Massage

People in every culture have rubbed and pressed painful areas with their hands since ancient times. The classic Chinese medical text *The Yellow Emperor’s Inner Canon* describes anmo (massage) as a way to care for the body, and Hippocrates of ancient Greece wrote that physicians should be skilled in rubbing techniques. In India’s Ayurveda, rubbing the whole body with warm oil also became part of everyday life.

The framework of Western massage as we know it today took shape in 19th-century Europe. Sweden’s Pehr Henrik Ling organized manual techniques for working with the body alongside gymnastics, and Dutch physician Johann Mezger named and systematized basic movements such as stroking, kneading, and tapping. This formed the foundation of Swedish massage, from which various adapted styles later developed.

• Swedish massage — Combines five basic movements—stroking, kneading, rubbing, tapping, and vibration—to gently relax the whole body. It is a straightforward starting point if you are new to massage.
• Deep tissue massage — Uses slow, deep pressure to work on the deeper layers of muscle and fascia. People seek it out when they want focused work on areas of longstanding tightness, such as the shoulders or lower back.
• Sports massage — Varies speed and intensity to get the body ready before exercise and support recovery afterward.
• Aromatherapy massage — Focuses on easing tension and stress through scented oils and gentle touch.
• Trigger point therapy — Identifies firm knots within muscles and applies sustained pressure to release them. It is often used for neck and shoulder stiffness.
• Acupressure — An Eastern technique that applies sustained pressure to designated points on the body with the fingers and palms. For its schools, see Shiatsu styles and lineages.
• Thai massage — Combines pressing and stretching while you remain clothed, without oil. It appeals to people whose bodies feel stiff and do not stretch easily.
• Manual lymphatic drainage — Uses very light stretching of the skin to support lymph flow and is used to manage swelling.

Other branches include Hawaii’s Lomilomi, China’s Tui na, reflexology, which applies pressure to reflex points on the feet and hands, and pediatric massage for babies.

Despite differences in style, many people notice similar changes after a massage.

• The body and mind relax. Massage with an appropriate amount of pressure eases tension and allows the body to enter a comfortable resting state. Heart rate and blood pressure fall, and the stress hormone cortisol also decreases temporarily.
• Soreness and stiffness ease. Tight muscles soften, making it easier to turn the neck or move the shoulders.
• Mood feels lighter, and sleep comes more easily. Anxiety settles, and many people report sleeping soundly on the night after a massage.
• Post-exercise muscle soreness is reduced. Athletes often use massage as a recovery method to ease delayed onset muscle soreness, which appears the day after exercise.

These changes involve not only the pressure of the hands but also warm touch, a quiet setting, and trust in the practitioner. The emotional reassurance that comes from touch is also an important part of massage’s effects.

Many people think of post-exercise massage as “flushing out lactic acid,” but the body processes lactic acid on its own within one or two hours after exercise. Massage feels soothing because muscle tension eases and sensations become more comfortable.

Our skin transmits the sensation of touch to the brain through two pathways.

• Discriminative touch: This is handled by thick, fast nerve fibers (Aβ fibers), which are abundant in the fingertips and palms. They accurately convey where pressure is applied and how strong it is.
• Affective touch: This is handled by thin, slow nerve fibers (C-tactile afferents), which are abundant in hairy skin, such as on the arms and back. They respond best to slow stroking at about 1–10cm per second and to warm touch at a temperature close to that of the skin.

Signals from affective touch travel to brain regions involved in sensing emotions and the body’s internal state. Rather than identifying a location, they create feelings such as “this feels pleasant” or “I feel at ease.” This is also why long, slow strokes down the back with warm hands can help the mind relax as well. This kind of contact is also understood to be associated with oxytocin, a hormone related to bonding.

This also helps explain why massage feels less comfortable when the practitioner’s hands are cold or the movements are rushed. The warmth of the touch and its unhurried rhythm influence comfort just as much as the technique used.

During a massage, the area being touched becomes warm and slightly red. This happens because pressing and rubbing dilate blood vessels near the skin and muscles, increasing blood flow in that area. This change gradually returns to baseline over time after the massage ends.

The calf muscles provide the main force that pushes blood and lymph from the legs toward the heart. Each time you walk, the calves contract and squeeze the veins, which is why they are called the “second heart.” When you stand or sit for a long time, this pump stops working, making the legs more likely to swell.

If your legs tend to swell, move your body frequently as well as getting massage. Combining massage strokes from the toes toward the knees with ankle pump exercises and short walks, and resting with your legs raised slightly above your heart, can help them feel lighter. For more details, see Venous circulation and Lower limb edema.

Medical massage

Medical massage is not a single defined technique, but a broad term for massage that targets a particular physical concern. It is used in various ways: for massage provided in hospitals or rehabilitation facilities, massage aimed at discomfort in a specific area such as the lower back or neck, and the names of training courses. The name alone does not tell you what pressure will be used, which areas will be treated, or for how long, so it is helpful to ask beforehand what the session involves, how long it lasts, and whether exercise is included.

Rehabilitation massage

Rehabilitation massage is massage received while regaining physical function after an injury or surgery. In the early stages, when movement is limited, gentle touch eases tension in the surrounding muscles and helps the body feel comfortable. Once exercise begins in earnest, massage helps prepare the body before exercise and supports recovery afterward. Progressive exercise is what strengthens muscles and tendons; massage plays a supporting role in making that process more comfortable. For an overview, see Rehabilitation.

Biodynamic massage

Biodynamic massage is an approach developed in the 1960s–70s by Gerda Boyesen, a Norwegian-born psychologist and physical therapist. It combines massage techniques with the perspective of body psychotherapy, which considers the body and mind together. This approach views accumulated emotions and tension as remaining in the body, and works to release that tension through touch and attention to breathing and bodily sensations. Another feature of this approach is interpreting stomach rumbling during massage as a sign that tension is being released. For other methods that address the body and mind together, see Bodywork.

How often is suitable depends on why you are getting massage.

• For rest and stress management: It is helpful to receive massage regularly at intervals that suit your routine and budget, such as once every 2–4 weeks. Notice how many days the relaxed feeling lasts afterward, and use that to decide the interval.
• For tightness in a specific area: Start with shorter intervals, such as about once a week, and gradually space sessions out as your body improves. If the same area quickly tightens again, look at your posture and work habits as well.
• Alongside exercise: Avoid deep pressure immediately before an important competition and keep the massage light. After intense exercise, allowing a day or two before a massage can prevent the soreness from overlapping.

More frequent massage is not necessarily better. Strong pressure every day leaves tired muscles no time to rest, so it is helpful to give your body enough time to recover on its own after a session.

• Ask for a comfortable level of pressure. Harder pressure does not necessarily release tension more effectively. If you feel pain, do not endure it; feel free to say, “Please use a little less pressure,” at any time.
• Explain your health circumstances beforehand. If you are pregnant, take medication because your bleeding does not stop easily, or have a recent injury or varicose veins, the practitioner will adjust the pressure and areas treated.
• Avoid massage immediately after a meal, and drink water and rest afterward. You may feel a little sore the next day, but this usually settles within a day or two. For details, see Post-massage soreness.