Massage

Massage is the rubbing or kneading of the body's soft tissues.[1] Massage techniques are commonly applied with hands, fingers, elbows, knees, forearms, feet, or a device.[2][3] The purpose of massage is generally for the treatment of body stress or pain.[4][5][6] In English-speaking European countries, traditionally a person professionally trained to give massages is known by the gendered French loanwords masseur (male) or masseuse (female). In the United States, these individuals are often referred to as "massage therapists."[7] In some provinces of Canada, they are called "registered massage therapists."[8][9]

In professional settings, clients are treated while lying on a massage table, sitting in a massage chair, or lying on a mat on the floor.[10] There are many different modalities in the massage industry, including (but not limited to): deep tissue, manual lymphatic drainage, medical, sports, structural integration, Swedish, Thai and trigger point.[11]

## Contents

* 1 Etymology
* 2 History
* 2.1 Ancient times
* 2.2 Middle Ages
* 2.3 18th and 19th centuries
* 2.4 Modern times
* 2.4.1 China
* 2.4.2 United States
* 2.4.3 United Kingdom
* 2.4.4 Sports, business and organizations
* 3 Types and methods
* 3.1 Acupressure
* 3.2 Ashiatsu
* 3.3 Ayurvedic massage
* 3.4 Burmese massage
* 3.5 Biomechanical stimulation (BMS) massage
* 3.6 Biodynamic massage
* 3.7 Craniosacral therapy
* 3.8 Erotic massage
* 3.9 Hammam massage
* 3.10 Lomilomi and indigenous massage of Oceania
* 3.11 Lymphatic drainage
* 3.12 Medical massage
* 3.13 Myofascial release
* 3.14 Reflexology
* 3.15 Shiatsu
* 3.16 Sports massage
* 3.17 Structural Integration
* 3.18 Swedish massage
* 3.19 Thai massage
* 3.20 Traditional Chinese massage
* 3.21 Trigger point therapy
* 3.22 Tui na
* 3.23 Watsu
* 4 Facilities, equipment, and supplies
* 4.1 Massage tables and chairs
* 4.2 Warm-water therapy pools
* 4.3 Dry-water massage tables
* 4.4 Vichy showers
* 4.5 Cremes, lotions, gels, and oils
* 4.6 Massage tools
* 4.6.1 Tools used by massage therapists
* 4.6.2 Tools used by both individuals and massagers
* 5 Medical and therapeutic use
* 5.1 Beneficial effects
* 5.1.1 Single-dose effects
* 5.1.2 Multiple-dose effects
* 5.1.3 Neuromuscular effects
* 6 Global regulation and practice
* 6.1 Canada
* 6.2 China
* 6.3 France
* 6.4 Germany
* 6.5 India
* 6.6 Japan
* 6.7 Myanmar
* 6.8 Mexico
* 6.9 New Zealand
* 6.10 South Africa
* 6.11 South Korea
* 6.12 Thailand
* 6.13 United Kingdom
* 6.14 United States
* 7 See also
* 8 References
* 9 External links

## Etymology

The word comes from the French massage 'friction of kneading',[12] which, in turn, comes either from the Arabic word مَسَّ massa meaning 'to touch, feel',[13] the Portuguese amassar 'knead', from the Latin massa meaning 'mass, dough',[14] or the Greek verb μάσσω (massō) 'to handle, touch, to work with the hands, to knead dough'.[15]

The ancient Greek word for massage was anatripsis[16][17] and the Latin was frictio.[18][17]

## History

Drawings of acupressure points on Sen lines at Wat Pho temple in Thailand

### Ancient times

Archaeological evidence of massage has been found in many ancient civilizations including China, India, Japan, Egypt, Rome, Greece, and Mesopotamia.

2330 BC: The Tomb of Akmanthor[19] (also known as "The Tomb of the Physician") in Saqqara, Egypt, depicts two men having work done on their feet and hands, possibly depicting a massage.[20]

1363–912 BC: The word muššuʾu ("massage") is written for the first time on a Middle Assyrian tablet. Its use is described in a list of recipes concerning diseases of the foot.[21]

722–481 BC: 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 (c. 2700 BC), misleading some into believing the text itself was written during the time of the Yellow Emperor (which would predate written history).[22][23][24][25]

762 BC: In the Iliad and the Odyssey, massage with oils and aromatic substances is mentioned as a means to relax the tired limbs of warriors and as a way to help the treatment of wounds.[18]

700 BC: Bian Que, the earliest known Chinese physician, uses massage in medical practice.[26]

500 BC: Jīvaka Komarabhācca was an Indian physician who according to the Pāli Buddhist Canon was Shakyamuni Buddha's physician. Jivaka is sometimes credited with founding and developing a style of massage that led to the type of massage practiced in modern Thailand. Though this claim is disputed.

493 BC: A possible biblical reference documents daily "treatments" with oil of myrrh as a part of the beauty regimen of the wives of Xerxes (Esther, 2:12).[27]

460 BC: Hippocrates wrote "The physician must be experienced in many things, but assuredly in rubbing."[28]

300 BC: Charaka Samhita, sometimes dated to 800 BCE, is one of the oldest of the three ancient treatises of Ayurvedic medicine, including massage. Sanskrit records indicate that massage had been practiced in India long before the beginning of recorded history.[29]

AD 1st or 2nd: Galen mentioned Diogas (Διόγας) who was an iatralipta (ἰατραλείπτης) (rubber and anointer/physiotherapist).[30]

AD 581: China establishes a department of massage therapy within the Office of Imperial Physicians.

### Middle Ages

One of the greatest Persian medics was Avicenna, also known as Ibn Sina, who lived from 980 AD to 1037 AD. His works included a comprehensive collection and systematization of the fragmentary and unorganized Greco-Roman medical literature that had been translated Arabic by that time, augmented by notes from his own experiences. One of his books, Al-Qānūn fī aṭ-Ṭibb (The Canon of Medicine) has been called the most famous single book in the history of medicine in both East and West. Avicenna excelled in the logical assessment of conditions and comparison of symptoms and took special note of analgesics and their proper use as well as other methods of relieving pain, including massage.

AD 1150: Evidence of massage abortion, involving the application of pressure to the pregnant abdomen, can be found in one of the bas reliefs decorating the temple of Angkor Wat in Cambodia. It depicts a demon performing such an abortion upon a woman who has been sent to the underworld. This is the oldest known visual representation of abortion.[31]

In Southeast Asia, massage traditions and techniques have already been entrenched in the people's diverse cultures for centuries before trade contact with Europe in the 16th century. In the Philippines, a distinct massage and healing tradition called hilot developed,[32][33][34] while in Thailand, the tradition of massage that developed was called nuad thai. Nuad thai was declared in 2019 as a UNESCO intangible cultural heritage.[35]

### 18th and 19th centuries

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.[25]

AD 1776: Pehr Henrik Ling, a Swedish physical therapist and teacher of medical-gymnastics, is born. Ling has often been erroneously credited for having invented "Classic Massage", also known as "Swedish Massage", and has been called the "Father of Massage".[36][37] AD 1779: Frenchman Pierre-Martial Cibot publishes "Notice du Cong-fou des Bonzes Tao-see", also known as "The Cong-Fou of the Tao-Tse", a French language summary of medical techniques used by Taoist priests. According to English historian of China Joseph Needham, Cibot's work "was intended to present the physicists and physicians of Europe with a sketch of a system of medical gymnastics which they might like to adopt—or if they found it at fault they might be stimulated to invent something better. This work has long been regarded as of cardinal importance in the history of physiotherapy because it almost certainly influenced the Swedish founder of the modern phase of the art, Pehr Hendrik Ling. Cibot had studied at least one Chinese book but also got much from a Christian neophyte who had become expert in the subject before his conversion."[38]

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 a little proper written account of their methods.[25][39][40]

AD 1868: Dutch massage practitioner Johan Georg Mezger applies French terms to name five basic massage techniques,[36] and coins the phrase "Swedish massage system". These techniques are still known by their French names (effleurage (long, gliding strokes), petrissage (lifting and kneading the muscles), friction (firm, deep, circular rubbing movements), tapotement (brisk tapping or percussive movements) and vibration (rapidly shaking or vibrating specific muscles)).

### Modern times

#### China

Massage room in Shanghai, China

As of 2005, with the city of Shanghai alone there were an estimated 1,300–2,000 foot massage centers, with more than 3,000 in Shenzhen. It was also estimated that there were nearly 30,000 massage workers in Shanghai and over 40,000 in Shenzhen.[41] The average rate of pay for a worker in the massage industry in China is over 10,000 yuan per month, making them a well-paying job in China's service sector.[42]

#### United States

Massage started to become popular in the United States in the middle part of the 19th century[27] and was introduced by two New York physicians, George and Charles Taylor, based on Pehr Henrik Ling's techniques developed in Sweden.[43][44]

During the 1930s and 1940s, massage's influence decreased as a result of medical advancements of the time, while in the 1970s massage's influence grew once again with a notable rise among athletes.[27] Until the 1970s, nurses used massage to reduce pain and aid sleep.[45] Popular books and videos, such as Massage for Relaxation, helped introduce massage to popular culture outside of a health setting. The massage therapy industry is continuously increasing. In 2009, U.S. consumers spent between $4 and $6 billion on visits to massage therapists.[46] In 2015, research estimates that massage therapy was a $12.1 billion industry.[47]

All but five states require massage therapists to be licensed, and licensure requires the applicant to receive training at an accredited school, and to pass a comprehensive exam. Those states that require licensure also typically require continuing education in massage techniques and in ethics.[48]

#### United Kingdom

The service of massage or "physiological shampooing" was advertised in The Times from as early as 1880. Adverts claimed it as a cure for obesity amongst other chronic ailments.[49]

#### Sports, business and organizations

Marathon runners receiving massages at the 2004 ING Taipei International Marathon

Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer ("aleiptes")[50] who would rub their muscles with oil. Pehr Ling's introduction to massage also came about directly as a result of his study of gymnastic movements.

The 1984 Summer Olympics in Los Angeles was the first time that massage therapy was televised as it was being performed on the athletes. And then, during the 1996 Summer Olympics in Atlanta massage therapy was finally offered as a core medical service to the US Olympic Team.[51] Massage has been employed by businesses and organizations such as the U.S. Department of Justice, Boeing and Reebok.[52] Athletes such as Michael Jordan and LeBron James have personal massage therapists that at times even travel with them.

## Types and methods

### Acupressure

Main article: Medicine:Acupressure

Acupressure [from Latin acus "needle" (see acuity) + pressure (n.)[53]] is a technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in those meridians. Pressure may be applied by fingers, palm, elbow, toes or with various devices.

Some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, for helping lower back pain, tension headaches, stomach ache, among other things, although such studies have been found to have a high likelihood of bias.[54]

### Ashiatsu

A licensed massage practitioner performs Ashiatsu massage.

In ashiatsu, the practitioner uses their feet to deliver treatment. The name comes from the Japanese, ashi for foot and atsu for pressure.[55] 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.[56] Other manual therapy techniques using the feet to provide treatment include Keralite, Barefoot Lomilomi, and Chavutti Thirumal.

### Ayurvedic massage

Ayurvedic massage is known as Abhyangam in Sanskrit. According to the Ayurvedic Classics Abhyangam is an important dincharya (Daily Regimen) that is needed for maintaining a healthy lifestyle. The massage technique used during Ayurvedic Massage aims to stimulate the lymphatic system. Practitioners claim that the benefits of regular Ayurvedic massage include pain relief, reduction of fatigue, improved immune system and improved longevity.[57]

### Burmese massage

Traditional Burmese Foot Massage at Sapel in Yangon

"Known in Myanmar as Yoe Yar Nhake Nal Chin, meaning 'traditional massage', Burmese massage has its ancient origins from Thai, Chinese and Indian medicine. It includes the use of local natural ingredients such as Thanaka which helps to promote smooth skin and prevents sunburn."[58]

Burmese massage is a full body massage technique that starts from head to toes, drawing on acupuncture, reflexology and kneading. Signature massage strokes include acupressure using the elbows, quick gentle knocking of acupressure points, and slow kneading of tight muscles. The massage aims to improve blood circulation and quality of sleep, while at the same time help to promote better skin quality.[59][60]

### Biomechanical stimulation (BMS) massage

Biomechanical stimulation (BMS) is a term generally used for localised biomechanical oscillation methods, whereby local muscle groups are stimulated directly or via the associated tendons by means of special hand held mechanical vibration devices. Biomechanical oscillation therapy and training is offered in a variety of areas such as competitive sports,[61] fitness, rehabilitation,[62] medicine,[63] prevention, beauty and used to improve performance of the muscles and to improve coordination and balance. It is often used in myofascial trigger point therapy to invoke reciprocal inhibition within the musculoskeletal system. Beneficial effects from this type of stimulation have been found to exist.[64]

### Biodynamic massage

Main article: Medicine:Biodynamic massage

Biodynamic massage was created by Gerda Boyesen as part of Biodynamic Psychotherapy. It uses a combination of hands-on work and "energy work" and also uses a stethoscope to hear the peristalsis.[65]

### Craniosacral therapy

Main article: Unsolved:Craniosacral therapy

Craniosacral therapy (CST) is a pseudoscience[66] that aims to improve fluid movement and cranial bone motion by applying light touch to the skull, face, spine, and pelvis.[67]

### Erotic massage

A type of massage that is done in an erotic way via the use of massage techniques by a person on another person's erogenous zones to achieve or enhance their sexual excitation or arousal and to achieve orgasm.

It was also once used for medical purposes as well as for the treatment of "female hysteria" and "womb disease".[68][69]

Nuru massage is a Japanese form of erotic massage.

### Hammam massage

Le massage: scène au Hammam by Edouard Debat-Ponsan (1883). An Orientalist painting depicting a massage at a hammam.

In the traditional Hammam, massage involves not just vigorous muscle kneading, but also joint cracking, "not so much a tender working of the flesh as a pummeling, a cracking of joints, a twisting of limbs..."[70] An 18th-century traveler reported:

> ...one of the attendants begins to press and handle the tops of the shoulders, the muscles of the arm, and successively the whole body; first gently, then by degrees increasing the pressure, till he comes to handle pretty roughly, but without giving pain. This is repeated at short intervals till the skin is perfectly softened. The attendant then taking hold of the bather's fingers, with a dexterous jerk makes each joint crack successively; after which, laying him flat on his back, and bringing the arms across the breast, the shoulder joints are made to crack in like manner.

— Alexander Russell, The Natural History of Aleppo (1756)[71]

### Lomilomi and indigenous massage of Oceania

Main article: Medicine:Lomilomi massage

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, in Pukapuka and in Western Samoa.[72]

### Lymphatic drainage

Main article: Medicine:Manual lymphatic drainage

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 transports interstitial fluid and its waste products back into the bloodstream. Lymph also carries lymphocytes and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.[73][74][75]

### Medical massage

Main article: Medicine:Medical massage

Medical massage is a controversial term in the massage profession.[76] 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 trigger-point therapy, as well as osteopathic techniques, cranial-sacral techniques and many more can be used to work with various medical conditions.[77]

Massage used in the medical field includes decongestive therapy used for lymphedema[27] which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care.[78] Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT.[79] However, it is less effective than management of SVT with medications.[80]

A 2004 systematic review found single applications of massage therapy "reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level," while "multiple applications reduced delayed assessment of pain," and found improvements in anxiety and depression similar to effects of psychotherapy.[81] A subsequent systematic review published in 2008 found that there is little evidence supporting the use of massage therapy for depression in high quality studies from randomized controlled trials.[82]

### Myofascial release

thumb Myofascial release refers to the manual massage technique that claims to release adhered fascia and muscles with the goal of eliminating pain, increasing range of motion and equilibrioception. Myofascial release usually involves applying shear compression or tension in various directions, cross fiber friction or by skin rolling.[83]

### Reflexology

Reflexology, also known as "zone therapy", is an alternative medicine involving application of pressure to the feet and hands with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on a pseudoscientific[84] belief in a system of zones and reflex areas that purportedly reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body.[85]

### Shiatsu

Shiatsu (指圧) (shi meaning finger and atsu meaning pressure) is a form of Japanese bodywork based on concepts in traditional Chinese medicine such as qi meridians. It consists of finger, palm pressure, stretches, and other massage techniques. There is no convincing data available to suggest that shiatsu is an effective treatment for any medical condition.[86]

### Sports massage

Sports massage is the use of specific massage therapy techniques in an athletic context to improve recovery time, enhance performance and reduce the risk of injury.[87] This is accomplished using techniques that stimulate the flow of blood and lymph to and from muscles. Sports massage is often delivered before or after physical activity depending on the subject's needs, preferences and goals. Sports massages may help with flexibility, pain and recovery but the scientific evidence is mixed.[88]

### Structural Integration

Structural Integration's aim is to unwind the strain patterns in the body's myofascial system, restoring it to its natural balance, alignment, length and ease. This is accomplished by hands-on manipulation, coupled with movement re-education. While the promotion and practice of Structural Integration are generally regarded as quackery, there are approximately 15 schools dedicated to its teachings as recognized by the International Association of Structural Integration,[89] including the Dr. Ida Rolf Institute (with the brand Rolfing), Hellerwork, Guild for Structural Integration, Aston Patterning,[25] Soma,[90] and Kinesis Myofascial Integration.[91]

### Swedish massage

Estonian massage therapy school teaching the Swedish classical massage technique.

The most widely recognized and commonly used category of massage is Swedish massage. The Swedish massage techniques vary from light to vigorous.[92] Swedish massage uses five styles of strokes. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber or with the fibers) and vibration/shaking.[93]

The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitioner Johann Georg Mezger applied the French terms to name the basic strokes.[94] The term "Swedish massage" is actually only recognized in English- and Dutch-speaking countries, and in Hungary and Israel. Elsewhere the style is referred to as "classic massage".

Clinical studies have found that Swedish massage can reduce chronic pain, fatigue,[95][96] joint stiffness and improve function in patients with osteoarthritis of the knee.[97]

### Thai massage

Thai massage

Main article: Medicine:Thai massage

Known in Thailand as Nuat phaen boran, meaning "ancient/traditional massage", traditional Thai massage is generally based on a combination of Indian and Chinese traditions of medicine.

Thai massage combines both physical and energetic aspects. It is a deep, full-body massage progressing from the feet up, and focusing on sen or energy lines throughout the body, with the aim of clearing blockages in these lines, and thus stimulating the flow of blood and lymph throughout the body. It draws on yoga, acupressure and reflexology.

Thai massage is a popular massage therapy that is used for the management of conditions such as musculoskeletal pain and fatigue. Thai massage involves a number of stretching movements that improve body flexibility, joint movement and also improve blood circulation throughout the body. In one study scientists found that Thai massage showed comparable efficacy as the painkiller ibuprofen in the reduction of joint pain caused by osteoarthritis (OA) of the knee.[98]

### Traditional Chinese massage

Main article: Medicine:Traditional Chinese medicine

Massage of Chinese Medicine is known as An Mo (按摩pinyin: Ànmó) (pressing and rubbing) or Qigong Massage and is the foundation of Japan's Anma. Categories include Pu Tong An Mo (普通按摩pinyin: Pǔtōng ànmó) (general massage), Tui Na An Mo (推拿按摩pinyin: Tuīná ànmó) (pushing and grasping massage), Dian Xue An Mo (cavity pressing massage), and Qi An Mo (氣按摩 pinyin: Qì ànmó) (energy massage). Tui na (推拿pinyin: Tuīná) focuses on pushing, stretching, and kneading muscles, and Zhi Ya(指壓pinyin: Zhǐ yā) focuses on pinching and pressing at acupressure points. Technique such as friction and vibration are used as well.[99]

### Trigger point therapy

Sometimes confused with pressure point massage,[27] this involves deactivating trigger points that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (President Kennedy's physician) and David Simons. Trigger points have been photomicrographed and measured electrically[100] and in 2007 a paper was presented showing images of Trigger Points using MRI.[101] These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this technique is different from reflexology acupressure and pressure point massage.

### Tui na

Main article: Medicine:Tui na

Tui na is a Chinese manual therapy technique that includes many different types of strokes, aimed to improve the flow of chi through the meridians.

### Watsu

Main article: Medicine:Watsu

Watsu, developed by Harold Dull at Harbin Hot Springs, California, is a type of aquatic bodywork performed in near-body-temperature water, and characterized by continuous support by the practitioner and gentle movement, including rocking, stretching of limbs, and massage. The technique combines hydrotherapy floating and immersion with shiatsu and other massage techniques. Watsu is used as a form of aquatic therapy for deep relaxation and other therapeutic intent. Related forms include Waterdance, Healing Dance, and Jahara technique.[102][103]

## Facilities, equipment, and supplies

Massage table prepared for a massage session.

### Massage tables and chairs

Specialized massage tables and chairs are used to position recipients during massages. A typical commercial massage table has an easily cleaned, heavily padded surface, and horseshoe-shaped head support that allows the client to breathe easily while lying face down and can be stationary or portable, while home versions are often lighter weight or designed to fold away easily. An orthopedic pillow or bolster can be used to correct body positioning.

Ergonomic chairs serve a similar function as a massage table. Chairs may be either stationary or portable models. Massage chairs are easier to transport than massage tables, and recipients do not need to disrobe to receive a chair massage. Due to these two factors, chair massage is often performed in settings such as corporate offices, outdoor festivals, shopping malls, and other public locations.

### Warm-water therapy pools

Temperature-controlled warm-water therapy pools are used to perform aquatic bodywork.[104] For example, Watsu requires a warm-water therapy pool that is approximately chest-deep (depending on the height of the therapist) and temperature-controlled to about 35 °C (95 °F).[105]

### Dry-water massage tables

A dry-water massage machine at a shopping mall in Fargo, North Dakota.

A dry-water massage table uses jets of water to perform the massage of the patient's muscles. These tables differ from a Vichy shower in that the client usually stays dry. Two common types are one in which the client lies on a waterbed-like mattress which contains warm water and jets of water and air bubbles and one in which the client lies on a foam pad and is covered by a plastic sheet and is then sprayed by jets of warm water, similar to a Vichy shower.[106] The first type is sometimes seen available for use in shopping centers for a small fee.

### Vichy showers

A Vichy shower is a form of hydrotherapy that uses a series of shower nozzles that spray large quantities of water over the client while they lie in a shallow wet bed, similar to a massage table, but with drainage for the water. The nozzles may usually be adjusted for height, direction, and temperature to suit the patient's needs.

### Cremes, lotions, gels, and oils

File:Aroma Massage at Tara Angkor Hotel 2011-07-09 (flickr 5918125059).jpgA specially created aroma massage combining technique and aromatherapy oils.

Many different types of massage cremes, lotions, gels, and oils are used to lubricate and moisturize the skin and reduce the friction between skin (hands of technician and client).[107]

### Massage tools

These instruments or devices are sometimes used during massages.[108] Some tools are for use by individuals, others by the therapist.

#### Tools used by massage therapists

Calf massage with a bamboo massage tool.

Instrument-assisted soft-tissue massage can deploy stainless-steel devices to manipulate tissue in a way that augments hands-on work.

A body rock is a serpentine-shaped tool, usually carved out of stone. It is used to amplify the therapist' strength and focus pressure on certain areas. It can be used directly on the skin with a lubricant such as oil or corn starch or directly over clothing.

Bamboo and rosewood tools are also commonly used. They originate from practices in southeast Asia, Thailand, Cambodia, and Burma. Some of them may be heated, oiled, or wrapped in cloth.

Cupping massage is often carried out using plastic cups and a manual hand-pump to create the vacuum. The vacuum draws the soft tissue perpendicular to the skin, providing a tensile force, which can be left in one site or moved along the tissue during the massage.

#### Tools used by both individuals and massagers

Hand-held battery-operated massaging and vibrating instruments are available, including devices for massaging the scalp following a haircut.

Vibrating massage pads come in a range of sizes, some with the option of heating.

Vibrating massage chairs can provide an alternative for therapy at home.

There is a widespread market in erotic massage instruments, including electric dildos and vibrators such as the massage wand.[109]

## Medical and therapeutic use

File:Electrical Back Massage Chair, 1919.pngGlenn S. Noble's 1919 electric massage chair, featured in The Electrical Experimenter.

The main professionals who provide therapeutic massage are massage therapists, athletic trainers, physical therapists, and practitioners of many traditional Chinese medicine and other non-Western medicines. Massage practitioners work in a variety of medical settings and may travel to private residences or businesses. Certain medical conditions may require modification of the technique or the avoidance of massage in specific areas. For example, direct massage over a limb affected by deep vein thrombosis (DVT) is considered an absolute contraindication due to the risk of dislodging a clot and causing pulmonary embolism.[110] Massage during anticoagulant therapy (for example, warfarin use) should be applied with caution and often limited to lighter pressure techniques to reduce the risk of bruising or internal bleeding.[111] Likewise, clients with osteoporosis, recent fractures, bone fragility, or certain cancer treatments may require reduced pressure or avoidance of massage over vulnerable areas.[112] Fever or systemic infection is generally regarded as a contraindication until the condition resolves.[113]

### Beneficial effects

Oil dispersion bath and brush massage

Peer-reviewed medical research has shown that the benefits of massage include pain relief, reduced trait anxiety and depression, temporarily reduced blood pressure, heart rate, and state of anxiety.[114] Additional testing has shown an immediate increase in, and expedited recovery periods for, muscle performance.[115] Theories behind what massage might do include: enhanced skeletal muscle regrowth and remodeling,[116] blocking nociception (gate control theory),[117] activating the parasympathetic nervous system (which may stimulate the release of endorphins and serotonin, preventing fibrosis[118] or scar tissue), increasing the flow of lymph, and improving sleep.[27][119]

Infant massage has been found to hold therapeutic benefits for premature infants and their parents.[120] Premature infants are susceptible to low birth weight and decreased immune function;[121] massage has been found to counter these effects, causing weight increase, reduced pain, and increased immune function.[121] Administering infant massage also reduces stress and increases oxytocin in parental figures regardless of gender, and overall improves emotional attachment with their child.[120]

Massage research is hindered from reaching the gold standard of scientific inquiry, which includes placebo-controlled and double blind clinical trials.[122][123] Developing a placebo manual therapy for massage would be difficult, since even light touch massage could have effects on a subject.[122] It would also be difficult to find a subject that would not notice that they were getting less of a massage, and it would be impossible to blind the therapist.[122] Massage research can employ randomized controlled trials, which are published in peer reviewed medical journals.[122] This type of study could increase the credibility of the profession because it displays that purported therapeutic effects are reproducible.[123]

#### Single-dose effects

Mechanical massage chairs

* Pain relief: Relief from pain due to musculoskeletal injuries and other causes is cited as a major benefit of massage.[27] A 2015 Cochrane Review concluded that there is very little evidence that massage is an effective treatment for lower back pain.[124] A meta-analysis conducted by scientists at the University of Illinois Urbana-Champaign failed to find a statistically significant reduction in pain immediately following treatment.[114] Weak evidence suggests that massage may improve pain in the short term for people with acute, sub-acute, and chronic lower back pain.[124]
* State anxiety: Massage has been shown to reduce state anxiety, a transient measure of anxiety in a given situation.[114]
* Blood pressure and heart rate: Massage has been shown to temporarily reduce blood pressure and heart rate.[114]

#### Multiple-dose effects

* Pain relief: Massage may reduce pain experienced in the days or weeks after treatment.[114][125]
* Trait anxiety: Massage has been shown to reduce trait anxiety; a person's general susceptibility to anxiety.[114]
* Depression: Massage has been shown to reduce sub-clinical depression.[114]

#### Neuromuscular effects

Massage has been shown to reduce neuromuscular excitability by measuring changes in the Hoffman's reflex (H-reflex) amplitude.[126] A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability.[127] Others explain, "H-reflex is considered to be the electrical analogue of the stretch reflex... and the reduction" is due to a decrease in spinal reflex excitability.[128] Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage.[129] It has been noted that "the receptors activated during massage are specific to the muscle being massaged," as other muscles did not produce a decrease in H-reflex amplitude.[127]

## Global regulation and practice

Because the art and science of massage is a globally diverse phenomenon, different legal jurisdictions sometimes recognize and license individuals with titles, while other areas do not. Examples are:

* Registered Massage Therapist (RMT) in Canada[130] and New Zealand[131]
* Certified Massage Therapist (CMT) in New Zealand[132]
* Licensed Massage Practitioner (LMP)[133]
* Licensed Massage Therapist (LMT)[134]
* Licensed Massage and Bodywork Therapist (LMBT) in North Carolina[135]
* Therapeutic Massage Therapist (TMT) in South Africa[136]

In some jurisdictions, practicing without a license is a crime. One such jurisdiction is Washington state, where any health professionals practicing without a license can be issued a fine and charged with a misdemeanor offense.[137]

### Canada

Canadian massage therapist at work.

In regulated provinces massage therapists are known as Registered Massage Therapists, in Canada six provinces regulate massage therapy:[138] British Columbia, Ontario, Newfoundland and Labrador, Prince Edward Island, Saskatchewan, and New Brunswick.[139] Registered Massage Therapy in British Columbia is regulated by the College of Massage Therapists of British Columbia (CMTBC).[140] Regulated provinces have, since 2012, established inter-jurisdiction competency standards.[141][138] Quebec is not provincially regulated. Massage therapists may obtain a certification with one of the various associations operating. There is the Professional Association of Specialized Massage Therapists of Quebec, also named Mon Réseau Plus, which represents 6,300 massage therapists (including ortho therapist, natural therapists, and others), the Quebec Federation of massage therapists (FMQ), and the Association québécoise des thérapeutes naturals; however, none of these are regulated by provincial law.

Canadian educational institutions undergo a formal accreditation process through the Canadian Massage Therapy Council for Accreditation (CMTCA).

### China

Most types of massage, with the exception of some traditional Chinese medicine, are not regulated in China. Although illegal in China, some of the smaller massage parlors are sometimes linked to the sex industry and the government has taken a number of measures in recent times to curb this. In a nationwide crackdown known as the yellow sweep ("Yellow" in Mandarin Chinese refers to sexual activities or pornographic content), limitations on the design and operation of massage parlors have been placed, going so far as requiring identification from customers who visit massage establishments late at night and logging their visits with the local police.[142][143]

### France

France requires three years of study and two final exams in order to apply for a license.[144]

### Germany

In Germany, massage is regulated by the government on a federal and national level. Only someone who has completed 3,200 hours of training (theoretical and practical) can use the professional title "Masseur und Medizinischer Bademeister" 'Masseur and Medical Spa Therapist'. This person can prolong his training depending on the length of professional experience to a Physiotherapist (1 year to 18 months additional training). The Masseur is trained in Classical Massage, Myofascial Massage, Exercise, and Movement Therapy. During the training, they will study anatomy, physiology, pathology, gynecology, podiatry, psychiatry, psychology, surgery, dermiatry, and orthopedics.[145] They are trained in Electrotherapy and Hydrotherapy. Hydrotherapy includes Kneipp, Wraps, underwater massage, therapeutic washing, Sauna, and Steambath. A small part of their training will include special forms of massage which are decided by the local college, for example, foot reflex zone massage, Thai Massage, etc. Finally, a graduate is allowed to treat patients under the direction of a doctor. Graduates are regulated by the professional body which regulates Physiotherapists. This includes restrictions on advertising and the oath of confidentiality to clients.[146]

### India

In India, massage therapy is licensed by The Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH) under the Ministry of Health and Family Welfare (India) in March 1995. Massage therapy is based on Ayurveda, the ancient medicinal system that evolved around 600 BC. In ayurveda, massage is part of a set of holistic medicinal practices, contrary to the independent massage system popular in some other systems.[147] In Siddha, Tamil traditional medicine from south India, massage is termed as "Thokkanam" and is classified into nine types, each for a specific variety of diseases.[148]

### Japan

Traditional Japanese blind massage

### Myanmar

In Myanmar, massage is unregulated.[149] However, it is necessary to apply for a spa license with the government to operate a massage parlor 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.

### Mexico

In Mexico massage therapists, called sobadores, combine massage using oil or lotion[150] with a form of acupuncture and faith.[151] Sobadores are used to relieve digestive system problems as well as knee and back pain.[150][151] Many of these therapists work out of the back of a truck, with just a curtain for privacy.[151] By learning additional holistic healer's skills in addition to massage, the practitioner may become a curandero.[152]

In some jurisdictions, prostitution in Mexico is legal, and prostitutes are allowed to sell sexual massages. These businesses are often confined to a specific area of the city, such as the Zona Norte in Tijuana.

### New Zealand

In New Zealand, massage is unregulated. There are two levels of registration with Massage New Zealand, the professional body for massage therapists within New Zealand, although neither of these levels are government recognized. Registration at the certified massage therapist level denotes competency in the practice of relaxation massage. Registration at the remedial massage therapist denotes competency in the practice of remedial or orthopedic massage. Both levels of registration are defined by agreed minimum competencies and minimum hours.[153]

### South Africa

### South Korea

In South Korea, only blind and visually impaired people can become licensed masseurs.[154]

### Thailand

In Thailand, Thai massage is officially listed as one of the branches of traditional Thai medicine, recognized and regulated by the government. It is considered to be a medical discipline in its own right and is used for the treatment of a wide variety of ailments and conditions. Massage schools, centers, therapists, and practitioners are increasingly regulated by the Ministries of Education and Public Health in Thailand.[155][156]

### United Kingdom

To practice commercial massage or massage therapy in the UK, an ITEC[157] or VTCT[158] certificate must be obtained through training which includes Beauty and Spa Therapy, Hairdressing, Complementary Therapies, Sports & Fitness Training and Customer Service.

Therapists with appropriate paperwork and insurance may join the Complementary and Natural Healthcare Council (CNHC), a voluntary, government regulated, professional register. Its key aim is to protect the public.[159]

In addition, there are many professional bodies that have a required minimum standard of education and hold relevant insurance policies including the Federation of Holistic Therapists (FHT),[160] the Complementary Therapists Association (CThA),[161] and the Complementary Health Professionals (CHP).[162] In contrast to the CNHC these bodies exist to support therapists rather than clients.

### United States

A hot stone massage performed by a professional in Oxnard, California.

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.[163] As of 2022, there are an estimated 872 state-approved massage training programs operating in the U.S.[164] 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. Training programs in the US are typically 500 hours to 1000 hours in total training time and can award a certificate, diploma, or degree depending on the particular school.[165] 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.[27] The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S. and there are almost 300 schools that are accredited through this agency.[166]

Forty-seven states, Puerto Rico, and the District of Columbia offer some type of credential to professionals in the massage and bodywork field—usually licensure, certification or registration.[48][167][168] Forty-five states require some type of licensing for massage therapists.[48][169] There are two nationally recognized tests to gain a massage therapy license, as well as state-specific exams.[170][171] In the US, 38 states accept the National Certification Board for Therapeutic Massage and Bodywork's (NCBTMB) later unavailable certification program as a basis for granting licenses either by rule or statute.[171][172] The NCBTMB formerly offered the designation Nationally Certified in Therapeutic Massage and Bodywork (NCTMB) but as of 2024[update] only offers its certificate program, Board Certification in Therapeutic Massage and Bodywork (BCTMB) which does not qualify for licensure.[173][174] Forty-three states, as well as Puerto Rico and the District of Columbia, accept the Massage & Bodywork Licensing Examination (MBLEx), administered by the Federation of State Massage Therapy Boards (FSMTB).[175][176] Between 10% and 20% of towns or counties independently regulate the profession.[139] 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.[139][177]

In the US, licensure is the highest level of regulation and this restricts anyone without a license from practicing massage therapy or calling themselves by 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.[177] In the US, most certifications are locally based. 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. Only Kansas, Minnesota, and Wyoming, California and Vermont do not require a license or a certification at the state level.[48] Some states allow license reciprocity, where licensed massage therapists who relocate can relatively easily obtain a license in their new state.[178]

In New York State in 2024, a man was arrested and charged with three counts of third-degree Sexual Abuse and three counts of Forcible Touching, as well as New York State Education Department Law violations, for providing massage therapy services without a New York State license to do so.[179]

In 1997 there were an estimated 114 million visits to massage therapists in the US.[165] Massage therapy is the most used type of alternative medicine in hospitals in the United States.[167] Between July 2010 and July 2011 roughly 38 million adult Americans (18 percent) had a massage at least once.[180] People state that they use massage because they believe that it relieves pain from musculoskeletal injuries and other causes of pain, reduces stress and enhances relaxation, rehabilitates sports injuries, decreases feelings of anxiety and depression, and increases general well-being.[27]

In a poll of 25–35-year-olds, 79% said they would like their health insurance plan to cover massage.[51] In 2006 Duke University Health System opened up a center to integrate medical disciplines with CAM disciplines such as massage therapy and acupuncture.[181] There were 15,500 spas in the United States in 2007, with about two-thirds of the visitors being women.[169]

The number of visits rose from 91 million in 1999 to 136 million in 2003, generating a revenue that equals $11 billion.[182] Job outlook for massage therapists was also projected to grow at 20% between 2010 and 2020 by the Bureau of Labor Statistics, faster than the average.[183]

## See also

* Manual therapy
* Massage chair
* Spa

## References

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70. ↑ Richard Boggs, Hammaming in the Sham: A Journey Through the Turkish Baths of Damascus, Aleppo and Beyond, 2012, ISBN 1859643256, p. 161
71. ↑ 2nd edition, 1794, p. 134-5
72. ↑ Chai, R. Makana Risser, ed. Na Mo'olelo Lomilomi: Traditions of Hawaiian Massage and Healing, Bishop Museum, 2005; Parsons, Claire D. F., ed. Healing Practices in the South Pacific, 1985, The Institute for Polynesian Studies; Tregear, Edward. Maori-Polynesian Comparative Dictionary. Lyon and Blair, Wellington NZ, 1891
73. ↑ Milady's Guide to Lymph Drainage Massage; Ramona Moody French; Delmar/Cengage; 2004
74. ↑ Stillerman, Elaine (2009). Modalities for Massage and Bodywork. Mosby. pp. 129–143. ISBN 978-0-323-05255-9.
75. ↑ Levine, Andrew (1998). The Bodywork and Massage Sourcebook. Lowell House. pp. 173–84. ISBN 978-0-7373-0098-7. https://archive.org/details/unset0000unse_k8j9.
76. ↑ "Medical Massage Controversy". Massage-career-guides.com. 6 February 2013. http://www.massage-career-guides.com/medical-massage.html.
77. ↑ "Introduction, With a Response to AMMA". https://www.massagetoday.com/articles/10631/Introduction-With-a-Response-to-AMMA.
78. ↑ van Veen, Suzan; Drenth, Hans; Hobbelen, Hans; Finnema, Evelyn; Teunissen, Saskia; de Graaf, Everlien (January 10, 2024). "Non-pharmacological interventions feasible in the nursing scope of practice for pain relief in palliative care patients: a systematic review" (in en). Palliative Care and Social Practice 18. doi:10.1177/26323524231222496. ISSN 2632-3524. PMID 38223744.
79. ↑ "Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage". Annals of Emergency Medicine 31 (1): 30–5. January 1998. doi:10.1016/S0196-0644(98)70277-X. PMID 9437338.
80. ↑ "Heart rate is a predictor of success in the treatment of adults with symptomatic paroxysmal supraventricular tachycardia". European Heart Journal 25 (15): 1310–7. August 2004. doi:10.1016/j.ehj.2004.05.011. PMID 15288158.
81. ↑ "A meta-analysis of massage therapy research". Psychological Bulletin 130 (1): 3–18. January 2004. doi:10.1037/0033-2909.130.1.3. PMID 14717648.
82. ↑ "Massage therapy for the treatment of depression: a systematic review". International Journal of Clinical Practice 62 (2): 325–33. February 2008. doi:10.1111/j.1742-1241.2007.01553.x. PMID 18081800.
83. ↑ "Chapter 12: Myofascial release". An Osteopathic Approach to Diagnosis and Treatment (3rd ed.). Lippincott Williams & Wilkins. 2005. pp. 80–82. ISBN 978-0-7817-4293-1. https://books.google.com/books?id=tot78_5FxZwC&pg=PP1.
84. ↑ Barrett, Stephen (25 September 2004). "Reflexology: A close look". Quackwatch. https://www.quackwatch.org/01QuackeryRelatedTopics/reflex.html.
85. ↑ Kunz, Kevin; Kunz, Barbara (1993). The Complete Guide to Foot Reflexology. Reflexology Research Project. ISBN 978-0-9606070-1-3. https://archive.org/details/completeguidetof00barb.
86. ↑ Ernst, Edzard; Pittler, Max H; Wider, Barbara; Boddy, Kate (2008). Oxford Handbook of Complementary Medicine. doi:10.1093/med/9780199206773.001.0001. ISBN 978-0-19-920677-3.
87. ↑ Brummitt, Jason (February 2008). "The Role of Massage in Sports Performance and Rehabilitation: Current Evidence and Future Direction". North American Journal of Sports Physical Therapy 3 (1): 7–21. ISSN 1558-6162. PMID 21509135.
88. ↑ "Master Your Recovery: The Benefits Of Sports Massage" (in en). https://www.anotherround.co.uk/post/recovery-benefits-sports-massage#:~:text=A meta-analysis study of previous studies found,or reduce delayed onset muscle soreness (DOMS)..
89. ↑ "Structural integration: origins and development". J Altern Complement Med 17 (9): 775–80. 2011. doi:10.1089/acm.2011.0001. PMID 21875349.
90. ↑ Knaster, Mirka (1996). Discovering the Body's Wisdom: A Comprehensive Guide to More Than Fifty Mind-Body Practices. Bantam. pp. 195–208. ISBN 978-0-307-57550-0. https://books.google.com/books?id=zLdAGUCyHGwC.
91. ↑ Myers, Thomas W. (19 September 2001). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Elsevier Health Sciences. ISBN 978-0-443-06351-0. https://books.google.com/books?id=l2aGtM1zkYkC.
92. ↑ Braun, Mary Beth. Introduction to Massage Therapy (Third ed.). Lippincott Williams & Wilkins. p. 16.
93. ↑ "Swedish Massage". Massagereister.com. http://www.massageregister.com/western-massage/swedish-massage.
94. ↑ "Pages from history: Swedish massage". Massage Magazine. http://www.massagemag.com/Magazine/2002/issue100/history100.php.
95. ↑ "The effectiveness of Swedish massage with aromatic ginger oil in treating chronic low back pain in older adults: a randomized controlled trial". Complementary Therapies in Medicine 22 (1): 26–33. February 2014. doi:10.1016/j.ctim.2013.11.002. PMID 24559813.
96. ↑ "Managing pain and fatigue in people with spinal cord injury: a randomized controlled trial feasibility study examining the efficacy of massage therapy". Spinal Cord 55 (2): 162–166. February 2017. doi:10.1038/sc.2016.156. PMID 27897186.
97. ↑ "Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial". PLOS ONE 7 (2). February 2012. doi:10.1371/journal.pone.0030248. PMID 22347369. Bibcode: 2012PLoSO...730248P.
98. ↑ "Thai massage, and Thai herbal compress versus oral ibuprofen in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial". BioMed Research International 2014. 2014. doi:10.1155/2014/490512. PMID 25254207.
99. ↑ Jwing-Ming, Yang. 2005. Qigong massage: fundamental techniques for health and relaxation, 2nd ed. Ymaa Publication Center. ISBN 978-1594390487.
100. ↑ David G Simons, Siegfried Mense and IJ Russell, Muscle Pain: Understanding Its Nature, Diagnosis, and Treatment Chapter: Myofascial Pain Caused by Trigger Points p.205–288 (1st hardcover edition), 2000, Lippincott Williams & Wilkins
101. ↑ Chen et al., p.2 2007, Archives of Physical Medicine and Rehabilitation
102. ↑ Schoedinger, P. 2011. Watsu in aquatic rehabilitation. In: Becker, BE and Cole, AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671. http://www.comprehensiveaquatictherapy.com/CAT3/Home_Page.html
103. ↑ Dull, H. 2008. Watsu: freeing the body in water, 4th edition. Watsu Publishing. ISBN 978-1605853710.
104. ↑ Osinski, A. 2011. Facility design and water management. Chapter 18 In Becker, BE and Cole, AJ (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.
105. ↑ Blessing A and Blessing H. 2008. Watsu pool design and care. pp 186–193, Appendix G In: Dull, H. Watsu: freeing the body in water, 4th edition. Watsu Publishing. ISBN 978-1605853710.
106. ↑ "Using a Water Massage Machine". Circlesoflight.com. 16 March 2007. http://www.circlesoflight.com/alternative/water-jet-machine.html.
107. ↑ Capellini, Steve; Welden, Michel Van (11 May 2010). Massage For Dummies. John Wiley & Sons. p. 20. ISBN 978-0-470-64275-7. https://books.google.com/books?id=KgFnbJ7E90IC&pg=PA20.
108. ↑ Stone, Victoria (2010-12-01) (in en). The World's Best Massage Techniques The Complete Illustrated Guide: Innovative Bodywork Practices From Around the Globe for Pleasure, Relaxation, and Pain Relief. Fair Winds Press. p. 237. ISBN 978-1-61059-383-0. https://books.google.com/books?id=HSy8sMP-iyoC&dq=These+instruments+or+devices+are+sometimes+used+during+massages&pg=PA237.
109. ↑ Trout, Christopher (28 August 2014). "The 46-year-old sex toy Hitachi won't talk about". Engadget. https://www.engadget.com/2014/08/27/history-of-the-hitachi-magic-wand/.
110. ↑ Krongkarn, Ngamnet (2020). "Leg massage during pregnancy with unrecognized deep vein thrombosis". BMJ Case Reports 13 (5). doi:10.1136/bcr-2020-234612. PMID 32341187. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178622/. Retrieved 2025-09-29.
111. ↑ Bauer, Bob (2015-09-01). "Massage and Medication". https://www.amtamassage.org/publications/massage-therapy-journal/massage-and-medication/.
112. ↑ "Massage Contraindications & Precautions Every Therapist Should Know". 2022. https://mblexguide.com/massage-contraindications-therapists-should-know/.
113. ↑ "Contraindications for Massage: What Therapists Must Know". 2020. https://www.aiam.edu/massage-therapy/contraindications-for-massage/.
114. ↑ 114.0 114.1 114.2 114.3 114.4 114.5 114.6 "A meta-analysis of massage therapy research". Psychological Bulletin 130 (1): 3–18. January 2004. doi:10.1037/0033-2909.130.1.3. PMID 14717648.
115. ↑ "An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review with Meta-Analysis". Frontiers in Physiology 9: 403. 2018. doi:10.3389/fphys.2018.00403. PMID 29755363.
116. ↑ "Enhanced skeletal muscle regrowth and remodelling in massaged and contralateral non-massaged hindlimb". The Journal of Physiology 596 (1): 83–103. January 2018. doi:10.1113/JP275089. PMID 29090454.
117. ↑ "Management of chronic pain using complementary and integrative medicine". BMJ 357. April 2017. doi:10.1136/bmj.j1284. PMID 28438745.
118. ↑ "Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury". Journal of the Neurological Sciences 361: 168–80. February 2016. doi:10.1016/j.jns.2015.12.029. PMID 26810536.
119. ↑ "Non-pharmacological interventions for improving postpartum maternal sleep: A systematic review and meta-analysis". Sleep Medicine Reviews 41: 87–100. October 2018. doi:10.1016/j.smrv.2018.01.005. PMID 29449122.
120. ↑ 120.0 120.1 "Effects of massage intervention on discharged premature infants' weight, parental stress, and parent–child attachment: A randomized controlled trial", Infant Behavior and Development 72, 2023, doi:10.1016/j.infbeh.2023.101867
121. ↑ 121.0 121.1 "Massage therapy research review", Complementary Therapies in Clinical Practice 20: 224–229, 2014, doi:10.1016/j.ctcp.2014.07.002
122. ↑ 122.0 122.1 122.2 122.3 "What Does the Research Say?". Regents of the University of Minnesota. 2006. http://takingcharge.csh.umn.edu/therapies/massage/research.
123. ↑ 123.0 123.1 "Anatomy of a Research Article". Massage Therapy Foundation. 2004. http://www.massagetherapyfoundation.org/pdf/Anatomy of a research article.pdf.
124. ↑ 124.0 124.1 "Massage for low-back pain". The Cochrane Database of Systematic Reviews 2015 (9). September 2015. doi:10.1002/14651858.CD001929.pub3. PMID 26329399.
125. ↑ "What effect can manual therapy have on a patient's pain experience?". Pain Management 5 (6): 455–64. 2015. doi:10.2217/pmt.15.39. PMID 26401979.
126. ↑ "Roller massage decreases spinal excitability to the soleus". Journal of Applied Physiology 124 (4): 950–959. April 2018. doi:10.1152/japplphysiol.00732.2017. PMID 29357488. http://research.library.mun.ca/12893/1/thesis.pdf.
127. ↑ 127.0 127.1 "The effect of two intensities of massage on H-reflex amplitude". Physical Therapy 72 (6): 449–57. June 1992. doi:10.1093/ptj/72.6.449. PMID 1589464.
128. ↑ Weerapong, Pornratshanee; Hume, Patria A.; Kolt, Gregory S. (2005). "The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention". Sports Medicine 35 (3): 235–256. doi:10.2165/00007256-200535030-00004. PMID 15730338.
129. ↑ Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria (2007). "Massage therapy research". Developmental Review 27: 75–89. doi:10.1016/j.dr.2005.12.002.
130. ↑ "How to Become an RMT in Canada" (in en). 2023-11-24. https://www.caringsupport.com/blog/become-registered-massage-therapist-canada.
131. ↑ "Levels" (in en-NZ). https://www.massagenewzealand.org.nz/site/membership/levels.aspx.
132. ↑ "Massage.ca: Massage Therapy Regulations and Licensing in New Zealand". https://www.massage.ca/regulation_and_licensing_nz.html.
133. ↑ "Licensed Massage Practitioner vs. Registered Massage Therapist: What's the Difference Between Them? - Zippia" (in en-US). 2023-09-25. https://www.zippia.com/licensed-massage-practitioner-jobs/licensed-massage-practitioner-vs-registered-massage-therapist-differences/.
134. ↑ "Certified vs Licensed Massage Therapist: Key Differences" (in en-US). 2023-10-30. https://www.massageliabilityinsurancegroup.com/massage-therapist/cmt-vs-lmt/.
135. ↑ "RULES AND REGULATIONS of the NORTH CAROLINA BOARD of MASSAGE & BODYWORK THERAPY". 2021-04-21. https://www.bmbt.org/downloads/Rules/Rules and Regulations.pdf.
136. ↑ "MTASA About Page" (in en-ZA). https://mtasa.co.za/about/.
137. ↑ "RCW 18.130.190: Practice without license—Investigation of complaints—Cease and desist orders—Injunctions—Penalties.". https://app.leg.wa.gov/RCW/default.aspx?cite=18.130.190.
138. ↑ 138.0 138.1 "Overview of Manual Therapy in Canada". The National Center for Complementary and Integrative Health (NCCIH). 10 June 2005. https://nccih.nih.gov/node/3365.
139. ↑ 139.0 139.1 139.2 "Massage Therapy Law and Licensure and States Regulating Massage". Natural Healers. http://www.naturalhealers.com/qa/massage.html.
140. ↑ "Health Professions Act & Regulations". https://www.cmtbc.ca/law-standards/health-professions-act-regulations/.
141. ↑ "Inter-Jurisdiction Competency Standards". 10 June 2012. http://www.cmto.com/cmto-wordpress/assets/Inter-Jurisdictional-Competency-Standards-June-2012.pdf.
142. ↑ Ramzy, Austin (8 July 2014). "To Curb Prostitution, Guangdong Tries to Clean Up Massage Industry". https://sinosphere.blogs.nytimes.com/2014/07/08/to-curb-prostitution-guangdong-tries-to-clean-up-massage-industry/.
143. ↑ Wong, Edward (17 February 2014). "Chinese Officials Widen Campaign Against Vices". The New York Times. https://www.nytimes.com/2014/02/18/world/asia/a-clampdown-on-prostitution-and-gambling-spreads-in-china.html.
144. ↑ "Décret n° 2009-494 du 29 avril 2009 relatif aux études préparatoires et au diplôme d'Etat de masseur-kinésithérapeute" (in fr). Legifrance. http://www.legifrance.gouv.fr/affichTexte.do;jsessionid=7F4C787EF6BFD7F0C51286E82C217E0F.tpdjo09v_1?cidTexte=JORFTEXT000020567935&categorieLien=id.
145. ↑ Menz, Hylton B; Borthwick, Alan M; Potter, Mike J; Landorf, Karl B; Munteanu, Shannon E (2010-12-18). "'Foot' and 'surgeon': a tale of two definitions". Journal of Foot and Ankle Research 3: 30. doi:10.1186/1757-1146-3-30. ISSN 1757-1146. PMID 21167060.
146. ↑ "Code of Ethics in Massage Therapy: Principles & Violation Consequences" (in en). https://study.com/academy/lesson/code-of-ethics-in-massage-therapy-principles-violation-consequences.html.
147. ↑ Sankaran, Ravi; Kamath, Ravindranath; Nambiar, Vivek; Kumar, Anand (2019-04-01). "A prospective study on the effects of Ayurvedic massage in post-stroke patients". Journal of Ayurveda and Integrative Medicine 10 (2): 126–130. doi:10.1016/j.jaim.2018.02.137. ISSN 0975-9476. PMID 30579676.
148. ↑ Shukla, S.S., Saraf, S., Saraf, S. (2011). "Fundamental Aspect and Basic Concept of Siddha Medicines." Systematic Reviews in Pharmacy. doi:10.4103/0975-8453.83439
149. ↑ "Massage parlors avoid the squeeze as bribery remains entrenched". The Myanmar Times. 24 December 2014. https://www.mmtimes.com/opinion/12663-regional-government-happy-to-keep-the-bribes-flowing.html.
150. ↑ 150.0 150.1 Howard, Christopher (24 May 2010). "What the heck are sobadores and pegas?". Liveincostarica.com. http://www.liveincostarica.com/blog/2010/05/what-the-heck-are-sobadores-and-pegas.html.
151. ↑ 151.0 151.1 151.2 Associated, The (24 March 2009). "Mexican tradition of massage lives on in Tijuana". Nydailynews.com. http://www.nydailynews.com/latino/2009/03/25/2009-03-25_mexican_tradition_of_massage_lives_on_in-2.html.
152. ↑ Vanderbilt, Shirley. "Curanderismo: Mexican Folk Healers". Massagetherapy.com. http://www.massagetherapy.com/articles/index.php/article_id/208/Curanderismo:-Mexican-Folk-Healers.
153. ↑ "Levels of Membership". Massage New Zealand. https://www.massagenewzealand.org.nz/Site/membership/levels.aspx.
154. ↑ "Blind S Korea masseurs win case". BBC News. 30 October 2008. https://news.bbc.co.uk/2/hi/asia-pacific/7699114.stm.
155. ↑ "Only in Thailand... You can get a Thai massage for under $5". Chiangrai Bulletin. http://www.chiangraibulletin.com/2013/07/17/only-in-thailand-you-can-get-a-thai-massage-for-under-5/.
156. ↑ "Contemplating Thai Massage Regulation". Massagetoday.com. 21 January 2013. http://www.massagetoday.com/mpacms/mt/article.php?id=13826.
157. ↑ "ITEC – Qualifications for the world". http://www.itecworld.co.uk/.
158. ↑ Awarding world-class qualifications . VTCT. Retrieved on 26 August 2018.
159. ↑ "CNHC Register". https://www.cnhcregister.org.uk/.
160. ↑ "Federation of Holistic Therapists Directory Service". https://www.fht.org.uk/.
161. ↑ "Complementary Therapists Association". http://www.ctha.com/.
162. ↑ "Membership | Complementary Health Professionals | United Kingdom". https://www.complementaryhealthprofessionals.co.uk/.
163. ↑ "2012 Massage Therapy Industry Fact Sheet". American Massage Therapy Association. https://www.amtamassage.org/uploads/cms/documents/amta2012_industryfactsheet.pdf.
164. ↑ "Massage Graduate Numbers on the Rise". July 21, 2023. https://www.abmp.com/updates/news/massage-graduate-numbers-rise.
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169. ↑ 169.0 169.1 "Beyond the Body Wrap: What Makes a Spa Stand Out?". The New York Times. 15 July 2007. https://www.nytimes.com/2007/07/15/business/yourmoney/15spa.html.
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