, really any kind of “massaging with movement,” and probably even massage itself.

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]


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


It is frequently asserted that massage therapy (MT) reduces cortisol levels, and that this mechanism is the cause of MT benefits including relief from anxiety, depression, and pain, but reviews of MT research are not in agreement on the existence or magnitude of such a cortisol reduction effect, or the likelihood that it plays such a causative role. A definitive quantitative review of MT's effect on cortisol would be of value to MT research and practice.
“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!”  
Number 10 across: Anxious, overwhelmed, or freaking out (seven letters). If you guessed “Stressed,” you’re in good shape to try some crossword puzzles. Brain games that require lots of concentration can help take our mind off whatever’s worrying us Trait anxiety and impoverished prefrontal control of attention. Bishop, S.J. Department of Psychology and Helen Wills Neuroscience Institute, University of California Berkley, Berkley, CA. Nature Neuroscience 2009;12(1):92-8..

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]
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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Some research has shown that massage therapy can be effective during pregnancy due to its anxiety-lowering effects, and women who receive massages before and during labor tend to experience decreased depression, anxiety, and leg and back pain. Results from one study found that women who received massages prior to and during labor had significantly less pain, plus their labors were on average three hours shorter and required less need for medication.

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A dry-water massage table uses jets of water to perform the massage of the client's muscles. These tables differ from a Vichy shower in that the client usually stays dry. Two common types are one in which the client lies on a waterbed-like mattress which contains warm water and jets of water and air bubbles and one in which the client lies on a foam pad and is covered by a plastic sheet and is then sprayed by jets of warm water, similar to a Vichy shower.[77] The first type is sometimes seen available for use in malls and shopping centers for a small fee.
This geeky basic neurology experiment produced a rough estimate of the density of nerve endings in human glabrous (hairless) skin: about 6000 per square centimetre, so a whole hand probably contains about as many as the maximum capacity of the largest stadiums in the world. They measured an average nerve diametre of about 3 thousandths of a millimetre.
For example, I worked on the Indiana Sports Massage Team starting in 1989, as well as the NCAA Swimming & Diving Championships and National Championships. I coordinated massage for the 1992 Olympic Trials and was on the 1996 Olympic Massage Team for the Atlanta Olympics—the first time massage therapy was part of the medical staff for the Olympics. These were all volunteer positions, but I loved it!
Sports massage has become an integral part of the new athletic regimen from sports medicine clinics, to college training rooms, to professional locker rooms to Olympic training. Growing number of trainers believe that massage can provide an extra edge to the athletes who participate in high performance sports. Massage has become a necessary ingredient for a complete workout. More and more people are realizing that a complete workout routine includes not only the exercise itself, but also caring for the wear-and-tear and minor injuries that naturally occur with strenuous movement. The physiological and psychological benefits of massage make it an ideal complement to a total conditioning program.
I’ve often said that massage therapy research is in its early stages. And after thinking about that more today, I’ve realized it’s worse than that. Massage therapy research is stunted, and not showing signs that it is ready to progress. Some might disagree, and would point to the increasing number of massage therapy studies. (I’ve charted it myself in at least one paper I’ve published, and there is no doubt that the number of papers on the subject is increasing.) But I would counter by noting that there is no discussion in the field. The studies are conducted and published in isolation. They are not often being critiqued, and researchers with different theories and perspectives are not addressing each other in the literature or even at conferences. 

Thai massage – or Nuat Thai – combines both physical and energetic aspects. It is a deep, full-body massage progressing from the feet up, and focusing on sen or energy lines throughout the body, with the aim of clearing blockages in these lines, and thus stimulating the flow of blood and lymph throughout the body. It draws on yoga, acupressure and reflexology.
“Runners put so much effort into training, but very few athletes put effort into taking good care of body that helps them perform,” says Gammal, who recommends incorporating regular massage—even if it’s just a 30-minute session once a month—so as to prevent injuries and the overtraining of muscles.  Scheduling mid-training appointments can also reveal places that are tight and places that should be addressed in post-workout stretching. “Massage isn’t a luxury, Gammal says. “It’s an investment.”
Two general effects [of massage, MT] are well-supported by scientific data and widely agreed-upon by MT researchers. Quantitative research reviews show that a series of MT treatments consistently produces sizable reductions of depression in adult recipients. The effects of MT on anxiety are even better understood. Single sessions of MT significantly reduce state anxiety, the momentary emotional experiences of apprehension, tension, and worry in both adults and in children, and multiple sessions of MT, performed over a period of days or weeks, significantly reduce trait anxiety, the normally stable individual tendency to experience anxiety states, to an impressive degree in adults.
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. 

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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.
This seems to be a common problem. The actor Diane Keaton told More magazine: “I wouldn’t know what to do with a week off,” while the musician Gwen Stefani told Stylist that whenever she has any downtime, she feels as if she is “panicking a bit or trying to plan the next thing”. Elon Musk, when asked what he usually does after work, said: “Usually work more” – which does not seem to be turning out well for him.
Crashing waves, warm sand, a gentle breeze ruffling your hair. Well, at least the image is nice. Take a break from work and start browsing the web for some future vacation spots. Sometimes the whole fun of a trip is in the planning, anyway Looking forward, looking back: anticipation is more evocative than retrospection. Van Boven, L., Ashworth, L. Department of Psychology, University of Colorado, Boulder, CO. Journal of Experimental Psychology: General 2007;136(2):289-300..

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Massage reduces inflammation. Um, no. The opposite, if anything.60 According to a sensationalized science news item in early 2012, supposedly massage “reduces inflammation” and “promotes muscle recovery.” But this was a small and technical gene profiling study, several steps removed from clinical reality, trying to explain a phenomenon that doesn’t clearly exist: we already knew that massage doesn’t do much for DOMS.61 All of the evidence about this and DOMS is explored in detail in a separate DOMS article.

3. Slowing: this third step will now bring your attention to what is happening inside you, particularly your breathing and heart rate. Although there are a lot of ways we can learn to change the way our body responds in any given moment, the easiest is to control our breathing. There are dozens of breathing techniques, but the one I have found to be the easiest to use is called "4-7-8 Breathing". It works like this:

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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.
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.
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..
Massage therapists, and others in the holistic arts … seem to be a particularly gullible bunch. And there are a lot of people who have seized upon that, and marketed their products, their classes, their modalities, and their wild claims to us … and many of us have fallen for it, hook, line and sinker … and unfortunately, gone on to convince our clients to buy into it, as well. … Our profession has turned into the snake oil medicine show. 

Shoulder pain. A 2017 study published in the Journal of Physical Therapy Science reports that shoulder pain is one of the most common musculoskeletal disorders, affecting as many as 66.7 percent of the population. The study goes on to say that massage therapy can often help reduce this type of pain, sometimes in a matter of days, though 36 sessions appeared to offer the greatest level of relief.
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.
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
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.
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.

The second reason it is not that commonly found is that it requires special training. Many American massage therapists are serious students who have traveled to Asia for intensive programs, but others might have to take a weekend workshop. You might want to inquire about their training before you sign up. If you live in a major city, you might be able to get a high quality, no-frills Thai massage for a reasonable price. 

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Perspective cuts both ways here. On the one hand, it’s not as bad as it sounds: these “events” are minor and moderate in severity; only 1 or 2 per thousand visits causes a serious problem; and drugs are actually relatively worse. That is, you are modestly more likely to have an “adverse event” if you are given a pill. This just refers to typical side effects, such as ibuprofen’s tendency to cause indigestion.

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.
Why so different? If you pay in United States dollars (USD), your credit card will convert the USD price to your card’s native currency, but the card companies often charge too much for conversion, well above the going exchange rate — it’s a way for them to make a little extra money. So I just offer my customers prices converted at slightly better than the current rate.
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

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.


Cathy Wong explains in her article “Deep Tissue Massage: Everything You Need to Know” on verywell.com that while Deep Tissue massages can be slightly uncomfortable, they have been known to reduce stress hormones and heart rate while releasing oxytocin and serotonin, which allow the client to experience a boost in mood and relaxation. Deep Tissue massages are often used to relieve chronic aches and pain, stiff necks, upper back and lower back pain as well as muscle tightness. Therapists treat such issues by utilizing Deep Tissue massages to break up scar tissue and muscle knots and working out adhesions that might be hindering circulation and limiting movement.
Stressed? Me? Ha! Laughter’s one of the sillier ways to beat stress, but there’s science behind it Humor and Laughter May Influence Health. Bennett, M.P., Lengacher, C.A. Evidence-Based Complimentary and Alternative Medicine 2006;3(1):61-3.. A fit of hysterics can increase blood flow and boost immunity. Keep a book of jokes handy in the desk drawer or check out a hilarious YouTube video (maybe a piano-playing pug?) for a quick pick-me-up.
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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