Hepatic hematoma. Hepatic hematoma is a painful liver condition, which The New England Journal of Medicine says has been instigated by deep tissue massage. In this case, a 39-year-old woman received a deep tissue massage, which included the abdomen and right upper quadrant. Within 24 hours, she developed abdominal discomfort, nausea, and pain in her right shoulder. A large hematoma was found in her right hepactic lobe, causing the woman to feel nauseous and have a fever for the following six months.
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:

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Adequate recovery is also a major factor in avoiding the over-training syndrome. Over-training is characterized by irritability, apathy, altered appetite, increased frequency of injury, increased resting heart rate, and/or insomnia. It occurs when the body is not allowed to recover adequately between bouts of heavy exercise. Therapeutic massage helps you avoid over-training by facilitating recovery through general relaxation, and its other physiological effects. 
Obviously, open sores to the hands and/or feet would be a reason to avoid reflexology. Acute injuries also must be handled with care. Anyone with active blood clots should avoid rubbing near the area of the clot. Burns, wounds, gout and infections to the hands or feet should also limit the use of reflexology. Lower extremity swelling or chronic skin changes that are a result of vascular problems to the feet should also limit this form of therapy. Recent removal of a cancerous tumor or other surgical procedures, such as wart removal, also make reflexology inadvisable. There is some evidence that rubbing of the feet during pregnancy might stimulate contractions, and so should be avoided in the later stages of pregnancy.
Sheets and wrappings of connective tissue called fascia are considered an exciting frontier in massage therapy. Supposedly fascia can get tight and needs to be “released.” However, key examples of research either fail to support fascial therapy or actually undermine it — for instance, fascia is too tough to actually change. Fascia enthusiasm seems to be a fad. For more information, see Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties. BACK TO TEXT
During the 1990s, I observed at least seven foot reflexologists at work during health expositions. In most cases, the process appeared to be an ordinary prolonged foot massage with little communication between the practitioners and their clients. But at one exhibit, the practitioners claimed that they could reduce stress, cleanse the body of toxins, increase circulation, assist in weight loss, and improve the health of organs throughout the body. On another occasion, I underwent a 15-minute session in which the practitioner felt my foot for diagnostic purposes and then massaged it for "therapeutic" purposes. During the previous year, I had had severe shoulder pain caused by an inflamed tendon that was rubbing against a bony surface inside my left shoulder joint. Thorough medical evaluation had determined that the appropriate treatment was arthroscopic surgery in which a drill is used to shave the bony area that was impinging on the tendon. The reflexologist claimed that he could detect the shoulder problem by feeling my left foot, that it was caused by stress, and that pressing on my foot—perhaps for a few sessions—could solve the problem. His "treatment," which lasted about 10 minutes, consisted of massaging the foot and from time to time, pressing hard on the ball of my foot, a procedure that was quite painful. The "treatment," of course, did absolutely nothing to help my shoulder. A few months later, I had the surgery, which cured the problem immediately and permanently.

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.


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.
To put it bluntly, it’s not clear that massage has any musculoskeletal benefits at all. It probably does, but mostly quite temporary and highly unpredictable. There’s not nearly enough science, and therapists are hopelessly biased assessing their own efficacy. See Does Massage Therapy Work? A review of the science of massage therapy … such as it is. BACK TO TEXT

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To put it bluntly, it’s not clear that massage has any musculoskeletal benefits at all. It probably does, but mostly quite temporary and highly unpredictable. There’s not nearly enough science, and therapists are hopelessly biased assessing their own efficacy. See Does Massage Therapy Work? A review of the science of massage therapy … such as it is. BACK TO TEXT

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For me, the opportunity to work with individuals who have such an awareness of their bodies is exceptional. You and the athlete are a team. Locating an area of dysfunction, aiding in the relief or facilitating improvement in the area, then watching the athlete go out and perform well is uplifting. The environment is charged. What’s more, learning from health care professionals while teaching them how massage fits into overall health and wellness is just plain awesome! 

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Trigger point massage therapy is specifically designed to alleviate the source of the pain through cycles of isolated pressure and release. ... The results and benefits of trigger point massage are releasing constricted areas in the muscles thus alleviating pain. You can experience a significant decrease in pain after just one treatment. Receiving massage with trigger point therapy on a regular basis can help naturally manage pain and stress from chronic injuries.

Diagnosing or treating disease would constitute the practice of medicine and would be illegal for anyone who does not have a professional license to do these things. Although many diagnose and treat disease, I am not aware of any prosecutions. In some states that license massage therapists, unlicensed reflexologists might also be prosecutable for practicing massage therapy without a license [11].

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Massage is hindered from reaching the gold standard of scientific research, which includes placebo-controlled and double blind clinical trials.[86][87] Developing a "sham" manual therapy for massage would be difficult since even light touch massage could not be assumed to be completely devoid of effects on the subject.[86] It would also be difficult to find a subject that would not notice that they were getting less of a massage, and it would be impossible to blind the therapist.[86] Massage can employ randomized controlled trials, which are published in peer reviewed medical journals.[86] This type of study could increase the credibility of the profession because it displays that purported therapeutic effects are reproducible.[87]

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This may come as a surprise, but in fact there is no therapeutic benefit to stretching skin so hard that it feels like it is going to tear! And it is a completely different and uglier sensation than how fascial stretching can feel and should feel (more like a good massage). When I complained about this (politely), the therapists made no distinction between skin-tearing and fascial stretching, and more or less tried to tell me that I was objecting to perfectly good therapy. Needless to say, I never returned to those therapists.
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.

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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Like massages, chiropractic care can be beneficial for lowering pain and improving recovery. It’s also been shown to lower stress, headaches and more. One way that chiropractors help treat pain is by lowering mechanical compression and irritation of spinal joints, which can send nerve signals throughout the body that increase inflammation and irritation.


People do have clear pressure preferences: they often fire massage therapists who give treatments that are too painful or too fluffy. Pressure that’s fine for you may cause severe pain, emotional distress, “sensory injury” (sensitization) in others, or even physical injury, so pressure should be customized but often isn’t. Brutal massages might be appreciated or even helpful, but most people can’t tell the difference between the kind of pain that might be a necessary part of therapy, and ugly pain that is just abusive and dangerous.

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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.

Addressing anything from headaches to sinus problems to stomach issues, if sensitivity or tenderness is experienced when certain areas of the foot are stimulated, it usually indicates bodily weaknesses or imbalances within the corresponding organ. With repeated practice of applying pressure and manipulating nerve endings (traditionally in the foot), reflexology can help to clear any channels of blocked energy through moving the flow of blood, nutrients and nerve impulses to ultimately improve overall health and balance. In addition to manipulating the pressure points on the foot, reflexologists sometimes work on the hands or ears to trigger relaxation as well.

People respond in different ways to a massage so if you have the luxury to try one at different times in your training then determine what is right for you. However, the majority of people will tend to favor the post-race/post-long workout time more. Both are beneficial but the pre-race massage will stimulate your muscles whereas the post-race massage is more of a cool-down/recovery massage.
Specialized massage tables and chairs are used to position recipients during massages. A typical commercial massage table has an easily cleaned, heavily padded surface, and a horseshoe-shaped head support that allows the client to breathe easily while lying face down and can be stationary or portable, while home versions are often lighter weight or designed to fold away easily. An orthopedic pillow or bolster can be used to correct body positioning.

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.

“The number one thing therapists should do to protect themselves from injury is avoid doing too much work,” says Bykofsky. She also recommends not over-scheduling, working too many hours, or holding too many deep massage sessions a week. Also, take advantage of other “tools” at your disposal, such as different parts of your hands and arms, using them for leverage to take some of the pressure off your thumbs.

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.

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“Seeing a naturopathic doctor changed my life. She gave me a food sensitivity test and following those recommendations has almost completely eliminated my symptoms and allowed me to even lose weight. No other doctors I had been to had ever thought about a holistic approach and I don't know what I would not have healed without going to the Wellness Center.”
The NCCIH adds that massage therapy may also be potentially harmful to women who are pregnant. Even though research has found that it offers this demographic some positive effects, such as decreased depression and anxiety and reduced leg and back pain, it is still important to obtain approval from her healthcare provider first to ensure that she can receive a safe sports massage.
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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“A couple of years ago, a friend told me about the team of massage therapists at The Wellness Center (TWC). I had a positive relationship with another therapist at that time, so I didn't book an appointment at TWC for quite some time. When circumstances changed, and I found myself looking for a new therapist, I immediately turned to TWC. I booked an appointment with one of the therapists over a year ago, and have since worked with several others. Each therapist brings their training and specialization as well as their own unique approach to massage into each session. I really appreciate that. So, whether I need a gentle massage or more robust deep tissue work, I get what I need each and every time. They also offer other services and modalities, including acupuncture and chiropractic. I haven't tried either of these, but I've heard great things from others who have. The space is really nice and the location is convenient (their offices are located over the Glendale Whole Foods). AND here's what I really appreciate: there are typically appt times available that fit my schedule. Love that about the Wellness Center!"

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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.

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Neck pain. Neck pain is tied with headaches as the second most common pain experienced by adult Americans (also 15 percent), and massage can typically help with this too. For instance, a systematic review and meta-analysis published in 2014 in Evidence-Based Complementary and Alternative Medicine analyzed 15 studies and found that there was “moderate evidence” that massage therapy helped provide relief.
One difference, however, is that you may not want to drift off the same way you might during a conventional massage. "The only times I run into issues with people not liking their treatment is when they just plop down on the table and go to sleep," Colin says, adding that you should "be honest with your therapist, let them know what your goals and expectations are, and have that conversation."

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Some reflexologists who deny that they diagnose or treat disease claim that the majority of health problems are stress-related and that they can help people by relieving the "stress" associated with various diseases or body organs [1]. This type of double-talk is similar to chiropractic claims that "subluxations" lower resistance to disease and that "adjusting" the spine to correct subluxations will improve health. All ten of the books I have inspected mention scores of health problems that reflexology has supposedly helped.

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Integrative Reflexology is defined as “massage therapy-based reflexology, practiced as both energy work and bodywork.” Integrative reflexology is an holistic discipline which uses the therapist’s hands to apply alternating and firm pressure to stimulate physiological changes in the body. The therapist activates the zone reflex points and meridian points to create beneficial responses in the nervous, electrical and chemical systems of the body. Integrative Reflexology allows the body to relax by releasing tension and improving blood flow. It helps the body to adjust to its own healthy balance.
The pressure from Swedish massage is ideal for relieving muscle tension, like the kind that builds up from hunching over a computer all day. This tension can sometimes result in knots: trigger points of extremely tense muscle fibers that form tiny nodules. Massage therapists are trained to feel for these knots, and Swedish-massage techniques are ideal for gently coaxing them away.

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In Swedish massage, the person to be massaged lies on a massage table and is draped with a towel or sheet. It is a full-body massage treatment, except in areas that are contraindicated or where the client requests not to be touched. Aromatic or unscented oil or lotion is used to facilitate the massage movements. Each session usually lasts 30-60 minutes. Depending on the client's preferences, a massage session may involve the use of several or all of the following basic techniques: effleurage, petrissage, friction, vibration, and tapotement.
“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!”  

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