Massage Therapy: A Beginner’s Guide to This Type of Healing Bodywork

“Massage therapy is the manipulation of soft tissues of the body, using varying degrees of pressure and movement, by a trained, licensed professional massage therapist,” says Michaele Colizza, based in Johnston, Rhode Island, who serves as president of the American Massage Therapy Association (AMTA). While this type of bodywork can help you de-stress, there are many other wellness perks associated with massage therapy as well.

If you’ve never had a massage from a professional massage therapist, read on for in-depth information about how it works, possible health benefits, how to stay safe, and what to know before you attend your first appointment.

Massage therapy has been around for a long time. First referenced in Chinese texts as many as 4,000 years ago, according to Encyclopedia.com, it was also likely practiced in Asia, India, and other areas of the world long before it was ever recorded. Hippocrates, who is often referred to as the father of modern medicine, advocated for massage — or, as it was called in ancient Greece, “rubbing.”

In the United States, modern massage developed in the 1800s. During that time, two physicians opened the first two clinics in the states: the Posse Institute in Boston and the Swedish Health Institute in Washington, D.C.

As massage therapy in the United States evolved during the 20th century, a greater interest in wellness, fitness, and integrative treatments contributed to the public’s growing interest in massage therapy, notes the AMTA. With interest from researchers about identifying the possible benefits of massage, the practice gained legitimacy, and it became important to properly identify experts in the field.

In the 1990s, some states started to require massage therapists to be licensed. Today, there are 45 states, as well as D.C., Puerto Rico, and the U.S. Virgin Islands, where massage therapists must adhere to licensing requirements, according to Associated Bodywork and Massage Professionals.

Today, the overwhelming majority of people view massage therapy as a form of healthcare, according to a survey conducted in 2020 by the AMTA.

As you’re on the table, your body slides into its relaxation response, says Beret Loncar, a licensed massage therapist and owner of Body Mechanics Orthopedic Massage in New York City. In other words, massage may encourage you to calm the sympathetic nervous system (aka the fight-or-flight response) and engage the parasympathetic nervous system (aka rest-and-digest mode.)

Activating the relaxation response dilates and relaxes the capillaries and veins in your muscles, sending blood flow to your core, she explains. As you’re touched, the sensory stimulation draws blood flow back to the surface of the skin at the site of your therapist’s fingertips. And this doesn’t just feel good: “It’s healthy to move blood in diverse ways into tissues that may be a little underserved,” Loncar says.

There’s also a meditative element to massage, something Loncar says is akin to a physical guided meditation, which has potential benefits for your mind. Many people consider massage to be a spiritual practice, or a way to foster the mind-body connection.

According to various reviews and studies, researchers have also hypothesized about and studied other mechanisms for the effects of massage, such as its impact on the following bodily systems: immune, central nervous, physiologic, neurologic, biomechanical, and psychological.

A massage is not just a massage. In fact, there are many different techniques that can be used, according to the Cleveland Clinic:

• Swedish Massage A full-body massage using gentle touch.
• Deep-Tissue Massage Targets tight muscles and tendons.
• Sports Massage A deeper massage targeted at the muscles worked in your sport and to address injuries.
• Trigger-Point Massage Focuses on releasing tight spots in tissues.
• Myofascial Release Targets tight muscles and tendons with massage and stretching.
• Lymphatic Massage A light-touch massage that aims to support the flow of your body’s lymphatic fluid.
• Prenatal Massage A type of massage done on women who are pregnant.

In addition, you can also experience:

• Neuromuscular Massage Focuses on trigger points to release muscle strain, according to the American Institute of Alternative Medicine.
• Shiatsu Applies thumbs, hands, elbows, knees, and feet to acupressure points, notes Gwinnett Colleges and Institute.
• Reflexology Focuses on reflex points on the hands, feet, and ears.
• Hot Stone Massage Applies heated stones to certain places on the body to release muscle stiffness.
• Thai Massage Therapists use their feet, elbows, knees, and hands to apply compression and stretching while you remain fully clothed, according to the American Massage Therapy Association.
• Tuina Massage An ancient, therapeutic form of massage focuses on applying pressure to meridians and acupoints to balance one’s qi (or energy), notes Pacific College of Health and Science.
• Other Types of Massage There are numerous additional types of massage to explore as well.

When you’re in search of relaxation, a massage can certainly help, but its benefits go far beyond feeling at ease. According to the 2020 AMTA survey, 93 percent of people said that massage was beneficial to overall health and wellness.

May Boost Relaxation and Improve Mental Health

If you sit at a computer all day or have a sedentary job, you may be familiar with the feeling of muscle tightness, especially in your back and shoulders.

“For the average healthy person, the potential benefit of massage therapy is that it helps muscles relax, so you don’t feel as tense,” says Polly Liontis, a licensed massage therapist with the NorthShore University HealthSystem Integrative Medicine Program in Glenview, Illinois. In addition, one-quarter of people said that they received a massage for stress-related reasons, according to the AMTA survey.

Research shows that massage may help healthcare workers manage work-related stresses. People who gave themselves foot massages (foot reflexology) reported less stress, fatigue, and depression, according to a meta-analysis of three trials. Another meta-analysis of eight studies on pregnant women found that massage therapy was useful in moderately decreasing symptoms of depression and anxiety, compared with control groups.

May Help Relieve Pain

There are many different pain conditions, from low-back pain to neck pain to osteoarthritis — and more — in which massage therapy may be a treatment to consider. “Research continues to show that massage therapy can make a positive difference for those dealing with chronic pain,” says Colizza.

One review and meta-analysis evaluating various pain populations concluded that massage therapy may be more effective in managing pain than receiving no treatment at all, and it was also found to improve mood and quality of life in some participants.

That said, research on the effects of massage on specific types of pain, like chronic low-back pain, knee pain, and neck and shoulder pain, is still evolving, and it may only suggest short-term benefits, or limited benefits, according to the National Center for Complementary and Integrative Health (NCCIH). Therefore, exactly how massage therapy may affect different types of chronic pain is still being investigated, and more research is ongoing.

May Assist With Injury and Surgery Recovery

After a surgery or injury, the pain and discomfort can make it challenging to get back to everyday activities. Massage therapy may improve the quality of life of people in recovery by alleviating post-operative pain, at least in the short-term, research suggests. In addition, studies have found that adding massage to typical postoperative treatment can help reduce anxiety better than experiencing only the usual care.

Medical Massage Can Be Used in Combination With Some Medical Treatments

One type of specialty massage is medical massage. “These massage therapists have more extensive training in specialty areas,” says Liontis. Medical massage is more commonly offered in a clinic or healthcare setting, along with your conventional treatment plan.

For instance, for people with some cancers, massage can help lessen the side effects of treatments such as chemotherapy. “For people who have certain types of cancer, getting a massage halfway in between appointments can help alleviate the nausea and fatigue, improve their appetite, better sleep, and relieve constipation,” Liontis explains.

Another common medical use is tension headache massage, as in for chronic migraine headaches. Relaxing the muscles and taking your body out of the fight-or-flight stress response may help reduce the number of headaches you experience, says Liontis. If you have an ongoing medical issue and are interested in seeking out integrative therapies, such as medical massage and/or therapeutic massage, talk to your doctor about how it may fit into your treatment.

If you have cancer, massage therapy can be beneficial. But it’s important that your therapist is knowledgeable in how to safely apply touch. They should not work directly on areas of cancer or where you are receiving treatment, according to Memorial Sloan Kettering Cancer Center.

In addition, if you have a bleeding disorder or are on blood thinners, you should not receive a vigorous massage, says Colizza. Your massage therapist should also avoid any areas with blood clots, fractures, open or healing wounds, skin infections, or recent sutures, she says.

In addition, if you’ve been recently injured, wait until any swelling has subsided, says Liontis. People who have had surgery may have to wait weeks or months before massage therapy, she says. Again, talk to your doctor about what’s safe for you before you try it.

If you are pregnant, tell your massage therapist. They will ask you to lay in positions that are safe for you and your baby, such as on your side, or they may perform other types of massage instead, such as chair massage, says Colizza.

Lastly, Liontis says that if you are sick, you should not come in for a massage, as it puts your massage therapist at risk and may make your symptoms worse.

If you are in need of relaxation or have noticed that your stress levels are building, massage therapy may help your body and mind settle down. In addition, if you have any of the health concerns mentioned above, such as headaches, pain, or low mood, you may benefit from it.

For people who have active medical conditions, it may still be safe to get a medical massage. However, you’ll want to discuss it with your doctor first, and then be up front and honest about your condition and any treatments or medications you’re using to manage it, so that your massage therapist can deliver the type of touch that is safe for you.

Find a Massage Therapist

You can find qualified massage therapists in chiropractic clinics, integrated healthcare practices, spas, health clubs, hospitals, and massage therapy franchises, says Colizza. Look to see what their qualifications are. Yours should be a licensed (depending on state requirements), registered, or certified professional massage therapist.

If you are interested in massage being part of your treatment for a medical condition, talk to your doctor, and look for a therapist who is experienced in the care you need, such as those found in a clinical or hospital setting. You can also ask your doctor for a referral, as they may work with an integrated medical program.

And it’s important to note that although licensing falls to state regulation, some massage therapists elect to become board certified by the National Certification Board for Therapeutic Massage and Bodywork, according to the NCCIH. To do this, they must meet specific educational requirements, undergo a background check, and pass an examination.

Take a Tour

If you’re looking to make massage a regular part of your practice or are aiming to get your first session, it’s important that you feel secure. “Massage therapy is and always should be about health and well-being in a safe environment. This includes a comfortable environment before, during, and after the massage,” says Colizza. So, don’t be shy about asking for a tour of a new place to ensure that you feel comfortable when you’re there.

Check Your Coverage

Typically, insurance does not cover massage. However, some plans may offer some coverage for massage in certain instances, research indicates. (In that case, you may need a prescription from your doctor.) Call your insurance company to check what’s offered under your plan, check to see whether you can use health savings account or flexible spending account funds for massage therapy, or see whether your employer offers it as a perk in some way. Medicare does not cover massage therapy at all.

Choose the Right Time

Sometimes, life is so crazy that there’s only a small window of time for self-care practices like massage therapy. In that case, fit it in where you can. But if you have the luxury of a more flexible schedule, consider setting up an appointment for a day/time when it will provide the most benefit, such as after work, a half-day Friday, or at the beginning of a week that you know will be tough, advises Loncar. The right time will differ depending on your needs, but take some time to think about when massage will best serve you.

Congrats on setting up your first appointment! Here’s some helpful insight about what might happen from the moment you walk through the door until after you leave:

You’ll Talk About Your History

A massage is more than just a relaxation exercise. Be prepared to talk about why you’re there, your medical history, lifestyle, stress levels, medication, and areas of physical pain, says Colizza. This information will help your therapist provide a safe and effective treatment tailored to you, though it isn’t always discussed extensively for more routine therapeutic massage. Be up front about your medical history, even if it does not seem pertinent.

You’ll Share Your Goals

Your therapist should ask you why you’re there and what your expectations are. Perhaps your neck and back are especially tight, for instance, or you’re running a marathon in two weeks, or you’re simply looking for quiet time and stress relief.

At that point, your therapist can talk to you about what they think should happen during the treatment. “We want to give clients a reasonable, safe plan that manages their time in an effective way,” says Loncar. If you don’t agree, it’s okay to speak up and ask questions.

Set Noise Expectations

Some people like to talk during a massage, while others prefer to be quiet. Some want music, while others don’t. There’s no wrong answer here, but you should be clear about your needs, notes the AMTA.

You Can Adjust, If Needed

Before the appointment, your therapist might ask you what type of pressure you prefer. You can always speak up during the treatment and ask to adjust as needed. For instance, maybe you requested a pressure level of 7 out of 10, but now you really need to scale that down. You can ask them to go lighter. And if you’re uncomfortable during the massage for any reason, you can ask the therapist to stop, notes the AMTA.

You May Grow to Feel More At Ease

With regular sessions (especially with similar therapists), over time, you will train your body and mind to shut down more easily. “You’re training your body to get better at relaxing,” says Loncar. Initially, this might not happen until halfway into a massage, but over time, you may feel relaxed as soon as you walk in the door, she says. And being better able to tap into chill-down mode is valuable training, which can translate to the rest of your life.

You May Feel Energized

“The average person who is sitting during the day may get fatigued because they’re breathing shallowly, and as a result the muscles are not well oxygenated,” says Liontis. You not only release these muscles through massage, but you’re also likely taking deeper breaths. Together, these actions will help you feel more relaxed and also energized as you leave your session.

Results Take Time

While you may leave feeling like a new person, you might not experience the benefits until you’ve had more sessions. Liontis recommends committing to 6 to 10 sessions (assuming that’s possible for you financially). Talk to your massage therapist to determine exactly how you might space out the time between sessions. If you’re going in for general health, wellness, and relaxation, once a month is generally a good interval, adds Loncar.

Best Organizations

American Massage Therapy Association

The AMTA is an excellent resource for learning about various benefits of massage, depending on your concerns. This portal connects readers with handy information sheets and additional links to resources. And its Find a Massage Therapist directory allows you to search for a massage professional near you with name or keyword and/or city/state/ZIP code. This search supplies the names of therapists who are AMTA members. Click on their profile and you can learn a little bit about them to see if they may be a good fit for what you’re looking for.

National Certification Board for Therapeutic Massage and Bodywork

Though credentialing varies by state, the NCBTMB offers a directory where you can search for board-certified massage therapists who are near you and aligned with your wellness goals. For therapeutic assistance with health conditions, and after you’ve talked to your doctor, it’s also a good resource for finding medical massage therapists within condition specialties or who offer certain types of massages.

Best Research Information

National Center for Complementary and Integrative Health

There’s a lot of research on massage therapy, but when you want it condensed for you in an easy-to-understand way, the NCCIH is a great place to start. The Condition and Summary of Current Evidence section of the site covers eight conditions (e.g., headache, osteoarthritis, fibromyalgia, etc.) and where the massage-related research stands on each.

Best Try-at-Home Resources

Book for Self-Massage Approaches

Complete Self Massage Workbook

For the times when you can’t get away for an appointment, this workbook takes you through 100 self-massage techniques you can do on your head, neck, shoulders, and lower back to release everyday tension. When you learn how to practice self-massage, it’s another tool you can add to your self-care and de-stressing toolbox.

App for Self-Massage Approaches

Insight Timer

This free app (with in-app purchases) offers many guided self-massages, so you can combine both meditation with the soothing qualities of self-massage.