Strength and stamina: There is no question that massage therapists must have a great deal of physical strength and endurance to perform their jobs every day. It takes a significant amount of arm and shoulder strength to perform various massage techniques especially when you have to do it all day with consistency. This is especially true for those who perform deep tissue massage or Swedish massage. Most sessions run an hour long. So, if you see at least six clients a day, it is crucial that you maintain your strength, focus, and attention to detail.
International Institute of Reflexology has been conducting reflexology training and course. This institute has acceptable qualification and has been teaching for over 50 years to the highest professional standard. This institute teaches the original Ingham method and it is taught only by tutors who have approved licence from the IIR to ensure that authenticity is maintained. All the graduates have international and European recognition for their training by the addition of City and Guides Level 3.
While a foot massage may feel the same as a reflexology treatment, a reflexologist will work on areas to promote a healing response in the corresponding organs. A massage therapist giving a foot massage will manipulate muscles and other soft tissues to improve circulation, relieve pain, and heal injuries in the area or to induce overall relaxation.
A traditional Swedish massage involves the whole body. You will begin on either your back or your stomach and flip over at the halfway point. If you have an area of particular concern, such as a tight neck, you can ask your therapist to spend more time in this area. Depending on your preferences, you can ask your massage therapist to use light, medium, or firm pressure.

During the 1930s and 1940s massage's influence decreased as a result of medical advancements of the time, while in the 1970s massage's influence grew once again with a notable rise among athletes.[10] Until the 1970s, nurses used massage to reduce pain and aid sleep.[22] The massage therapy industry is continuously increasing. In 2009, U.S. consumers spent between $4 and $6 billion on visits to massage therapists.[23] In 2015, research estimates that massage therapy was a $12.1 billion industry.[24]

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Muscles are layered on top of each other and over lap. Some muscles are right on the surface like your rectus abdominis (six pack ab muscles), and some are much deeper in the body like your Psoas muscle (deep hip flexor). So a DTM implies that the therapist is not just working on the superficial musculature, but reaching layers of muscle and fascia (connective tissue) further below the surface.
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.”
"Rosemary did a wonderful job working out neck and shoulder build up that was causing me acute pain. I greatly appreciate the Wellness Center’s thoughtfulness in adjusting my appointment last minute too, so I could have a longer session to get all the help that I needed. They’re my go-to place in Denver for quality massage. I actually walk out feeling better and I can’t say that about other places I’ve gone for treatment.”

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Using this chart, you can perform something like pain relief for the shoulders. The proper technique here would be to find on the foot the part of the spine that is level with the shoulders (from bottom of big toe to where the ball of the foot finishes), locate the part of the spine that is level with the shoulder area (from the base of big toe to where ball of foot finishes), thumb walk this part on the spine area up and down for several minutes, and then thumb walk the entire shoulder area.
When you are looking for massage therapy, be sure to check which type of massage a practitioner can provide. Match that with the benefits you hope to get from the massage session. You may want to chat with several different practitioners to find the one who understands your needs and is used to working with people with similar goals. Be sure also to discuss any allergies, such as to scents or plant oils, so your massage will be relaxing and beneficial without that concern.
In 2015 the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; reflexology was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.[5] Accordingly In 2017 the Australian government named reflexology as a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".[6]

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As for the basics of how it works, foot reflexology simply refers to the reflexes that have been mapped out in the foot. There are many different foot reflexology charts that show where the reflexes are for every part of the body. Although it is like a massage, its principles are entirely different. It is thought that reflexology works through nerve endings, while massage focuses on the muscles and soft tissue of the body. This is where the practice gets its name; it works on the reflexes, not just the skin, muscle, or tissue. It should not be painful, though like in a massage there could be stressed areas of your body that are more tender or uncomfortable. However, the applied pressure to those areas, the less tender they will become.

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The therapist might use Swedish massage to stimulate circulation of blood and lymph fluids, and trigger point therapy to break down adhesions (knots in the muscles), and stretching to increase the range of motion. Other techniques could include myofascial release, craniosacral therapy, lymphatic drainage and orthopedic assessment. The therapist should also have a good foundation in hydrotherapy modalities including cryotherapy and thermotherapy, which can help with recovery, repair and healing processes.
Massage in China is an extremely popular therapy, the city of Shanghai alone playing host to over 1500 foot massage centers while there are more than 3000 in Shenzhen. It is one of the biggest service industries in China with workers in Shanghai numbering in the tens of thousands.[17] The average rate of pay for a worker in the massage industry in China is over 10000 yuan per month, making it among the highest paid jobs in China’s service sector.[18] China’s massage parlors are frequently linked to the sex industry and the government has taken a number of measures in recent times to curb prostitution and the spread of disease. In a nationwide crackdown known as the yellow sweep ("Yellow" in Mandarin Chinese refers to sexual activities or pornographic content), limitations on the design and operation of massage parlors have been placed, going so far as requiring identification from customers who visit massage establishments late at night and logging their visits with the local police.[19][20]

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Structural Integration's aim is to unwind the strain patterns in the body's myofascial system, restoring it to its natural balance, alignment, length, and ease. This is accomplished by hands-on manipulation, coupled with movement re-education. There are about 15 schools of Structural Integration as recognized by the International Association of Structural Integration,[60] including the Dr. Ida Rolf Institute (with the brand Rolfing), Hellerwork, Guild for Structural Integration, Aston Patterning,[8] Soma,[61] and Kinesis Myofascial Integration.[62]
Swedish massage therapy can be helpful with a number of other physical challenges, such as reduction in scar tissue by physically manipulating the fibers of the tissue, allowing the scar tissue to be successfully reabsorbed into the skin. Additionally, it can aid with lymphatic drainage, where the long strokes of the therapist help move fluids successfully out of clogged areas.
Finally, sports massage is designed specifically for the very physically active (whether you're a professional athlete or not). It combines Swedish, Shiatsu, and other techniques to concentrate on the areas that are related to your sport. Athletes often get sports massages to prepare for peak performance, prevent injury, and also treat injury. Sports Injury Clinic, which offers several demonstration videos, says:
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.

Many training programs are now available throughout the world that require a minimum of 500 hours of basic massage therapy training, in addition to continuing education credits that can require up to another 400–500 hours. (19) Always make sure you’re “in good hands” by first checking that a therapist has proper qualifications and experience, specifically asking about training in NMT, trigger point therapy, sports massage, pain management, myofascial release and orthopedic massage.

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Swedish massage is the therapeutic massage standard for much of the Western world. Developed in the 1800s by Pehr Henrik Ling, it incorporates a variety of specific massage techniques to treat sore muscles, tension, stress, and poor circulation. Most Western massage modalities have their origins in in this form, and the majority of massage therapists in the West are trained in it before they learn any other massage techniques. Swedish massage is so ubiquitous that in Europe that it is known as classic massage.

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By far the most popular form of massage, Swedish Massage “relaxation massage” was popularized by early 19th century Swedish fencing master and gymnastics teacher Henrik Ling. Swedish massage involves long, flowing strokes, often in the direction of the heart, along with kneading and circular movements, all while using massage lotion or oil to minimize friction. Used most often for its relaxation benefits, Swedish massage is the common “introductory” technique for people who have never experienced massage before.


How are NMT and Sports Massage treatments different from a basic massage Treatment? While each system uses a hands-on approach to soft tissue manipulation, NMT and Sports Massage are extremely specific. Like massage therapy, NMT and Sports Massage address the muscle bellies, but they also go to work with the entire length of the muscle from origin to insertion. Instead of a general approach, Sports Massage identifies postural and biomechanical distortions that are involved with pain patterns. These systems also go on to strategically manipulate specific soft tissue components to facilitate structural change and balance.


Clients interested in experiencing Swedish massage should seek out a reputable massage therapist to explore it. Often it takes several visits to multiple therapists to find one who is a good match with the client. Like other massage modalities, this form is most effective when undertaken at least once a month, although once every two weeks is a more therapeutically useful interval. Clients should remember to communicate clearly with the therapist for a productive session.

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When you think of a massage, you probably think of soothing music, a gentle brush of hands softly kneading the stress from your shoulders, maybe even of a loved one offering to rub your back after a long day at work. While some massages can be soothing, and rely on gentle touches to work out a client’s stress or anxiety, there are other massages that have a little more grit to them. For example, the Deep Tissue massage, which is very similar in style to the Swedish massage, utilizes some of the same techniques as its much gentler cousin; Deep Tissue massages, however, are designed to focus on the deeper layers of muscle tissues and fascia, the protective layer that surrounds muscles and joints. Working out these harder to reach muscles will require more pressure, making the Deep Tissue massage slightly uncomfortable, gritty and highly effective.
In the United Kingdom, reflexology is coordinated on a voluntary basis by the Complementary and Natural Healthcare Council (CNHC). Registrants are required to meet Standards of Proficiency outlined by Profession Specific Boards,[12] but since CNHC is voluntary anyone practicing can describe themselves as a reflexologist. When the CNHC began admitting reflexologists, a skeptic searched for, and found, 14 of them who were claiming efficacy on illnesses. Once pointed out, the CNHC had the claims retracted as it conflicted with the UK's Advertising Standards Authority code.[13]

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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.

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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].

Before you can decide which massage style is best for you, you need to ask yourself a question. Do you simply want a massage for relaxation and stress control? Or do you need symptom relief or help with a certain health condition? Before booking a massage, let the therapist know what you're looking for and ask which style the therapist uses. Many use more than one style. Or the therapist may customize your massage, depending on your age, condition, or any special needs or goals you have.


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.

In another study, 35 women with premenstrual syndrome (PMS) were randomly assigned to ear, hand, and foot reflexology or to placebo therapy done on sham reflex points. The women kept a daily record of 38 possible symptoms selected from previous PMS research questionnaires. The treatment group reported significantly fewer symptoms than the placebo group, and these improvement persisted for 2 months after treatment. Many women in this group fell asleep during the 30-minute sessions and reported feeling more energetic during the next day. The placebo group reported that they thought they were receiving genuine reflexology, The authors note, however, that it was very difficult to develop a credible placebo control group, which may have been the study's flaw. Normally, reflexology is soothing, but the placebo treatment was described as "either overly light or very rough." [13] Thus the differences could have been differences in the quality of the massage being administered. The study suggests that massage may relieve PMS symptoms, but it does not validate the alleged connection between reflex points and body organs
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.
"I've been coming to the Wellness Center, well since it opened! I've NEVER had a poor / lack luster treatment. I see many of the LMT's, Dr. Price (the most fabulous Chiropractor in the universe) and Dr. Shwu the acupuncturist of your dreams...seriously, I do not think there is anything she cannot fix. Everyone at The Wellness Center is kind, understanding, helpful, and most importantly, a master of their craft."
During hot stone massage, your body is not only weighted down with hot, smooth stones, but the masseuse also uses the stones to massage your body. It's like being caressed by the smoothest (rollerball-like) hands, but also being scorched by them for a "Yeeooowwww!….Ahhhhh" effect. A hot stone massage is mostly relaxing, but it also is more invigorating than your run-of-the-mill massage, thanks to the almost-too-much heat bringing you back to focus on the moment instead of letting you drift off. The heat helps release the tension in your back and shoulders, mostly, so those muscles can be worked on more effectively.

Deep Tissue massages are among the most effective forms of massage therapy available to clients. If you are interested in furthering your massage therapy education or pursuing a career in wellness, it is important to have this technique firmly under your belt. Fremont College offers an extensive program in massage therapy, sports therapy education and physical therapy education. Take a look at our programs page for a more detailed description of the courses and degrees we offer!
Increased blood flow. Your Swedish Massage Therapist should use effleurage – a long, stroking motion in the direction of blood flow towards the heart – in order to open up your blood vessels and increase your blood flow. Increased blood flow means that your muscles are getting more nutrients and oxygen and that your body is removing toxins more efficiently.
I’ve worked in a variety of exciting environments, including the Salt Lake City Winter Olympics, the Greece Paralympic Summer Games and on the road with the U.S. National Powerlifting Team. Plus, I have worked with collegiate, ABL and WNBA athletes. Currently, I travel with the WTA (Women’s Tennis Association) as part of the sports science and medicine team. In my private clinic, I specialize in orthopedic massage.

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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.


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).
RCTs have a vital role in the assessment of efficacy in reflexology. However, they only address the effect of reflexology in which other pertinent issues are unexplored such as the mechanism of reflexology, psyche, and the experience of participants receiving reflexology. Nursing research has long used qualitative research to explore various health care phenomena. Similarly, qualitative approach can provide further understanding about the patient's perception and belief towards reflexology.4, 36 Qualitative research also assists in understanding the impact of the context and the process of reflexology intervention. A greater understanding of reflexology intervention has the potential to enhance the delivery of health care. Thus, it is argued that qualitative explorative methods combined with RCTs could potentially reveal the contributing factors of reflexology effect.
According to Robert Noah Calvert, author of The History of Massage, what we now call Swedish massage was never part of Ling’s movement system. Swedish massage, as Calvert asserts, is defined by its system of stroking, kneading, and other bodily manipulations. These he credits to a Dutch practitioner, Johann Georg Mezger, who lived and worked in the late 19th century. As a result, what Americans know as Swedish massage is called “classic massage” throughout most of Europe.
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
Trust and pain. Bear in mind that feeling safe is critical to the experience of good pain. Tiny differences in trust and comfort can make the difference between an intense pain being good or bad. Much of the “goodness” of good pain comes from mental context, from knowing that a pain is not dangerous or pointless, that it will not increase suddenly, or anything else yucky or shocking.
No one really knows how a painful massage can also feel so good at the same time. This is a sensory phenomenon mostly beyond the reach of science — not entirely14 — all we can do is speculate. A main question is whether good pain is good because we expect relief to follow pain, or because positive and negative qualities are being produced simultaneously. My bet is on the latter.
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.

Many training programs are now available throughout the world that require a minimum of 500 hours of basic massage therapy training, in addition to continuing education credits that can require up to another 400–500 hours. (19) Always make sure you’re “in good hands” by first checking that a therapist has proper qualifications and experience, specifically asking about training in NMT, trigger point therapy, sports massage, pain management, myofascial release and orthopedic massage. 

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Currently, the learning centre which provides training for reflexology is very limited. Normally anyone interested to learn reflexology will learn about reflexology through apprenticeship. Recently, Stella In, a local Malaysia training centre offers certification of training in reflexology. This institute was established by the Ministry of Tourism Malaysia as one of the centres of excellent which offers spa therapy training, specifically for Malaysian, with full job guarantee at any officially approved spa organizations. This institute offers certified qualification of national/international diploma in reflexology foot massage course. Learning about the body zones, feet reflexes, and reflexology techniques which can improve blood circulation, removal of toxins from body, and help to increase the energy level are offered in this course. The teaching techniques include theory and practical.14
The primary goal of deep tissue massage is to reduce pain and discomfort, while improving the body’s ability to heal itself. Deep tissue massages are not only relaxing — they also help “lengthen and release muscles” that frequently feel tense and get stuck in uncomfortable holding patterns. (1) Let’s explore what, exactly, deep tissue massage is and all the ways it can benefit your body and mind.
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.

According to practitioners, foot reflexology is a simple, non-invasive method to help balance the body. It has been described as a natural therapy that requires the application of a specific type of pressure on particular areas of the feet. It gets its school of thought from the principle that there are reflexes in the feet which correspond to every part of the body, so by understanding the “maps,” you can do anything from relaxation to improved circulation, and also add a general feeling of wellness. It’s like a massage for your feet…that affects your whole body!


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]
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I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com

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.


There is no consensus among reflexologists on how reflexology is supposed to work; a unifying theme is the idea that areas on the foot correspond to areas of the body, and that by manipulating these one can improve health through one's qi.[8] Reflexologists divide the body into ten equal vertical zones, five on the right and five on the left.[9] Concerns have been raised by medical professionals that treating potentially serious illnesses with reflexology, which has no proven efficacy, could delay the seeking of appropriate medical treatment.[10]

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The whole Swedish experience is also a potential stress reliever, which is a benefit unto itself. Plus, it can improve blood flow, delivering more oxygen to cells. A lesser-known benefit—moisturized, glowing skin—results from the application of massage oils. Many therapists prefer to use sweet almond oil because it absorbs slowly into the skin, yet doesn’t leave clients feeling like they’re covered in grease. Other favorite oils include grapeseed (non-greasy, no smell) and jojoba oil (easily absorbed, mixes well with aromatherapy oils).

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