Myofascial trigger points — so-called “muscle knots” — are increasingly recognized as a factor in many of the world’s aches and pains. This book-length tutorial focuses on advanced troubleshooting for patients who have failed to get relief from basic tactics, but it’s also ideal for starting beginners on the right foot, and for pros who want to stay current and as science-based as possible. 196 sections inspired by the famous texts of Drs. Travell & Simons, but also much more recent science. Also offered as a free bonus (2-for-1) with the low back, neck, muscle strain, or iliotibial pain tutorials. Buy it now for $19.95 or read the first few sections for free!
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
Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer ("aleiptes")[27] who would rub their muscles with oil. Pehr Ling's introduction to massage also came about directly as a result of his study of gymnastic movements.
The Thai Ministry of Public Health's Department for Development of Thai Traditional and Alternative Medicine regulates Thai traditional massage venues and practitioners. As of 2016 the department says 913 traditional clinics have registered nationwide in Thailand.[2] As of 2018, of the 8,000 to 10,000 spa and massage shops in Thailand, only 4,228 are certified by the Health Ministry's Department of Health Service Support (HSS).[3]

Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The word lomilomi also is used for massage in Samoa and East Futuna. In Samoa, it is also known as lolomi and milimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it romiromi and mirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known as popo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.[46]


In all cases, such massage techniques are employed in collaboration with other appropriate medical care. For example, encouraging circulation around a bruise, but not directly on it, through the use of compression, cross-fiber techniques or even long, deep strokes is only used after appropriate medical referral and diagnostics indicate that there are no clots formed in the area which may embolize.

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).
Develop an invisible shield between yourself and stressed folk. This is really a visualization technique, in which you imagine that you are cocooned against the negative vibes of overly stressed people around you. See their behavior and attitudes for what they are, recognize what their stress is doing to them but refuse to let this penetrate your shield.
The need for some simple source of relaxation can be seen in the initial surge in popularity of the adult colouring book, as well as last year’s 13.3% increase in sales of books providing spiritual guidance on how to live in a hectic world, and the mindfulness “mega trend” seen in Headspace, the meditation app that has been downloaded more than 15m times. Those of us who spent our money on these products were presumably searching for answers to some of the same questions – and many of us are still looking. The bottom has now dropped out of the colouring book market, with Forbes declaring it “dead” in May, and, in June last year, Headspace laid off 13 staff members.
The staff at Therapeutic Thai Massage believe everyone should take advantage of the therapeutic and stress relieving benefits of massage therapy. Our certified massage therapists will create an oasis of healing and tranquility with the sole goal of catering to your needs. Are you seeking improved circulation? Need relief from sore muscles? Or, do you simply want to treat yourself and relax in our steam room? Visit Therapeutic Thai Massage today.
While this is practically a no-brainer, it’s still important to note that exercising is an excellent way to get rid of stress. Find the type of exercise that suits you and makes you happy doing it. Some people find walking or jogging very relaxing while others like to dance or lift weights. Find a physical exercise that suits you and raise your heart rate around 20-30 minutes every day.  Simple ways to increase exercise are to take the stairs, and park farther away so you have to walk further.  Look for opportunities to walk and move at home, school or on the job.
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.

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Early mobilization and range of motion exercises, for instance, will be taught by competent massage therapists to clients with cervical injuries, because they help people get better faster.2627 In fact, the evidence strongly suggests recovery from nearly any injury or surgery is greatly facilitated by early mobilization. But “massaging with movement” is not “massage therapy,” of course — it’s something that a few well-trained massage therapists prescribe, and only in specific circumstances.

Acupressure [from Latin acus "needle" (see acuity) + pressure (n.)[31]] is a technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in those meridians. Pressure may be applied by fingers, palm, elbow, toes or with various devices.
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.
Traction is a great example — pulling on the spine. Often used by massage therapists to treat low-back pain and neck pain, it might be an effective technique for a few patients, but I wouldn’t count on it, or advise anyone to spend much money on it. Like many popular therapies, the evidence is a mess.30 The absence of conclusive evidence is significant: if traction worked well, it probably would have shown up clearly by now. If traction works at all, it’s certainly not reliable. I discuss traction in considerable detail in both my neck pain and back pain tutorials.
Continual improvement is the reason you train in the dead of winter, hammer up the hills on the bike, do track work, and train in the pouring rain. Well, that is the same reason you should get a good sports massage. After a massage you'll feel lighter, more powerful and more flexible, and all those nagging aches and pains can be addressed, helping to reduce the likelihood of injury.
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.
"If you walk in the door decompressed, it gives you a jump-start for the rest of the evening," says productivity expert Julie Morgenstern, author of Time Management from the Inside Out ($15; amazon.com). Do you take public transportation home? Resist the siren call of email and try a meditation app, such as Insight Timer, Calm, or Stop, Breathe & Think (all free on iTunes and Google Play). "Call a friend or loved one, listen to music—any activity that breaks you out of your normal train of thought should help," says Morgenstern. "One client found it effective to set his relaxation intentions on his way home from work. He'd tell himself, 'I want to enjoy cooking with my partner and make sure so-and-so does homework, but I'll ask in a gentle way,' and so on."
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.
Post-event massage is usually given 1–2 hours after the competition is over in order to give dilated blood vessels a chance to return to their normal condition. Post-event massage is light and gentle in order not to damage already stressed muscles. The goal is to speed up removal of toxic waste products and reduce swelling. Very light effleurage will decrease swelling while light petrissage will help clear away toxins and relieve tense, stiff muscles. Post-event massage can be self-administered on some parts of the body, such as the legs.

The therapist may utilize some Swedish techniques to warm up the tissues (kneading, friction, percussion), softening the superficial layers so that he or she can access the deeper ones more easily. Then, with little or no lotion, the therapist utilizes the hard surfaces of their hands and arms — surfaces such as fingers, knuckles, forearms, and elbows — and employs a very slow, sustained type of stroke.


Trust and pain. Bear in mind that feeling safe is critical to the experience of good pain. Tiny differences in trust and comfort can make the difference between an intense pain being good or bad. Much of the “goodness” of good pain comes from mental context, from knowing that a pain is not dangerous or pointless, that it will not increase suddenly, or anything else yucky or shocking.

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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.
Massage has been practiced for thousands of years. Today, if you need or want a massage, you can choose from about 80 massage therapy styles with a wide variety of pressures, movements, and techniques. These all involve pressing, rubbing, or manipulating muscles and other soft tissues with hands and fingers. Sometimes, even forearms, elbows, or feet are used. 

You’d hope this sort of thing would be rare, but it’s not. Readers regularly tell me about massage therapists who do not ask them what they want, who dismiss their patients’ concerns about pressure, and who ignore signs that their clients are in pain. They display a “doctor knows best” arrogance — ironic for an alternative health care professional — imposing their own idea of the “right” intensity.
Thai Massage is a popular massage therapy that is used for management of conditions such as musculoskeletal pain and fatigue. Thai Massage involves a number of stretching movements that improve body flexibility, joint movement and also improve blood circulation throughout the body. In one study scientists found that Thai Massage showed comparable efficacy as the painkiller ibuprofen in reduction of joint pain caused by osteoarthritis (OA) of the knee.[69]
Seriously, walk away from the screen(s). In fact, once you finish reading this article, you can walk away from this screen, too. Today, there’s so much time spent taking in information. You read the news, have your most personal conversations, and work, all from the same little screen. So, leave it behind. Taking regular breaks from your phone and computer can help reset your brain and bring relief. And doing so before bed (at least 45 minutes before) will help you drift to slumber without a heavy mind.
For starters, you bear in mind the things described above that tend to cause ugly pain, and you avoid that kind of therapy like the plague. Then you look for some clues that painful pressure is okay. Here are at least three reasons why unpleasantly intense pressure might be therapeutic — “bad pain,” but not ugly. In each of these situations, it might be acceptable to tolerate sensations so intense and painful that the only thing about them that is pleasant is the part where it stops. 

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.

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
The standard type of massage offered in most clinics, gyms, spas, and wellness centers, Swedish massage is virtually synonymous with massage therapy. Swedish massage is based on the Western concepts of anatomy and physiology, compared to the energy-centric style more common in Asian forms of massage. Using lotion or oil, massage therapists typically begin with broad general strokes and then transition to specific strokes to address problem areas. 

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Massage treats delayed onset (post-exercise) muscle soreness. Supposedly, massage therapy can stop that awful soreness that develops after an intense workout, known as delayed-onset muscle soreness (DOMS) — which is ironic, because massage is also well-known to cause a little next-day soreness. Although some studies have shown that massage can take the edge off DOMS, that’s about as good as it gets59 — perhaps a 30% temporary pain reduction when the planets align. It certainly doesn’t restore your strength any sooner. As with increasing circulation, it’s important to maintain perspective: it wouldn’t matter much even if massage did cure DOMS. Although DOMS can be pretty unpleasant, it’s one of the most trivial of all pain problems, guaranteed to solve itself within three days. On a closely related note …

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This alternative medicine form is a component of Chinese medicine involving thin needles inserted into the body at certain points known as meridians. This is an ancient healing modality that can be used solely or in conjunction with other treatments. There’s ample research evidence to indicate that Acupuncture can be an effective treatment for anxiety.
You must have thought that breathing is just a simple thing. You do it all the time without even noticing. However, there’s a good chance that you aren’t doing it properly. If you breathe properly, there’s a great chance of reducing anxiety. Use the 4-7-8 breathing exercise a few times a day to ensure that you provide oxygen to your body the right way. This will calm you down and keep you grounded.
This is not only an inaccurate and potentially harmful picture of this type of therapy, but such misguided practices can bruise muscles, elicit a defensive reaction in a client’s body, and worsen pain cycles. Properly executed deep tissue work should not cause the client to grit their teeth in agony as the therapist coerces the body into submission! If you find yourself clenching, shortening or holding your breath, or gritting your teeth, then it’s TOO DEEP. Even when it gets intense, it should not go above about a 7 on the pain scale: enough to “hurt so good,” but not enough that you want to leap off the table (and never come back).

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In Germany massage is regulated by the government on a federal and national level. Only someone who has completed 3,200 hours of training (theoretical and practical) can use the professional title "Masseur und Medizinischer Bademeister" or Medical Masseur and Spa Therapist. This person can prolong his training depending on the length of professional experience to a Physiotherapist (1 year to 18 months additional training). The Masseur is trained in Classical Massage, Myofascial Massage, Exercise and Movement Therapy. During the training they will study: Anatomy, Physiology, Pathology, Gynecology, Podiatry, Psychiatry, Psychology, Surgery, and probably most importantly Dermiatry and Orthopedics. They are trained in Electrotherapy, and Hydrotherapy. Hydrotherapy includes: Kneipp, Wraps, underwater Massage, therapeutic washing, Sauna and Steambath. A small part of their training will include special forms of massage which are decided by the local college, for example: Foot reflex zone massage, Thai Massage etc. Finally a graduate is allowed to treat patients under the direction of a doctor. He is regulated by the professional body which regulates Physiotherapists. This includes the restriction on advertising and oath of confidentiality to clients.[citation needed]

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.
While a typical runner’s sports massage focuses primarily on the legs, Denunzio insists on incorporating upper body work as well. As she explains it, “nobody has perfect form, especially when they’re fatigued” and runners can unknowingly tense their upper bodies when working out, which in turn creates tightness in their arms, shoulders and back. Ideally, those areas should receive a little TLC as well.  
While a typical runner’s sports massage focuses primarily on the legs, Denunzio insists on incorporating upper body work as well. As she explains it, “nobody has perfect form, especially when they’re fatigued” and runners can unknowingly tense their upper bodies when working out, which in turn creates tightness in their arms, shoulders and back. Ideally, those areas should receive a little TLC as well.   

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.

There are several types of massage that focus on different parts of the body or healing approaches. Massage is the practice of rubbing and kneading the body using the hands. During a massage, a massage therapist will apply gentle or strong pressure to the muscles and joints of the body to ease pain and tension. A massage therapist is a person trained in giving massages.
When we're anxious and stressed, it can cause you to take shorter breaths, so by deliberately taking a series of deep ones, you can help increase the supply of oxygen to your brain.This, in turn, stimulates the parasympathetic nervous system, sometimes referred to as the "rest and digest system," because it's the part of the nervous system that slows heart rate, increases intestinal activity, and relaxes certain stomach muscles.
“I rearrange all of the art and furniture and items in my apartment and usually do some sort of cleaning out of something (books, clothes, kitchen cabinets) in the process. My brain enters this hyper-relaxed state where I’m actively considering space and meaning and emotion but in a non-literal language that makes my mind kind of…hum? Does that make sense? And then I blink and it’s been four hours and I have a few missed calls and emails but I don’t care because I feel wonderful.” 

Massage therapists choose from literally hundreds of different ways of trying to help people with their hands, and many of these ways are not actually “massage” as we usually think of it. The majority of these manual therapies are nearly untouched by science. Many are dubious and obscure, while others are quite familiar and mainstream. Some of them may well be effective for certain things, but the overall usefulness of this mish-mash of techniques ishard to know.
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

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Partners in Healing is a full service holistic healing center. From Acupuncture to Chiropractic Care, Manual Therapies and more, we provide our patients with holistic care personalized for their unique needs. We strive to truly create a partnership between the patient and practitioners, enabling each patient to reach their optimal state of wellness.

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About footnotes. There are 85 footnotes in this document. Click to make them pop up without losing your place. There are two types: more interesting extra content,1Footnotes with more interesting and/or fun extra content are bold and blue, while dry footnotes (citations and such) are lightweight and gray. Type ESC to close footnotes, or re-click the number.
“What is an ice cream walk? Great question. The process is pretty simple. Step one: exit your abode to go for a walk. Step two: walk toward an ice cream shop — any ice cream shop. Step three: order an ice cream. Step four: eat ice cream. Impromptu walks are one of my favorite ways to clear my head, but adding ice cream into the mix makes it feel like an intentional way of treating myself, literally and figuratively. I recommend Van Leeuwen if you happen to be ice cream-walking in NYC.”

Wiltshire et al subjected 12 people to intense hand-gripping exercises to boost blood levels of lactic acid and other waste products of muscle physiology. Then they measured those substances with and without the subjects receiving basic sports massage. Their data showed that massage significantly “impairs lactic acid and hydrogen ion removal from muscle following strenuous exercise by mechanically impeding blood flow.”

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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.”

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Are you stressed or unhappy? Do you need to calm down? Training your mind to relax isn't difficult and can help you feel rested and prepared at any time. To relax your mind, consider meditating, practicing healthier habits like exercise, engaging in relaxing activities like listening to music, and avoiding or reducing common stress triggers like social media. When you find methods that work for you, cultivate and practice them often. In time, you'll be able to relax quicker and easily.
No need to go on a retreat to the mountains—five minutes of peace is all it takes to reap the benefits of meditation. There’s evidence that just two quick bouts of silent meditation per day can relieve stress and depression A Randomized, Controlled Trial of Meditation for Work Stress, Anxiety and Depressed Mood in Full-Time Workers. Manocha, R., Black, D., Sarris, J., Stough, C., et al. Discipline of Psychiatry, Sydney Medical School, Royal North Shore Hospital, Sydney University, St. Leonards, Australia. Evidence-basedcomplimentary and alternative medicine. Epub 2011.. Find a comfortable spot in a quiet place, concentrate on your breath, and feel those anxieties start to disappear.
The best we can say is that there is some reason to believe that painful pressures on muscles might be therapeutic for some people some of the time. Pretty decisive, eh? This is why it drives me nutters that so many therapists insist that strong pressures are “essential” to achieve “a complete release.” It really isn’t possible to know! It really does depend! Why would anyone pretend to “know”?

The skin does get flushed and warm, of course. That’s just superficial, cutaneous hyperaemia: capillaries in the skin respond to mechanical stimulation by dilating (which is likely an immune function: the body transports blood to the site of possible skin breakage). Blood is hot, so the skin gets quite toasty! But it’s clinically trivial and superficial only, and it has nothing to do with the intention of the claim that massage works by increasing circulation. BACK TO TEXT

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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
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.
Another problem is that it can be tricky to untangle our own wishes from those of the people around us, says Nina Grunfeld, the founder of Life Clubs, an organisation that aims to help people live more fulfilling lives. It can take a lot of effort to discover where your enjoyment ends and your partner’s begins. “When my husband and I were young,” she says, “we went to Rome on holiday, and he wanted to go to every church, every restaurant, every everything. And I got home completely shattered. It was only after coming to know myself, after thinking about my life without him and what I like as an individual, that I realised that for me to enjoy a holiday and to come back feeling relaxed and refreshed, I need to read and be still. Now we’ll go on holiday and he goes off to do the churches by himself, but I’m very happy just lying by the beach, pool or fire and reading. It’s a real treat. I might join him for the restaurants, though.”
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.
(Disclaimer: This article and accompanying content (links, etc) is for informational and discussion purposes only and should not be construed as psychotherapy or psychotherapeutic advice of any kind. The Maven Circle assumes no liability for use or interpretation of any information contained in this post. The information contained in this post is intended for discussion purposes only and should not be an alternative to obtaining professional consult from a licensed mental health professional in your state based on the specific facts of your clinical matter.)
Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer ("aleiptes")[27] who would rub their muscles with oil. Pehr Ling's introduction to massage also came about directly as a result of his study of gymnastic movements.
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]
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:
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
Due to this techniques harsher pressure, there are certain individuals who should seek pain relief elsewhere. Deep Tissue massages can be dangerous for clients who have blood clots, as the pressure and movements might cause the clots to be dislodged. If you have had blood clots in the past, currently have blood clots or are at risk of forming blood clots, you should consult a doctor before pursuing a Deep Tissue massage. If you are currently recovering from recent surgery, chemotherapy, radiation or are suffering from osteoporosis you too should speak with a doctor before experimenting with Deep Tissue massages. As this is particularly high pressure massage, you should not allow rashes, wounds, tumors, hernias, etc. to be massaged directly. Expecting mothers should also avoid Deep Tissue massages; instead, ask your doctor about therapists that specialize in pregnancy massage techniques.

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.
For many years the best review of the science that was available, by Furlan et al., had a cautiously optimistic conclusion, declaring that “massage is beneficial.”37 But then, in 2015, Furlan et al. added another dozen studies to the pool of data, and actually changed their tune: now they have “very little confidence that massage is an effective treatment for LBP.”38 And nor should they. Although there are scraps of good news, the evidence damns massage with faint praise — just like all other “promising” back pain treatments.

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At times, this fight-or-flight response is healthy and necessary—for instance, it helps you kick butt on that work presentation, catch the bus that’s about to pull away, or yank a small child out of harm’s way just in time. However, when anxiety becomes chronic, it may lower your immunity, potentially lead to heart disease, and even cause everyday ailments like headaches, back pain, stomach problems, and poor sleep. Fight back against stress with these five proven tension-tamers.

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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