The reason the Pressure Question exists is that it’s hard for patients to tell the difference between nasty pain that might be a necessary part of therapy, and ugly pain that is just abusive. Not everything that hurts is therapeutic, but not every therapeutic procedure is painless! How can we tell if an intense massage technique is therapeutic or not?

Sharpsburg Coweta 30277 Georgia GA 33.4013 -84.654


Hepatic hematoma. Hepatic hematoma is a painful liver condition, which The New England Journal of Medicine says has been instigated by deep tissue massage. In this case, a 39-year-old woman received a deep tissue massage, which included the abdomen and right upper quadrant. Within 24 hours, she developed abdominal discomfort, nausea, and pain in her right shoulder. A large hematoma was found in her right hepactic lobe, causing the woman to feel nauseous and have a fever for the following six months.

Marietta Cobb 30066 Georgia GA 34.0378 -84.5038


Aquatic bodywork comprises a diverse set of massage and bodywork forms performed in water. This includes land-based forms performed in water (e.g., Aquatic Craniosacral Therapy, Aquatic Myofascial Release Therapy, etc.), as well as forms specific to warm water pools (e.g., Aquatic Integration, Dolphin Dance, Healing Dance, Jahara technique, WaterDance, Watsu).[33]

Lawrenceville Gwinnett 30046 Georgia GA 33.9496 -83.9942


Area of focus. Deep tissue massage targets the inner layers of your muscles. It’s used to treat muscle and tendon injuries, pain, and stiffness in your major muscle groups and joints. Swedish massage targets the superficial layers of muscle and focuses on the parts of your body that tend to hold the most tension, such as your neck, shoulders, and back.

Lilburn Gwinnett 30047 Georgia GA 33.8656 -84.0725


Another alarmingly common example is the sensation of skin tearing. This has been inflicted on me personally on at least three occasions, and not by poorly trained therapists — quite the opposite, the perpetrators were all well-trained massage therapists doing a kind of “fascial release” therapy that they clearly thought of as an “advanced” technique.7

Stone Mountain DeKalb 30086 Georgia GA 33.8913 -84.0746


Massage therapy is also being investigated as an aide to patients with more neuromuscular disorders, such as multiple sclerosis (MS). A Iranian 2013 study published in Clinical Rehabilitation looked at 48 individuals with MS who participated in a five-week massage experiment. They were assigned to one of four groups: massage therapy, exercise therapy, combined massage-exercise therapy and control group.

Porterdale Newton 30070 Georgia GA 33.5712 -83.8951


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:


For Pietrunti, an interest in sports massage began as part of his military experience. Serving as a Navy Chief Petty Officer where he was a fitness leader at various naval commands, Pietrunti says, “I began to look into corrective exercise to help my sailors and clients with athletic performance and pain management, but I felt that something was missing.”
Find the right massage therapist. Look for a therapist who specifically identifies the massage type you’re interested in as part of their practice and background. If necessary, look for someone trained to treat a particular condition, such as sports injuries, fibromyalgia, arthritis, or pregnancy. Also check if the therapist is licensed or certified according to state requirements.

Decatur DeKalb 30036 Georgia GA 33.8913 -84.0746


Sheets and wrappings of connective tissue called fascia are considered an exciting frontier in massage therapy. Supposedly fascia can get tight and needs to be “released.” However, key examples of research either fail to support fascial therapy or actually undermine it — for instance, fascia is too tough to actually change. Fascia enthusiasm seems to be a fad. For more information, see Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties. BACK TO TEXT
But the relief model is certainly tempting. There are many painful-but-relieving analogies in medicine and biology.15 That’s similar to what good pain in massage feels like, but it’s not the same: no one thinks that lancing a boil or popping a shoulder joint back in is anything but painful while it’s happening.16 And we can’t necessarily take the good pain sensation at face value and assume it means there’s actually going to be a positive outcome. Brains are not all-knowing. Sometimes they see danger where there is none, and sometimes they see help where there is none.
Obviously, open sores to the hands and/or feet would be a reason to avoid reflexology. Acute injuries also must be handled with care. Anyone with active blood clots should avoid rubbing near the area of the clot. Burns, wounds, gout and infections to the hands or feet should also limit the use of reflexology. Lower extremity swelling or chronic skin changes that are a result of vascular problems to the feet should also limit this form of therapy. Recent removal of a cancerous tumor or other surgical procedures, such as wart removal, also make reflexology inadvisable. There is some evidence that rubbing of the feet during pregnancy might stimulate contractions, and so should be avoided in the later stages of pregnancy.

A deep tissue massage is perfectly explained by its name. The pressure is adjusted to manipulate the deeper tissue layers in the body. The bit that is somewhat confusing however, is what exactly the deeper tissue layers are. It means all the tissue layers that lay on top of the muscle, though not the muscle itself. The therapist works on these layers, but not so deep as to work all the way through like with a sports massage. This type of pressure is still efficient enough to release any newly formed or small knots and to stretch stiff muscles. I mention new or small knots, because big tension knots are caused by a build up over time, or because of injury. This is a job for a specially trained sports massage therapist.
Forty-three states, the District of Columbia and five Canadian provinces currently offer some type of credential to professionals in the massage and bodywork field—usually licensure, certification or registration.[79][118] Thirty-eight states and the District of Columbia require some type of licensing for massage therapists.[119] In the US, 39 states use the National Certification Board for Therapeutic Massage and Bodywork's certification program as a basis for granting licenses either by rule or statute.[120] The National Board grants the designation Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). There are two tests available and one can become certified through a portfolio process with equivalent training and experience.[121] Between 10% and 20% of towns or counties regulate the profession.[97] The National Certification offered by the NCBTMB does not mean that someone can practice massage in any state.[122] These local regulations can range from prohibition on opposite sex massage, fingerprinting and venereal checks from a doctor, to prohibition on house calls because of concern regarding sale of sexual services.[97][123]
The reason the Pressure Question exists is that it’s hard for patients to tell the difference between nasty pain that might be a necessary part of therapy, and ugly pain that is just abusive. Not everything that hurts is therapeutic, but not every therapeutic procedure is painless! How can we tell if an intense massage technique is therapeutic or not?
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.  

Duluth Gwinnett 30026 Georgia GA 33.963 -84.0923


According to research done by the American Massage Therapy Association, as of 2012 in the United States there are between 280,000 and 320,000 massage therapists and massage school students.[115] As of 2011, there were more than 300 accredited massage schools and programs in the United States.[116] Most states have licensing requirements that must be met before a practitioner can use the title "massage therapist", and some states and municipalities require a license to practice any form of massage. If a state does not have any massage laws then a practitioner need not apply for a license with the state. However, the practitioner will need to check whether any local or county laws cover massage therapy. Training programs in the US are typically 500–1000 hours in length, and can award a certificate, diploma, or degree depending on the particular school.[117] There are around 1,300 programs training massage therapists in the country and study will often include anatomy and physiology, kinesiology, massage techniques, first aid and CPR, business, ethical and legal issues, and hands on practice along with continuing education requirements if regulated.[10] The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S. and currently (Aug 2012) there are approximately 300 schools that are accredited through this agency.
Hepatic hematoma. Hepatic hematoma is a painful liver condition, which The New England Journal of Medicine says has been instigated by deep tissue massage. In this case, a 39-year-old woman received a deep tissue massage, which included the abdomen and right upper quadrant. Within 24 hours, she developed abdominal discomfort, nausea, and pain in her right shoulder. A large hematoma was found in her right hepactic lobe, causing the woman to feel nauseous and have a fever for the following six months.

Marietta Cobb 30066 Georgia GA 34.0378 -84.5038


Designed to relieve tension and stress put on a mother's body during pregnancy, the Mother-to-Be massage aids in diminished hip and back pain and improved circulation. Enjoy the ease of a side-lying position for the ultimate in comfort. Note: This massage cannot be performed during the first trimester or for those experiencing a high-risk pregnancy.

Cumming 30130 Georgia GA 34.2216 -84.1537


Athletes tend to know their bodies fairly well, so information presented to the therapist seems to be better. Compared to the general client, the athlete is also in good shape and is concerned about getting back to the field of play as soon as possible. Some athletes have an obsessive compulsive behavior about their sport. This generally makes them very compliant with the therapists’ recommendations. 

Carrollton Carroll 30116 Georgia GA 33.6045 -85.0499


So what does all of this mean? It seems that the positive mind (psychological) benefits of sports massage are indeed supported by research studies. Study findings also support that sports massage does not negatively affect performance, but the positive body (physiological) benefits on performance are not quite as clear. More research is needed on the positive body effects and also on the mind/body interaction after sports massage.
For starters, you bear in mind the things described above that tend to cause ugly pain, and you avoid that kind of therapy like the plague. Then you look for some clues that painful pressure is okay. Here are at least three reasons why unpleasantly intense pressure might be therapeutic — “bad pain,” but not ugly. In each of these situations, it might be acceptable to tolerate sensations so intense and painful that the only thing about them that is pleasant is the part where it stops.

Grantville Coweta 30220 Georgia GA 33.2473 -84.835


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.

Concord Pike 30206 Georgia GA 33.0998 -84.447


I am also a triathlon coach and personal trainer, so I mix and match my appointments every week in between massage sessions and coaching and training sessions with my clients. I typically have between five and eight massage sessions per day, four to five days per week. There are typically two sports massage sessions per day. Most massage sessions include corrective exercise review so the client knows what self-care they should perform.

Cartersville Bartow 30120 Georgia GA 34.187 -84.8204


Friction strokes work on deeper muscles than the techniques previously described. The friction technique is a pressure stroke and is the deepest that is used in Swedish massage. The massage therapist applies pressure by placing the weight of his or her body on the flat of the hand and the pads of the thumbs, knuckles, fingers, or the back of the forearms, and then releases the pressure slowly and gently. This movement should be a continuous sliding motion or a group of alternating circular motions.
Sheets and wrappings of connective tissue called fascia are considered an exciting frontier in massage therapy. Supposedly fascia can get tight and needs to be “released.” However, key examples of research either fail to support fascial therapy or actually undermine it — for instance, fascia is too tough to actually change. Fascia enthusiasm seems to be a fad. For more information, see Does Fascia Matter? A detailed critical analysis of the clinical relevance of fascia science and fascia properties. BACK TO TEXT

The light-touch, free massages often offered at finish line festivals can help calm the nervous system by allowing the body to commence its natural repair state quicker, explains Rosemarie Rotenberger, an orthopedic massage therapist in Mertztown, Pennsylvania. And  Denunzio says that racers can schedule a recovery-focused sports massage within several hours up to 48 hours after an event, although she recommends massage newbies wait three to four days, as they may be too sore within the first few days fully benefit from (and appreciate) the experience.
Medical Massage is a controversial term in the massage profession.[50] Many use it to describe a specific technique. Others use it to describe a general category of massage and many methods such as deep tissue massage, myofascial release and triggerpoint therapy as well as osteopathic techniques, cranial-sacral techniques and many more can be used to work with various medical conditions.[51]
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.

The significant difference in the two approaches is their effect on these layers. A Swedish technique uses lubricant to glide over the layers – whether that be on a superficial layer (light pressure) or a deeper layer (firm pressure). There may also be kneading of the muscles, vibration or percussion to stimulate the muscles, and passive and/or active joint movements. All of these techniques serve to increase circulation of blood and lymph, soften and relax the tissues, reduce cortisol levels in the body (the stress hormone), and provide a generalized sense of relaxation for the client.
Sports massage is a form of bodywork geared toward participants in athletics. It is used to help prevent injuries, to prepare the body for athletic activity and maintain it in optimal condition, and to help athletes recover from workouts and injuries. Sports massage has three basic forms: pre-event massage, post-event massage, and maintenance massage.

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.

Decatur 30089 Georgia GA 33.7749 -84.3046


Sports Massage can be characterized two ways: pre-activity and post-activity massage. Pre-activity uses dynamic stretching to allow the connective tissue to work through a full range of motion, thereby reducing possible injury. Post-activity massage focuses on recovering the muscle tissue that may have been impacted doing the particular sport. It involves long strokes to flush out the toxins that causes soreness in the muscles and joints. 
For starters, you bear in mind the things described above that tend to cause ugly pain, and you avoid that kind of therapy like the plague. Then you look for some clues that painful pressure is okay. Here are at least three reasons why unpleasantly intense pressure might be therapeutic — “bad pain,” but not ugly. In each of these situations, it might be acceptable to tolerate sensations so intense and painful that the only thing about them that is pleasant is the part where it stops.

Tucker DeKalb 30085 Georgia GA 33.8913 -84.0746


Take it slow. Remember, the inner and outer charts are for people experienced with foot reflexology. Wait until you feel comfortable with the basics before trying to fully understand how to work the inner and outer charts. You may want to meet with a foot reflexology specialist or consider taking classes if you're interested in the inner and outer charts.[11]

Sunny Side Spalding 30284 Georgia GA 33.3453 -84.2898


Good pain. In massage, there is a curious phenomenon widely known as “good pain.” It arises from a sensory contradiction between the sensitivity to pressure and the “instinctive” sense that the pressure is also a source of relief. So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching, and are often described as a “sweet” aching. The best good pain may be such a relief that “pain” isn’t even really the right word.

Ellenwood Clayton 30294 Georgia GA 33.6166 -84.2939


Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The word lomilomi also is used for massage in Samoa and East Futuna. In Samoa, it is also known as lolomi and milimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it romiromi and mirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known as popo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.[46]

Area of focus. Deep tissue massage targets the inner layers of your muscles. It’s used to treat muscle and tendon injuries, pain, and stiffness in your major muscle groups and joints. Swedish massage targets the superficial layers of muscle and focuses on the parts of your body that tend to hold the most tension, such as your neck, shoulders, and back.
Reflexologists use a map of the feet where all the organs, glands, and corresponding parts of the body are laid out. The toes reflect the head. The ridge beneath the toes on the top part of the ball of the foot is a natural shoulder or neck line. The ball of the foot reflects the chest. The arch mirrors the digestive organs, and the heel and ankles contain reflexes for the reproductive system. The inside curve of each foot (where we find the spinal reflex) corresponds to the actual curves of the spine.
Area of focus. Deep tissue massage targets the inner layers of your muscles. It’s used to treat muscle and tendon injuries, pain, and stiffness in your major muscle groups and joints. Swedish massage targets the superficial layers of muscle and focuses on the parts of your body that tend to hold the most tension, such as your neck, shoulders, and back.

Lilburn Gwinnett 30047 Georgia GA 33.8656 -84.0725


Somatoemotional release. Mental and emotional context is a major factor in how we experience pain. Painful sensations are unusually good at stimulating catharsis — the expression of strong or repressed emotion. — because physical pain often strongly “resonates” with emotional pain.12 For instance, the pain of an injury may blur together with the emotional frustrations of functional limits and rehab. That’s a basic example, and much more complex interactions between emotional and physical pain are obviously possible. Whether it is the clear goal of therapy, or simply a natural side benefit, experiencing very strong sensations can certainly be a meaningful part of a personal growth process “just” by changing your sense of yourself, how it feels to be in your skin, and perhaps bumping you out of some other sensory rut.13

Middle-Ages: Medical knowledge, including that of massage, made its way from Rome to Persia in the Middle Ages.[citation needed] Many of Galen's manuscripts, for instance, were collected and translated by Hunayn ibn Ishaq in the 9th century. Later in the 11th century copies were translated back into Latin, and again in the 15th and 16th centuries, when they helped enlighten European scholars as to the achievements of the Ancient Greeks. This renewal of the Galenic tradition during the Renaissance played a very important part in the rise of modern science.
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

Atlanta Fulton 30305 Georgia GA 33.832 -84.3851


In ashiatsu, the practitioner uses their feet to deliver treatment. The name comes from the Japanese, ashi for foot and atsu for pressure.[34] This technique typically uses the heel, sesamoid, arch and/or whole plantar surface of foot, and offers large compression, tension and shear forces with less pressure than an elbow, and is ideal for large muscles, such as in thigh, or for long-duration upper trapezius compressions.[35] Other manual therapy techniques using the feet to provide treatment include Keralite, Barefoot Lomi Lomi, Chavutti Thirumal.
Thai massage works your entire body. It's one of the most invigorating types of massages, as the therapist rigorously manipulates your body, moving it into yoga-like stretches. (It's sometimes referred to as "Yoga for the lazy".) The therapist uses every part of his or her body—hands, knees, legs, and feet—to not only stretch you but also apply pressure on your muscles and loosen your joints. You might even get walked on! This type of massage is both energizing and, at times, relaxing.

Decatur DeKalb 30037 Georgia GA 33.8913 -84.0746

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