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.
A 2014 Chinese review of studies by Li et al48 is a good example of what a shabby state massage therapy research is in. Let me be clear up front: I don’t think this paper actually proves anything one way or the other. I think it’s straightforwardly inconclusive. It has a positive sounding conclusion that isn’t really justified and there are major caveats. But it doesn’t mean that I wouldn’t go get me some massage if I had fibromyalgia. I probably would! But that’s another story. This is about the science, so here goes:
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
Posterior interosseous syndrome. Physiopedia explains that posterior interosseous syndrome is a compression of the posterior interosseous nerve, which is located near the shaft of the humerus and the elbow, that may result in paresis or paralysis of the thumbs and fingers. Though cryotherapy, ultrasound, dry needling, and other modalities often help with this condition, so too does deep tissue work that is focused on the thoracic outlet, pectoralis minor, triceps, brachioradialis, and other surrounding areas.

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]
Our body and mind need sleep in order to rest and refresh. Sleep deprivation is one of the primary causes of anxiety. An average person requires eight hours of sleep every day. When your brain is sleep deprived, it may not be able to respond to emotional events appropriately. Go to bed early and make sure that you get seven to nine hours of sleep every night to maintain a healthy mind.
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. 

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.
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.
“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.”
You don’t have to run in order to get a runner’s high. All forms of exercise, including yoga and walking, can ease depression and anxiety by helping the brain release feel-good chemicals and by giving your body a chance to practice dealing with stress. You can go for a quick walk around the block, take the stairs up and down a few flights, or do some stretching exercises like head rolls and shoulder shrugs.
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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Yet kicking back is hardly an unproductive activity; experts say that it keeps us healthy and happy. And research shows that regular de-stressing can help ward off heart disease and obesity, act as a buffer against depression, and even boost immunity against colds. Plus, when you're calm, you perform tasks smarter and more efficiently, leaving you with time to—wait for it—relax. Check out these strategies and inspiration for R in R: relaxing in reality.

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.

I’ve often said that massage therapy research is in its early stages. And after thinking about that more today, I’ve realized it’s worse than that. Massage therapy research is stunted, and not showing signs that it is ready to progress. Some might disagree, and would point to the increasing number of massage therapy studies. (I’ve charted it myself in at least one paper I’ve published, and there is no doubt that the number of papers on the subject is increasing.) But I would counter by noting that there is no discussion in the field. The studies are conducted and published in isolation. They are not often being critiqued, and researchers with different theories and perspectives are not addressing each other in the literature or even at conferences.


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.

Following injury, and especially if it’s also a very stressful time, inflammation can prevent proper blood flow from reaching damaged tissue and can cut off vital nutrients and oxygen. This can cause toxins to accumulate around damaged tissue, which only increases swelling and pain. Some studies have found that even self-administered massage can help reduce pain associated with plantar fasciitis and other injuries. (10)


In this unique healing system of Thai Yoga Massage, also called Nuad Boran, the practitioner guides the client through a series of yoga postures, while palming and thumbing along the body’s energy (‘Sen’) lines and pressure points. Together these actions result in a comprehensive full body treatment that relieves muscular tension, improves circulation, boosts the immune system and balances the body energetically.

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.

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.


Cancer. Used as a complement to traditional, Western medicine, massage can promote relaxation and reduce cancer symptoms or side effects of treatment. It may help reduce pain, swelling, fatigue, nausea, or depression, for example, or improve the function of your immune system. However, there are specific areas that a massage therapist should avoid in a cancer patient, as well as times when massage should be avoided altogether. Talk to your doctor before getting massage therapy if you have cancer.

Over-analyzing things can quickly lead to mounting stress. Don’t sweat the small stuff.  Let it go!  If you find yourself worrying over things you have no control over, distract yourself.  Go outside. Check out the sky.  Are the stars out?  Is the wind blowing?  Will it be warmer as the day progresses? Play your favorite song.  Look at pictures or photos that make you smile.  List all the little things you can be grateful for and focus on those.
Have you ever heard of power poses? These are body movements that increase your confidence and tend to be more powerful than traditional confidence-boosting exercises.  Identify yours and make sure you practice holding that pose throughout the day. Also identify low power poses and remove them from your personal body language. Power poses basically trick your mind and tell it that you’re amazing! This feeds your subconscious mind, and increases your ability to be positive and anxiety-free.
That is, regardless of all other considerations, a massage therapist must talk to you about pressure, respect your preferences (they are more important than any treatment ideology), and be careful about stumbling into areas that need much less pressure (for comfort) or much more pressure (for satisfaction). Far too many therapists make the mistake of setting a “default” pressure for a client early on, and then using roughly that much pressure everywhere.
Posterior interosseous syndrome. Physiopedia explains that posterior interosseous syndrome is a compression of the posterior interosseous nerve, which is located near the shaft of the humerus and the elbow, that may result in paresis or paralysis of the thumbs and fingers. Though cryotherapy, ultrasound, dry needling, and other modalities often help with this condition, so too does deep tissue work that is focused on the thoracic outlet, pectoralis minor, triceps, brachioradialis, and other surrounding areas.
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.
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.” 

We often forget to focus on the simplest, shortest (and one of the most restorative) activities available to us: our breath. Yoga teacher Anna Guest-Jelley suggested taking five deep breaths. “As you do, notice the natural pause between your inhale and exhale, and then between your exhale and your next inhale. Your body has a built-in break — how great is that?!”

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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.
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.

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Trigger point masssage is still 100% experimental. It has rarely been directly tested and it has never been done well (and never for back pain specifically, which is probably of the greatest interest).78 If you squint optimistically, you could call the best of the evidence “promising.” You could say that where there’s smoke, there’s fire. But it’s like the smoke from last night’s campfire — more of a smokey smell than a smoke where any fire might be hiding. Dial up even a mild cynical impulse, and the evidence collectively looks more like a damning failure to produce any clearly good news. 

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
This energy-based, traditional Thai massage, focuses on feet and reflexology, up to the knees, using a wooden therapy stick, massage oil from Wat Po in Thailand and massage cream. reflexology points on the soles of the feet are associated with particular body organs. Pressure on specific points helps stimulate activities of the inner organs, promotes deep relaxation and improves blood circulation. $80/1hr. $115/1.5hr
Ergonomic chairs serve a similar function as a massage table. Chairs may be either stationary or portable models. Massage chairs are easier to transport than massage tables, and recipients do not need to disrobe to receive a chair massage. Due to these two factors, chair massage is often performed in settings such as corporate offices, outdoor festivals, shopping malls, and other public locations.
Provided for mommies-to-be from 14 weeks to labor.  Pre-natal massages are a wonderful way to relieve the aches and pains and stresses of pregnancy.  Given in a safe and comfortable side-lying position, this session allows you to take a break from the hustle and bustle of every day life and focuses on YOU.  *High risk pregnancies will require a doctor's release.
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.
Good massage therapists are the ones with more training and a bigger toolkit. They do what they can with the tools they judge to be the most useful, and they candidly discuss risks, benefits, evidence, and controversies. They don’t just pay lip service to humility as a general principle of alternative medicine — they make it a centerpiece, recognizing that they really are not trained enough to know much.
In a world where the only thing news sites are non-stop talking about are crime, corruption, economic breakdown, and the end of the world,  you realize that exposing yourself to this on a daily basis is the same as planting seeds of fear and anxiousness. Try and limit the time that you spend watching the news or browsing on social media, and focus your time and energy on things that will help you get forward and appreciate who you really are without you having to worry about the future.
4. Coaching: once you have the breathing pace down, keep doing it while you move to this step. The key here is giving yourself positive, reassuring, and calm messages, rather than continuing with the tense, anxious, and angry thoughts. When I do this, I think things like "I can get through this. It will be OK. I can handle whatever happens. I am going to calmly do my best." Everyone will have a different way of doing this, and some people like to imagine this in the voice of someone they care about, or with the image of that person telling them those things. Keep doing this along with the breathing until you feel sufficiently ready to reconnect with what you were doing.
So you’ve decided you need some therapeutic work, huh?  At Mantis, we offer customized massages. We don’t have a routine.  We don’t all do the same thing.  We are therapists. Massage therapist with different skills and trainings, and what makes Mantis the best therapeutic massage clinic is the fact that we LISTEN.  You tell us what’s going on, and we cater to that. You need a massage that will fix those damn problems in your neck, low back, and hips?  You haven’t been able to turn your head to the right for three days?  Every time you run you get this searing pain in your foot, or your fingers go numb when you are typing on the computer?  Maybe you’re just STRESSED.  Whatever it is, we will tailor our work to your body and give you pro-tips to take home with you at the end of a session.  We want to help you understand and treat your body right, that is our mission.
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.
Another commenter complains that the infographic makes massage sound too much like an “indulgence” and not enough like “health care.” It’s clear that he wants to make grander claims for massage, regardless of the evidence. Irony fail! If there was stronger evidence to cherry-pick in service of promoting massage as medicine, it would have ended up on this infographic.

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We usually need to relax when we are feeling tense, anxious, or angry. Part of these feelings are due to an activation of something called the sympathetic nervous system, which includes parts of your brain that detect and respond to threats and stress. Without getting too deep into the physiology, when you are tense, anxious, or angry, your sympathetic nervous system is activated, and your heart rate increases, your breathing becomes rapid and shallow, your blood pressure increases, your digestion stops, your muscles tense, your circulation changes, stress hormones (cortisol and adrenaline, among others) are released in your blood stream, and your thoughts speed up and focus on a target (read more about that in Three Frames of Mind). When this is happening, our bodies feel unpleasant and we look for ways to feel better.
Brush aside any thoughts that massage is only a feel-good way to indulge or pamper yourself. To the contrary, massage can be a powerful tool to help you take charge of your health and well-being, whether you have a specific health condition or are just looking for another stress reliever. You can even learn how to do self-massage or how to engage in massage with a partner at home.
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.
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.
In Thailand, Thai massage is officially listed as one of the branches of traditional Thai medicine, recognized and regulated by the government. It is considered to be a medical discipline in its own right and is used for the treatment of a wide variety of ailments and conditions. Massage schools, centers, therapists, and practitioners are increasingly regulated by the Ministries of Education and Public Health in Thailand.[107][108]
Think about how easy it is for a baby or small child to fall asleep. We're born with the instinct to relax and sleep when our bodies or minds need a break. Over the years, it becomes necessary to control and even suppress these natural urges to rest, because we must remain alert as we attend school, learn professions, go to work, or care for a family. Many people spend years conditioning themselves to perform well despite feelings of tiredness. While no one would argue that suppressing tiredness can be a necessary skill, it can impair our ability to actually "let go" and relax when we do find the time.
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.
Ugly pain in massage therapy is, by my definition, never okay. Ugly pain is often caused by things that are not going to offer even minimal, delayed benefits, and may even be dangerous. It’s important to be able to spot ugly pain for what it is and completely eliminate it from any therapy you’re receiving. What kinds of handling may cause “ugly” pain?

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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.
Brush aside any thoughts that massage is only a feel-good way to indulge or pamper yourself. To the contrary, massage can be a powerful tool to help you take charge of your health and well-being, whether you have a specific health condition or are just looking for another stress reliever. You can even learn how to do self-massage or how to engage in massage with a partner at home.
Meditation in its purest form involves focusing on one thing to clear your mind. Usually done in a quiet room, it calms the mind and the body — and can get your mind off your pain. Meditation sounds easier than it is, however, and distraction is usually a problem for beginners. Try following a recorded guided meditation, or seek the guidance of an experienced meditation teacher.
Unsurprisingly, the conclusions here are superficially positive: massage “significantly improved pain, anxiety, and depression in patients with FM.” But that’s statistical significance only, not a clinically significant degree of improvement: the size of the effect is trivial (much smaller than amplitude of the noise in the data). As usual, using the word “significantly” this way is technically correct and defensible, but otherwise misleading to all but the most alert readers.
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.
This seems to be a common problem. The actor Diane Keaton told More magazine: “I wouldn’t know what to do with a week off,” while the musician Gwen Stefani told Stylist that whenever she has any downtime, she feels as if she is “panicking a bit or trying to plan the next thing”. Elon Musk, when asked what he usually does after work, said: “Usually work more” – which does not seem to be turning out well for him.
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]
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.
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.
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.
Provided for mommies-to-be from 14 weeks to labor.  Pre-natal massages are a wonderful way to relieve the aches and pains and stresses of pregnancy.  Given in a safe and comfortable side-lying position, this session allows you to take a break from the hustle and bustle of every day life and focuses on YOU.  *High risk pregnancies will require a doctor's release.
Medical Massage is a controversial term in the massage profession.[50] Many use it to describe a specific technique. Others use it to describe a general category of massage and many methods such as deep tissue massage, myofascial release and triggerpoint therapy as well as osteopathic techniques, cranial-sacral techniques and many more can be used to work with various medical conditions.[51]

Of course, back in the day when people were mostly hunters and gatherers, these physiological changes would help our ancestors run from predators or environmental hazards. And maybe back then, people didn’t know how to relax. Maybe they weren’t really supposed to. But today, people aren’t asked to regularly respond to such great threats, and knowing how to relax may be a better modern survival tactic than a ready stress response.
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

Although there is a lot of negativity — also known as realism — in this article, I also still recommend massage. It has some plausible medical benefits, even if they are inconsistent and unproven. For instance, patients may get at least temporary pain reduction from any kind of stimulation of “muscle knots,” which are a likely factor in many common pain problems — but poorly understood, controversial, and certainly treatment is unreliable in any case. (I summarize this topic below, but it’s such a huge topic that I have several other large pages devoted to trigger points.)
Good pain. In massage, there is a curious phenomenon widely known as “good pain.” It arises from a sensory contradiction between the sensitivity to pressure and the “instinctive” sense that the pressure is also a source of relief. So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching, and are often described as a “sweet” aching. The best good pain may be such a relief that “pain” isn’t even really the right word.
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 …

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

If this theory is correct, or even half-right, it would go a long way to explain the strong appeal of massage — maybe it actually can take the edge off a great variety of problems — but also its inability to work miracles. If trigger points are the main reason massage seems at least a little bit helpful in so many cases, they are also the reason that the results are so unpredictable. The best ways to treat trigger points are simply unknown, and it may be next to impossible. All trigger point therapy is guesswork. Therapists have greatly variable education, skill, and luck in this process. Most simply aren’t that good at it — they can’t be, because muscle pain physiology is obscure, complex, and basically way out of their league.80
Whenever athletes exercise heavily, their muscles suffer microtraumas. Small amounts of swelling occur in the muscle because of tiny tears. Post-event sports massage helps reduce the swelling caused by microtraumas; loosens tired, stiff muscles; helps maintain flexibility; promotes blood flow to the muscle to remove lactic acid and waste build-up; and reduces cramping. In addition, post-event massage helps speed the athlete's recovery time and alleviates pulls, strains, and soreness.

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