The ability to detect the painful side by feel alone is difficult for reasons that make sense, consistent with what we actually know about how neck and back pain work— that is, they don’t cause obvious, consistent changes in tissue texture and they correlate poorly (really barely at all) with obvious structural problems. Being able to detect nonexistent signs actually an important diagnostic skill. BACK TO TEXT

Most sports massage therapists will wear a white coat or uniform. This projects a professional image. It will also prevent unsightly oil stains on clothes. When you are referred to a massage therapist by a doctor or other qualified person then you should expect their instructions to be carried out to the letter and not added to or altered by the massage therapist.


An effective maintenance program is based on the massage therapist's understanding of anatomy and kinesiology, combined with an expert knowledge of which muscles are used in a given sport and which are likely candidates for trouble. By zeroing in on particular muscle groups and working specific tissues, the sports massage therapist can help the athlete maintain or improve range of motion and muscle flexibility. The overall objective of a maintenance program is to help the athlete reach optimal performance through injury-free training.
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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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).
Pressure to meet a deadline can be stressful, but acupressure can help release all that tension. Acupressure’s a kind of touch therapy that works by balancing the circulation of fluids and energies in the body. Use the thumb and forefinger to massage the soft area between the thumb and index finger of the other hand. Dab on some lavender oil for extra relaxation.
American Heart Association: "Four Ways to Deal With Stress."; PubMed Central: "Psychosocial and Psychophysiological Effects of Human-Animal Interactions: The Possible Role of Oxytocin."; NIH News in Health: "Can Pets Keep You Healthy?"; Cleveland Clinic: "Want a Healthy Heart? Laugh More!"; HelpGuide.org: "Laughter Is the Best Medicine."; Association for Psychological Science: "Power Posing: Brief Nonverbal; Displays Affect Neuroendocrine; Levels and Risk Tolerance."; Harvard Business School: "Power Posing: Fake It Until you Make It."; IZA.org: "The Effect of Sexual Activity on Wages."
Inflammation caused by chronic stress and muscle tension can lead to worsened overall health, longer recovery time, reduced immune function and cardiovascular problems, such as high blood pressure. Studies have found that massage therapy can help lower cortisol levels and even boost production of the hormone called oxytocin, which relaxes the body and has soothing effects. (7) Oxytocin is the primary hormone responsible for sustaining social bonds in humans and increasing motivation for cooperative behaviors, which is why it’s often called the “cuddle hormone” and known to be released during hugs, birth, social bonding and from touch.
This article thoroughly discusses massage therapy in a way that is quite unusual in the profession: a skeptical, critical-thinking sort of way. This is normal in modern medicine, where critical self-appraisal is a formal part of the professional culture.85 And yet there are some skeptical massage therapists! We do exist! For instance, the Skeptical Massage Therapists Facebook group has quickly grown into the best discussion group available — although there’s not much competition! — for massage therapists who also happen to be scientific skeptics. Founder and moderator Brantley Moate:
When the body is experiencing pain, it reacts with tension. During a deep tissue massage, discomfort is normal and will be felt if there are inconsistencies within the tissues. Discomfort is described as a "good hurt", the kind that feels good at the same time. On the other hand, pain can be described as being uncomfortable and not tolerated well by the body.
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.

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Anxious? Just squeeze, release, and repeat. Progressive relaxation involves tensing the muscles in one body part at a time to achieve a state of calm Effects of progressive relaxation on anxiety and quality of life in female students: a non-randomized control trial. Dehghan-Nayeri, N., Adib-Hajbaghery, M. Tehran University of Medical Sciences, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran, Iran. Complementary Therapies in Medicine 2011;19(4):194-200.. The method (also used by actors) is a great way to help fall asleep.

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.
BC 500 Jīvaka Komarabhācca, also known as Shivago Komarpaj, the founder of Traditional Thai massage (Nuad Boran) and Thai medicine.[citation needed] According to the Pāli Buddhist Canon, Jivaka was Shakyamuni Buddha's physician.[citation needed] He codified a healing system that combines acupressure, reflexology, and assisted yoga postures.[citation needed] Traditional Thai massage is generally based on a combination of Indian and Chinese traditions of medicine. Jivaka is known today as "Father Doctor" in Thailand.[citation needed]

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To put it bluntly, it’s not clear that massage has any musculoskeletal benefits at all. It probably does, but mostly quite temporary and highly unpredictable. There’s not nearly enough science, and therapists are hopelessly biased assessing their own efficacy. See Does Massage Therapy Work? A review of the science of massage therapy … such as it is. BACK TO TEXT


The results are underwhelming. Although they did a little better than just guessing, the results suggest that it’s difficult even for expert examiners to detect the location of neck and back pain by feel. As well, they were only attempting to detect the side of pain. Imagine how much worse their performance would have been if they had had to identify the location more precisely, or if the pain could have been anywhere or nowhere. So they barely passed the easiest possible test, and probably would have failed a harder one and done no better than guessing.
The following relaxation process is all about taking steps to change your physiology when you are tense, anxious, or angry. This is basically done by shifting attention and taking control of breathing as a way to jump-start the parasympathetic nervous system. There is no magic, just basic steps (some that you already do) that should result in you feeling more relaxed, quickly. I encourage you to practice doing the full sequence at least once a day for two weeks during times of lower tension before you start using it in more urgent situations. Additionally, there is no set amount of time that this takes. It could last as little as a minute or two, or go on as long as you like.

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It's hard to sink into a state of zen if you're one big ball of knots. "When you live a life full of demands, your body regularly releases adrenaline and cortisol, increasing energy expenditure that can result in muscle tension," says Gregory Fricchione, MD, director of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital. Try progressive muscle relaxation: Tense the muscles in your toes for at least five seconds, relax for 30, and repeat, working your way through the muscle groups up to your neck and head.
Completely new to massage? Book your first appointment either well before a race—at least a few weeks out—or wait until the day after. “Just like you wouldn’t test out new socks or shoes on day of race, you shouldn’t experiment with any pre-race bodywork,” says Denunzio. Those who are familiar with massage can benefit from a pre-race rubdown in the seven to two-day window prior to an event. Getting treatment less than 48-hours prior puts all runners—even those who are massage veterans—at risk of race day soreness. 

Really, stop and smell ’em. Certain odors can change our mood, and it’s hard to feel angry or upset with a nose full of roses The impact of natural odors on affective states in humans. Weber, S.T., Heuburger, E. Department of Clinical pharmacy and Diagnostics, University of Vienna, Vienna, Austria. Chemial Senses 2008;33(5):441-7.. Keep a fresh jar of your favorite flowers near your workspace or in the living room, and take a whiff whenever anxiety strikes.
“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.”
Thai massage has been practiced in America since the 1990s when Westerners began practicing it. Thai massage is more commonly found than it used to be at American spas, but you can't find it everywhere for two reasons. First, the spa needs a room with a large, padded mat in order to offer Thai massage. It's easiest if the room is always set up for Thai massage, and yet it is more of a specialty request. It just makes more economic sense to have the room set up with a table for a Swedish massage.

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

Even if you do yoga, meditate and perform other stress-reducing activities, calm may allude you. Instead of getting a prescription for Xanax, try a natural supplement to relax. There are several herbs you can take in a nice cup of tea that could give you the sedative effect you need during times of hardship. Examples of such herbs are Chamomile, Valerian, and Kava.  Generally, one teaspoon of dried herbs or three tablespoons of fresh herb to one cup of water is a beneficial amount. Most herbs should steep for 5 to 10 minutes.
When you think of a massage, you probably think of soothing music, a gentle brush of hands softly kneading the stress from your shoulders, maybe even of a loved one offering to rub your back after a long day at work. While some massages can be soothing, and rely on gentle touches to work out a client’s stress or anxiety, there are other massages that have a little more grit to them. For example, the Deep Tissue massage, which is very similar in style to the Swedish massage, utilizes some of the same techniques as its much gentler cousin; Deep Tissue massages, however, are designed to focus on the deeper layers of muscle tissues and fascia, the protective layer that surrounds muscles and joints. Working out these harder to reach muscles will require more pressure, making the Deep Tissue massage slightly uncomfortable, gritty and highly effective.

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]
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.
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.  

One risk is clearly neurological and complex: some people are basically sitting ducks for the well-documented and nasty phenomenon of “central sensitization,” and indeed may already be in pain and seeking help because of it. A strong massage can severely aggravate that situation, with long term and extremely unfortunate consequences. It’s rare, but it happens. The typical clinical scenario here is a gung-ho under-trained therapist over-treating someone in, say, the early stages of fibromyalgia. Bad, bad, bad.
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.
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. 

Typically, sports massage therapists hold a certification and maintain licensure. A good option is to become board certified through the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and have an active membership with an association, like AMTA, to keep up to date with industry trends. Exact requirements depend upon the state in which the sports massage therapist practices. 

Structural Integration's aim is to unwind the strain patterns in the body's myofascial system, restoring it to its natural balance, alignment, length, and ease. This is accomplished by hands-on manipulation, coupled with movement re-education. There are about 15 schools of Structural Integration as recognized by the International Association of Structural Integration,[60] including the Dr. Ida Rolf Institute (with the brand Rolfing), Hellerwork, Guild for Structural Integration, Aston Patterning,[8] Soma,[61] and Kinesis Myofascial Integration.[62]
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.

Sports Massage is a no-nonsense massage that helps stretch tight muscles, stimulates inactive muscles and improves soft tissue condition. Sports Massage will help you move your body more freely with more flexibility and in time can improve your posture. As the name suggests it is popular with athletes, as it enhances performance, assists recovery and prevents injury – benefits we can all enjoy.

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Unfortunately, such massage therapists are quite rare. Most are poorly trained and uncertified. Most work in spas or resorts and on cruise ships, doing treatments that are infamously fluffy and skin deep, with little therapeutic value other than the comfort of a quiet hour of touching (even though many patients find skin-deep massage to be more annoying than anything else). Most of these therapists are earnest and view themselves as medical semi-professionals, despite their comparative lack of training. It’s actually inappropriate to call them “therapists” at all, and in some places (here) it’s actually illegal — they have to use terms like “bodyworker” or “masseuse.”
Watsu, developed by Harold Dull at Harbin Hot Springs, California, is a type of aquatic bodywork performed in near-body-temperature water, and characterized by continuous support by the practitioner and gentle movement, including rocking, stretching of limbs, and massage. The technique combines hydrotherapy floating and immersion with shiatsu and other massage techniques. Watsu is used as a form of aquatic therapy for deep relaxation and other therapeutic intent. Related forms include WaterDance, Healing Dance, and Jahara technique.[73][74]

Inflammation caused by chronic stress and muscle tension can lead to worsened overall health, longer recovery time, reduced immune function and cardiovascular problems, such as high blood pressure. Studies have found that massage therapy can help lower cortisol levels and even boost production of the hormone called oxytocin, which relaxes the body and has soothing effects. (7) Oxytocin is the primary hormone responsible for sustaining social bonds in humans and increasing motivation for cooperative behaviors, which is why it’s often called the “cuddle hormone” and known to be released during hugs, birth, social bonding and from touch.
5. Emerging: the key in this final step is calmly reentering the world. Rather than just stopping this process and jumping back in, focus on going back to what you need to do with the same peace you might have when you wake up from a nice sleep. Just gently getting back into the flow of your day. This should keep your mind and body both staying in a more relaxed and positive state.
Take a tropical vacation without leaving the desk chair. Use a five-minute break to peel, slice, and bite into a juicy mango, which packs a compound called linalool that helps lower stress levels Stress repression in restrained rats by (R)-(-)-linalool inhalation and gene expression profiling of their whole blood cells. Nakamura, A., Fujiwara, S., Matsumoto, I., et al. Technical Research Center, T Hasegawa Co, ltd, Kawasaki-shi, Japan. Journal of Agricultural and Food Chemistry 2009;57(12):5480-5.. Don’t fret about the juice dripping down your chin—the stress relief is worth the mess.

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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.

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