Since reflexology is not recognized by law, no formal training is required to practice reflexology or call oneself a reflexologist. However, some nurses and massage therapists offer reflexology as part of their licensed practice. Some courses are accredited for continuing education for nurses and massage therapists. The most widely publicized training source is probably the International Institute of Reflexology, of St. Petersburg, Florida, which claims to have 25,000 members worldwide [9]. Its seminar on the "Original Ingham Method of Foot Reflexology" are taught by Ingham's nephew, Dwight Byers. Its "Certified Member" status requires 200 hours of instruction plus passage of written and practical tests. As far as I know, this certification process has neither legal nor medical recognition. The Institute's Web site states:

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The NCCIH adds that massage therapy may also be potentially harmful to women who are pregnant. Even though research has found that it offers this demographic some positive effects, such as decreased depression and anxiety and reduced leg and back pain, it is still important to obtain approval from her healthcare provider first to ensure that she can receive a safe sports massage.

Six papers meet the inclusion criteria and were summarized and reviewed. Both Thai and  Swedish massages are reported to relieve chronic low back pain by enhancing physical functions;  providing pain relief, improving disability and range of motion, improving psychological functions;  reducing anxiety and improving mood. Although based on different theoretical frameworks, they appear to be equally effective in relieving chronic low back pain.
This may come as a surprise, but in fact there is no therapeutic benefit to stretching skin so hard that it feels like it is going to tear! And it is a completely different and uglier sensation than how fascial stretching can feel and should feel (more like a good massage). When I complained about this (politely), the therapists made no distinction between skin-tearing and fascial stretching, and more or less tried to tell me that I was objecting to perfectly good therapy. Needless to say, I never returned to those therapists.
Neuromuscular therapy is a form of soft tissue manipulation that aims to treat underlying causes of chronic pain involving the muscular and nervous systems. This medically oriented form of massage addresses trigger points (tender muscles points), circulation, nerve compression, postural issues, and biomechanical problems that can be caused by repetitive movement injuries.

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Elementary Reflexology™ is a form of reflexology incorporating energy balancing with point specific work. Integrating the ancient art of Ayurvedic reflexology with the modern energetic principles of Polarity, and is based on the concept of the inter-relationship of the five elements: Ether, Air, Fire, Water, and Earth. What sets Elemental Reflexology™ apart is its foundation in the assessment and balancing of these five elements. Elemental Reflexology™ is focused exclusively on the feet, because in polarity, they are the most negative pole in the body-the place where energy is the most dense and tends to crystallize and become blocked. Working on the feet frees up this stagnant energy, allowing it to be released and flow freely throughout the body. This process is suited for all ages and many conditions.
Swedish massage is given to increase blood circulation, easing the tension in the body’s muscles and improving the muscles’ flexibility. It stimulates the skin as well as the nervous system to soothe the nerves, reducing both emotional and physical stress. In fact the massage is a staple in most stress management programs. A Swedish massage is given to help with increasing the flow of oxygen in the blood, releasing toxins from the body’s muscles flushing the lactic acids, uric acids, and other type of metabolic wastes out of the body tissues. It can really shorten the recovery time for a muscular strain!!

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Integrative Reflexology is defined as “massage therapy-based reflexology, practiced as both energy work and bodywork.” Integrative reflexology is an holistic discipline which uses the therapist’s hands to apply alternating and firm pressure to stimulate physiological changes in the body. The therapist activates the zone reflex points and meridian points to create beneficial responses in the nervous, electrical and chemical systems of the body. Integrative Reflexology allows the body to relax by releasing tension and improving blood flow. It helps the body to adjust to its own healthy balance.
A high attention to detail is important to be successful in sports massage. I also feel my professional communication with clients and other practitioners assists with this process. It’s vital to get all the necessary facts about the client and follow up with them after each session. I also feel it’s important that I have experience in endurance training and racing to help with the rapport with my clients.
Another study compared the effects of foot reflexology, simple massage, and conversation on 130 patients who had undergone abdominal gynecologic surgery under full anesthesia. The patients were asked how they felt, and data were recorded on general condition, pain intensity, movement of the bowels, urination, and sleep, from the day before the operation until until the tenth day afterward. Simple massage turned out to be a relaxing, positive experience, whereas foot reflexology had various effects, some of which were negative. The researchers concluded that foot reflexology is not effective in acute, abdominal postsurgical situations in gynecology and can occasionally trigger abdominal pain [15].
Pain management. If you have a condition like sciatica or osteoarthritis and are suffering from chronic pain as a result, Swedish massage can be an effective method for managing that pain in a natural way. Notify your massage therapist about your pain points, he or she can target those areas and use a stroking motion to improve local circulation and reduce muscle tension.

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Although a lot of Bastian 2014 is certainly relevant to the concept of “good pain,” strictly speaking I don’t think they are writing about the good pain paradox, which is defined by simultaneous pleasure and pain. They are writing about pleasure following pain (relief from pain). This is more comfortable scientific ground: it’s pretty straightforward that relief from pain might be “associated with positive consequences” or lead to “activation of the brain’s reward circuitry,” for instance. Lance a boil, then feel better, right? Of course. But that’s definitely not what we mean by “good pain” in massage. BACK TO TEXT
Each treatment is designed to provide restoration for your body and mind, and also make you look and feel the best you can. Massage can reduce stress and muscle tension, improve circulation, eliminate stiffness and soreness, boost the immune system, reduce pain and even help control one’s blood pressure. Couples who strive to practice a healthy lifestyle can enjoy these benefits and more together.

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Bad pain. Bad pain comes with no obvious, immediate benefits. If there is anything good about it, there is no way to tell from the sensation at the time. Bad pains are usually sharp, burning, or hot. Such pain is usually caused by excessive but harmless pressure. As bad as it feels, it probably won’t hurt you — maybe a little bruising — but there’s also a good chance that it won’t be therapeutic either. The big question about bad pain is whether or not it is ever justified.
In Myanmar, massage is unregulated.[101] However, it is necessary to apply for a spa license with the government to operate a massage parlour in major cities such as Yangon. Blind and visually impaired people can become masseurs, but they are not issued licenses. There are a few professional spa training schools in Myanmar but these training centers are not accredited by the government.[citation needed]

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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:

Alhough he was a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association at the time, Pietrunti says that he ultimately decided to pursue licensure in massage therapy as well. This provided that missing link while also being “a good way to ‘bridge the gap’ and provide a better service to my clients,” he says.

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Following injury, and especially if it’s also a very stressful time, inflammation can prevent proper blood flow from reaching damaged tissue and can cut off vital nutrients and oxygen. This can cause toxins to accumulate around damaged tissue, which only increases swelling and pain. Some studies have found that even self-administered massage can help reduce pain associated with plantar fasciitis and other injuries. (10)

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In the US, licensure is the highest level of regulation and this restricts anyone without a license from practicing massage therapy or by calling themselves that protected title. Certification allows only those who meet certain educational criteria to use the protected title and registration only requires a listing of therapists who apply and meet an educational requirement.[123] It is important to note that a massage therapist may be certified, but not licensed. Licensing requirements vary per state, and often require additional criteria be met in addition to attending an accredited massage therapy school and passing a required state specified exam (basically the certification requirements in many states). In the US, most certifications are locally based. However, as of March 2014, some states still do not require a license or a certification.[citation needed] However, this is thought to change eventually as more regulatory bodies governing the profession of massage are established in each state. Furthermore, some states allow license reciprocity where massage therapists who relocate can relatively easily obtain a license in their new state. Not all states provide this option.[124]
For instance, I tried a new young massage therapist. He introduced a pain scale right away, and asked me to use it to define an intensity I was comfortable with — a 5 out 10, say — and then actually used that scale to check with me quite a few times throughout an hour treatment. He also responded with clear adjustments to his technique when I reported that we were under or over the target I’d set. Great work! BACK TO TEXT
Following injury, and especially if it’s also a very stressful time, inflammation can prevent proper blood flow from reaching damaged tissue and can cut off vital nutrients and oxygen. This can cause toxins to accumulate around damaged tissue, which only increases swelling and pain. Some studies have found that even self-administered massage can help reduce pain associated with plantar fasciitis and other injuries. (10) 

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Evidence of massage can be traced back several thousands of years in several different countries. Archaeological evidence of massage has been found in many ancient civilizations including China, India, Japan, Korea, Egypt, Rome, and Greece. Today, with the advancement of science, many studies are providing valuable, scientific proof of the benefits massage can have on the body. Although the popularity of massage has ebbed and flowed over time, these findings have made massage a much sought-after therapy in contemporary society.

Reflexology utilizes finger and thumb techniques on the feet and hands to promote deep relaxation, clarity of mind, and a sense of well-being. A session assists with: digestive ailments, hormonal imbalance, structural pain, attention deficit disorders, headache/migraines, sleeping disorders, releasing emotional tension, and strengthening the immune system.
Some research has shown that massage therapy can be effective during pregnancy due to its anxiety-lowering effects, and women who receive massages before and during labor tend to experience decreased depression, anxiety, and leg and back pain. Results from one study found that women who received massages prior to and during labor had significantly less pain, plus their labors were on average three hours shorter and required less need for medication.
Post-event massage is usually given 1–2 hours after the competition is over in order to give dilated blood vessels a chance to return to their normal condition. Post-event massage is light and gentle in order not to damage already stressed muscles. The goal is to speed up removal of toxic waste products and reduce swelling. Very light effleurage will decrease swelling while light petrissage will help clear away toxins and relieve tense, stiff muscles. Post-event massage can be self-administered on some parts of the body, such as the legs.
Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.

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Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.

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To put it bluntly, it’s not clear that massage has any musculoskeletal benefits at all. It probably does, but mostly quite temporary and highly unpredictable. There’s not nearly enough science, and therapists are hopelessly biased assessing their own efficacy. See Does Massage Therapy Work? A review of the science of massage therapy … such as it is. BACK TO TEXT
Swedish massage therapy is the modality that comes to mind when most people think about massage. As the best-known type of bodywork performed today, one of the primary goals of the Swedish massage technique is to relax the entire body. This is accomplished by rubbing the muscles with long gliding strokes in the direction of blood returning to the heart. But Swedish massage therapy goes beyond relaxation. Swedish massage is exceptionally beneficial for increasing the level of oxygen in the blood, decreasing muscle toxins, improving circulation and flexibility while easing tension.
Completely new to massage? Book your first appointment either well before a race—at least a few weeks out—or wait until the day after. “Just like you wouldn’t test out new socks or shoes on day of race, you shouldn’t experiment with any pre-race bodywork,” says Denunzio. Those who are familiar with massage can benefit from a pre-race rubdown in the seven to two-day window prior to an event. Getting treatment less than 48-hours prior puts all runners—even those who are massage veterans—at risk of race day soreness.
Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.[47][48][49]
Your body creates melatonin, a hormone necessary for good-quality sleep, from serotonin. More Swedish massage = more serotonin = more melatonin = better sleep. Stress can also interfere with sleep, so lower stress levels will help bedtime become sleepy time.  (Plus, since Zeel Massage Therapists come to your home or hotel room, you can go right to sleep after your soothing massage.)
Several mechanisms for deep massage’s natural stress-relieving effects include its ability to dilate blood vessels and also lower activity of the limbic system (including the hypothalamus), which is responsible for autonomic nervous system regulation and cortisol secretion. Massage has been shown to improve relaxation by boosting activity of the parasympathetic nervous system, as measured by heart rate, blood pressure and heart rate variability. (8, 9)
The most commonly offered and best known type of massage. Devised at the University of Stockholm in 1812 by Henri Peter Ling, this technique employs five different movements (long strokes; kneading of individual muscles; percussive, tapping movement; rolling of the fingers; and vibration) and oils beneficial to the skin. Used to improve the circulation, ease muscle aches and tension, improve flexibility and create relaxation.

BC 722-481: Huangdi Neijing is composed during the Chinese Spring and Autumn period. The Nei-jing is a compilation of medical knowledge known up to that date, and is the foundation of Traditional Chinese Medicine. Massage is referred to in 30 different chapters of the Nei Jing. It specifies the use of different massage techniques and how they should be used in the treatment of specific ailments, and injuries. Also known as "The Yellow Emperor's Inner Canon", the text refers to previous medical knowledge from the time of the Yellow Emperor (approx 2700 BC), misleading some into believing the text itself was written during the time of the Yellow Emperor (which would predate written history).[7][8]
Reflexology is one of the most used alternative therapies in Denmark. A national survey from 2005 showed that 21.4% of the Danish population had used reflexology at some point in life and 6.1% had used reflexology within the previous year.[14] A study from Norway showed that 5.6% of the Norwegian population in 2007 had used reflexology within the last 12 months.[15]

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Injury: in the case of an injury, the recovery treatment will adapt to the healing process of the injury. At the beginning of an injury, massages are more frequent, short and focused on the area. For example, a sprained ankle may need light but bi-weekly work after the acute phase is over. As the injury recovers, massages are more intense, and less frequent. The ankle will receive deeper massages and deeper stretches as it heals. Once the injury is recovered, only one or two check-up massage sessions will be required.
While a foot massage may feel the same as a reflexology treatment, a reflexologist will work on areas to promote a healing response in the corresponding organs. A massage therapist giving a foot massage will manipulate muscles and other soft tissues to improve circulation, relieve pain, and heal injuries in the area or to induce overall relaxation.
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]

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Empathy: Most people opt for massage therapy because they are in pain or because they are stressed out and need to calm down. As a massage therapist, it is imperative that you are empathetic to the needs of your clients, regardless of your day is going. If you appear or feel anxious or stressed, you are not going to be able to make your client feel calm and relaxed. Create trust with your patients by being personable and communicating effectively. Be receptive to their needs.

AD 1813 The Royal Gymnastic Central Institute for the training of gymnastic instructors was opened in Stockholm, Sweden, with Pehr Henrik Ling appointed as principal. Ling developed what he called the "Swedish Movement Cure." Ling died in 1839, having previously named his pupils as the repositories of his teaching. Ling and his assistants left little proper written account of their methods. [8][15][16]

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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.

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This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.


Reflexology is based on an absurd theory and has not been demonstrated to influence the course of any illness. Done gently, reflexology is a form of foot massage that may help people relax temporarily. Whether that is worth $35 to $100 per session or is more effective than ordinary (noncommercial) foot massage is a matter of individual choice. Claims that reflexology is effective for diagnosing or treating disease should be ignored. Such claims could lead to delay of necessary medical care or to unnecessary medical testing of people who are worried about reflexology findings.
AD 1776: Jean Joseph Marie Amiot, and Pierre-Martial Cibot, French missionaries in China translate summaries of Huangdi Neijing, including a list of medical plants, exercises and elaborate massage techniques, into the French language, thereby introducing Europe to the highly developed Chinese system of medicine, medical-gymnastics, and medical-massage.[8]
Ugly pain in massage therapy is, by my definition, never okay. Ugly pain is often caused by things that are not going to offer even minimal, delayed benefits, and may even be dangerous. It’s important to be able to spot ugly pain for what it is and completely eliminate it from any therapy you’re receiving. What kinds of handling may cause “ugly” pain?
Make yourself comfortable. If your therapist wants you to adjust your position, she or he will either move you or will ask you to move what is needed. Otherwise, change your position anytime to make yourself more comfortable. Many people close their eyes and relax completely during a session; others prefer to talk. It’s up to you. It is your massage, and whatever feels natural to you is the best way to relax. Do not hesitate to ask questions at any time.

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The physiological effects are a bit of a moot point: if the pressure doesn’t suit you, you’re not likely to continue with the therapy. The exception is the patient who is willing to put up with intense pain long enough to find out if there appears to be a therapeutic effect afterwards, which there may be. But that judgement call is often made without much knowledge of whether or not the pain is really justified. BACK TO TEXT
Over time, deep-tissue massage therapy can help break up and eventually erase scar tissue in the body. It does this by improving lymphatic circulation and drainage to improve flexibility and range of motion in the affected area. Scar tissue is often associated with ongoing pain and stiffness, so deep-tissue massage can improve these symptoms. Massage therapy is often recommended for people who are recovering from surgery.
Ever gone to a county fair, music festival, or conference and envied other people getting chair massages? Passed by the chair massage section in an airport? Or, maybe you're lucky enough to work at a company that offers 15- to 20-minute massages as a regular benefit. Onsite, chair massages are done while you're seated fully clothed in a portable, specially designed chair. They usually involve a massage of your neck, shoulders, back, arms, and hands.

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The Couples Massage at Le Reve Rittenhouse Day Spa is Philadelphia’s romantic escape for couples wishing privacy to enjoy each other’s company while indulging in Gourmet Chocolates and sipping on sparkling Champagne in a calming, relaxing atmosphere. Le Reve Rittenhouse Day Spa offers luxurious couples massage packages. Some couples enjoy being together every minute of the day. Others prefer going their own way, then meeting for special experiences. Either way, a romantic couple’s massage makes a wonderful gift. The gift might be for a big event like a wedding or anniversary. It might be a reminder that, even with the arrival of a new baby or with the departure of a new graduate, time spent together is still important. Surprise your partner with a trip to the best spa in Philadelphia for a rejuvenating Couples Massage. To find the best spa for couples massage in Philadelphia, look no further, Le Reve Rittenhouse Day Spa is here to satisfy your wishes.
“Runners put so much effort into training, but very few athletes put effort into taking good care of body that helps them perform,” says Gammal, who recommends incorporating regular massage—even if it’s just a 30-minute session once a month—so as to prevent injuries and the overtraining of muscles.  Scheduling mid-training appointments can also reveal places that are tight and places that should be addressed in post-workout stretching. “Massage isn’t a luxury, Gammal says. “It’s an investment.”
In its Comprehensive Accreditation Manual for Hospitals, The Official Handbook, updated in August 2000, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) suggests massage therapy can be used successfully in pain management. Some hospitals are including massage therapists in patient care teams to fight pain. Their teams may include a physician, nurses, a nutritionist, a yoga instructor, and a massage therapist.  Hospitals are now including massage due to public demand.  More research needs to be done to evaluate not only the effectiveness of such teams but to determine which combination of therapies works best for different types of patients and different types of pain.

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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

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Aspects of sports massage therapy are gaining popularity as useful components in a balanced training regimen. Sports massage therapy can be used as a means to enhance pre-event preparation and reduce recovery time for maximum performance during training or after an event. Athletes have discovered that specially designed sports massage promotes flexibility, reduces fatigue, improves endurance, helps prevent injuries and prepares their body and mind for optimal performance.

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In a poll of 25–35-year-olds, 79% said they would like their health insurance plan to cover massage.[28] In 2006 Duke University Health System opened up a center to integrate medical disciplines with CAM disciplines such as massage therapy and acupuncture.[126] There were 15,500 spas in the United States in 2007, with about two-thirds of the visitors being women.[119]
Now for some benefits that are not supported by research. The ability of sports massage to help the muscles get rid of lactic acid is not supported in research studies. Many researchers feel this is linked to the fact that sports massage does not increase blood flow to muscles. For example, a 2010 study found that blood flow was actually mechanically impeded by massage and that was a possible reason that lactic acid removal was impaired. A quicker recovery after sports massage is not yet supported by the research. Studies do support that active recovery (low-intensity exercise after work-out) is the best method of decreasing the amount of lactic acid that builds up after exercise and speeds recovery.
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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