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)
Another alarmingly common example is the sensation of skin tearing. This has been inflicted on me personally on at least three occasions, and not by poorly trained therapists — quite the opposite, the perpetrators were all well-trained massage therapists doing a kind of “fascial release” therapy that they clearly thought of as an “advanced” technique.7

Acworth Cobb 30102 Georgia GA 34.0707 -84.5894


Quick muscle knot orientation: Muscle knots — myofascial “trigger points” — are a factor in most of the world’s aches and pains. Their biology is still mostly mysterious: conventional wisdom says they are tiny spasms, but they might also be a more pure neurological problem. Regardless, they can cause strong pain that often spreads in confusing patterns, and they grow like weeds around other painful problems and injuries, making them quite interesting and tricky. Although they are well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. For more information about how trigger points might be involved in your own medical history, see PainScience.com’s best-selling tutorial:
Chronic back pain. The American Academy of Pain Medicine (AAPM) reports that 100 million Americans suffer from chronic pain, with is more than those afflicted with diabetes, coronary heart disease, stroke, and cancer combined. Additionally, back pain is the most common type of pain reported, accounting for 27 percent of all chronic pain cases. It is also the leading cause of disability in Americans who are 45-years-old or younger. Research has found that deep tissue massage can potentially help ease this pain, offering these individuals a chance at a higher quality of life.

There are five main techniques in Swedish massage: effleurage, friction, petrissage, tapotement and vibration. Within each category there are various movements, all intended to ease muscle tension and pain. Each movement has a specific purpose for loosening, warming, soothing or stimulating your muscles during your massage. Here is a breakdown of each of the five Swedish massage techniques:

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Area of focus. Deep tissue massage targets the inner layers of your muscles. It’s used to treat muscle and tendon injuries, pain, and stiffness in your major muscle groups and joints. Swedish massage targets the superficial layers of muscle and focuses on the parts of your body that tend to hold the most tension, such as your neck, shoulders, and back.

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The University of Maryland Medical Center reports that deep-tissue massage is more effective and affordable for relieving chronic pain than conventional medical remedies. Because deep-tissue massage increases the flow of blood through through the body, it helps reduce the inflammation that causes pain. Deep-tissue massage can also help alleviate muscle tension that is often a side effect of chronic pain by loosening the tight tissue clusters.
With possible benefits such as improved fitness endurance and performance, increased flexibility and recovery time, and injury prevention, sports massage is way more than just a massage for athletes! Traditionally, sports massage is a deep tissue massage that targets the deepest layers of muscle in order to stimulate blood flow. It is best done before or after the event as a means to later restore or rehabilitate. For more, see our Comprehensive Guide to Massage.

Inman Fayette 30232 Georgia GA 33.4038 -84.5044


Raizelah Bayen is a California Certified Massage Therapist, currently employed as the Spa Services Manager at Osmosis Day Spa Sanctuary in Freestone, California.  She has been practicing massage for over 25 years, and teaching T’ui Na, Acupressure, Sports and Pregnancy Massage in massage certification programs for 15 years.  Raizelah is an approved CEU Instructor by the National Certification Board of Therapeutic Massage and Bodywork (NCBTMB), offering trainings in Freestone, California and on-site training at your massage school or spa.  For more information, connect with Raizelah Bayen on LinkedIn.

Sometimes confused with pressure point massage,[10] this involves deactivating trigger points that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (President Kennedy's physician) and David Simons. Trigger points have been photomicrographed and measured electrically[71] and in 2007 a paper was presented showing images of Trigger Points using MRI.[72] These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this technique is different from reflexology, acupressure and pressure point massage.
Swedish massage is rooted in Western practices of anatomy and physiology. To perform this type of massage, licensed therapists apply an arsenal of pressure styles that include stroking, kneading, striking, rubbing, and vibrations. Using massage oil to help their strokes glide, they focus the pressure along the muscles that run the length of the body.
Swedish massage is the most popular type of massage in the United States. It involves the use of hands, forearms or elbows to manipulate the superficial layers of the muscles to improve mental and physical health. Active or passive movement of the joints may also be part of the massage. The benefits of Swedish massage include increased blood circulation, mental and physical relaxation , decreased stress and muscle tension, and improved range of motion.

Griffin Spalding 30223 Georgia GA 33.2549 -84.2728


The Swedish massage can also be used as therapy for people who suffer from any type of debilitating joint disorder that causes them pain. This benefit of the Swedish massage works to increase the elasticity in the tissues, flexibility, and to reduce the paint that they feel. After the Swedish massage many of these people will find that they are able to use their joints more than before and with little to no pain.

Dallas Paulding 30132 Georgia GA 33.9163 -84.8278


If you’re interested in learning this art for yourself, fret not. Reflexology is fairly easy to learn. It usually involves a few hands-on courses in the practical application, as well as provide a theoretical understanding of the anatomy and physiology of the body. The most popular method of reflexology is typically of the feet, but hand and ear reflexology are also practiced.

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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!

Plantar fasciitis. According to the JAMA Network, plantar fasciitis occurs when the fibrous band on the bottom of the foot becomes irritated and inflamed, causing pain in the heel and arch areas. The Pacific College of Oriental Medicine further indicates that deep tissue massage can be an effective treatment for this particular condition as it helps “release the muscle tension, break scar tissue, and lead to its elimination.”
Maintenance sports massage is done at least once a week as a regular part of athletic training programs, although professional athletes who have their own massage therapists may have maintenance massage daily. Maintenance massage increases the flow of blood and nutrients to the muscles. It also keeps the tissues loose so that different layers of muscle slide easily over each other. Maintenance sports massage also helps reduce the development of scar tissue while increasing flexibility and range of motion.

Smyrna Cobb 30081 Georgia GA 33.8588 -84.7106


If you feel that you would benefit from experiencing a Deep Tissue massage, do some research into local spas around you that offer the treatment. Make sure that your therapist is certified and has been trained in this technique. As always, check with your doctor before giving this massage a try. Be sure to share your concerns with your therapist, go into detail as to what has brought you in to seek the treatment and do not be afraid to speak up if the pressure becomes too uncomfortable. Remember, more pain does not mean the massage is working.

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For example, I worked on the Indiana Sports Massage Team starting in 1989, as well as the NCAA Swimming & Diving Championships and National Championships. I coordinated massage for the 1992 Olympic Trials and was on the 1996 Olympic Massage Team for the Atlanta Olympics—the first time massage therapy was part of the medical staff for the Olympics. These were all volunteer positions, but I loved it!

The University of Maryland Medical Center reports that deep-tissue massage is more effective and affordable for relieving chronic pain than conventional medical remedies. Because deep-tissue massage increases the flow of blood through through the body, it helps reduce the inflammation that causes pain. Deep-tissue massage can also help alleviate muscle tension that is often a side effect of chronic pain by loosening the tight tissue clusters.
Deep tissue massage is a therapeutic technique that relieves deep-seated muscle tension and soothes chronic tightness. During a deep tissue massage, a trained therapist delivers intense pressure through slow strokes and targeted fascial release. This technique is often used to treat repetitive-stress injuries, posture problems, and sports injuries.

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.
Recovery. Therapeutic massage helps the body recover from the stresses of strenuous exercise, and facilitates the rebuilding phase of conditioning. The physiological benefits of massage include improved blood and lymph circulation, muscle relaxation, and general relaxation. These, in turn, lead to removal of waste products and better cell nutrition, normalization and greater elasticity of tissues, deactivation of trigger points, and faster healing of injuries. It all adds up to relief from soreness and stiffness, better flexibility, and less potential for future injury.

We recently received an email from a representative of Modern Reflexology asking if they could advertise their website on ours and offering to pay. Of course, we don’t accept advertising. But I was puzzled as to why they approached us and what they thought was science-based about reflexology. I was intrigued enough to visit their website to learn what “modern” reflexology was all about. I learned about a lot of specific claims I hadn’t heard before, but I found no science whatsoever. By writing this article, I am in a sense giving them the advertising that they asked for; but it will be negative publicity, not positive. Old adage: Don’t wish too hard for what you want; you might get it.
The proper design, control, and intervention protocols of research on reflexology remain debatable. The use of randomized controlled trials (RCTs) is the golden standard in assessing the efficacy of complementary therapies such as reflexology.34 Verhoef et al. have described the challenges when researching complementary therapies: standardization of regimented treatment that limit the individualization of treatment; client's focus on health with restricted roles for disease treatment; ethical issues involving the recruitment and randomization due to participants pre-conceived belief on reflexology; practicality of applying sham reflexology; interference of psychological influence on rapport between patient-provider.35
In short, yes. An athlete’s medical condition and history should not be discussed with anyone except other trainers or coaches. There is nothing the media likes more than to hear a high profile athlete is sick or injured, so those discussions don’t happen outside of closed doors. The athlete is the only person who should be deciding what information they want to share.
One of the key benefits of Sports massage therapy compared to other modalities is its ability to target muscle-tendon junctions. A 2010 study in the journal of Strength and Conditioning Research found that even a 30-second massage improved hip-flexor range of motion. Another study conducted by Margaret Jones, Ph.D. of the American College of Sports Medicine, demonstrated a notable trend toward decreased muscle soreness in the athletes who received massage either before or after exercise.

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.


The reason the Pressure Question exists is that it’s hard for patients to tell the difference between nasty pain that might be a necessary part of therapy, and ugly pain that is just abusive. Not everything that hurts is therapeutic, but not every therapeutic procedure is painless! How can we tell if an intense massage technique is therapeutic or not?

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The underlying theory behind reflexology is that there are certain points or "reflex areas" on the feet and hands that are connected energetically to specific organs and body parts through energy channels in the body. By applying pressure to reflex areas, a reflexologist is said to remove energy blockages and promote health in the related body area.
A person receiving a deep tissue massage usually lays on the stomach or back in one position, while deep pressure is applied to targeted areas of the body by a trained massage therapist. The massage is beneficial mostly because it helps stimulate blood flow and relieve muscle tension, while at the same time lowering psychological stress and releasing “happy hormones” like serotonin and oxytocin.

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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.
Until recently, reflexology was mostly ignored by science and relied on anecdotal evidence to buoy its good name. Today, though, there are many associations and organizations promoting and supporting the work of reflexologists from around the world. There is even an International Council of Reflexologists which has produced a Research Analysis Document that contains over 300 reflexology research studies, mainly from such places as China, Denmark, and the United Kingdom. Even in North America, a study has been published in the American Journal of Obstetrics and Gynaecology. Some of this research studies examined the effects of reflexology upon certain health conditions such as: asthma, back pain, cancer, chest pain, childbirth, PMS, heart disease, constipation, gout, migraine, headaches, multiple sclerosis, and nervous exhaustion.

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Deep-tissue massage helps ease stress and tension, which can have a beneficial effect on blood pressure. People who had a deep-tissue massage saw their systolic pressure drop by an average of 10.4 mm Hg and their diastolic pressure drop an average 5.3 mm Hg, according to a study cited by the University of Maryland Medical Center. Deep-tissue massage can help increase the body's production of serotonin, the hormone that promotes happiness and good feelings.

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Reflexology is an alternative medicine system that claims to treat internal organs by pressing on designated spots on the feet and hands; there is no anatomical connection between those organs and those spots. Systematic reviews in 2009 and 2011 found no convincing evidence that reflexology is an effective treatment for any medical condition. Quackwatch and the NCAHF agree that reflexology is a form of massage that may help patients relax and feel better temporarily, but that has no other health benefits. Our own Mark Crislip said, “The great majority of studies demonstrate reflexology had no effects that could not be replicated by picking fleas off your mate…And it has no anatomic or physiologic justification.”
Their website seems to conflate reflexology with acupuncture and acupressure. There are five tabs at the top of the home page: (1) Store, which links to a single Amazon.com page selling a reflexology foot massager, (2) Acupressure Points and (3) Reflexology Treatment, both of which have multiple articles on acupuncture and acupressure, (4) Reflexology Machines – foot massagers and acupressure mats, and (5) Courses. Notable by its absence is a tab for scientific studies showing that any of this stuff works.

Whitesburg Carroll 30185 Georgia GA 33.5111 -84.9254


The underlying theory behind reflexology is that there are certain points or "reflex areas" on the feet and hands that are connected energetically to specific organs and body parts through energy channels in the body. By applying pressure to reflex areas, a reflexologist is said to remove energy blockages and promote health in the related body area.
A sports massage is typically a combination of several massage techniques that are tailored to your affected muscle groups based on the activities that you do. A properly administered sports massage can help flush the lactic acid out of your body. There are two types of sports massages that can benefit triathletes depending on when you schedule your appointment and your race schedule.
A couples massage allows partners to experience massage together in the same area as one therapist works on each person. Some spas turn this into a romantic event that can leave guests starry-eyed, setting the treatment in a special room or suite large enough for two, beachside underneath the stars, or in the couple’s guest room at a hotel or resort. For an extra-special touch, rooms reserved for side-by-side massage treatments may feature cozy spa fixtures such as fireplaces, shower facilities, Jacuzzis, and dual soaking tubs, and some spas offer irresistible amenities like champagne and strawberries as a sumptuous treat. Many spas offer treatments à deux so spa-goers can share a pampering experience with a significant other, but a couples massage isn’t just for romantics—mother-daughter duos and best friends may also enjoy side-by-side services. For couples, this form of massage can offer a double dose of benefits. The tandem treatment invites couples to get a bit closer and reconnect, and it can enhance intimacy and teach each partner how to take care of the other. Plus, select spas allow lovebirds to get in sync by offering sessions that teach massage techniques. Pampering and rejuvenating facials, massages, and other treatments in a half- or full-day increments can make up a whole spa package for couples. For more on Couples Massage, see our guide.
The findings by a recent study have confirmed the efficacy of reflexology by recording 31% of pain reduction among the patients with back pain. Quinn et al. reported that the pain intensity score decreased to an average extent in the experimental group.23 Poole et al. demonstrated that there was a significant difference between the control and experimental groups before and after the reflexology treatment.24

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Alhough he was a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association at the time, Pietrunti says that he ultimately decided to pursue licensure in massage therapy as well. This provided that missing link while also being “a good way to ‘bridge the gap’ and provide a better service to my clients,” he says.


Chronic back pain. The American Academy of Pain Medicine (AAPM) reports that 100 million Americans suffer from chronic pain, with is more than those afflicted with diabetes, coronary heart disease, stroke, and cancer combined. Additionally, back pain is the most common type of pain reported, accounting for 27 percent of all chronic pain cases. It is also the leading cause of disability in Americans who are 45-years-old or younger. Research has found that deep tissue massage can potentially help ease this pain, offering these individuals a chance at a higher quality of life.

Beyond the feel-good effects of the treatment, the practice and purpose go deeper than the skin and muscles by taking specific reflex points on the foot to induce a healing response in corresponding organs and areas of the body, as seen in the chart to the left. Kneading the soft fleshy ball of the foot, pulling on the toes, tracing around the heel and pushing deep into the arch are just a few of the many small, intense movements you’ll experience during a reflexology treatment.

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Understand reflexology zones. Reflexology is based on the idea that the body can be divided into zones.[4] Picture your body divided into a system of longitudinal and transverse zones. Imagine five zones on each side of your body, starting at the tip of each toe, and running up the length of your body to the top of your head. The transverse zones (similar to lines of latitude) divide the areas of your feet into zones that correspond to your head and neck, your chest, abdomen and your pelvis area. Engaging the tip of a particular zone by applying pressure to a place on the foot activates the body's healing power for that entire zone. This concept is also referred to as zone therapy.
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Proprioceptive studies are much more abundant than massage and proprioception combined, yet researchers are still trying to pinpoint the exact mechanisms and pathways involved to get a fuller understanding.[94] Proprioception may be very helpful in rehabilitation, though this is a fairly unknown characteristic of proprioception, and "current exercises aimed at 'improving proprioception' have not been demonstrated to achieve that goal".[95] Up until this point, very little has been studied looking into the effects of massage on proprioception. Some researchers believe "documenting what happens under the skin, bioelectrically and biochemically, will be enabled by newer, non-invasive technology such as functional magnetic resonance imaging and continuous plasma sampling".[93]

The reason the Pressure Question exists is that it’s hard for patients to tell the difference between nasty pain that might be a necessary part of therapy, and ugly pain that is just abusive. Not everything that hurts is therapeutic, but not every therapeutic procedure is painless! How can we tell if an intense massage technique is therapeutic or not?

Jersey Walton 30018 Georgia GA 33.718 -83.8015

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