Massage Therapy

History of Massage
Types of Massage
Massage Therapy Today
What Responds To Clinical Massage?
Basic Techniques of Swedish Massage
Self Massage
Workplace Massage or Chair Massage
Safety Precautions and Contra-Indications

Massage therapy is the systematized approach to normalize soft tissues. Practitioners use a variety of physical methods.  They apply pressure to, hold, or move the muscles. Therapists primarily use their hands, but may also use their forearms, elbows, knees, or feet. Massage is part science and part art. Its goal is to help the body heal itself. Massage improves circulation, helps with the elimination of waste products, speeds healing after injury, promotes general well-being, enhances self-esteem, and may boost the immune.

Massage comes in many forms, including:  Swedish a gentle, relaxing massage; 0ressure point therapy for certain conditions or injuries; and sports massage which focuses on muscle groups relevant to a particular sport.

History of Massage

Massage may be the form of medical care. Egyptian tomb paintings show people practicing massage.  Ayurveda, the traditional Indian system of medicine, places great emphasis on massage and it remains widely practiced in India.  A Chinese book from 2,700 B.C., The Yellow Emperor's Classic Book of Internal Medicine, recommends 'breathing exercises and massage of the skin and flesh."  Massage was used for pain relief by both ancient Greek and Roman physicians. Julius Caesar was said to have been given a daily massage to treat neuralgia. Hippocrates, the father of Western medicine wrote that "he physician must be experienced In many things … but assuredly in massage."

The image of massage is sometimes tarnished by the use of the words “massage parlor”  by some criminals who are camouflage illegal businesses.  Massage is, however, widely used in medicine.  It is used in intensive care units, by pediatricians, in the elderly by physical therapists, and in many pain clinics.  A variety of massage techniques are integral to other complementary therapies, such as aromatherapy, reflexology, Rolfing, Hellerwork, and osteopathy.

Types of Massage

Relaxation Massage: A smooth, flowing style that promotes general relaxation, improves circulation and range of movement, and relieves muscular tension.

Remedial Massage: A paramedical treatment that helps to restore function to injured "soft tissues" (muscles, tendons and ligaments). Therapy may involve the use of various types of Massage, as well as a range of other physical treatments to assist your recovery. In addition, you may be asked to perform some activities at home to assist the process of recovery.

Sports Massage: Combines different Massage techniques to enhance sports performance and recuperation. This is an effective component of any training program.

Aromatherapy Massage:  Combining the therapeutic properties of essential oils with specific massage techniques to promote health and well-being.

Reflexology: Using thumb and finger pressure on the reflex points of the feet (which correspond to all areas of the body) to assist in achieving balance within the body.

Oriental Massage Therapies: Oriental-based systems of finger pressure Massage, such as Acupressure and Shiatsu, which treat points along the acupressure meridians, aiming to release discomfort and rebalance energy.

Massage Therapy Today

Massage is a holistic therapy that reduces the heart rate, lowers blood pressure, increases blood circulation and lymph flow, relaxes muscles, improves range of motion, and increases endorphins, the body's natural painkillers.  Consumers spend $2 billion to $4 billion a year on visits to massage therapists, according to an American Massage Therapy Association (AMTA) analysis of a study published in the New England Journal of Medicine in 1993. A national survey conducted by the State University of New York at Syracuse found 54 percent of primary care physicians and family practitioners said they would encourage their patients to pursue massage therapy as a treatment, and a third of those said that they were willing to refer patients to a massage therapist.  The American Massage Therapy Association's membership has increased nearly four-fold in the past decade, to more than 28,000.

What Types of Dysfunctions Respond To Clinical Massage?

Neck and low back can be caused by a variety of “soft tissue” problems. The following are all “soft tissue” conditions which respond to clinical massage.

Massage and Myofascial Pain and Dysfunction

Pain and/or physiological dysfunction originates from identifiable points within muscles and their fascial tissues. These locations are known as trigger points because they often trigger distant reactions.

Scientists have developed extensive maps of such referred pain. They have also identified nearly a hundred dysfunctions that can have myofascial trigger point origins. Some of these are: carpal tunnel syndrome, TMJ dysfunction, PMS, headache, diarrhea, dizziness, cardiac arrhythmia, indigestion, tennis elbow, urinary frequency, sinusitis, deafness, and blurred vision.

Massage and Fascial Plane Dysfunction

Fascia can be compared to the body's own version of "Saran Wrap." It covers most of the body in large, continuously connected sheets. Injury, postural patterns and chemical imbalances can cause these sheets to distort and bind to themselves and nearby tissues. Since all major blood vessels and nerves follow these fascial sheathes through the body, properly aligned and released fascia is vital to good health and the proper operation of the circulatory and nervous systems.

Massage and Neuromuscular Dysfunction

The smallest muscular activity requires that countless nerve impulses be sent to the muscle to be activated and to all of the adjoining and opposing muscles. For example, let us say that you want to flex your elbow. This requires that you must tighten the biceps and other associated muscles while simultaneously relaxing the triceps and other associated muscles. The combined nervous activity and muscular response must be precisely timed and exactly proportionate.

For more complex movements like rotating the head or taking a breath, the amount of coordinating activity increases exponentially. Unfortunately, the mechanism responsible for such coordination can break down and muscle fibers or whole muscles can actually lock in opposition to their normal activity.

Massage and Tonus System Dysfunction

When overused, muscles can lose their ability to understand how to relax. This is referred to as hypertonic. As a result, the muscles become overly tight. They tend to harbor myofascial trigger points, and cause stress on the muscles that oppose them and the joints that they cross.

Massage and Dermatomic and Spondylogenic Dysfunctions

If a nerve is pinched where it leaves the spine, the area that nerve serves will feel pain. Many people have experienced such a problem with the sciatic nerve. It originates in the low back, but when pinched can make the knee, shin, or heel hurt. This is an example of dermatomic pain - literally translated - pain in an area of skin.

Massage and Spondylogenic Dysfunction

This occurs when the joints of the spine are compressed or otherwise impaired and cause their own special trigger point-type pain or dysfunction.

Both of these are successfully treated with clinical massage by loosening the muscles and other soft tissue that surrounds the affected joint or nerve.

Massage for Pain Control

Massage is a very effective technique for controlling pain. How does it work? There are number of ways massage may help in controlling pain. Massage blocks the body's pain signals; it may increase endorphin levels, body's natural painkillers; massage provides deep relaxation, it relieves muscle tension, spasm, and stiffness; and, massage relieves mental stress and anxiety.

Basic Techniques of Swedish Massage

Traditional Swedish Massage uses five main strokes, and many variations, to achieve its relaxing and healing effects. Many therapists use a variety of techniques.


This consists of long, gliding strokes from the neck down to the base of the spine or from the shoulder down to the fingertips. When done on the limbs, all strokes are toward the heart to aid blood and lymphatic flow. It is done with the whole hand or the thumb pads. Effleurage is designed to acquaint the therapist with his or her subject’s body and vice versa.


This involves gently lifting muscles up and away from the bones, then rolling and squeezing them, again with a gentle pressure. It generally involves kneading and compression motions - rolling, squeezing, or pressing the muscles to enhance deeper circulation. Petrissage attempts to increase circulation with clearing out toxins from muscle and nerve tissue.


This is the most penetrating of the strokes, and consists of deep circular or transverse movements made with the thumb pads or fingertips. The therapist applies deep, circular movement near joints and other bony areas (such as the sides of the spine). Friction breaks down adhesions, which are knots that result when muscle fibers bind together during the healing process, thus contributing to more flexible muscles and joints.


This consists of a series of briskly applied percussive movements, using the hands alternately to strike or tap the muscles for an invigorating effect. There are many variations on this stroke. It may be applied with the edge of the hand, with the tips of the fingers, or with a closed fist. Tapotement attempts to release tension and cramping from muscles in spasm.

Vibration or Shaking

This involves the therapist pressing his or her hands on the back or limbs, and rapidly shaking for a few seconds. It boosts circulation and increase the power of the muscles to contact. Vibration is particularly helpful to people suffering from low-back pain.

Self Massage

There are simple massage you can do it yourself. This is a great "pick-me-up" after a hard day of work. You can also get benefits of massage by immersing yourself in a Jacuzzi with the water doing the massaging.  Many massage and wellness centers offer workshops on massages and partner massages. It may be worthwhile going for a workshop to get some familiarity with this technique.  For the exercises given below you don’t need anything other than a few tennis balls, a quiet corner and your own two hands.

Head Massage

Pressure points in your skull can relax your whole body. There are two very significant acupressure points at the base of the skull on what's called the occipital ridge. If you apply consistent pressure there, you can achieve total relaxation.

How do you find these points and apply pressure on those spots? There is a simple solution. Put two tennis balls in a sock and tie the end. Lie on your back on the floor and place the sock behind the upper neck, so that the two balls each touch the skull ridge that's right above the hollow spot. Stay like that for 20 minutes. If you like, you can listen to soothing music. The pressure on those acupressure points send messages down the spinal column to relax all the muscles and it is very effective.

Face Massage

Just touch your face. There's no need to knead it. With a very light touch, cup your cheeks and temples with your hands using no more pressure than the weight of a nickel. Hold your hands there for a minute. The warmth of the hands relaxes the muscles and connective tissue, bringing on an overall sense of relief.

Jaw Massage

Pull the sides of your ears gently straight outward, then straight up, then straight down. Or, with your index finger, press the tender spot next to your earlobe where it attaches to your head, press and release. Now do it on the other ear. Repeat the procedure, alternating ears, ten to fifteen times each.

Torso Massage

Get a quick boost by rubbing the area above your kidneys. That's at waist level where the tissue is still soft. Rub briskly with your fists in a circular motion. This energizes the whole body.

Feet Massage

Foot massage is very soothing. After you try the following techniques on one foot, switch feet and repeat.

  1. Sit on a chair and place one foot on the opposite thigh. Rub some massage oil or lotion onto your foot if you like. Apply pressure with your thumbs to the sole of your foot, working from the bottom of your arch to the top near your big toe. Repeat five times.
  2. Make a fist and press your knuckles into the bottom of your foot, moving from your heel to your toes. Repeat five times.
  3. Massage each toe by holding it firmly and moving it from side to side. Extend each toe gently out and away from the ball of your foot. Then apply pressure to the areas between your toes.
  4. Hold your toes in one hand and bend them backward holding them there for five to ten seconds. Then bend them in the opposite direction and hold for five to ten seconds. Repeat three times.
  5. Press and roll your thumbs between the bones of the ball of your foot.

Workplace Massage or Chair Massage

One of the main contributors to our everyday stress is our workplace. Seventy percent of workers surveyed by a national survey stated that their job is very stressful. Stress is the number one cause of disability. It costs employers billions of dollars a year on lost productivity and healthcare costs. (You can learn more about stress in our section on stress management.) Since workplace is stressful, it seems commonsense to provide some means of stress relief at the workplace. More and more employers are recognizing that a regular massage can reduce the physical and mental effects of stress, thus reducing burnout and stress related diseases.

Safety Precautions and Contra-Indications

Certain medical conditions require the exercise of caution concerning the advisability of giving or receiving massage. If you are in any doubt, or if you or your partner are under medical supervision, check with your doctor or other qualified medical practitioner before embarking on massage therapy. This advice applies particularly in the case of cardiovascular conditions and heart disease, especially in cases of thrombosis, phlebitis, and edema.

Never apply pressure under or over varicose veins. Never massage directly over infected skin, for example where there are warts, herpes, or boils, or where there is inflammation, unexplained lumps, bruises and open cuts. While giving a massage, cover up any open cuts or scratches on your hands with a plaster or other dressing. Massage on the abdomen is best avoided during the first three months of pregnancy when the risk of miscarriage is highest.

The causes of acute back pain should first be diagnosed by a physician before receiving massage treatment. Consult a qualified medical practitioner in cases of raised temperature, infections, or contagious disease.

Seek medical advice before having a massage if you suffer from phlebitis, thrombosis, varicose veins, severe acute back pain, or fever.

Swellings, fractures, skin infections, or bruises should not be massaged. Lumps and swellings should be checked by your doctor.

Massage of the abdomen, legs, and feet should not be given during the first three months of pregnancy.

Cancer patients are best treated by specially trained practitioners who know which areas to avoid and which kind of massage is appropriate.

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Last modified: 08/06/08