A 2004 systematic review found single applications of massage therapy "reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level", while "multiple applications reduced delayed assessment of pain", and found improvements in anxiety and depression similar to effects of psychotherapy.[54] A subsequent systematic review published in 2008 found that there is little evidence supporting the use of massage therapy for depression in high quality studies from randomized controlled trials.[55]

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However, since having the feet or hands rubbed is an enjoyable and relaxing experience for most people, there is little doubt that hand and foot reflexology can promote stress relief and a sense of well being in much the same way as any other form of massage. This therapy may be an especially useful complementary treatment for neuropathy of the legs, feet and toes. It can also be useful for sore hands and feet after a workout, running or taking a long walk. 

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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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Friction strokes work on deeper muscles than the techniques previously described. The friction technique is a pressure stroke and is the deepest that is used in Swedish massage. The massage therapist applies pressure by placing the weight of his or her body on the flat of the hand and the pads of the thumbs, knuckles, fingers, or the back of the forearms, and then releases the pressure slowly and gently. This movement should be a continuous sliding motion or a group of alternating circular motions.

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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.”

A 2004 systematic review found single applications of massage therapy "reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level", while "multiple applications reduced delayed assessment of pain", and found improvements in anxiety and depression similar to effects of psychotherapy.[54] A subsequent systematic review published in 2008 found that there is little evidence supporting the use of massage therapy for depression in high quality studies from randomized controlled trials.[55]

There are 58 training programs accredited by the Commission for Massage Therapy Accreditation/Approval in the United States. They provide a minimum of 500 hours of massage training. Certified therapists have graduated from these programs and passed the national certification examination for therapeutic massage. They are also required to participate in continuing education programs to keep their skills current.

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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.
Stroking in smooth movements, kneading to loosen muscles, rubbing or friction with the practitioner using both hands back and forth in opposite directions, and striking (tapping or chopping the body with fingers or hands) are all used in combination. These movements help relax the body, increase circulation, and improve drainage in the lymphatic system.
Massage therapy is also being investigated as an aide to patients with more neuromuscular disorders, such as multiple sclerosis (MS). A Iranian 2013 study published in Clinical Rehabilitation looked at 48 individuals with MS who participated in a five-week massage experiment. They were assigned to one of four groups: massage therapy, exercise therapy, combined massage-exercise therapy and control group.
Swedish massage helps the body heal itself by physically manipulating and stimulating the body’s circulatory and lymphatic systems. This works to energize and help eliminate toxins in the body. Also, through Swedish massage, a high level of relaxation can often be achieved, and this relaxation can help prepare the body to act as an open, receptive vessel in which healing can more rapidly occur.
Sports Massage is a combination of massage strokes and techniques combined with flexibility and specific exercise routines geared to increase an athletes performance capabilities. The application of Sports Massage is determined by ones own specific anatomical and physiological needs. Basic musculoskelatal evaluations, orthopedic assessments, and flexibility analysis do this. By determining the athletes specific needs, the Sports Massage therapist will not only be able to provide increased strength, speed and flexibility, but also improve biomechanical efficiency and decrease the potential for injury. This is a comprehensive program with a shared responsibility between the Sports Massage Therapist and the athlete.

To understand this difference, it’s helpful to first think of the body’s fascia and muscles in layers. Notice in this image the many overlappinglayers of these tissues. Fascia is a connective tissue which permeates the entire body – literally holding the body together, wrapping around every muscle, nerve, organ, blood vessel, and bone. These wrappings are all interconnected in a three-dimensional maze. The muscle layers run superficial to deep in the body.

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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]
So what does all of this mean? It seems that the positive mind (psychological) benefits of sports massage are indeed supported by research studies. Study findings also support that sports massage does not negatively affect performance, but the positive body (physiological) benefits on performance are not quite as clear. More research is needed on the positive body effects and also on the mind/body interaction after sports massage.

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Sports massage tends to be deeper and more intense. It is based on the various elements of Swedish massage and often incorporates a combination of other techniques involving stretching, compression, friction, toning, and trigger point response techniques similar to Acupressure and Shiatsu. The skilled therapist brings together this blend of techniques, knowledge and advice during treatment, to work effectively with the client to bring about optimum performance and to provide injury-free training and minimise post event injuries.
Another institute that offers a short course of reflexology is Karisma Institute which is a specialist training institute. This institute is registered with the Ministry of Human Resource and Ministry of Tourism Malaysia. This institute offers many courses that are geared towards meeting the market needs. For those who registered as participants at this institute, they are supplied with registration kits which consist of foot reflexology book, reflexology zone poster, massage cream, and towel. This institute offers 10% lecture class on theory and 90% practical session with demonstration. The overall contents of this short course are introduction to reflexology, human physiology, organs function, consultation, treatment, and entrepreneurship.16
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]
One risk is clearly neurological and complex: some people are basically sitting ducks for the well-documented and nasty phenomenon of “central sensitization,” and indeed may already be in pain and seeking help because of it. A strong massage can severely aggravate that situation, with long term and extremely unfortunate consequences. It’s rare, but it happens. The typical clinical scenario here is a gung-ho under-trained therapist over-treating someone in, say, the early stages of fibromyalgia. Bad, bad, bad.

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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.
Burmese massage is a full body massage technique that starts from head to toes, drawing on acupuncture, reflexology, and kneading. Signature massage strokes include acupressure using the elbows, quick gentle knocking of acupressure points, and slow kneading of tight muscles. The massage is aimed to improve blood circulation and quality of sleep, while at the same time help to promote better skin quality.

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Reflexology utilizes finger and thumb techniques on the feet and hands to promote deep relaxation, clarity of mind, and a sense of well-being. A session assists with: digestive ailments, hormonal imbalance, structural pain, attention deficit disorders, headache/migraines, sleeping disorders, releasing emotional tension, and strengthening the immune system.
Your massage or bodywork session will take place in a warm, comfortable, quiet room. Soft music may be played to help you relax. You will lie on a table especially designed for your comfort. Each guest will have their own Licensed Therapist, as well as individual massage therapy table. Your pain & area(s) of concern are individually treated while in the comfort of your loved one in the same therapy room.

As the name suggests, deep tissue massage applies deep pressure onto specific trouble points. It feels very much like someone is torturing you on purpose by pushing into your knotted muscle, and the massage can leave you feeling sore. It's not just more pressure all over your body, however (which would be true torture), it's very specific, methodical treatment. As Moyer Wellness explains:

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Shoulder pain. A 2017 study published in the Journal of Physical Therapy Science reports that shoulder pain is one of the most common musculoskeletal disorders, affecting as many as 66.7 percent of the population. The study goes on to say that massage therapy can often help reduce this type of pain, sometimes in a matter of days, though 36 sessions appeared to offer the greatest level of relief.
Reflexologists posit that the blockage of an energy field, invisible life force, or Qi, can prevent healing. Another tenet of reflexology is the belief that practitioners can relieve stress and pain in other parts of the body through the manipulation of the feet. One claimed explanation is that the pressure received in the feet may send signals that 'balance' the nervous system or release chemicals such as endorphins that reduce stress and pain. These hypotheses are rejected by the medical community, who cite a lack of scientific evidence and the well-tested germ theory of disease.[9]

In Japanese, shiatsu means "finger pressure." For shiatsu massage, the therapist uses varied, rhythmic pressure on certain precise points of the body. These points are called acupressure points, and they are believed to be important for the flow of the body's vital energy, called chi. Proponents say shiatsu massage can help relieve blockages at these acupressure points.
A good massage therapist will never force pressure into the muscle. They will continue to apply pressure until the muscle pushes back against them. The muscle will then slowly begin to release and allow the therapist to move along it. The pressure used should not be painful, but should walk a fine line between pleasurable release of tension and a pain-blocking response from the body (tensing up).
If you are a massage therapist, or sports physical therapist, it might be a good idea to explain what a this type of massage will accomplish and what to expect.  At first, a Deep Tissue massage might feel like your typical Swedish massage. First, your therapist will warm up and prepare your muscles by applying light pressure to the areas that require attention. Only after your muscles have been sufficiently prepared will your therapist begin applying specific techniques. The most commonly used strokes in Deep Tissue massages are stripping and friction. Stripping usually involves your therapist applying deep and gliding pressure to the length of your muscle fibers with an elbow, forearm, knuckles or thumbs. Friction, on the other hand, applies pressure across the grain of the muscle in order to relieve adhesions and realign the fibers of the tissue.
The 1984 Summer Olympics in Los Angeles was the first time that massage therapy was televised as it was being performed on the athletes. And then, during the 1996 Summer Olympics in Atlanta massage therapy was finally offered as a core medical service to the US Olympic Team.[28] Massage has been employed by businesses and organizations such as the U.S. Department of Justice, Boeing and Reebok.[29] Notable athletes such as Michael Jordan and LeBron James have personal massage therapists that at times even travel with them.
Diabetes: 6 points specified. One of them: “Place your fingers 2 centimeters below the knee, as shown in the picture. Massage this area with a little pressure for 5 minutes every day. It balances the digestive system. Diabetes is said to begin with stomach fire and proper digestion can reduce this problem. You will immediately see the result. This method is also used to prevent aging, arthritis and other forms of weaknesses.”
Swedish massage is focused primarily on the body and, therefore, is a more physical approach to relieving stress, aches, pains, and tension. One benefit of Swedish massage is its ability to relax the mind-brain connection—the mind being the energy and thoughts, and the brain being the physical matter. This is thought to contribute to a more balanced, stimulated, and integrated system. A healthy mind-brain connection may also help facilitate better physical health.
Deep tissue technique uses very little to no lubricant so that the muscles can be hooked or grabbed, thereby stretching and lengthening them, and to separate adhered muscle compartments. Strokes will be considerably slower and possibly shorter as the therapist waits for a slow release of tension. Some areas may be skipped so more time can be spent on specific areas of need. Doing this provides better alignment of the muscles and less restriction in the joints, thereby improving their movement and function. It is a massage in which the primary goal is less about general relaxation and more about promoting change in the actual structure of the body.
While there is certainly carryover between who can benefit from each type of massage, the deep tissue massage may be better suited for people who are experiencing a specific injury or who have chronic, nagging pain in a particular area. Athletes or individuals in the midst of training for a more intense event may also find this technique particularly helpful.
Pain relief: Relief from pain due to musculoskeletal injuries and other causes is cited as a major benefit of massage.[10] A 2015 Cochrane Review concluded that there is very little evidence that massage is an effective treatment for lower back pain.[88] A meta-analysis conducted by scientists at the University of Illinois at Urbana-Champaign failed to find a statistically significant reduction in pain immediately following treatment.[80] Weak evidence suggests that massage may improve pain in the short term for people with acute, sub-acute, and chronic lower back pain.[88]
In addition to my private practice, I work with patients at the Initiative for Women with Disabilities (IWD) at NYU Medical’s Hospital for Joint Diseases. Many of the patients I see are dealing with issues such as chronic pain, fibromyalgia, multiple sclerosis, cerebral palsy, and rheumatoid arthritis, and find reflexology a beneficial way to incorporate integrative therapies into their treatment.

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A typical reflexology session runs from thirty to sixty minutes. Shoes and socks are removed, and the client is made comfortable, usually by sitting or reclining. Some reflexologists offer a foot bath at the beginning of the session, however, no lotions or oils are used. Pressure is applied in thumb-and-finger “walking” patterns, resulting in gentle stretching and massaging of specific zones of the hands and feet that are thought to correspond to body organs. Simple self-care instructions may be discussed at the completion of the session.
Combine these with the 4,146 active players in the NFL (National Football League) MLB (Major League Baseball), NBA (National Basketball Association), NHL (National Hockey League) and MLS (Major League Soccer); the 244 Olympic athletes on Team USA who competed in the 2018 Winter Games; and all of the “weekend warriors” who play sports on a more sporadic basis and this represents a huge number of individuals who rely on their bodies to consistently perform at higher levels.
In Myanmar, massage is unregulated.[101] However, it is necessary to apply for a spa license with the government to operate a massage parlour in major cities such as Yangon. Blind and visually impaired people can become masseurs, but they are not issued licenses. There are a few professional spa training schools in Myanmar but these training centers are not accredited by the government.[citation needed]

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Pain management. If you have a condition like sciatica or osteoarthritis and are suffering from chronic pain as a result, Swedish massage can be an effective method for managing that pain in a natural way. Notify your massage therapist about your pain points, he or she can target those areas and use a stroking motion to improve local circulation and reduce muscle tension.
Many different movements and techniques are used in sports massage. Examples of these techniques include; Swedish style massage, effleurage (stroking), petrissage (kneading), compression, friction, tapotement (rhythmic striking), vibration, gliding, stretching, percussion, and trigger points. These movements and techniques are used to try to help the athlete's body achieve maximum performance and physical conditioning with a decreased chance of injury or pain and a quicker recovery.
Sports Massage can be characterized two ways: pre-activity and post-activity massage. Pre-activity uses dynamic stretching to allow the connective tissue to work through a full range of motion, thereby reducing possible injury. Post-activity massage focuses on recovering the muscle tissue that may have been impacted doing the particular sport. It involves long strokes to flush out the toxins that causes soreness in the muscles and joints. 
The recently increased demand for evidence-based practice challenges the researchers to provide a relevant but holistic assessment of reflexology. Despite the recent vast use of reflexology, minimal attention has been given to the ethical issues related to the research on reflexology. In the view of public health and safety, we argue that the research on reflexology should adhere to the same ethical requirements for all clinical research.
Sports massage has become an integral part of the new athletic regimen from sports medicine clinics, to college training rooms, to professional locker rooms to Olympic training. Growing number of trainers believe that massage can provide an extra edge to the athletes who participate in high performance sports. Massage has become a necessary ingredient for a complete workout. More and more people are realizing that a complete workout routine includes not only the exercise itself, but also caring for the wear-and-tear and minor injuries that naturally occur with strenuous movement. The physiological and psychological benefits of massage make it an ideal complement to a total conditioning program.

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