Massage

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Massage
This article is part of the branches of CAM series.
Complementary and alternative medicine Classifications
NCCAM:	Manipulative and body-based methods
Modality:	Professionalized

Massage in Frankfurt, Germany.

Massage is the treatment and practice of manipulation of the soft body tissues with physical, functional, i.e. mechanical, medical/therapeutic, and in some cases psychological purposes and goals. The word comes from the French massage "friction of kneading," possibly from Arabic massa "to touch, feel, handle" or from Latin massa "mass, dough". (In distinction the ancient Greek word for massage itself was anatripsis , and the Latin was frictio.)

Massage involves acting and manipulating the patient's body with pressure (structured, unstructured, stationary, and/or moving), tension, motion, or vibration done manually or with mechanical aids. Target tissues may include muscles, tendons, ligaments, skin, joints, or other connective tissue, as well as lymphatic vessels, and/or organs of the gastrointestinal system. Massage can be applied with the hands, fingers, elbows, forearm, and feet. There are over eighty different massage modalities. The most cited reasons for introducing massage was patient demand and perceived clinical effectiveness.

In professional settings, massage involves the client being treated while lying on a massage table, sitting upright in a massage chair, or lying on a pad on the floor. Except for modalities such as Acupressure, Shiatsu, Tui Na, Thai Massage, or Barefoot Deep Tissue, the massage subject is generally unclothed or partially unclothed, also referred to as disrobed, and their body would be "draped" with towels or sheets.

History

Ancient and medieval times

Writings on massage have been found in many ancient civilizations such as Rome, Greece, Japan, China, Egypt, and India. Hippocrates wrote in 460 BC that "The physician must be experienced in many things, but assuredly in rubbing." The ancient Chinese book called Huangdi Neijing by the Yellow Emperor recommended "massage of skin and flesh." The technique of massage abortion, involving the application of pressure to the pregnant abdomen, has been practiced in Southeast Asia for centuries. One of the bas reliefs decorating the temple of Angkor Wat in Cambodia, dated circa 1150, depicts a demon performing such an abortion upon a woman who has been sent to the underworld. This is believed to be the oldest known visual representation of abortion. In Romania some illnesses were treated by a massage in which the patient was treaded on by a tame bear..

Modern times

United States: Massage started to become popular in the United States in the middle part of the 1800s and was introduced by two New York physicians based on Per Henrik Ling's techniques developed in Sweden.

During the 1930s and 1940s massage's influence decreased because of recent medical advancement, while in the 1970s massage's influence grew once again with a notable rise among athletes. Massage was used up until the 1960s and 1970s by nurses to help ease patients’ pain and help them sleep.

Because it is illegal to advertise or offer sexual services in most of the United States, such services are sometimes advertised as "massage".

United Kingdom: Massage is popular in the United Kingdom today and gaining. There are many private practitioners working from there own premises as well as those who operate from commercial venues.

Massage in sports, business and organizations: The 1996 Summer Olympics in Atlanta was the first time that massage was offered as a core medical service. Massage has been employed by businesses and organizations such as the U.S. Department of Justice, Boeing and Reebok.

Equipment

Massage Table

Massage table used in Kerala-style Ayurveda Abhyanga massage.

A typical commercial massage table has an easily cleaned, heavily padded surface, and a horseshoe-shaped head support that allows the client to breathe easily while lying face down and can be stationary or portable. An orthopedic pillow or bolster can be used to correct body positioning.

Massage Chair

Mechanical massage chairs at VivoCity in Singapore.

Ergonomically designed massage chairs for positioning a person who will be receiving a massage, similar in function to a massage table. Chairs may be either stationary or portable models.

Massage chairs are easier for the practitioner to maneuver than massage tables, and clients 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.

Oil

Many different types of oils can be used including fractionated coconut oil, grape seed oil, macadamia oil, sesame oil, pecan oil, and mustard oil. Arnica, from the flowers or leaves of the Arnica montana. Often uses olive oil as a base when used medicinally, or almond oil when used as a massage oil. Aromatherapy oils such as neroli oil and pine oil can also be mixed with carrier oils.

Mechanical aids

Electronic massage chairs are commercially available, which operate without any manual help. Lexus cars of the fourth generation LS include shiatsu and shoulder massage systems.

Massage methods

Different specialized massage methods sorted in alphabetical order.

Massage can be performed by a professional Massage Practitioner, or by other health care professionals, such as chiropractors, osteopath, Athletic trainers, and/or physical therapists. Massage therapists work in hospitals as allied health professioners, in nursing homes, sports and fitness facilities, spas, beauty salons, cruise ships, private offices, and travel to private residences or businesses. Contraindications to massage include, deep vein thrombosis, bleeding disorders or taking blood thinners such as Warfarin, damaged blood vessels, weakened bones from cancer, osteoporosis, or fractures, and fever.

Acupressure

Main article: Acupressure

Ayurvedic Abhyanga massage

Traction Massage in marma therapy given in Sreepathy cvn kalari for inter vertebral disc prolapse

Ayurveda is a natural health care system originating in India over 5,000 years ago. It incorporates massage, yoga, meditation and herbal remedies. Ayurvedic Massage, also known as Abhyanga part of Panchakarma is usually performed by one or two therapists using a heated blend of herbal oils that are believed to be based on the body's dosha.The aim is to loosen the excess doshas through techniques such as kneading, rubbing, and squeezing. The feet are used in chavutti thirummal, a specialized technique where the therapist suspends himself by a rope from the ceiling to apply extra pressure with his feet.

Barefoot deep tissue

Barefoot deep tissue is a blend of Eastern barefoot techniques with Western manual therapy. Clients typically wear loose clothes while lying on a mat on the floor in supine, prone and side-lying positions with pillows or bolsters with no oil used. Because the therapist can apply a broad range of pressure with ease and does not have to strain, more effort and concentration can be used to sense and manipulate tissue, release fascia, as well as search for and attack trigger points, regardless of client's size or build. John Harris, who worked in the 1984 Olympics developed this modality.

Bowen therapy

Main article: Bowen therapy

Bowen technique involves a rolling type movement over fascia, muscles, ligaments, tendons and joints. It is said not to involve deep or prolonged contact with muscle tissues as in most kinds of massage, but claims to relieve muscle tensions and strains and to restore normal lymphatic flow. It is based on practices developed by Australian Tom Bowen.

Chair massage at Novell BrainShare 2007.

Breema

Main article: Breema

Breema bodywork is performed on the floor with the recipient fully clothed. It consists of rhythmical and gentle leans and stretches. Fifty minute sessions are common. There are also self-Breema exercises. The essence of Breema is expressed in the Nine Principles of Harmony.

Chair massage

"Seated massage" (also refereed to as chair-massage), is done in a variety of diverse settings, e.g., business,corporate and clinical settings, and in public areas such as airports, shopping centers, sport clubs, and salons. A seated-massage typically lasts 10-30 minutes, and is performed while fully clothed. Seated massage is an excellent technique to use for working on the neck, shoulders and upper back areas of the body. Due to the way the individual is positioned, seated massage allows the therapist to work with the force of gravity while doing a treatment.

"Champie" (Indian Head Massage) in Mumbai, Maharashtra, India.

Champissage

Main article: Champissage

Champissage or (Indian head massage) has been used in India for centuries. It combines massage with the more subtle form of chakra balancing. It is normally done by applying oil over the body. Also called 'champi' or Maalis. The word shampoo in English usage dates back to 1762, with the meaning "to massage". The word was a loan from Anglo-Indian shampoo, in turn from Hindi chāmpo (चाँपो Template:IPA), imperative of chāmpnā (चाँपना Template:IPA), "to smear, knead the muscles, massage". It itself comes from Sanskrit/Hindi word "champā" (चम्पा Template:IPA), the flowers of the plant Michelia champaca which have traditionally been used to make fragrant hair-oil. It is often performed by the barber after a haircut on the head, shoulders, arms, and neck.

The term and service was introduced by a Bengali entrepreneur Sake Dean Mahomed, who opened a shampooing bath known as 'Mahomed's Indian Vapour Baths' in Brighton, England in 1759.

Craniosacral therapy

Main article: Craniosacral therapy

Craniosacral therapy is a gentle, hands-on method of evaluating the functioning of the craniosacral system, and is often mistakenly referred to as a type of massage. It works through using the body's own self-correcting mechanisms rather than the application of physical force from the practitioner. When used by a massage practitioner, craniosacral therapy can usefully complement the massage treatment,

Deep tissue massage

Deep tissue techniques are generally designed for more focused massage work. Working a specific joint, muscle or muscle group, the practitioner can access deeper layers of the soft tissue. Starting superficially and easing into the depth of the muscle slowly often allows more movement. If the pressure is applied too deeply or too quickly, the muscle may tighten to protect that area, and unnecessary damage or inflammation can be induced. Very little lubricant is used as the pressure doesn't travel much over the skin.

The most commonly used 'tools' during deep tissue massage may include, 3 and 6 fingers, reinforced fingers, knuckles, a flat elbow, opposing thumbs, the heel of the hand or foot, and the forearm. Deep tissue is similar to Myofascial Release.

Deep muscle therapy was created by Therese Pfrimmer of Canada.

Horstmann technique

Practical technique that works by initially balancing the "energy field" and then holding on special energy points while mobilising limbs.

Esalen Massage

Main article: Esalen Massage

Esalen Massage was developed by Charlotte Selver and works with gentle rocking of the body, passive joint exercises and deep structural work on the muscles and joints, together with an energetic balancing of the body.

Infant massage

Shantala massage is an ancient Indian massage technique with a rhythmic character, given to massage babies and children. It was introduced into Western society by Dr. Frederique Leboyer, a French obstetrician.

Lomilomi

Main article: Lomilomi

Massage in Tarifa, Spain.

Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The styles most known today are those of Auntie Margaret Machado of the island of Hawaii, Uncle Kalua Kaiahua of Maui and Oahu, and Kahu Abraham Kawaii of Kaua'i, who called his style Kahuna Bodywork. Other names given to massage performed in Hawaii are temple style, lomi lomi, lomi lomi nui, romi kapa rere, romi romi and ma-uri. Some of these styles may be traditional, and others may have been influenced by or created in modern times. The purported Lomilomi massage given by Barbra Streisand to Robert De Niro in "Meet the Fockers" was not an accurate representation of the style.

Medical massage

Massage used in the medical field includes Manual lymphatic drainage used for lymphedema which can be used in conjunction with the treatment of breast cancer. 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. However, it is less effective than pharmaceutical management of SVT with verapamil or adenosine.

Myofascial release

Myofascial release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia, integument, and muscles with the goal of eliminating pain, increasing range of motion and equilibrioception. Injuries, stress, trauma, overuse and poor posture can cause restriction to fascia. This is usually done by applying shear compression or tension in various directions, or by skin rolling. Myofascial release originators come from Physical Therapy and from Structural Integration (Rolfing); its current developers include John Barnes, Art Riggs, Michael Stanborough, Tom Myers, Til Luchau and Michael Leahy, the originator of a complete regime called Active Release Technique or ART.

Proprioceptive Neuromuscular Facilitation (PNF) and myofacial techniques are believed to lengthen tight/facilitated muscles while fiber activation techniques are believed tone weak/inhibited muscles.

Neuromuscular therapy

Neuromuscular Therapy (NMT) is used for pain relief. Perceived imbalances in Human position are assessed initially through a postural assessment. These are then addressed through systematic and site specific massage. NMT was developed in the 1930s by Dr. Stanley Leif, current practitioners include Paul St. John.

Nihon Kaifuku Anma - Traditional Japanese massage

Introduced to Japan about 1300 years ago. Anma is deep tissue work using no oils and is based on kneading movements. Shiatsu massage grew out of this rich tradition.

Pregnancy massage

Doulas will often use massage in an attempt to smooth the labor process.

Reflexology massage

Pebble massage sandals from Dalian, China.

Reflexology, also called Foot zone therapy, is traditionally practiced without lotion, as the pressure points on the feet are stimulated by thumb and finger walking, as well as static pressure. Foot massage practitioners believe that the ailment of an internal organ will be associated with the nerve ending on the sole of the foot. As pressure is applied to the sole, theory holds that a healthy patient should not feel any strong pain. This theory is based on a perceived energetic flow of "meridians" in the body, also known as Chi.

Before the massage, the patient's feet are soaked for about ten minutes in a foot bath, typically a solution of hot water and Chinese herbs. The practitioner rubs and massages the painful spots to break down rough spots and accumulated crystals which have not been scientifically researched. Based on this idea, some shoe liners are made with pressure points to stimulate the soles of the feet.

Shiatsu

Main article: Shiatsu

Shiatsu (指圧) is a form of Japanese massage that uses thumb pressure and works along the same energy meridians as acupressure and incorporates stretching. While receiving Shiatsu, you are fully clothed while laying on a mat on the floor.

Soft tissue therapy

Treatment techniques include trigger point therapy, myofascial Release, friction for adhesions between fascial layers and muscles. Sustained finger pressure to alleviate hypertonic, or tight, areas within muscle and fascia, active Release therapies, and deep tissue massage are all derivatives of soft tissue therapy. Different types of stretching such as static stretching, dynamic stretching, and/or PNF stretching (proprioceptive neuromuscular facilitation).

Another form of Soft tissue therapy is Muscle energy technique (MET) which uses reciprocal inhibition (RI) which is when the therapist uses a client’s muscle to stretch the opposing muscle. The therapist takes the muscle that they are wishing to stretch to its full range of motion. The therapist then gets the client to use the opposing muscle by moving away from the therapist. When the client relaxes the therapist then moves the muscle in an attempt to realign the muscle fibers.

Massage therapist working at a Triathlon in Fremantle, Western Australia, Australia.

Sports massage

A Sports Massage can be described as massage that has derived from the Swedish style massage specifically to treat sporting injuries and sports persons, pre and post-event. The same techniques of effleurage, petrissage, friction, tapotement, compression, and vibration are employed; however, the movements are often reinforced, which makes the effect much deeper, and are usually targeted towards specific muscles and tissues to treat them in isolation, as well as holistically. A Sports Massage may involve treating the entire body, as part of a training routine, or more usually a specific area is treated due to a particular muscle strain or injury. Due to the nature of various sports and athletic pursuits, clients may attend for treatment with recent injuries. Direct pressure over the injury site is specifically contra-indicated for 48-72 hours after the occurrence; this over and above the standard massage contra-indications.

Neuro Muscular Technique (NMT) and Muscle Energy Technique (MET) are often used by the Sports Massage Therapist to treat high degrees of tension or 'knotting' of specific muscles. These techniques are extremely useful in relaxing the muscles sufficiently to allow the therapist perform a more standard massage routine.

A hot stone massage being performed in Oxnard, California.

Stone massage

Heated stones were used by Egyptians, Native Americans and in Lomilomi massage. Smooth hot or cold stones, usually basalt or marble, are used to massage the body. When heated stones are used, muscles relax, allowing the massage therapist to work deeper into the muscle. Energy medicine is sometimes incorporated into stone massage. Stones are heated in hot water and are placed under the back, along both sides of the spine, and on top of the torso and are believed to heat the chakra or meridians centers. Heated stones coated in oil are then used directly in the hands of the therapist delivering various massaging strokes.

Structural Integration

Rolfing, a method of Structural Integration, works with realigning the body structurally and human gait.

Swedish massage

This style utilizes long, flowing strokes, often but not necessarily in the direction of the heart. There are six basic strokes: effleurage from the French effleurer, 'to skim over', petrissage from the French pétrir, 'to knead', friction, tapotement, compression, and vibration. Petrissage is a kneading movement with the whole palm or finger tips, using wringing, skin rolling, compression, and/or lifting. Petrissage is usually applied vertically to the muscle tissue. Oil, cream, or lotion is applied on the skin to reduce friction and allow smooth strokes. Effleurage consists of long, flowing or gliding strokes, performed with open hands. In many massage sessions, effleurage is used as the initial type of stroking, as it has a calming effect when performed slowly. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks.

History

This style of massage is generally attributed to the Swedish fencing master and gymnastics teacher Per Henrik Ling (1776-1839). However, it was in fact the Dutch practitioner Johan Georg Mezger (1838-1909) who adopted the French names to denote the basic strokes. The term Swedish Movement System was transposed to Swedish Massage System sometime during the second half of the 19th century. Ling’s system was the Swedish Movement System or Swedish Gymnastic Movement System. This may be how he has become incorrectly associated for so long with Swedish massage.

The Aikikai foundation of the Japanese martial art Aikido incorporates massage into their routine, in Slovenia.

Tai Ji/Tai Chi massage

This massage uses the natural principles of Yin and Yang to achieve balance in the energies of the body. Practitioners of Tai Ji believe that it uses Tao and deals with Qi blockages.

Thai massage

Main article: Thai massage

Known in Thailand as นวดแผนโบราณ (Nuat phaen boran, IPA Template:IPA), meaning "ancient/traditional massage", Thai massage is also known as Thai ancient massage, traditional Thai massage, Thai yoga massage, yoga massage, Thai classical massage, Thai bodywork, passive yoga or assisted yoga. Thai massage originated in India based and is based on Ayurveda and yoga, thereafter becoming popular in ancient Siam, now known as Thailand. It was believed that the massage art was brought over to Thailand by Shivago Komarpaj (Jivaka Kumarabhacca), a contemporary of Gautama Buddha over 2500 years ago. The receiver is put into many yoga like positions during the course of the massage. In the northern style based out of Chiang Mai, Thailand there is a lot of stretching movements, unlike the southern style where acupressure is emphasized.

Drawings of accupressure points on Sen lines at Wat Pho temple in Phra Nakhon district, Bangkok, Thailand.

The massage recipient changes into loose, comfortable clothes and lies on a mat or firm mattress on the floor. (It can be done solo or in a group of a dozen or so patients in the same large room.) The massage practitioner leans on the recipient's body using hands and usually straight forearms locked at the elbow to apply firm rhythmic pressure. The massage generally follows the Sen lines on the body — somewhat analogous to meridians or Channel (Chinese medicine) and Indian nadis. Legs and feet of the giver can be used to fixate the body or limbs of the recipient. In other styles, hands fixate the body, while the feet do the massaging action. Oil is not used in traditional Thai Massage. A full Thai massage session typically lasts two hours or more, and includes rhythmic pressing and stretching of the entire body; this may include pulling fingers, toes, ears, cracking the knuckles, walking on the recipient's back, and arching the recipient's into bhujangasana or (cobra position). There is a standard procedure and rhythm to this massage. In Thailand a two hour massage might cost around 300 Thai baht (US $8 in 2005) depending on location (it may cost ten times more inside a five star hotel).

Nuat phaen boran or Thai massage, side-lying position in Frankfurt, Germany.

Note: The traditional therapeutic practice of Thai massage should not be confused with the sexual service of the same name that is available in some hotels and brothels. Sometimes the traditional therapeutic Thai Massage, or ancient massage, is referred to as "old lady massage", while the sexual practice, which has nothing to do with therapeutic traditional massage is called "young lady massage".

Traditional Chinese massage

Tui Na (推拿) focusing on pushing, stretching and kneading the muscle. Zhi Ya (指壓) is similar to Tui Na massage except it focuses more on pinching and pressing at acupressure points. They are both based on principles from Traditional Chinese Medicine.

Trager Approach

Main article: Trager Approach

The Trager Approach combines movement, massage and education.

Trigger point therapy

This can also be called pressure point massage. A trigger point is an area of a muscle (about 50 cells) that may refer pain sensations to other parts of the body. Manual pressure is applied to these points. This work was founded by Dr. Janet G. Travell, U.S. President John F. Kennedy's physician and David Simons. This work can be incorporated into other styles of massage therapy such as neuromuscular therapy (NMT) or Swedish.

Visceral manipulation

One form is Mayan abdominal massage which is practiced in many countries in Latin America. This type of massage was developed by Don Elijio Panti and Dr. Rosita Arvigo of Peru.

Mantak Chia introduced a form of abdomen massage called Chi Nei Tsang, which he teaches, helps to "clears negative emotions" (in the form of "bad winds" or "sick winds") which gather near the navel.

Massager Jacuzzi in the Santiago Bernabéu Stadium.

Watsu

Main article: Watsu

Watsu is the combination of hydrotherapy and Shiatsu developed by Harold Dull in his time spent at Harbin Hot Springs near Middletown, California, USA. The work is done in skin temperature water with both the therapist and practitioner in the water, usually a pool which is between 3.5 ft to 4 ft. (100–120 cm) deep. The work entails much movement in the water and practitioners believe that it incorporates the activation of the energy lines derived from Shiatsu.

Associated methods

Many types of practices are associated with massage and include Bodywork (alternative medicine), manual therapy, energy medicine, and breathwork. Other names for massage and related practices include hands-on work, body/somatic therapy, and somatic movement education. Body-mind integration techniques stress self-awareness and movement over physical manipulations by a practitioner. Therapies related to movement awareness/education are closer to Dance and movement therapies. Massage can also have connections with the New Age movement and alternative medicine as well as being used by mainstream medical practitioners.

Beneficial effects

Peer-reviewed medical research has shown that the benefits of massage include pain relief, reduced trait anxiety and depression, and temporarily reduced blood pressure, heart rate, and state anxiety. Theories behind what massage might do include blocking nociception (gate control theory), activating the parasympathetic nervous system which may stimulate the release of endorphins and serotonin, preventing fibrosis or scar tissue, increasing the flow of lymph, and improving sleep but such effects are yet to be supported by well designed clinical studies.

Massage is hindered from reaching the gold standard of scientific research which includes placebo-controlled and double blind clinical trials. Developing a "sham" manual therapy for massage would be difficult since even light touch massage could not be assumed to be completely devoid of effects on the subject. 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. Massage can employ randomized controlled trials which are published in peer reviewed medical journals. This type of study could increase the credibility of the profession because it displays that purported therapeutic effects are reproducible.

Single dose effects

Pain relief: Relief from pain due to musculoskeletal injuries and other causes is cited as a major benefit of massage. In one study, cancer patients self-reported symptomatic relief of pain. This study, however, did not include a no treatment or placebo control group so these effect may be due to the placebo effect or regression towards the mean. Massage can also relieve tension headaches. Acupressure or pressure point massage may be more beneficial than classic Swedish massage in relieving back pain. However, a meta-study conducted by scientists at the University of Illinois at Urbana-Champaign failed to find a statistically significant reduction in pain immediately following treatment.

State anxiety: Massage has been shown to reduce state anxiety, a transient measure of anxiety in a given situation.

Blood pressure and heart rate: Massage has been shown to reduce blood pressure and heart rate as temporary effects.

Attention: After massage, EEG patterns indicate enhanced performance and alertness on mathematical computations, with the effects perhaps being mediated by decreased stress hormones.

Other: Massage also stimulates the immune system by increasing peripheral blood lymphocytes (PBLs). However, this immune system effect is only observed in aromatherapy massage, which includes sweet almond oil, lavender oil, cypress oil, and sweet marjoram oil. It is unclear whether this effect persists over the long term.

Multiple dose effects

Pain relief: When combined with education and exercises, massage might help sub-acute, chronic, non-specific low back pain. Furthermore, massage has been shown to reduce pain experienced in the days or weeks after treatment.

Trait anxiety: Massage has been shown to reduce trait anxiety; a person's general susceptibility to anxiety.

Depression: Massage has been shown to reduce subclinical depression.

Diseases: Massage, involving stretching, has been shown to help with spastic diplegia resulting from Cerebral palsy in a small pilot study. The researchers warn that these results should "be viewed with caution until a double-blind controlled trial can be conducted".

Massage has been used in an effort to improve symptoms, disease progression, and quality of life in HIV patients, however, this treatment is not scientifically supported.

Regulation

In the USA there are about 90,000 massage therapists. Training programs in the US are typically 500–1000 hours in length, and can award a certificate, diploma, or degree depending on the particular school. There are around 1,300 programs training massage therapists in the country and study will often include anatomy and physiology, kinesiology, massage techniques, first aid and CPR, business, ethical and legal issues, and hands on practice along with continuing education requirements if regulated. The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S.. 38 states and the District of Columbia require some type of licencing for massage therapists. In the US, 32 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. The National Board grants the designation Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). There are two tests available and you can become certified through a porfolio process if you have equivalent training and experience. Between 10-20% of towns or counties regulate the profession. 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 reguarding sale of sexual services.

In the USA 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.

In Canada only three provinces regulate massage therapy they are British Columbia, Ontario, and Newfoundland and Labrador. The Canadian Massage Therapists Alliance (CMTA) has set a level of 2200 practice hours in Ontario, and Newfoundland and Labrador and 3000 hours in British Columbia. In India, massage therapy is licenced by The Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of Health and Family Welfare (India) in March of 1995.

Because the art and science of massage is a globally diverse phenomenon, different legal jurisdictions sometimes recognize and license individuals with titles. Examples are:

• Registered Massage Therapist (RMT) Canada
• Certified Massage Therapist (CMT)
• Licensed Massage Practitioner (LMP)
• Licensed Massage Therapist (LMT)
• Licensed Massage and Bodywork Therapist (LMBT) North Carolina

Prevalence in the United States

In 1997 there was an estimated 114 million visits to massage therapists in the US. Massage therapy is the most used type of Complementary and alternative medicine in hospitals in the United States.

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.

In a poll of 25-35 year olds 79% said they would like their health insurance plan to cover massage. Some of the companies that offer massage to their employees include Allstate, Best Buy, Cisco Systems, FedEx, Gannett (which runs USA Today), General Electric, Hewlett-Packard, Home Depot, JC Penney, Kimberly-Clark, Texas Instruments and Yahoo. In 2006 Duke University Health System opened up a center to integrate medical disciplines with CAM disciplines such as massage therapy and acupuncture, this trend was started by Andrew Weil. There were 15,500 spas in the United States in 2007 with about a third of the visitors being men.

The number of visits rose from 91 million in 1999 to 136 million in 2003, generating a revenue that equals $11 billion.

Prevalence in Asia

Foot massages given by blind therapists in Sabah, Malaysia.

In Asia, bathroom attendants may provide a hot face towel and a massage.

Notable practitioners

Heinrich Himmler, commander of the Schutzstaffel (SS) and one of the most powerful men in Nazi Germany might have lost faith in German victory due to his discussions with his masseurs Felix Kersten and Walter Schellenberg. Albert Bedane (1893–1980) who provided shelter to a Jewish woman and others during World War II was a massage/physiotherapist.

See also

• Massage therapist organizations
• Haptics study of human touching behaviour
• U.S. National Center for Complementary and Alternative Medicine
• Acupuncture
• Physical medicine and rehabilitation
• Erotic Massage
• Wilhelm Reich
• Feldenkrais method
• Neo-Reichian massage
• Kinetic Awareness
• Silas Weir Mitchell
• Fire cupping
• Eutony
• Bartenieff Fundamentals
• Laban Movement Analysis
• Spondylosis
• Adams Approach
• Osteopathy
• Joint manipulation
• Joint mobilization
• Spinal manipulation
• Spinal mobilization
• Spinal manipulative therapy
• Traction
• Applied Kinesiology

• Dorn method
• Autogenic training
• Body Psychotherapy
• Psychotherapeutic Postural Integration
• Kinetic Awareness
• Kripalu Center
• Kinetic Awareness
• Emf balancing technique
• Lomilomi
• Bioenergetic analysis
• Subtle body
• Liniment
• Pilates
• Jacobson's Progressive Muscle Relaxation
• Somatic psychology
• Somatherapy
• Carpal tunnel syndrome
• Psychotherapeutic Postural Integration

• Naprapathy
• Herbalism or phytotherapy
• Shoulder problems
• Palliative care
• Spinal disc herniation
• Back pain
• Anthroposophical medicine
• Repetitive strain injury
• Erythema
• Michael Shermer
• Sebastian Kneipp
• Jin Shin Do
• Health care in Japan
• Seitai
• Natural health
• Pushing hands
• Wikipedia:MeSH E02
• Ita Wegman
• Mabel Todd
• Alexander Lowen
• Heinrich Jacoby
• Elsa Gindler

External links

• Massage How To Videos
• Massage Therapy: Riddled with Quackery
• Glossary of bodywork
• How Massage Works