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]
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)
There is not necessarily a hard line between these two techniques, and many sessions often incorporate both depending on your needs. It is usually the case that not all the muscles in your body need deep tissue techniques applied. Rather than being overly concerned with choosing the “right” session, make sure you communicate to your therapist the goals for your session so that he or she can customize the right blend of techniques for you. One massage style is often the foundation of the session, with other techniques used as needed. Due to the slow pace of deep tissue massage it is necessary to schedule a 90-minute session if you would like your full body addressed. Use these guidelines for communication based on your primary goal for the session:

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]

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Most people feel very relaxed. Some experience freedom from long-term aches and pains developed from tension or repetitive activity. After an initial period of feeling slowed down, people often experience increased energy, heightened awareness, and greater productivity which can last for days. Since toxins are released from your soft tissues during a massage, it is recommended you drink plenty of water following your massage. Massage therapists sometimes recommend a hot Epsom salt bath that encourages the release of toxins that may have been stirred up from the massage treatment.

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.

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Another centre called CEPP Wellness Centre also offers 5 days of training courses on reflexology. The tutors in charge for this short course have the qualification as a professional therapy from International Therapy Examination Council, UK (ITEC) which holds a diploma in aromatherapy and holistic massage. They are very committed in helping participants to get the certificate. During this course, different aspects of reflexology theory such as the anatomy of the feet, including bones and muscles, reflex zones of the feet, and others. This course also applies theory and practical session.

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Referred pain basically just makes trigger point stimulation feel bigger, more important. Press on a small spot … feel it down your entire arm. Wow! Impressive! Even though it’s just a thumb on a trigger point, it feels as though that “itch” is being scratched throughout an entire region. Referred pain amplifies the good pain effect — or the bad pain effect, if the pressure is too intense!

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