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:
According to the Neuromuscular Therapy Center, NMT is one type of deep massage technique that focuses on applying manual therapy to soft tissue with “quasi-static pressure” in order to stimulate skeletal striated muscle. (17) In addition to massaging a painful or inflamed muscle, the area around the affected muscle that normally supports it is also massaged in order to release tension. NMT therapists often focus on several factors that can add to muscle or tissue dysfunctions, including joint pathologies, postural positioning, disruptive habits of use, nutritional components, emotional well-being, allergies and neurotoxins.
Neuromuscular therapy is a form of soft tissue manipulation that aims to treat underlying causes of chronic pain involving the muscular and nervous systems. This medically oriented form of massage addresses trigger points (tender muscles points), circulation, nerve compression, postural issues, and biomechanical problems that can be caused by repetitive movement injuries.

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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.

Muscles have a natural reflex to resist pain. When a muscle thinks it's about to be injured, this reflex is triggered. When too much pressure is applied during a massage, the muscle or group of muscles will naturally resist force by tightening further. This is the opposite effect of what a massage is all about. Effective massages relax and release areas of tension.

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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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 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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“The Wellness Center is a rare gem in the sea of health !! The staff is amazing and the services are stellar. I’ve been with the center for 11 years and have never been disappointed. Each practitioner is professional and truly has your best interest at heart. Kudos to Dr Shwu, Dr Binder, Dr Tim and all the awesome massage therapists. Truly holistic disease prevention care to those seeking total wellness of mind, body and soul.”

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Sometimes you're not intimate partners, just traveling with someone you don't get to see often enough — a sister, mom or best friend — and you want to spend as much time together as possible. All of these scenarios are fine, really, because you make the rules up. If you want to talk to each other during the massage, you can. If you want to quietly commune, that's good, too. The therapists will follow your lead.

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Thai Massage is a popular massage therapy that is used for management of conditions such as musculoskeletal pain and fatigue. Thai Massage involves a number of stretching movements that improve body flexibility, joint movement and also improve blood circulation throughout the body. In one study scientists found that Thai Massage showed comparable efficacy as the painkiller ibuprofen in reduction of joint pain caused by osteoarthritis (OA) of the knee.[69]

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The significant difference in the two approaches is their effect on these layers. A Swedish technique uses lubricant to glide over the layers – whether that be on a superficial layer (light pressure) or a deeper layer (firm pressure). There may also be kneading of the muscles, vibration or percussion to stimulate the muscles, and passive and/or active joint movements. All of these techniques serve to increase circulation of blood and lymph, soften and relax the tissues, reduce cortisol levels in the body (the stress hormone), and provide a generalized sense of relaxation for the client.
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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Research studies regarding perceived fatigue and recovery showed that subjects felt they were less fatigued and felt like they recovered faster after sports massage. Decreased anxiety, improved mood, better sleep, and enhanced feelings of well-being were also noted. Delayed onset muscle soreness (DOMS) is reduced by sports massage, according to a wide variety of studies.
For starters, you bear in mind the things described above that tend to cause ugly pain, and you avoid that kind of therapy like the plague. Then you look for some clues that painful pressure is okay. Here are at least three reasons why unpleasantly intense pressure might be therapeutic — “bad pain,” but not ugly. In each of these situations, it might be acceptable to tolerate sensations so intense and painful that the only thing about them that is pleasant is the part where it stops.

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Reflexology is actually an ancient practice. It’s been practiced for thousands of years in such places as China, Egypt, and India. It was first brought to North America by Dr. William Fitzgerald, who was an ear, nose and throat specialist. His first stab at Western reflexology was called “zone therapy”; this was around the early 1900s. From there, Eunice Ingham, a physiotherapist, picked up the pieces and developed techniques and a body map of the foot, which later became known as reflexology. In modern days, reflexology is increasingly becoming a popular form of holistic therapy.

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Bastian B, Jetten J, Hornsey MJ, Leknes S. The Positive Consequences of Pain: A Biopsychosocial Approach. Pers Soc Psychol Rev. 2014 Apr;18(3):256–279. PubMed #24727972. Bastian et al. write about “pain’s capacity to produce positive consequences, thereby decoupling the experience of pain from the experience of suffering” — pain’s silver linings, basically. BACK TO TEXT


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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Deep tissue massages are often utilized following injuries to help break up newly forming scar tissue that can make recovery more difficult and lead to stiffness. Massage has been shown to help reduce inflammation and muscle spasms by stimulating blood flow, loosening up muscles to allow for more oxygen and also helping reduce the nervous system’s automatic stress response.
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.
Swedish massage uses five basic movements to increase circulation and remove toxins from the muscles. Always working towards the heart, the massage therapist incorporates these techniques into a flowing massage session that leaves the patient physically and emotionally relaxed. The trademark move is Effleurage, long gliding strokes that can be firm or soft, depending on purpose and client. Many therapists start out a session with Effleurage to familiarize themselves with the patient, and then start to bring more pressure to bear for deeper work.
A study conducted by the National Center for Complementary and Alternative Medicine, and published in The New York Times, found that volunteers who received a 45-minute Swedish massage experienced significant decreases in levels of the stress hormone cortisol, as well as arginine vasopressin-a hormone that can lead to increases in cortisol. Volunteers also had increases in the number of lymphocytes, white blood cells that are part of the immune system, and a boost in the immune cells that may help fight colds and the flu.
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.
A good massage is truly a treat and offers many health benefits, but as you've noted, massage places tend to offer lots of options on their services menus. In fact, there are over 200 different massage techniques and types, all treating different needs and providing various benefits. Let's break it down. Here are nine of the most popular types of massages and when you might want to choose them.

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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. 

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During Thai massage the therapist puts you through a series of stretches that cover the entire body. You lie on a floor mat or on a table wide enough to accommodate you and the therapist, and you wear loose-fitting clothing, often supplied by the spa, because there’s no way a sheet can stay put during these moves! The therapist might kneel on the b Show more
There are many types of massage therapy, from classics like Swedish and deep tissue to more exotic styles like shiatsu. Whether you'd like to branch out a bit or have a health condition or injury, choosing a style of massage can be confusing if you're not quite sure what it involves. Here is a list of the most popular types of massage (including some that may be new to you).
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.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Peer-reviewed medical research has shown that the benefits of massage include pain relief, reduced trait anxiety and depression, and temporarily reduced blood pressure, heart rate, and state of anxiety.[80] Additional testing has shown an immediate increase and expedited recovery periods for muscle performance.[81] Theories behind what massage might do include enhanced skeletal muscle regrowth and remodeling,[82] blocking nociception (gate control theory),[83] activating the parasympathetic nervous system, which may stimulate the release of endorphins and serotonin, preventing fibrosis[84] or scar tissue, increasing the flow of lymph, and improving sleep.[10][85]
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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Reflexology has been chosen by most people to treat their body health problems because it offers high level of safety and effectiveness. It also offers natural treatment without consuming drugs and it is easy to use.1 Learning reflexology and its application is quite easy, there is no limitation for people to apply it anytime and anywhere.1 Its effectiveness in treating the root of some diseases may lead to many benefits in health concern such as it helps in easing day-to-day stresses and alleviates the effects from injury and illness.1 However, it is not used in diagnosing processes.11
Previous research has showed that reflexology can reduce the peripheral neuropathy of a patient who suffers from type 2 diabetes mellitus.31 76 patients ranged from 40–79 years old were listed from public health centres in Busan City. Tactile response to monofilament and intensity of the symptoms of peripheral neuropathy were used as the variable outcomes in this study. Tingling sensation and pain were reduced and tactile was more sensitive to 10 g force monofilament.32 The author added that the reflexology can be used as one of the interventions for encouraging foot care in patients who have diabetes mellitus.32 It also can be measured based on glycaemic control and nerve conductivity which show improvement with reflexology.31

At All is Well Massage and SPA, we look forward to helping all of our clients achieve health and tranquility. We are always happy when we can serve more people with a couple’s massage on their journey to a ‘all is well’ life. We invite you to discuss with our massage therapists any concerns or accommodations they may have regarding their couple’s massage.
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.

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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