In all cases, such massage techniques are employed in collaboration with other appropriate medical care. For example, encouraging circulation around a bruise, but not directly on it, through the use of compression, cross-fiber techniques or even long, deep strokes is only used after appropriate medical referral and diagnostics indicate that there are no clots formed in the area which may embolize.
In the United Kingdom, reflexology is coordinated on a voluntary basis by the Complementary and Natural Healthcare Council (CNHC). Registrants are required to meet Standards of Proficiency outlined by Profession Specific Boards, but since CNHC is voluntary anyone practicing can describe themselves as a reflexologist. When the CNHC began admitting reflexologists, a skeptic searched for, and found, 14 of them who were claiming efficacy on illnesses. Once pointed out, the CNHC had the claims retracted as it conflicted with the UK's Advertising Standards Authority code.
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Pumping - The stroking movements in massage suck fluid through blood vessels and lymph vessels. By increasing the pressure in front of the stroke, a vacuum is created behind. This is especially important in tight or damaged muscle tissue as a tight muscle will squeeze blood out like a sponge, depriving the tissues of vital nutrients and energy to repair.
It’s just a theory: no one knows if this is actually effective.11 However, it may explain why so many massage patients report a “gets a bit worse before it gets much better” response to quite painful treatments: motor end plates are (painfully) destroyed by strong pressures, and then that tissue is quite sensitive and a bit weak as it heals over a day or two … and then you finally feel much better after that!