In spa settings, Swedish massage is one of the most requested therapies and treatments. Comprehensive spa packages often combine Swedish massage with other spa services, such as body scrubs, wraps and facials. Massage therapists who receive their foundational education in massage school often have additional training in spa treatments if they pursue a career in spa therapy.


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.


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:
While a Swedish massage works great to help people who suffer from health conditions it also works wonders on people who suffer from everyday troubles and concerns. There are many things in our life that can cause us to be stressed and worried on a constant basis. The more that we stress the more our muscles became tense and we find it hard to relax them.

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Sports massage is a systematic manipulation of the soft tissues of the body that focuses on muscles relevant to a particular sport. Runner Paavo Nurmi, known as the "Flying Finn," was one of the early users of sports massage. Nurmi is said to have used sports massage during the 1924 Olympics in Paris where he won five gold medals. Jack Meagher is thought to be the father of sports massage in the United States.
A traditional Swedish massage involves the whole body. You will begin on either your back or your stomach and flip over at the halfway point. If you have an area of particular concern, such as a tight neck, you can ask your therapist to spend more time in this area. Depending on your preferences, you can ask your massage therapist to use light, medium, or firm pressure.

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The price of a couples massage depends on the spa, the amount of time, and the amenities. Generally, it is the cost of a regular massage, times two. Sometimes you can add on private time. For instance, Aspira the Spa at The Osthoff Resort in Wisconsin offers couples massage at $135 per person for 50-minutes. Couples can enjoy an additional hour of time alone together in the spacious suite, equipped with a master shower, whirlpool bath, stone fireplace, and sofa, for $50 per person. At some spas, the package might include private time and amenities like Champagne, which sends the price higher.
When most people think of massage, they think of Swedish. The style takes its name from a 19th-century Swedish physiologist, Per Henrik Ling, whose system of medical gymnastics included massage. Johan Georg Mezger (1838-1909) coined a reduced set of maneuvers and techniques of Dr. Ling’s system as the “Swedish massage” system. Swedish massage is defined by four or five (somewhat familiar) techniques, which have French names: effleurage (stroking), petrissage (kneading), tapotement (rhythmic choppings), and friction (rubbing). Some therapists now incorporate advanced techniques that have rehabilitating effects and stretches for improving your range of motion. But the ultimate goal is relaxation. As the default Western massage, Swedish massage is extremely popular and is simple, soothing touch therapy.

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As the name suggests, deep tissue massage applies deep pressure onto specific trouble points. It feels very much like someone is torturing you on purpose by pushing into your knotted muscle, and the massage can leave you feeling sore. It's not just more pressure all over your body, however (which would be true torture), it's very specific, methodical treatment. As Moyer Wellness explains:

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
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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.

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Keep in mind that reflexology is not a substitute for medical treatment, but is a supportive measure. There are two reflexology points on the feet that may help with knee pain: 1) Spine reflex point on the inside portion of the feet from the edge of the heel to the neck of the big toe. 2) Knee reflex point, one inch below the ankle bone in the small, soft triangular section.
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.

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In massage therapy, so much can be achieved while inflicting only good pain on patients that bad pain must be justified by vivid, quick, and somewhat lasting benefits — which is a high bar to clear. All health care practices must be justified by benefits. As risk and pain and expense increase, the benefits must also. There is simply no point in tolerating — and paying for — painful treatment without an obvious return on the investment.

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