One theory is that muscle knots may be caused by something that goes wrong at the “motor end plate” — where a nerve ending attaches to a muscle cell.9 We don’t know why this happens, or what exactly goes wrong, but there is circumstantial evidence that motor end plates are the “point” in trigger point. That evidence is too complex and controversial to review properly here. It is explored in detail in my book. Some research has suggested that it may actually be possible to physically destroy the motor end plate with strong massage, thereby inactivating the trigger point.10 When it regrows — these are microscopic structures, it doesn’t take them long to heal — the trigger point may be gone.
The pressure from Swedish massage is ideal for relieving muscle tension, like the kind that builds up from hunching over a computer all day. This tension can sometimes result in knots: trigger points of extremely tense muscle fibers that form tiny nodules. Massage therapists are trained to feel for these knots, and Swedish-massage techniques are ideal for gently coaxing them away.

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Typically, sports massage therapists hold a certification and maintain licensure. A good option is to become board certified through the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and have an active membership with an association, like AMTA, to keep up to date with industry trends. Exact requirements depend upon the state in which the sports massage therapist practices.

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]
Accredited sports massage therapists must first complete a course in general massage from a school accredited by the American Massage Therapy Association/Commission on Massage Training Accreditation/Approval (AMTA/COMTAA) or their State Board of Education. They must then complete an additional training program approved by the AMTA National Sports Massage Certification Program. Many sports massage practitioners also complete the National Certification Examination for Therapeutic Massage and Bodywork.
While a typical runner’s sports massage focuses primarily on the legs, Denunzio insists on incorporating upper body work as well. As she explains it, “nobody has perfect form, especially when they’re fatigued” and runners can unknowingly tense their upper bodies when working out, which in turn creates tightness in their arms, shoulders and back. Ideally, those areas should receive a little TLC as well.  

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.


Adequate recovery is also a major factor in avoiding the over-training syndrome. Over-training is characterized by irritability, apathy, altered appetite, increased frequency of injury, increased resting heart rate, and/or insomnia. It occurs when the body is not allowed to recover adequately between bouts of heavy exercise. Therapeutic massage helps you avoid over-training by facilitating recovery through general relaxation, and its other physiological effects. 

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Practices resembling reflexology may have existed in previous historical periods. Similar practices have been documented in the histories of China and Egypt.[9] Reflexology was introduced to the United States in 1913 by William H. Fitzgerald, M.D. (1872–1942), an ear, nose, and throat specialist, and Edwin F. Bowers. Fitzgerald claimed that applying pressure had an anesthetic effect on other areas of the body.[16][17] It was modified in the 1930s and 1940s by Eunice D. Ingham (1889–1974), a nurse and physiotherapist.[18][19] Ingham claimed that the feet and hands were especially sensitive, and mapped the entire body into "reflexes" on the feet, renaming "zone therapy" reflexology.[20] "Modern reflexologists use Ingham's methods, or similar techniques developed by the reflexologist Laura Norman."[9]

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.
Deep tissue massage is a type of massage that aims at affecting the deeper tissue structure of the muscles. It also affects the connective tissue, known as fascia. Deep tissue massage helps with both small muscle injuries as well as chronic problems. Deep tissue massage is an excellent way to deal with a whiplash or sports injury, postural misalignment, treating spasms as well as muscle tension. During a deep tissue massage the therapist concentrates on releasing specific chronic muscle tension as well as the muscular knots, or adhesions.

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