Only the statistical significance of the results is touted in the abstract, not their size. This almost always means a real effect that was too small to emphasize. So I read the full paper and, sure enough, the effects of massage were positive but modest at best (and in many cases trivial). There were a lot of measures of success, and none changed all that much. The phrase “damned with faint praise” comes to mind, as it so often does in massage science.


Relaxing is increasingly difficult in our always-on digital world. This first struck me a couple of years ago when I had to stop exercising after an injury. Exercise had always been my go-to “me-time” activity, and without it I felt totally lost. I recently started again, but having only one means to de-stress now feels very limited and I am not even sure it counts as relaxing – it is quite hard work, and inherently competitive. When I find myself at home with a free evening, I often have no idea what to do and inevitably end up staring emptily at one screen or another for hours, before stumbling off to bed, wondering where the time has gone. 

It is hard to study what you can’t define … and it is extremely difficult to define massage precisely. Many possible questions arise! What kind of massage therapy? What methods? Could a combination of methods be effective where another combination fails? How well trained is the therapist? Are “advanced” techniques better than relaxation and Swedish techniques? Or maybe the basics are the basics because they really work? How much massage therapy? Could five sessions succeed where two would fail? Is one appointment “massage therapy,” or does it really need more? Could nine sessions actually be better still? Or perhaps counterproductive? Can anything be done with short sessions, or are long ones needed? If massage works, how much of the benefit can be attributed to non-massage elements like bedside manner, relaxation, and reassurance? How much do those factors define massage? What if massage didn’t work at all, or very poorly, without them? Would that mean “massage” works because it’s a great way of delivering a nice experience? Or that nice experiences “work” and the massage is irrelevant? What if massage therapy of a certain type for a specific condition was only effective 20% of the time? 60%? 80%? At what point is it “worth a shot”? (And worth the expense?)

An Indian physician named Shivago Kumar Bhucca, a contemporary of the Buddha, is often credited with developing Thai massage. The impetus was to give monks and nuns the flexibility to sit for long hours in meditation. Whatever its genesis, massage was considered such a crucial aspect of medical treatment in Thailand that until the early 20th century, the Thai Department of Health included an official massage division. Thai massage is based on releasing blockages along ten lines of energy called sen, which are similar to the meridians of traditional Chinese medicine. The technique incorporates stroking and kneading of muscles, manipulation of joints, and pressure applied to specific points in order to balance the body’s four elements—earth, water, fire, and air. But there’s also rocking, breathing, and lots of stretching—Thai massage is often referred to as “lazy yoga.”
When we face stressors in life, we can carry physical and psychological tension, and these tensions can feed off of one another. Feeling physically tense can increase your psychological and emotional tension and vice versa. Conversely, relaxing your body physically can help relieve psychological stress, and relaxing your mind can help you to physically relax and release tension in your body. When your stress response is no longer triggered, it becomes far easier to approach challenges in a proactive, peaceful way.

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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.
Relaxation is also a uniquely individual activity. Napping or just doing nothing might be your idea of relaxation, but this amount of inactivity might drive someone else crazy. Others may relax by participating in sports or undertaking physical challenges, but some people would find these activities stressful. Whatever your idea of relaxation, the following tips can help you re-train and regain some of those lost relaxation skills:

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.
Only the statistical significance of the results is touted in the abstract, not their size. This almost always means a real effect that was too small to emphasize. So I read the full paper and, sure enough, the effects of massage were positive but modest at best (and in many cases trivial). There were a lot of measures of success, and none changed all that much. The phrase “damned with faint praise” comes to mind, as it so often does in massage science.
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.
Massage is a profoundly valuable service regardless of what specific effects it does or does not have on pain, tissues, or pathologies. A pleasant, relaxing experience may have any number of minor therapeutic benefits, such as bringing your blood pressure down. However, the subtler benefits of massage extend well beyond that, into the territory of emotional and psychological benefits that are virtually impossible to define or measure — and surprisingly potent.
Like having your feet worked on? The therapist uses finger pressure and techniques such as kneading and rubbing to promote relaxation and healing in the body. Reflexology is based on "reflex areas" on the hands and feet, whose energy is believed to be connected to organs and other body parts. By applying pressure to the reflex points, the reflexologist can balance your nervous system and stimulate endorphins, the body's natural pleasure response, which reduces stress and discomfort. 

Doctors think looking up health information online can be problematic because the computer doesn’t have the same diagnostic skills as a healthcare professional. Physicians determine whether an issue is serious by considering personal factors like a patient’s family history and age. (Wrinkles at age five isn’t normal— sorry, Benjamin Button.) On the other hand, when someone searches for “headaches” online, they may find several sources suggesting they are suffering from something much worse…
Most of us have dealt with financial stress at some point. Debt can easily become overwhelming and become a major contributor to feelings of low self-esteem and hopelessness.  Organize your finances by tracking your expenses. Cut down unnecessary expenses. Create a budget for every week or month. Spend your money wisely and make a workable plan to pay your debt.  Try to save a little of every paycheck.

This step may seem silly or obvious, but when we are anxious, tense, or angry, we are almost never paying attention to our immediate surroundings. Instead, we are usually consumed with our thoughts or feelings related to things that are not present where we are. Orienting allows us to start relaxing by recognizing our immediate surroundings, which are hopefully calm, stable, and safe.
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.

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.


In India, massage therapy is licensed by The Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of Health and Family Welfare (India) in March 1995. Massage therapy is based on Ayurveda, the ancient medicinal system that evolved around 600 BC. In ayurveda, massage is part of a set of holistic medicinal practices, contrary to the independent massage system popular in some other systems. In Siddha, Tamil traditional medicine from south India, massage is termed as "Thokkanam" and is classified in to nine types, each for specific variety of disease.

Another serious general concern about the quality and effectiveness of massage therapy is that there is so much emphasis placed on specific, branded “techniques” and styles. The massage world is fragmented into dozens or even hundreds of these, depending on how you count. It is especially troubling that so many proprietary techniques are hyped as “advanced” and taught in place of genuine continuing (academic) education. This is the serious problem of certification rackets or “modality empires” — selling credibility to therapists in the form of certifications for a treatment method. These techniques are proprietary and profit-motivated, and usually championed and promoted by a single entrepreneur who gets treated like a guru and has legions of dedicated followers (who tolerate criticism rather poorly).

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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The reason the Pressure Question exists is that it’s hard for patients to tell the difference between nasty pain that might be a necessary part of therapy, and ugly pain that is just abusive. Not everything that hurts is therapeutic, but not every therapeutic procedure is painless! How can we tell if an intense massage technique is therapeutic or not?

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.

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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.
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]
Deep Tissue Massage can release the chronic patterns of tension in the body through slow deep strokes on any contacted areas and deep finger pressure on the contracted areas, either following or going across the grain of muscles, tendons and fascia. It is called deep tissue, because it also focuses on the deeper layers of muscle tissue. It can help reduce pain, increase range of motion, relieve muscle spasms and improve circulation.
There are a lot of relaxation techniques out there that we can all learn and practice. However, I have found that many of my clients (and myself) struggle with the way these are presented, and they also have problems motivating themselves to use them. In response to that, I researched the types of relaxation techniques that have the most research support, and I developed a five-step sequence that anyone can do to feel more relaxed in minutes, minus the new-age vibes.  

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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..
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.
Thai massage, long considered a medical treatment in Thailand, the therapist puts you through a series of stretches that cover the entire body. (That’s why it’s often called lazy man’s yoga.) You lie on a floor mat or on a table wide enough to accommodate the therapist, and you wear loose-fitting clothing (often supplied by the spa), because there’s no way a sheet can stay put during these moves—the therapist might kneel on the back of your legs and pull your arms to arch your back and open your chest, or place her shoulder under your heel to lift your leg and stretch your hamstring. Thai massage also includes deep-pressure point work to stimulate the sen, or the body’s energy pathways.

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
For others, the notion of being in touch with their own needs and desires is totally alien, says Andrew. People who grew up in a family environment that centred around the needs of a sibling or a parent might have spent their whole lives never being asked about what they wanted to do. “It might genuinely be something they’ve never considered before,” she says. For those people, identifying something they might find enjoyably relaxing, and pursuing it, can be a huge, life-changing shift. “It can be quite dramatic.”
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?
BC 722-481: Huangdi Neijing is composed during the Chinese Spring and Autumn period. The Nei-jing is a compilation of medical knowledge known up to that date, and is the foundation of Traditional Chinese Medicine. Massage is referred to in 30 different chapters of the Nei Jing. It specifies the use of different massage techniques and how they should be used in the treatment of specific ailments, and injuries. Also known as "The Yellow Emperor's Inner Canon", the text refers to previous medical knowledge from the time of the Yellow Emperor (approx 2700 BC), misleading some into believing the text itself was written during the time of the Yellow Emperor (which would predate written history).[7][8]

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We are creatures of habit and pattern, a strong property of the way the human nervous system functions. Every time we experience something, we are more likely to experience it the same way again in the future, because perception and sensation are so strongly built on expectations, especially threat assessment. That is, we tend to see and feel what we expect to see and feel, and we are particularly prone to expecting the worst (as a survival strategy). If our expectations are negative and fearful—as they often are, because life is harsh, and trauma is common—that then colours our experiences quite a bit. This is a very important principle in chronic pain, which routinely involves “central sensitization,” the brain-driven tendency to overreact to noxious stimuli — the ultimate clinically relevant example of a “sensory rut.” BACK TO TEXT
Therapeutic Thai Massage is the first authentic Thai Massage spa specializing in age-old Thai practices along with contemporary procedures. Thai massages alternate between assisted Yoga and acupressure. This combination will ensure a unique experience to every customer seeking relief from tight muscles, chronic tension and those looking to promote overall health throughout the entire body.
And yet some medical benefits are plausible despite the lack of evidence. For instance, many apparently successful treatments may be due to the effects of pressure on “muscle knots,” which are a likely factor in many common pain problems, but poorly understood (and difficult to treat). And regardless, the effects on mood and mental health are so profound that patients can’t really lose — it’s a valuable service whether it “works” for pain or not.
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.
Athletes tend to know their bodies fairly well, so information presented to the therapist seems to be better. Compared to the general client, the athlete is also in good shape and is concerned about getting back to the field of play as soon as possible. Some athletes have an obsessive compulsive behavior about their sport. This generally makes them very compliant with the therapists’ recommendations. 
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]

There are a few “medical” massage therapists out there with some training in orthopedics and rehabilitation. My education in massage therapy here in British Columbia, Canada, was three years long — the longest massage therapy training program in the world. There are also a few other places with two-year programs. A massage therapist with this level of education is certainly the kind that patients should seek out if they want massage as a treatment.
Deep Tissue Massage can release the chronic patterns of tension in the body through slow deep strokes on any contacted areas and deep finger pressure on the contracted areas, either following or going across the grain of muscles, tendons and fascia. It is called deep tissue, because it also focuses on the deeper layers of muscle tissue. It can help reduce pain, increase range of motion, relieve muscle spasms and improve circulation.
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..
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]
Referred pain spreads the goodness. Undoubtedly another reason that massage pain can feel good is the phenomenon of referred sensation. If you stimulate internal tissues anywhere in the body, muscle or otherwise, the brain really has trouble telling quite where the sensation is coming from. When you press hard enough on your muscles, particularly on sensitive trigger points, the pain is often experienced as though it originated from a much broader area.
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!
Our mind and body respond to scent as the brain reacts directly to smell.  Aromatherapy is based on exactly that. Different scents have different effects, and there are volumes of research about which scent does what. Some have the ability to calm and relax, which is exactly why aromatherapy could be very useful for people with anxiety. Use an oil diffuser to spread the aroma of your choosing around your household or simply add a few drops of oil to your bath or onto your skin. Take care using undiluted oils on your skin, however.  Read the instructions carefully as some can cause irritation.
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]

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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. 
Massage-StLouis.com [Internet]. Sanvito A. How Does Massage Work?; 2016 December 31 [cited 17 Feb 28]. While the skin is indeed “the surface of the brain,” there are of course many sensory receptors in deep tissues as well. Massage therapy mainly interacts with the nervous system via the skin, which is extremely richly innervated, and the importance of this is often underestimated or discounted entirely … but it’s not limited to that. For instance, I’ve always particularly loved having my joints moved passively, which creates a flood of proprioception — movement/position sensation — that my brain didn’t initiate, which feels weird in a delicious way. BACK TO TEXT
I saw a few chiropractors and acupuncturists. But despite some initial short relief, their work seemed to lose effectiveness after a few visits. I went to a massage therapist, whose treatment actually was the opposite of my experiences with neurologists: It was enjoyable. This was the beginning of what I called a foray into “recreational medicine.”

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

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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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