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.


Hair loss: Massaging several acupressure points will “stimulate and energize the nerves that are causing the problem.” The Paihui is important. “The Paihui is located right in the middle of your scalp. Most of the pressure points related to the hair re-growth are present near this area. Take ten toothpicks and wrap them in a rubber band. Use them to gently poke the paihui, be very careful not to hurt yourself. This action improves the blood circulation in the scalp, which reduces hair fall.”

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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.
...It is very important to ALWAYS speak up and let your therapist know if you need the pressure to be corrected, (i.e. if you need them to lighten up because it is too deep, or to apply more because it is not deep enough). Most everyone needs more pressure in some areas and less in others. This occurs because muscle tissue that contains Trigger Points is more sensitive to pressure and can be tender to the touch.

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.
For example, I worked on the Indiana Sports Massage Team starting in 1989, as well as the NCAA Swimming & Diving Championships and National Championships. I coordinated massage for the 1992 Olympic Trials and was on the 1996 Olympic Massage Team for the Atlanta Olympics—the first time massage therapy was part of the medical staff for the Olympics. These were all volunteer positions, but I loved it! 

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Soft tissue techniques employed by sports massage therapists are effective in the management of both acute and chronic injuries. For example, adding lymphatic massage to the "standard care" procedure in the acute stage of injury will improve control of secondary, hypoxic injury and enhance edemous fluid removal throughout the healing cycle. Trigger point techniques reduce the spasms and pain that occur both in the injured and "compensation" muscles. Cross-fiber friction techniques applied during the subacute and maturation phases of healing improve the formation of strong and flexible repair tissue, which is vital in maintaining full pain-free range of motion during rehabilitation.
Deep tissue massage is a massage technique that’s mainly used to treat musculoskeletal issues, such as strains and sports injuries. It involves applying sustained pressure using slow, deep strokes to target the inner layers of your muscles and connective tissues. This helps to break up scar tissue that forms following an injury and reduce tension in muscle and tissue.

Flushing. If massage can “improve” any tissue — unknown — one way it might do it is through simple hydraulics: physically pumping tissue fluids around, and/or stimulating the circulation of blood and lymph. I won’t get into the evidence about it here. Suffice it to say that it might be true, and if it’s true then it may not much matter if the process is uncomfortable. While gentler massage may feel pleasant and satisfying, it is possible that more biological benefits can only be achieved hydraulically — whether it’s comfortable or not. This is even more plausible because of trigger points: it’s likely that the tissue fluids of a trigger point are quite polluted with waste metabolites, and the need for flushing is greater, but it’s especially uncomfortable to squish those polluted patches of tissue.
Hair loss: Massaging several acupressure points will “stimulate and energize the nerves that are causing the problem.” The Paihui is important. “The Paihui is located right in the middle of your scalp. Most of the pressure points related to the hair re-growth are present near this area. Take ten toothpicks and wrap them in a rubber band. Use them to gently poke the paihui, be very careful not to hurt yourself. This action improves the blood circulation in the scalp, which reduces hair fall.”
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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The literature on reflexology is only beginning to emerge since early 1990. Several methodological shortcomings in the previous studies of reflexology safety and efficacy are worth mentioning. Firstly, the number and the methods of reflexology treatment given are not standardized. Furthermore, most studies have small sample size (around 20 participants).
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Reflexology is a practice in which different amounts of pressure are applied to specific points on the feet or hands. These points are believed to match up with certain other parts of the body. Reflexology is claimed to cause relaxation and healing in those parts of the body, but this has not been proven. In a study funded by the National Cancer Institute, women with advanced breast cancer who received reflexology treatments showed improvement in a few symptoms, such as shortness of breath, but not others, such as nausea or pain. In this study, reflexology was safe even for the most fragile patients.
Posterior interosseous syndrome. Physiopedia explains that posterior interosseous syndrome is a compression of the posterior interosseous nerve, which is located near the shaft of the humerus and the elbow, that may result in paresis or paralysis of the thumbs and fingers. Though cryotherapy, ultrasound, dry needling, and other modalities often help with this condition, so too does deep tissue work that is focused on the thoracic outlet, pectoralis minor, triceps, brachioradialis, and other surrounding areas.
Deep tissue massage is a focused, therapeutic massage that targets muscle knots (also known as "adhesions") and specific problem areas in the deeper layers of muscle and connective tissue. Using deliberate, slow strokes or friction across the grain of the muscle, the therapist addresses chronic tight or painful muscles, repetitive strain, postural problems, or injuries.

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.


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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No, because most therapists will customize the pressure of their strokes to suit your requests. According to Shannon Merten, a licensed massage therapist we interviewed about massage etiquette, communication is key. “I would rather my clients leave happy and satisfied than not, so if [the therapist] is doing something that is not enjoyable, a good ‘that’s a little too much pressure’ or ‘that area is too sensitive to be worked on’ should get you satisfying results,” she says.


Thank you so much for your article The Pressure Question in Massage Therapy. I just read it all. I went for a sports massage two weeks ago as I was recommended to have one as it was suggested it might help with tight calves, a side effect of some other injuries I have. I’ve been for sports massages many, many times before over the years. This one was one of the most painful experiences of my life — when I got home I was almost sick and felt in shock. My right achilles tendon was raging and it’s been bad ever since. It hurt so much when it was done (like someone was sticking knives in) and I kept asking if it was meant to hurt. I wish I’d just stopped the session or objected but I didn’t. It used to be a bad injury that affected me walking for about 6 months so I’m just devastated about this. I can hardly bear to put shoes on and its all this time on. I know there are good practitioners out there but experiences like this just make me want to stay away. I wish I’d gone to a “gentle” one.

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
Thai Yoga Massage School in Thailand also offers a foundation for the development of foot reflexologist. It has received authorization from Thai Ministry of Public Health. The course is taught by the vice president of Foundation for Development of Foot Reflexologist Thailand from the beginning until the end of the course. For those who have completed the course and pass the exam, they will be given a membership card of TYMS society which is authorized by Thai Government as the certification and qualification to become a practitioner in reflexology fields.21

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