Since reflexology is not recognized by law, no formal training is required to practice reflexology or call oneself a reflexologist. However, some nurses and massage therapists offer reflexology as part of their licensed practice. Some courses are accredited for continuing education for nurses and massage therapists. The most widely publicized training source is probably the International Institute of Reflexology, of St. Petersburg, Florida, which claims to have 25,000 members worldwide [9]. Its seminar on the "Original Ingham Method of Foot Reflexology" are taught by Ingham's nephew, Dwight Byers. Its "Certified Member" status requires 200 hours of instruction plus passage of written and practical tests. As far as I know, this certification process has neither legal nor medical recognition. The Institute's Web site states:

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Like the name suggests, deep tissue massage targets your body’s deepest layers of muscle and releases tension in overstressed areas. When your muscles are severely knotted, this therapeutic treatment is designed to break it up. Deep tissue massage is a mix of slow, short strokes and penetrating finger pressure focused on tight, contracted areas. Th Show more

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While there are numerous benefits to this branch of massage, elementsmassage.com reminds you that it is important to keep your expectations for the treatment reasonable. While Deep Tissue massages use more pressure to reach deeper muscle tissues and often yield immediately noticeable results, asking your therapist to apply more pressure and gritting your way through pain will do more damage than good. If you are in pain, your muscles will begin to contract, making the therapist’s efforts moot. Applying more pressure will not speed up the process. Like any treatment, Deep Tissue massages need time to be effective. Keep in mind that the injury or muscle tension that you are hoping to get resolved has had a great deal of time to form; it will take time to undo the damage. Like any treatment, often the therapy will not be enough; including other changes to your lifestyle, such as exercise, relaxation techniques or working on posture in addition to your massage appointments will help move the process along and help you see faster and longer lasting results.

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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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The first study I know of was supervised by William T. Jarvis, Ph.D., a professor who taught research methods to graduate students at Loma Linda University. Using questionnaires, 70 subjects were asked to state whether they had had health problems during the previous two years in any of 43 anatomical areas. These data were then compared with the findings of a reflexologist as recorded on a report form. The results did not differ from what would be expected by blind guessing. To prevent the reflexologist from asking questions or observing subtle clues, the experimental subjects were asked to remain silent and a curtain was placed so that their feet were the only part of their body visible to the reflexologist [12].

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.
If you’re interested in learning this art for yourself, fret not. Reflexology is fairly easy to learn. It usually involves a few hands-on courses in the practical application, as well as provide a theoretical understanding of the anatomy and physiology of the body. The most popular method of reflexology is typically of the feet, but hand and ear reflexology are also practiced.
Deep tissue massages are usually “cross-grain,” moving against the muscles to relieve aches or pains rather than moving  with them. This can sometimes feel a bit more painful as a result compared to standard “relaxation massages.” However, the pressure involved in deep massages is actually a good thing. It provides many of the benefits that this type of therapeutic massage has to offer. Deep tissue massages also tend to be slower-paced and longer than many other massages, ideally about 1.5 hours long, which gives bodily tissue enough time to warm up and then relax.

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.
Some research has shown that massage therapy can be effective during pregnancy due to its anxiety-lowering effects, and women who receive massages before and during labor tend to experience decreased depression, anxiety, and leg and back pain. Results from one study found that women who received massages prior to and during labor had significantly less pain, plus their labors were on average three hours shorter and required less need for medication.
A career in sports massage requires training in a broad range of massage therapy modalities, in-depth knowledge of injuries and rehabilitative treatments, and, in many cases, a willingness to stand ready and waiting on the sidelines of sporting events to treat participants in urgent situations. Additionally, you’ll need strong communication and business skills to help you build a sports massage practice.

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Inter- and intra-event massage is given between events or in time-outs to help athletes recover from the preceding activity, and prepare for the activity coming up. It is also short, and focuses on the major muscles stressed in the activity. Inter- and intra-event massage is given between events or in time-outs to help athletes recover from the preceding activity, and prepare for the activity coming up. It is also short, and focuses on the major muscles stressed in the activity. 
An effective maintenance program is based on the massage therapist's understanding of anatomy and kinesiology, combined with an expert knowledge of which muscles are used in a given sport and which are likely candidates for trouble. By zeroing in on particular muscle groups and working specific tissues, the sports massage therapist can help the athlete maintain or improve range of motion and muscle flexibility. The overall objective of a maintenance program is to help the athlete reach optimal performance through injury-free training.

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Nobody is going to enjoy the same kind of massage as another person, so be sure that you’re adjusting to people. When the recipient of a massage responds positively to something, that should be a sign to continue in that area or with the same kind of motion or pressure. Ask for feedback if your patient is not communicating about what they are enjoying or not.

In sports massage, the massage therapist generally concentrates on a specific problem area that you present, usually associated with some sort of sports activity, such as running, tennis, or golf. The most important thing with sports massage is that you find a specially-trained massage therapist who has mastery of a wide range of techniques and knows when to use them. In the past, many spas used to put sports massage on their menu as a way to appeal to men. As spas have become more sophisticated, however, they realize they shouldn't list sports massage unless they have some therapists with specialized training.


It’s just a theory: no one knows if this is actually effective.11 However, it may explain why so many massage patients report a “gets a bit worse before it gets much better” response to quite painful treatments: motor end plates are (painfully) destroyed by strong pressures, and then that tissue is quite sensitive and a bit weak as it heals over a day or two … and then you finally feel much better after that!

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An author found that a patient who afflict multiple sclerosis and choose reflexology as the complementary treatment for a period of time had notable symptom relief. It is measured by considering urinary symptoms, parenthesis, spasticity, and muscle strength as the parameters. All parameters showed a remarkable improvement except for muscle strength.30

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"The entire visit from reception to walking out is enjoyable. The staff is friendly and knowledgeable. Each massage is better than the last which seems impossible. Everyone acts as a team unit and are all on the same page. The therapist always ask how you are feeling and if there is anything you’d like to focus on. It is ALWAYS a full 60 minutes of hands on and certainly not a fluff massage. Dr Julia is amazing and the fact that they run chiro and massage under your insurance benefits is just the cherry on top! You won’t be disappointed at the Wellness Center!"
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.

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.
“I received a gift package of 3 massages, and have had two different therapists, both were fantastic. I have had injuries where I have had massages, deep tissue and sport and medical at different facilities throughout Denver. This tops all! Therapists are knowledgeable, intuitive and willing to concentrate on areas that need extra attention. Scheduling appointments has been a breeze. the overall experience is easy, seamless and straight forward. The facility is clean, not overly spa -ish and soothing. Big winner in my book!”
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.
Their website seems to conflate reflexology with acupuncture and acupressure. There are five tabs at the top of the home page: (1) Store, which links to a single Amazon.com page selling a reflexology foot massager, (2) Acupressure Points and (3) Reflexology Treatment, both of which have multiple articles on acupuncture and acupressure, (4) Reflexology Machines – foot massagers and acupressure mats, and (5) Courses. Notable by its absence is a tab for scientific studies showing that any of this stuff works.
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]
For thousands of years, Eastern healers have used pressure-point massage to balance the body; shiatsu is the Japanese version. The idea is that chi, or life energy, flows through the body in 14 meridians. When the meridians are blocked, physical or emotional problems result. During a shiatsu massage, you lie on a floor mat while the therapist gentl Show more
An author found that a patient who afflict multiple sclerosis and choose reflexology as the complementary treatment for a period of time had notable symptom relief. It is measured by considering urinary symptoms, parenthesis, spasticity, and muscle strength as the parameters. All parameters showed a remarkable improvement except for muscle strength.30

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"Back before we started wearing shoes everywhere, we developed natural stimulus points from the ground [making direct contact] with our feet," Colin says. "By walking and getting that stimuli, we would relieve stress. We don't get that anymore. So the idea of reflexology is going back and mimicking that stimuli to specific points and feeling where that stress sits."
Reflexology was introduced into the United States in 1913 by William H. Fitzgerald, M.D. (1872-1942), an ear, nose, and throat specialist who called it "zone therapy." As noted in the diagram to the right, he used vertical lines to divide the body into 10 zones. Eunice D. Ingham (1899-1974) further developed reflexology in the 1930s and 1940s, concentrating on the feet [3] Mildred Carter, a former student of Ingham, subsequently promoted foot reflexology as a miraculous health method [4-6]. A 1993 mailing from her publisher stated:

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