Many training programs are now available throughout the world that require a minimum of 500 hours of basic massage therapy training, in addition to continuing education credits that can require up to another 400–500 hours. (19) Always make sure you’re “in good hands” by first checking that a therapist has proper qualifications and experience, specifically asking about training in NMT, trigger point therapy, sports massage, pain management, myofascial release and orthopedic massage.
Traditional Thai massage is a different experience if you’ve only ever had a Swedish or deep tissue massage. In Thai massage, you wear loose-fitting clothing (often provided by the massage therapist) and start by lying on a mat. Throughout the massage, the therapist moves your body into various seated and prone positions, which stretch and release your muscles and soft tissue. Although your body is moving, the therapist is doing all the work, making it feel similar to supported yoga. The massage therapist will bend, stretch, and compress and lengthen your body using their hands, forearms, elbows and even feet. Don’t be alarmed by the feet! Many studios have overhead supports that allow the practitioners to safely walk on your back, releasing tight adhesions and promoting ease. Thai massage can be both invigorating and relaxing. It is an excellent option for keeping your muscles in good health if you regularly work out, or if you want to overcome a lack of flexibility. Studies show that Thai massage can increase blood circulation, improve flexibility, reduce muscle tension and enhance mental well-being.

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For starters, you bear in mind the things described above that tend to cause ugly pain, and you avoid that kind of therapy like the plague. Then you look for some clues that painful pressure is okay. Here are at least three reasons why unpleasantly intense pressure might be therapeutic — “bad pain,” but not ugly. In each of these situations, it might be acceptable to tolerate sensations so intense and painful that the only thing about them that is pleasant is the part where it stops.

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Phussapa Thai Massage School also offers reflexology training course. The educational systems available for this course are basically the theory, practice, and examination. This institution has the authorization from Thai Ministry of Education. The main curriculum included in this course is the general subject of reflexology such as the history of foot massage, basic knowledge of reflexology map, safe and proper foot massage, necessary equipment, and advice after session. For the practice session, a full session of one-hour foot massage and cool down massage is taught. The examination will be in written and practice format. After the completion of whole school course, the certificate will be issued.22

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Reflex zone is the region in the zone therapy that illustrates its interconnection with the whole parts of the body. Pressure applied to this region will help specific organ or particular part to alleviate the pain and symptoms of a disease. According to the theory, there is an invisible pathway that runs along the body in a vertical form based on the lines instead of reflexology maps in which each point on the soles of hand and feet correspond to a specific organ. Reflex zone therapy (Fig. 9) represents five zones in both sides of the feet.12 This zone is running along the whole body parts from top of the head until the tips of the toes and fingers and the whole body is divided into ten reflex zones.12 Each zone interconnects with different parts of the body.10 Reflex zone therapy-specific organ relationship is presented in Table 1 and Table 2.
Several mechanisms for deep massage’s natural stress-relieving effects include its ability to dilate blood vessels and also lower activity of the limbic system (including the hypothalamus), which is responsible for autonomic nervous system regulation and cortisol secretion. Massage has been shown to improve relaxation by boosting activity of the parasympathetic nervous system, as measured by heart rate, blood pressure and heart rate variability. (8, 9)

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“If your hands and fingers start to scream while you're working, you need to modify what you're doing,” says Bykofsky. “Also, if you notice that you’re sore at the end of your work day, Bykofsky also recommends that you “do the things you suggest to your clients: ice, apply something to help, perhaps take an anti-inflammatory, and, the hard one, rest!”  
Research studies regarding perceived fatigue and recovery showed that subjects felt they were less fatigued and felt like they recovered faster after sports massage. Decreased anxiety, improved mood, better sleep, and enhanced feelings of well-being were also noted. Delayed onset muscle soreness (DOMS) is reduced by sports massage, according to a wide variety of studies.

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In South Africa, massage is regulated, but enforcement is poor. The minimum legal requirement to be able to practice as a professional massage therapist is a 2-year diploma in Therapeutic Massage and registration with The Allied Health Professions Council of SA (AHPCSA). The 2 year qualification includes 240 credits, about 80 case studies, and about 100 hours community service.

Deep tissue massages are not for everyone, and it’s very important to find a well-trained therapist. If you’re actively healing from surgery, have nerve damage or an existing injury, you’re wearing a cast or brace, or you’re pregnant, then talk to your doctor before seeking a massage therapist. Although it’s rare, massages that are poorly performed can sometimes cause increased pain, inflammation and other complications in high-risk patients. (16)


Many training programs are now available throughout the world that require a minimum of 500 hours of basic massage therapy training, in addition to continuing education credits that can require up to another 400–500 hours. (19) Always make sure you’re “in good hands” by first checking that a therapist has proper qualifications and experience, specifically asking about training in NMT, trigger point therapy, sports massage, pain management, myofascial release and orthopedic massage.

Reflexology is an alternative treatment for a variety of conditions and has been in use for thousands of years. The ancient Chinese and Egyptians have documented practices similar to reflexology as a treatment for certain afflictions. It involves the reflexologist applying pressure to specific areas in the hands, feet, and ears that affect certain reflex areas of the body.


Deep Tissue Massage focuses on stretching fascia- a three-dimensional web of connective tissue that surrounds, supports and penetrates all of the muscles, bones, nerves and organs. Deep tissue massage works layer by layer through connective tissue and muscles down to the deepest accessible layers to change posture and create freedom of movement by releasing fascial adhesions and chronic muscle contracture. Adhesions and scar tissue form in muscles because of injury, chronic poor posture, chronic or acute inflammation and repetitive motions.
One narrative review in Open Access Journal of Sports Medicine explains that the impact of using these two modalities combined are somewhat inconclusive, mainly due to research limitations; however, after looking at 21 randomized controlled trials, the author ultimately concluded that “the effects of cold and static compression are clearly better than no treatment.”

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