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. 

And it was really a lot of massage (expensive in the real world). And the pure “kinesiotherapy” treatment was super basic — this control group barely did more than wiggle their toes and clench their thighs, so it’s hardly surprising that they didn’t improve much. I wish the study had included a third group doing more exercise, perhaps a half hour of brisk walking per day. I think there’s an excellent chance walkers would have performed as well or even far better than massage. And walking is notably a lot cheaper than massage.
Meditation is often seen as a great way to relax, and many studies back up that idea. In a meta-analysis looking at several studies of relaxation training in people with anxiety, the observed effects of meditation were greater than those observed for other intentional relaxation techniques, such as autogenic training (a process that involves making your body feel heavy and warm) and applied relaxation. Other studies have also outlined its effect as an anti-anxiety and antidepressant method.
Straightforward palpatory pareidolia. Pareidolia is a type of illusion or broken perception in which a vague or obscure stimulus — i.e. subtle textures under your skin — is perceived as if it was clear and distinct. Pareidolia is what makes naive Christians spot Jesus in a T-shirt stain, and why Percival Lowell thought he could see canals on Mars. BACK TO TEXT

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Full disclosure: I was a Registered Massage Therapist with a busy practice in downtown Vancouver from 2000–2010. Since then, I have made my living writing about musculoskeletal medicine and pain science, with a reputation for a skeptical perspective. This article is biased in the direction of debunking, but I also have a real soft spot for massage therapy, and still make a large percentage of my income from selling a book about trigger point therapy — a popular idea in massage that is maligned by many other skeptics (and with good reason). So I actually have competing, complicated biases. I try to compensate for them by sticking to what the evidence can support, and clearly identifying speculation and experimental therapy for what it is. BACK TO TEXT
In sports massage, the massage therapist generally concentrates on a specific problem area that you present, usually associated with some sort of sports activity, such as running, tennis, or golf. The most important thing with sports massage is that you find a specially-trained massage therapist who has mastery of a wide range of techniques and knows when to use them. In the past, many spas used to put sports massage on their menu as a way to appeal to men. As spas have become more sophisticated, however, they realize they shouldn't list sports massage unless they have some therapists with specialized training.
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.
Tension headaches: Treatment, causes, and symptoms Tension headaches, often described as a pressing or tightening pain of mild to moderate intensity, are the most common type of headache. Treatment includes pain relief medication, but overuse can increase the risk of headaches. Find out more about different types of headache and when to see a doctor. Read now
Does massage therapy “work”? What do massage therapists say that they can do for people and their pain, and is there any scientific evidence to support those claims? Massage is a popular treatment for low back pain, neck pain, and tension headaches — can it actually treat them, or does it just pleasantly distract patients and maybe take the edge off? In this article, I examine massage therapy in the light of science — not “objectively,” but fairly.1 I go out of my way to be critical of my former profession — I consider it an ethical duty. Health professionals must be self-critical and critical of each other: that is how we improve.2 And, alas, massage therapists are guilty of an astonishing amount of bullshit.
Perhaps one of the reasons massage reduces depression and anxiety: it’s relaxing. While not proven as well as you might think, it is a pretty safe bet,15 and the idea is further supported by evidence that massage therapy may reduces blood pressure1617 and helps people to sleep, even when they are under the unusual stresses of hospital care.18 These are all unsurprising … and unremarkable. Relaxation is an important component of wellness and pain management, and I do not underestimate its value, but it is hardly curative.
Surround yourself with positive affirmations and inspiration. Find quotes that help you feel better by inspiring you and post them where you can see them easily. Watch motivational videos and listen to inspirational music. Find (or create!) your own favorite positive affirmations.  Hang them on your mirror or your workstation and read and repeat them several times a day.  Or just make them your desktop or phone’s wallpaper to keep yourself inspired and motivated at all times. 
Other people like to write down what they’re grateful for, Kaplin said. This is especially helpful for relaxing. “When we’re stressed, we tend to focus on everything that is going wrong, which makes it even harder to unwind,” said Natasha Lindor, a coach and founder of The AND Factor who helps professionals have a successful career while working less and living more. She suggested writing down the top three good things that happen to you today.
But whether or not it massage is good medicine is still an open question, and this infographic is really just a bit of mild-mannered propaganda. Amatereurish boosterism never does a profession any favours. Paying lip service to science for promotional purposes cheapens it and impedes progress and understanding. Enthusiastically approving of such poor-quality information is a disturbing sign of how far the profession of massage therapy still has to go before it can be taken seriously as a full partner in health care.
We all have different goals and challenges in life; therefore it’s highly important that we create our own life motto to keep us on track. This mantra will focus your mind and stop you from being anxious and overwhelmed when life throws you yet another curve ball. Identify your challenges, weaknesses and goals so you can craft your own personal mantra.

“Many athletes and weekend warriors put themselves under a great deal of mental stress in preparation for a competition,” says Pietrunti. “For many amateur athletes, this is exacerbated by other day-to-day stressors from their jobs, families and life. Sometimes, just setting aside an hour to relax and unwind can be a huge step towards better performance and quality of life.”
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.
Lymphatic drainage is an interesting example of a specific massage technique, allegedly good for one thing and not much else: its purpose is to reduce swelling. By reputation, it’s the best treatment option for patients suffering from lymphoedema, a serious complication of mastectomy and other surgical procedures. But it’s also obscure, technical, and practiced by no more than a few hundred therapists globally. It’s not “massage therapy” per se; just a specialized tool that a tiny group of professionals specialize in, some of whom happen to be massage therapists. Oh, and bad news: there’s also recent evidence that it does not work,28 or not nearly as well as we’d like.29

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Deep tissue massages are often utilized following injuries to help break up newly forming scar tissue that can make recovery more difficult and lead to stiffness. Massage has been shown to help reduce inflammation and muscle spasms by stimulating blood flow, loosening up muscles to allow for more oxygen and also helping reduce the nervous system’s automatic stress response.
Even if you do yoga, meditate and perform other stress-reducing activities, calm may allude you. Instead of getting a prescription for Xanax, try a natural supplement to relax. There are several herbs you can take in a nice cup of tea that could give you the sedative effect you need during times of hardship. Examples of such herbs are Chamomile, Valerian, and Kava.  Generally, one teaspoon of dried herbs or three tablespoons of fresh herb to one cup of water is a beneficial amount. Most herbs should steep for 5 to 10 minutes.
Some people like to unwind by writing pages in their journal, said Lisa Kaplin, PsyD, a life coach who helps her clients during particularly stressful times in their lives and teaches stress management classes to corporations. Others prefer to jot down one or two lines about their day, she said. But if this becomes another task on your to-do list, skip it, she added.
In sports massage, the massage therapist generally concentrates on a specific problem area that you present, usually associated with some sort of sports activity, such as running, tennis, or golf. The most important thing with sports massage is that you find a specially-trained massage therapist who has mastery of a wide range of techniques and knows when to use them. In the past, many spas used to put sports massage on their menu as a way to appeal to men. As spas have become more sophisticated, however, they realize they shouldn't list sports massage unless they have some therapists with specialized training.

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Sports massage is a good option if you have a repetitive use injury to a muscle, such as what you may get from playing a sport. It’s also a good option if you’re prone to injuries because it can be used to help prevent sports injuries. You may also use sports massage to increase flexibility and performance. Additionally, sports massage can be used to relieve pain, anxiety, and muscle tension.

Unfortunately, the results of this study were actually negative: the data showed that massage has no significant effect on gene expression in muscle cells. There are several major problems with the study: the sample size was extremely small; the number of changes they found was trivial (and dwarfed by what exercise causes); the size of the differences was barely statistically significant—and short-lived, too; they measured genetic “signals” and not actual results, and guessed about their meaning; and we already know from clinical trials that massage doesn’t work any miracles for soreness after exercise, so what is there for the data to “explain”? Despite all of these problems, the results were spun as an explanation for how massage works in general — in the paper itself, the abstract, the journal’s summary, the press release, and interviews. Consequently, the results have been widely reported and discussed as if it is now a scientific fact that massage actually does reduce pain and promote recovery, and the only question was “how?” It’s a debacle.

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For instance, the average therapist is probably not even able to reliably find trigger points,81 and it is tricky to treat what you can’t find. Even when you have found them, we have no idea if they can actually be treated by any well-known method, none of which has ever been clearly shown to be effective. There are many kinds of treatments for trigger points, and not one of them is much more than an educated guess. And every patient seems to respond differently (for instance, some patients have clear cravings for brutal intensities of treatment that would cripple another patient).
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).

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Lactic acid is not a dead-end, “bad” metabolic waste product, and it does not cause post-exercise soreness. This is a pernicious and seemingly un-killable myth. It originated with “one of the classic mistakes in the history of science,” according to George Brooks, a Berkley physiologist. I will not give the myth any further air time here. See Gina Kolata’s clear overview in the New York Times, or a concise professional summary by Robergs in Experimental Phsyiology. For a deeper and geekier, but excellent read, see Dr. Goodwin’s entertaining rant about the prevalence of the lactate myth in the 2012 summer Olympics coverage. BACK TO TEXT

Oh, the irony: Even when free time falls into your lap, you may have no clue what to do with it (which is how you end up roaming around Whole Foods). Think about what truly mellows you out, then make a list on paper or in your phone. Notes Schulte, "We often get stuck during leisure time because we try to choose the exact perfect thing to do—so if one thing on your list doesn't appeal, pick something else!"
In a study looking at happiness levels in people who took vacations and then ranked them, those who rated their sprees as "very relaxed" also reported feeling happier compared to those who did not vacation, and even compared to those who did vacation but did not report feeling "very relaxed." The benefits of these "very relaxed" vacations typically lasted at most two weeks, the study found.

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.
Sheets and wrappings of connective tissue called fascia are considered an exciting frontier in massage therapy. Supposedly fascia can get tight and needs to be “released.” However, key examples of research either fail to support fascial therapy or actually undermine it — for instance, fascia is too tough to actually change. Fascia enthusiasm seems to be a fad. For more information, see Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties. BACK TO TEXT

This review is called a meta-analysis, which is weird, because “only 1 study met inclusion criteria for intrarater agreement and therefore no meta-analysis was performed.” So it was just a regular old review of 6 studies of how much different experts can agree on the location of myofascial trigger points. Lacking adequate data for statistical pooling, they had to “estimate” an agreement score of 𝛋=0.452 — a rather precise etimate! Of the criteria used to determine the location of trigger points, the most reliable were localized tenderness (.68) and pain recognition (.57). Those are actually decent reliability scores, but the authors conclude that “manual palpation for identification of MTrPs is unreliable.” Based on their estimated scores, this is technically correct but a bit misleading: most attempts to detect pathologies in the body are technically “unreliable,” falling well short of a score of κ=1.0 (perfect agreement), but still much better than κ=0 (coin flipping agreement). 

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.
According to the National Center for Complementary and Integrative Health (NCCIH), this includes individuals with bleeding disorders, low blood platelet counts, or those who are taking blood thinning medications. When these types of conditions are present, the NCCIH indicates that a sports massage with deep tissue work is generally not recommended.
I doubt that I personally know any skeptical massage therapists who aren’t already there, if they want to be, but I may have readers who qualify. Such skeptics are obviously a rarity in massage therapy, a profession notorious for attracting people with New Age and fringe science beliefs. The kind of people who would happily pay through the nose for tickets to see Deepak Chopra talk and think Mercola.com is a good source of health care information.

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.
Myofascial trigger points — muscle knots — are a ubiquitous muscular dysfunction, causing most of the aches, pains and stiffness in the world, and complicating virtually every other injury and disease process. A lot of massage is focused on them, directly or indirectly. Massage may be helpful because it relieves the symptoms of muscle knots, or even unties them. (No, not literally.)
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]
Practice mindful meditation. The goal of mindful meditation is to focus your attention on things that are happening right now in the present moment. For example, listen to your body. Is your breathing fast, slow, deep, or shallow? Do you hear noises, such as traffic, or do you hear only silence? The idea is just to note what is happening without trying to change it.
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.
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.

A boyfriend or girlfriend is okay, but they’re (usually) not furry enough. After a rough day, snuggle up with a pet for an instant slobbery smile, since pets can boost self-esteem and even ease the sting of social rejection Friends with benefits: on the consequences of pet ownership. McDonnell, A.R., Brown, C.M., Shoda, T.M. Department of Psychology, Miami University, Oxford, OH. Journal of Personaality and Social Psychology 2011;101(6):1239-52.. 

Full disclosure: I was a Registered Massage Therapist with a busy practice in downtown Vancouver from 2000–2010. Since then, I have made my living writing about musculoskeletal medicine and pain science, with a reputation for a skeptical perspective. This article is biased in the direction of debunking, but I also have a real soft spot for massage therapy, and still make a large percentage of my income from selling a book about trigger point therapy — a popular idea in massage that is maligned by many other skeptics (and with good reason). So I actually have competing, complicated biases. I try to compensate for them by sticking to what the evidence can support, and clearly identifying speculation and experimental therapy for what it is. BACK TO TEXT

When travelling with USA Swimming, a typical day for Olympic Trials, which is a 10-day trip, usually looks like the following: Arrive at pool by 9 a.m. to start 20-minute massage sessions for athletes. Break from 1:30 to 3 p.m. for lunch and return to pool by 4 p.m. for finals at 6 to 8:30 p.m. Massage athletes after finals at pool from 8:30 to 10 p.m.
The titles masseur and masseuse (the feminine form of the word masseur) have a long and colorful history related to massage. Both terms were used to describe men and women, respectively, who provided massage in exchange for payment. But these terms, especially masseuse, were hijacked by irreputable women operating under the guise of “massage,” beginning in the 1950s.  Over the past 30-plus years, massage professionals have worked to help get laws enacted that protect titles that reflect their training and professional standards. Today, state laws protect titles including massage therapist, massage practitioner and massage technician.  Still, the words masseuse and masseur live on as ways of describing the kind of touch not practiced by educated massage professionals.  ‘"Masseur is to massage therapist as stewardess is to flight attendant,’”  

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