Types of Massage Therapy and Bodywork
There are many types of massage therapy and bodywork that massage therapists can specialize in and offer to their clients. Most entry-level massage training programs provide students with thorough instruction of the foundational types of massage such as Swedish massage and deep tissue massage. Massage schools may also provide training in trigger point therapy, myofascial release, sports massage, hot stone massage, or other styles depending on the school and length of the program. After completing their massage education and training program, massage therapists may pursue learning other types of massage and bodywork based on their professional interest or the needs of their clients.
What is the difference between massage and bodywork? Bodywork is a generic term that refers to a holistic approach to improving health and wellbeing. Bodywork may include manual therapies such as massage, movement therapies, exercise training, breath work, or energetic therapies. Massage therapy is one form of bodywork which focuses on the manipulation of soft tissues.
Learning new techniques is a great way to keep work interesting and achieve the best client outcomes possible. There are a lot of types of massage available for therapists to choose from. Types of massage are characterized and named according to the:
- Type of client (e.g. pregnancy massage, oncology massage, equine massage)
- Developer of the therapy system (e.g. Hellerwork, Rolfing)
- Main techniques, primary effects, or targeted tissues (e.g. myofascial release, reflexology, and trigger point therapy).
Massage and bodywork is considered a type of complementary and alternative medicine (CAM). Many of the philosophies and modalities used by CAM contrast sharply to those used in conventional western medicine, also called allopathic medicine, which primarily rely on pharmaceutical drugs and surgery.
Learning how to provide other types massage is a great way for massage therapists to attract new clients, provide variety to current clients, reduce the risk of repetitive strain injuries, and keep work interesting. All of the massage and bodywork styles below can be learned through continuing education courses, workshops or apprenticeship.
Types of Massage Therapy Certifications
Getting certified in a specific type of massage modality comes after completing an entry-level massage training program, passing the MBLEx, and getting a massage license. Some massage certification programs require that therapists have a certain amount of experience before beginning their certification training program. The reason that professional and licensed massage therapists (LMTs) often seek advanced training and certification is to expand their skills and demonstrate their competency in a specific type of massage. Unlike getting a massage license which is required, getting a massage certification is voluntary.
Massage therapists can get certified in one or more massage specialties by taking continuing education courses and passing a massage certification exam. There are numerous massage certification programs for therapists to choose from. These advanced and specialty programs provide training in specific massage modalities or working with specific populations, and typically go into greater detail on these topics than most entry-level massage schools do. Becoming a certified in one of these massage specialties takes a therapist from just knowing about the modality, to being able to effectively and safely apply the massage principles and techniques related to that advanced massage specialty. The following is a list of 7 massage certifications that massage therapists may want to consider.
- Board Certification in Therapeutic Massage and Bodywork (BCTMB)
- Medical Massage Therapist Certification
- Myofascial Release Certification
- Manual Lymphatic Drainage Certified Specialist
- Pregnancy Massage Certification
- Certified Sports Massage Specialist
- Clinical Rehabilitative Massage
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Types of massage therapy and bodywork styles and modalities
Acupressure is a type of bodywork that involves the use of finger pressure to stimulate acupoints, which are key acupressure and acupuncture points located along the meridians of the body. Meridians are the “energy highways” that life energy flows through the body, according to Traditional Chinese Medicine (TCM) meridian theory. This life energy is also called chi or qi. Acupressure is very similar to acupuncture, but it uses manual pressure instead of needles. So there is less risk of injury with acupressure. Both acupressure and acupuncture are considered to be a type of complementary and alternative medicine (CAM). An acupressure practitioner may use their hand, elbow or other tool to apply the pressure. According to acupressure theory, acupressure works by stimulating these energetic points to clear energy blockages and improve the balance and flow of energy. There are other bodywork systems that use pressure at certain points of the body with a goal of stimulating a change elsewhere in the body. Some of these other bodywork systems such as shiatsu and reflexology are based on a similar theory of stimulating the body energy. Other manual therapy techniques such as trigger point therapy are based on anatomy and physiology principles and established referral patterns rather than energy theory. So the points that are treated by therapist applying trigger point therapy does not rely on meridians, but instead relies on palpation for trigger points within the muscles and fascia.
The Alexander Technique (AT) is a type of bodywork and alternative therapy that focuses on teaching the client how to improve posture and movement, with the goal of relieving body tension and pain. The treatment techniques were created by Frederick Alexander in the late 1800’s as he attempted to discover a way to help his own voice loss caused by recurring laryngitis. An Alexander technique practitioner, referred to as a teacher, helps the client, referred to as the student, in a one-on-one session (lesson) to identify points of muscle imbalance and tension. This therapeutic system often focuses on treating conditions that result from chronic or degenerative illness, especially those that result from stress. Other specific afflictions that the Alexander technique is claimed to benefit include: chronic pain management (especially low back pain), sciatica and pain from disc herniation, chronic fatigue syndrome, pain and dysfunction from osteoporosis and stenosis, work-related injuries, and repetitive strain injuries. The Alexander technique teacher helps the student to identify unwanted movement or positional habits and tension that may be contributing to their pain or dysfunction. The goal is to unlearn bad posture and movement habits in order to improve musculoskeletal alignment and poise. One of the key components is to help the student with self-analysis and to become more mindful of their position and movement when performing daily activities (e.g. sit, move, stand). Another key aspect is to help the student to develop their individual self-care strategies.
Aromatherapy massage is not a specific type of massage, but rather when essential oils are worked into the massage treatment. Types of relaxation massage such as Swedish massage and hot stone massage are commonly used to provide an aromatherapy massage. Practitioners who provide aromatherapy massage will often use pre-made blends of essential oils, or they will create their own blends based on client preference or therapeutic properties of the oils. Since essential oils are powerful, they must be diluted into a carrier oil or lotion, which also provides an appropriate amount of lubrication. Essential oils may also be used in a diffuser which aerosolizes the oil into the treatment room where it is inhaled and creates a pleasant scent. The therapeutic properties of specific essential oils vary, but may include increasing sense of calmness and relaxation, pain relief, and calming of the nerves. Before using an essential oil with a client, the therapist must first ensure that the client is not allergic to it. One additional benefit of aromatherapy massage and essential oils is that a version of this treatment can be done at home by the client as part of a self-care routine.
Ashiatsu massage, sometime called ashiatsu barefoot massage, or simply ashiatsu, is a type of massage in which the practitioner uses bare feet to massage the client. The therapist uses overhead bars to hold onto in order to help balance, increase safety, ease transitions and therapist position changes, and control the pressure. Ashiatsu may be performed on a floor mat or on a standard massage table. This style of massage is similar to shiatsu, which translates to “finger pressure”. Ashiatsu translates to “foot pressure”. Several other forms of massage and bodywork around the world such as Thai massage also involve the therapist using their feet to deliver pressure. The feet can be a better tool to apply deeper and prolonged pressure when compared to the hands and fingers because the feet are much stronger.
Assisted stretching is a therapeutic modality that can be incorporated into other types of massage and bodywork, or it can be a standalone form of bodywork. Sometimes called facilitated stretching, this intervention can help clients to improve flexibility, joint ROM, ease of movement, muscle relaxation and improved posture. A stretching routine that is assisted by a skilled therapist can enable the client to perform stretches that are difficult to perform by oneself. Many types of health and wellness professionals such as physical therapists, personal trainers, and yoga instructors incorporate some form of assisted stretching into their treatments. While many forms of bodywork such as Thai massage include stretches, the type of assisted stretching services that are offered at places like StretchZone, StretchLab and Stretch*d are relatively new. An assisted stretching routine may include specific types or techniques of stretching that are based on physiological principles of the nervous system, and known tissue responses to variable duration and intensity of stretching. Specific stretching techniques include proprioceptive neuromuscular facilitation (PNF), and post-isometric relaxation (PIR) also called contract-relax stretching.
Chair massage is a type of massage therapy in which the client sits up during the treatment. Usually a portable massage chair is used. This chair is specifically designed to support the client’s torso, head, arms and legs and allow the client to relax while giving the therapist easy access to the client’s back, neck and arms. Chair massage may also be performed with the client sitting in a turned-around straight-back chair, or with the client in a wheelchair and leaning forward onto a table with pillows to support the upper body, head and arms. Tabletop support systems are also available. Clients receiving a chair massage typically remain fully clothed, especially if the massage is provided in a public venue such as at an onsite corporate massage event, or other public event. Chair massage may also be used in a private treatment room instead of a massage table for clients who are unable to lye on the table comfortably. In these circumstances, the client may partially disrobe any areas that the therapist will work on, depending on the type of techniques to be used. Chair massage is a great way to introduce people to massage therapy, and it is a great marketing tool to help therapists promote massage services to new clients.
Clinical massage therapy combines techniques and treatment approaches from various systems of massage and bodywork to create effective, customized treatments for clients with specific needs. The techniques may include those originating from Western or Eastern therapy systems. Therapists who practice clinical massage tend to use a unique and eclectic set of techniques. Their choice of preferred techniques is typically influenced by their training as well as their experience and observations of what has worked with their previous clients. Therapists who practice clinical massage typically see a client for multiple sessions depending on the treatment goal. This type of massage practice is often referred to as outcome-based massage, where the goal is to solve the client’s problem rather than to just go through the motions and provide a 60-minute massage. Therapists who practice clinical massage need to be good at assessment, treatment planning, communication, as well as applying hands-on treatments. Clinical massage therapists often work in a clinical setting such as a physical therapy or chiropractor’s office, but not always.
Craniosacral therapy (CST) is a type of bodywork that was developed by osteopathic physician (DO) John Upledger in the 1970’s. This form of bodywork involves gentle palpation of the skull, spine and pelvis. It is based on the belief that there is a small degree of motion between the fused sutures of the skull, and that craniosacral therapy practitioners can detect and regulate the flow of the cerebrospinal fluid (CSF). CST theory proposes that the normal flow of cerebrospinal fluid can be interrupted by traumatic events such as a car accident, fall, other injury, or even due to psychological stress. Practitioners of craniosacral therapy claim that their gentle techniques use 5 grams of pressure (“about the weight of a nickel”) to remove CSF blockages and restore normal flow. There are many claims as to what sort of conditions CST can help including: fibromyalgia, chronic pain, MS, migraines and stroke. These claims however have been disproven by research and the CST system is based on the fundamental misconception regarding movement of the skull bones and the flow of CSF.
Deep Tissue Massage
Deep tissue massage (DTM) is a type of massage that typically uses more pressure than a relaxation massage, and is able to target deeper tissues in addition to superficial tissues. DTM is defined differently by different therapists, organizations and clients. Since deep tissue massage is loosely defined, the methods and techniques used by a therapist during DTM may overlap with those used in other types of massage such as myofascial release and trigger point therapy. Techniques from other systems such as Swedish massage may also be incorporated in order to warm up and loosen the tissues prior to doing deeper work. A common goal of deep tissue massage includes relieving fascial restrictions and adhesions that cause pain and impair posture or movement. A massage therapist performing a deep tissue massage may use different parts of their hand (fingers, thumbs, knuckles, palms), elbow, forearm, or even feet to deliver the therapeutic techniques. There are many types to massage tools that a massage therapist may also use to apply the techniques and protect their hands. A client is more likely to experience soreness after a deep tissue massage than after a lighter type of massage.
Feldenkrais Method is considered a type of movement therapy, somatic education and therapeutic exercise that has the primary goal of improving ease of movement, fluidity and motor control. This therapeutic system was developed by Moshé Feldenkrais in the late 1900’s. The claims are that it can improve movement and mental wellbeing by reorganizing the neural connections between the brain and the body. The benefits from Feldenkrais are likely similar to the benefits resulting from other forms of movement therapy that include focused, willful and volitional movement. These other forms of movement therapy include: tai chi, martial arts, dance, qigong, pilates, yoga, and the Trager Approach.
Geriatric massage is a type of massage therapy or bodywork that uses gentle techniques that are safe and are designed to meet the needs of elderly clients. Massage therapy and bodywork can provide numerous benefits for elderly clients including: promoting circulation, pain relief, improving flexibility, improving posture, stress reduction, and increasing their overall sense of well-being. Geriatric massage is not a specific style of massage with unique techniques, but rather an eclectic compilation of gentle massage and bodywork techniques from other systems. The clients of this special population are more likely to have additional safety risks that massage therapists must be aware of. Geriatric clients often have thinner, more fragile skin that can be damaged by manual therapy techniques. This clientele is also more likely to have a more complex medical history with one or more precautions or contraindications to massage, due to previous injures, illnesses, chronic disease, surgeries, medications, or diagnosis that requires modification of the massage treatment plan. Common conditions within the geriatric population that impact the safety of massage include: osteoporosis, history of joint replacement, increased sensitivity to cold and heat, hearing impairment, and medications which alter the effects of massage (e.g. increase risk of bruising). Geriatric clients may also have difficulty lying flat on the massage table, flipping over, and getting up from the table after the massage. Before offering geriatric massage, especially for the most vulnerable of this population, massage therapists should receive specialize training in working with geriatric clients if their initial massage therapy education did not cover this topic.
Hellerwork is a type of bodywork that combines structural integration and movement education. This deep tissue bodywork system focuses on improving posture and body alignment by correcting imbalances in the fascial system (connective tissue) of the body. According to the Hellerwork system, these fascial imbalances are caused by the continual effects of gravity, negative emotions, ongoing physical stresses, the effects of aging, and in some cases physical traumas. Other goals of Hellerwork include relieving muscle tension, pain, and stress, as well as increasing flexibility, freedom of movement and well-being. Hellerwork is similar to the Rolfing system of structural integration, however the treatments provided by a Hellerwork practitioner tend to be more gentle than those provided by a Rolfer. The Hellerwork bodywork system also includes a component which they call somatic dialogue, which has the aim of increasing the client’s self-awareness, particularly regarding their body-mind relationship. The movement education component of the Hellerwork system is designed to re-educate the clients movement patterns in order to replace old patterns of tension and rigidity with more fluid movement. Hellerwork is typically provided in a series of 11 sessions.
Hot Stone Massage
Hot stone massage is a type of massage therapy that uses smooth, heated stones to provide a relaxing massage that decreases muscle tension. This style of massage is similar to a Swedish massage which includes a lot of long, gliding strokes and uses plenty of oil to provide the necessary amount of glide. A hot stone massage uses the heated rocks to deliver therapeutic heat so that the client receives the benefits of thermotherapy as well. Therapists typically will also use the rocks as a tool to apply deep tissue techniques at targeted areas in order to relieve trigger points, fascial restrictions, or other soft tissue problems that would benefit from the heat and pressure from the hot stone. The rocks used in a hot stone massage are smooth, fairly flat, and come in different sizes. They are usually composed of basalt rock, which is a type of volcanic rock that retains heat longer than other common types of rocks. These rocks are kept heated to about 130-145 degrees (F) until they are ready to use. Massage therapists commonly use an electric warmer, similar to a crockpot, to warm the stones. Since hot stone massage includes the inherent risk of burns, massage therapists need to receive training on how to safely provide a hot stone massage before offering this to clients. Some professional liability insurance policies do not cover hot stone massage, or they have additional requirements in order for the therapist to get coverage for this service.
Lomi Lomi Massage
Lomi lomi is the traditional Hawaiian massage style. Since lomi lomi is a traditional healing system, there are often other healing aspects that accompany the massage treatments such as prayer and meditation, and education on improving diet. The intent of a lomi lomi massage (which is sometimes written as lomilomi) is to increase relaxation, and create a sense of well-being, balance and harmony. A lomi lomi practitioner may use blended aromatherapy oils, and uses their hands and forearms to deliver long, gliding strokes. These techniques are described as being similar to the rhythmic motion of the waves on the shores, which has influenced many aspects of the Hawaiian and other Polynesian cultures in addition to their health and bodywork systems.
Lymphatic massage is a type of massage therapy, and is also called manual lymphatic drainage (MLD) or lymphatic drainage therapy (LDT). This form of massage uses light rhythmic strokes at specific areas to encourage the flow of lymph in the lymphatic vessels. The lymphatic system of the body functions as part of the body’s waste removal system and plays an important role in the body’s immune function. The lymph nodes help to deactivate or destroy pathogens such as viruses, bacteria and other harmful microorganisms. Lymphatic fluid, or lymph, and other interstitial or extracellular fluids can accumulate and become congested in the body. This is sometimes the result of a pathological process or a post-surgical complication, and it can lead to a condition called lymphedema. Lymphatic massage can help to reduce this build up of fluid in the body by facilitating the lymphatic capillaries to take up the fluid, and assisting the flow of lymph in the lymphatic vessels. Lymphatic massage is often accompanied with client education and daily use of various compression garments to help minimize the re-accumulation of fluid in the affected limb(s).
Medical massage therapy is a type of massage that focuses on treating the signs and symptoms associated with a client’s specific medical diagnosis. Like clinical massage, a medical massage treatment plan often combines various techniques from different styles of massage and bodywork in order to create an effective treatment for an individual client based on his or her diagnosis and specific needs. Clients that receive medical massage are typically under the care of a physician, physical therapist or chiropractor for the condition. Medical massage can be an effective treatment for many conditions including: back or neck pain, chronic pain, fibromyalgia, sciatica, TMJ disorder, plantar fasciitis, whiplash, carpal tunnel syndrome, frozen shoulder, ITB syndrome, and many more. This form of massage therapy is especially useful for neuromusculoskeletal conditions, but is also helpful for clients with mental health conditions such as anxiety, depression, and PTSD. Medical massage is an outcome-based type of massage, which means that the objective is not just to deliver an enjoyable massage, but to create a measurable improvement towards the client’s therapy goals. Massage therapists who practice medical massage must be good at patient assessment, treatment planning, communication, marketing their services, as well as applying manual therapy treatments. It is common for medical massage therapists to work in a clinical setting such as a physician, physical therapy or chiropractor’s office, but may also work their own massage practice. Depending on the circumstances and whether not insurance will be billed, the client may need a prescription for medical massage.
Myofascial Massage or Myofascial Release Therapy
Myofascial massage, or myofascial release (MFR), is a type of massage or manual therapy that focuses on relieving restrictions in the fascia of the body. Fascia is the tough, sheetlike connective tissue that wraps around most structures of the body, including the muscles and fascicles, bones, and organs. Like most tissues of the body, fascia adapts to the demands placed on it, and conforms to the sustained positions and repeated movements that affect it. For example, a person who sustains a poor chronic sitting posture will tend to develop shortened and restricted fascia in certain areas of the body such as the anterior hips, pectorals, anterior cervical region, and posterior knees. This can result in impaired mobility, loss of flexibility and joint ROM, impaired circulation, pain, and increased muscle tension. Repeated movements like those associated with repetitive strain injuries can also be the source of fascia dysfunction. A massage therapist who provides myofascial release may focus the entire session on applying this technique, or may just incorporate the use of MFR techniques into the session as needed. The MFR technique requires little to no glide, and a high amount of drag on the skin, so no oils, lotions or creams are used. The technique involves the application of a gentle and sustained pressure in a specific direction. The therapist typically uses the entire hand(s) or forearm to deliver this sustained pressure. The motion is either static or almost imperceptibly slow, as the therapist allows time for the tissues to respond.
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Oncology massage is a type of massage therapy that is designed to meet the needs of people who are diagnosed with cancer. Like other forms of massage that specialize in treating a special population, oncology massage is not a unique or specific set of techniques, but rather a framework that focuses on enabling the therapist to safely provide massage for clients who may have additional complications and symptoms related to cancer treatments (e.g. chemotherapy, radiation), or the cancer itself. Benefits of massage for people with cancer include: decreased pain and muscle tension, reduced stress anxiety and depression, reduced fatigue, and improved sleep quality. Therapists who provide oncology massage must be competent in working with cancer patients. These massage therapists must also be good at patient assessment, treatment planning, observation, communication with the client and other medical professional involved in their plan of care, as well as providing appropriate massage or bodywork treatments.
Orthopedic massage is a type of massage therapy the focuses on helping clients with rehabilitation from injury, especially those involving the musculoskeletal system.
Pregnancy massage is the type of therapeutic massage or bodywork that is designed to meet the needs of pregnant clients. This includes massage therapy during pregnancy, which is also called prenatal massage. And it also includes massage to meet the needs of the postnatal female client.
Reflexology / Zone therapy
Reflexology is an energy-based system that stimulates points on the feet, hands and ears. It is also called zone therapy. Practitioners of reflexology believe that applying pressure to these points will create a physical change in the body at the corresponding areas of the body.
Reiki is a form of bodywork that focuses on balancing the body’s energy system (chi or qi). It was developed in Japan in the 1920’s.
Remedial massage refers to massage therapy that is intended to treat a specific problem. Like clinical massage, medical massage, or orthopedic massage, it focuses on achieving the treatment goal rather than just providing an enjoyable massage.
Shiatsu is a type of bodywork that developed in Japan in the 1900’s. It is based on the energetic concepts of the flow of chi through meridians of the body.
Sports massage is a type of therapeutic massage that is designed to meet the needs of clients who participate in sporting and fitness activities. This massage style is particularly useful when applied before or after a competitive event or intense training session.
Structural Integration / Rolfing
Structural integration is a form of bodywork that focuses on improving the client’s posture and musculoskeletal alignment through manipulating connective tissue such as fascia and ligaments. Rolfing is a specific type of structural integration that was developed by Ida Rolf.
Swedish massage is one of the most common and popular types of massage in the US. A Swedish massage is known for its ability to create physical and mental relaxation. It is recognized by the five specific massage techniques including effleurage, petrissage, tapotement, friction and vibration.
Thai massage is a form of bodywork that developed in Thailand. It consists of assisted stretches and stimulation of energetic points on the body.
The Trager Approach is a form of movement education that uses skilled touch and subtle movements directed by the practitioner. It also involves sensory awareness and internal imagery for the purpose of increasing proprioception and kinesthetic awareness.
Trigger Point Therapy / Neuromuscular Therapy (NMT)
Trigger point therapy, also called neuromuscular therapy is a type of massage that focuses on finding and relieving trigger points in the muscles of the body.