Massage involves working and acting on the body with pressure – structured, unstructured, stationary, or moving – tension, motion, or vibration, done manually or with mechanical aids. Massage can be applied with the hands, fingers, elbows, knees, forearm, feet, or a massage device. Massage can promote relaxation and well-being, can be a recreational activity, and can be sexual in nature (see Erotic massage).
In professional settings massage clients are treated while lying on a massage table, sitting in a massage chair, or lying on a mat on the floor, while in amateur settings a general purpose surface like a bed or floor is more common. Aquatic massage and bodywork is performed with recipients submersed or floating in a warm-water therapy pool. The massage subject may be fully or partially clothed or unclothed.
The word comes from the French massage “friction of kneading”, or from Arabic massa meaning “to touch, feel” or from Latin massa meaning “mass, dough”, cf. Greek verb μάσσω (massō) “to handle, touch, to work with the hands, to knead dough”. In distinction the ancient Greek word for massage was anatripsis, and the Latin was frictio.
Ancient and medieval times
BC 722-481: Huangdi Neijing is composed during the Chinese Spring and Autumn period (the beginning of recorded history). The Nei-jing is a compilation of medical knowledge known up to that date, and is the foundation of Traditional Chinese Medicine. Massage is referred to in 30 different chapters of the Nei Jing. It specifies the use of different massage techniques and how they should be used in the treatment of specific ailments, and injuries. Also known as “The Yellow Emperor’s Inner Canon”, the text refers to previous medical knowledge from the time of the Yellow Emperor (approx 2700 BC), misleading some into believing the text itself was written during the time of the Yellow Emperor (which would predate written history).
BC 500 Jīvaka Komarabhācca, also known as Shivago Komarpaj, the founder of Traditional Thai massage (Nuad Boran) and Thai medicine. According to the Pāli Buddhist Canon, Jivaka was Buddha‘s physician. He codified a healing system that combines acupressure, reflexology, and assisted yoga postures. Traditional Thai massage is generally based on a combination of Indian andChinese traditions of medicine. Jivaka is known today as “Father Doctor” in Thailand.
BC 300 Charaka Samhita believed to be 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.
AD 581: China establishes a department of massage therapy within the Office of Imperial Physicians.
Middle-Ages: Medical knowledge, including that of massage, made its way from Rome to Persia in the Middle Ages. Many of Galen’s manuscripts, for instance, were collected and translated by Hunayn ibn Ishaq in the 9th century. Later in the 11th century copies were translated back into Latin, and again in the 15th and 16th centuries, when they helped enlighten European scholars as to the achievements of the Ancient Greeks. This renewal of the Galenic tradition during the Renaissance played a very important part in the rise of modern science.
One of the greatest Persian medics was Avicenna, also known as Ibn Sina, who lived from 980AD to 1037AD. He was the foremost philosopher of medieval Islam and also a great philosopher, logician and medic. His works included a comprehensive collection and systematisation of the fragmentary and unorganised 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.
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.
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” aka “Swedish Massage”, and has been called the “Father of Massage”.
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 Joseph Needhan, 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, Per 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.”
AD 1813 The Royal Gymnastic Central Institute for the training of gymnastic instructors was opened in Stockholm, Sweden, with Pehr Henrik Ling appointed as principal. Ling developed what he called the “Swedish Movement Cure.” Ling died in 1839, having previously named his pupils as the repositories of his teaching. Ling and his assistants left little proper written account of their methods. 
AD 1878: Dutch massage practitioner Johan Georg Mezger applies French terms to name five basic massage techniques, 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)).
China: Massage has developed continuously in China for over 5000 years. Western ideas are considered within the traditional framework. It is widely practiced and taught in hospital and medical schools and is an essential part of health maintenance and primary healthcare.
United States: Massage started to become popular in the United States in the middle part of the 19th century and was introduced by two New York physicians based on Per Henrik Ling‘s techniques developed inSweden.
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. Until the 1970s, nurses used massage to reduce pain and aid sleep. The massage therapy industry is continuously increasing, with a projected 19% increase between 2008 and 2009. U.S. consumers spend between $4 and $6 billion on visits to massage therapists, as of 2009.
United Kingdom: Massage is popular in the United Kingdom today and gaining in popularity. There are many private practitioners working from their own premises as well as those who operate from commercial venues.
Massage in sports, business and organizations: Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnasticmovements, while Ancient Greek Olympians used a specific type of trainer (“aleiptes”) 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. Massage has been employed by businesses and organizations such as the U.S. Department of Justice, Boeing and Reebok. Notable athletes such as Michael Jordan and LeBron James have personal massage therapists that at times even travel with them.
Types and methods
Active release technique
Active release technique (ART) is a form of deep tissue manipulation patented by P. Michael Leahy in which specified techniques are used to release what are presumed to be soft tissue adhesions.:578
Acupressure [from Latin acus “needle” (see acuity) + pressure (n.)] is an alternative medicine 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 these meridians. Pressure may be applied by hand, by elbow, 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. Like many alternative medicines, it may benefit from a placebo effect.
Anma is a traditional Japanese massage involving vigorous kneading, rubbing, tapping and shaking. It is commonly performed through clothing. Anma contributed significantly to the formation of shiatsu.
Aquatic bodywork comprises a diverse set of massage and bodywork forms performed in water. This includes land-based forms performed in water (e.g., Aquatic Craniosacral Therapy, Aquatic Myofascial Release Therapy, etc.), as well as forms specific to warm water pools (e.g., Aquatic Integration, Dolphin Dance, Healing Dance, Jahara technique, WaterDance, Watsu).
In ashiatsu, the practitioner uses their feet to deliver treatment. The name comes from the Japanese, ashi for foot and atsu for pressure. This modality 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. Other modalities using the feet to provide treatment include Keralite, BarefootLomi Lomi, Chavutti Thirumal.
Ayurvedic Massage known as Abhyangam in Sanskrit is one of the most common and important Ayurvedic therapies. According to the Ayurvedic Classics Abhayngam is an important dincharya (Daily Regimen) that is needed for maintaining a healthy lifestyle. The massage technique used during Ayurvedic Massage is known to stimulate the lymphatic system to expel the toxins out from the body. The Ayurvedic Massage also stimulates production of lymphocytes which play a vital role in maintaining the immunity in human body. Thus regular Ayurvedic Massage can lead to better immunity and also help in body de-toxification. The other benefits of regular Ayurvedic Massage include pain relief, reduction of fatigue, prevention of ageing and bestowing longevity.
Balinese massage techniques are gentle and aim to make the patient feel relaxed and calm throughout. The techniques include skin folding, kneading, stroking, and other techniques. The massage therapist applies aromatherapy oil throughout the massage. A patient’s blood, oxygen and energy flow is said to increase due to the treatment. Balinese hot stones are an option.
Bowen technique involves a rolling 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.
Breema bodywork is performed on the floor with the recipient fully clothed. It consists of rhythmical and gentle leans and stretches.
Biodynamic massage was created by Gerda Boyesen as part of Biodynamic Psychotherapy. Practised as a stand-alone therapy, it is a combination of physical and energy work and also uses a stethoscope to hear the peristalsis.
Champissage is a massage technique focusing on the head, neck and face that is believed to balance the chakras.
Craniosacral therapy (CST) is a gentle approach that releases tensions deep in the body by applying light touch to the skull, face, spine, and pelvis.
Esalen Massage was developed at the Esalen Institute based on a combination of many massage and bodywork techniques. The two main influences were Swedish massage and the Sensory Awareness work of Charlotte Selver. Esalen Massage 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.
While various types of reflexology related massage styles focus on the feet, massage of (usually) the soles of the feet is often performed purely for relaxation or recreation. It is believed there are some specific points on our feet that correspond to different organs in the body. Stimulation of these points during foot massage can cause significant reduction in pain. Studies also suggest that foot reflexology massage can reduce fatigue and promote better sleep.
Hilot is a traditional healing technique from the Philippines that uses massage, joint manipulations, and herbs such as banana leaves. Hilot is claimed to relax muscles, reset sprained joints, assess and treat musculoligamentous and musculoskeletal ailments, aid in giving birth and post-birth recovery for mother and baby, and to induce abortion.
Infant massage is a type of complementary and alternative treatment that uses massage therapy for human infants. This therapy has been practiced globally, and has been increasingly used in Western countries as a treatment for infants.
Kum Nye and sKu-mNyé are a wide variety of Tibetan religious and medical body practices. The two terms are different spellings in the Latin alphabet of the same Tibetan phrase (Wylie: sku mnye), which literally means “massage of the subtle body”. Some systems of sku mnye are vaguely similar to Yoga, T’ai chi, Qigong, or therapeutic massage. “Kum Nye”, Ku Nye, and Kunye are also used to transcribe the Tibetan phrases dku mnye (“belly massage”) and bsku mnye (“oil massage”), which are pronounced identically to sku mnye. dKu mnye and bsku mnye manipulate the physical body, rather than the subtle (energetic) one.
Lomilomi and indigenous massage of Oceania
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 andmilimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it roromi and mirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known aspopo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.
Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.
Medical Massage is a controversial term in the massage profession. 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 triggerpoint therapy as well as osteopathic techniques, cranial-sacral techniques and many more can be used to work with various medical conditions.
Massage used in the medical field includes decongestive therapy used for lymphedema which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. 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 management of SVT with medications.
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. 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.
The Metamorphic Technique is a gentle form of foot, hand and head massage that can be carried out by anyone with a brief training in the technique. It draws on reflexology in its theory and approach.
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. Myofascial release usually involves applying shear compression or tension in various directions, or by skin rolling.
Pediatric massage is the complementary and alternative treatment that uses massage therapy, or “the manual manipulation of soft tissue intended to promote health and well-being” for children and adolescents.
Postural Integration is a process-oriented bodywork combining deep tissue massage with breathwork, body movement and awareness as well as emotional expression.
Prostate massage was once the most popular therapeutic maneuver used to treat prostatitis. According to the Prostatitis Foundation “it used to be, in the age before antibiotics (before about 1960 for prostatitis), doctors performed massage when their patients had prostatitis. In some cases it was enough to cure them of the disease. … it fell out of common practice with the advent of antibiotics.”
Reflexology is based on the principle that there are reflexes in the hands and feet that relate to every organ, gland, and system of the body.
Shiatsu (指圧) (shi meaning finger and atsu meaning pressure) is a type of alternative medicine consisting of the fingers and 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.
Also known as manual therapy, manipulative therapy, or manual & manipulative therapy, this is a physical treatment primarily used on the neuromusculoskeletal system to treat pain and disability. It most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.
A stone massage uses cold or water-heated stones to apply pressure and heat to the body. Stones coated in oil can also be used by the therapist delivering various massaging strokes. The hot stones used are commonly Basalt stones (or lava rocks) which over time have become extremely polished and smooth. As the stones are placed along the recipient’s back, they help to retain heat which then deeply penetrates into the muscles.
Structural Integration‘s aim is to unwind the strain patterns residing in the body’s myofascial system, restoring it to its natural balance, alignment, length, and ease. This is accomplished by deep, slow, fascial and myofascial manipulation, coupled with movement re-education. Various brands of Structural Integration are Rolfing, Hellerwork, Guild for Structural Integration, Aston Patterning, Soma, and Kinesis Myofascial Integration.
The most widely recognized and commonly used category of massage is the Swedish massage. The Swedish massage techniques vary from light to vigorous. 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. 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. 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. The term “Swedish” massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as “classic massage”.
Clinical studies report that Swedish Massage can effectively reduce low back pain and the effectiveness can last for as long as 15 weeks. One study reported that Swedish Massage caused reduction in salivary cortisol indicating its role in management of stress and improvement in mood.
Known in Thailand as นวดแผนโบราณ (Nuat phaen boran, IPA: [nûət pʰɛ́ːn boːraːn]), meaning “ancient/traditional massage”, Traditional Thai massage (Nuad Boran) is generally based on a combination of Indian and Chinese traditions of medicine.
Thai massage – or Nuat Thai – 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 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 reduction of joint pain caused by osteoarthritis (OA) of the knee.
Traditional Chinese massage
Massage of Chinese Medicine is known as An Mo (按摩, pressing and rubbing) or Qigong Massage, and is the foundation of Japan’s Anma. Categories include Pu Tong An Mo (general massage), Tui Na An Mo (pushing and grasping massage), Dian Xue An Mo (cavity pressing massage), and Qi An Mo (energy massage). Tui na (推拿) focuses on pushing, stretching, and kneading muscles, and Zhi Ya (指壓) focuses on pinching and pressing at acupressure points. Technique such as friction and vibration are used as well.
The Trager approach combines movement and touch, especially rocking and shaking, to educate the body/mind.
Trigger point therapy
Sometimes confused with pressure point massage, 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. and in 2007 a paper was presented showing images of Trigger Points using MRI. These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this modality is different from reflexology, acupressure and pressure point massage.
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.