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{{Infobox TwoColumns
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 |boxtitle= Massage therapy
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 |image_caption = Massage in [[Frankfurt, Germany|Frankfurt]], [[Germany]].
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 |headspan = '''[[Glossary of alternative medicine#CAM|Complementary and alternative medicine]] Classifications'''
 |label1 = [[Glossary of alternative medicine#NCCAM classifications|NCCAM]]
 |dataA1 = [[Glossary of alternative medicine#Manipulative and body-based methods|Manipulative and body-based methods]]
 |label2 = [[Glossary of alternative medicine#Modality classifications|Modality]]
 |dataA2 = [[Glossary of alternative medicine#Professionalized modalities|Professionalized]]
 |extra = This article is part of the branches of CAM series.
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{{Manipulative methods}}
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'''Massage''' is the manipulation of superficial layers of muscle and connective tissue to enhance the function and promote relaxation and well-being.<ref>[http://www.medterms.com/script/main/art.asp?articlekey=11623 Definition of ''massage'', Prescottlmt.com]</ref><ref>[http://altmedicine.about.com/od/treatmentsmtoq/a/massage.htm What is Massage Therapy?]</ref> The word comes from the [[French language|French]] ''massage'' "friction of kneading", or from [[Arabic]] ''massa'' meaning "to touch, feel or handle" or from [[Latin]] ''massa'' meaning "mass, dough".<ref>[http://www.etymonline.com/index.php?term=massage Online Etymology Dictionary, massage]</ref><ref>[http://m-w.com/dictionary/massage Merriam Webster Dictionary Online, massage]</ref> In distinction the ancient [[Ancient Greek|Greek]] word for massage was ''anatripsis'',<ref name=Noah>{{cite book | url = http://books.google.com/?id=KEyOi-KN0rgC&pg=PA2&lpg=PA2&dq=massage+etymology| title = The History of Massage: An Illustrated Survey from Around the World | last = Calvert | first = R. | publisher = Healing Arts Press| date = 2002-04-01}}</ref> and the Latin was ''frictio''.

Massage involves acting on and manipulating the body with pressure &ndash; structured, unstructured, stationary, or moving &ndash; tension, motion, or vibration, done manually or with mechanical aids. Target tissues may include [[muscle]]s, [[tendons]], [[ligaments]], [[skin]], [[joints]], or other [[connective tissue]], as well as [[lymphatic]] vessels, or organs of the [[gastrointestinal system]]. Massage can be applied with the [[hand]]s, [[finger]]s, [[elbow]]s, [[knee]]s, [[forearm]], and [[foot|feet]]. There are over eighty different recognized massage modalities.<ref name=nccam>{{cite web | url = http://nccam.nih.gov/health/massage/| title = Massage Therapy as CAM | publisher = The National Center for Complementary and Alternative Medicine (NCCAM)| date = 2006-09-01 | accessdate = 2007-09-26}}</ref> The most cited reasons for introducing massage as therapy have been client demand and perceived clinical effectiveness.<ref name=policy>{{cite web | url = http://web.ebscohost.com/ehost/pdf?vid=4&hid=113&sid=b53edf1d-ce65-438c-ab52-d14158569e4a%40sessionmgr109| title = Policy for Therapeutic Massage in an Academic Health Center: A Model for Standard Policy Development | publisher = The Journal of Alternative and Complementary Medicine| year = 2007 | accessdate = 2007-09-26}} 13 (4) pp.471-475</ref>

In professional settings massage involves the client being treated while lying on a massage table, sitting in a [[massage chair]], or lying on a mat on the floor. The massage subject may be fully or partly [[nudity|unclothed]]. Parts of the body may be covered with [[towel]]s or sheets.

== History ==
[[Image:Thai massage.jpg|thumb|right|250px|Drawings of [[accupressure]] points on [[Sen]] lines at [[Wat Pho]] temple in [[Thailand]].]]

=== Ancient and medieval times ===
Writings on massage have been found in many ancient civilizations including [[Ancient Rome|Rome]], [[Greece]], [[India]], [[Japan]], [[China]], [[Egypt]] and [[Mesopotamia]]. A biblical reference from c.493 BC documents daily massage with olive oil and myrrh as a part of the beauty regimen of the wives of Xerxes ([[Esther]], 2:9-12).<ref name=nccam/> [[Hippocrates]] wrote in [[460 BC]] that "The physician must be experienced in many things, but assuredly in rubbing".<ref name=harvard>{{cite web | url = http://web.ebscohost.com/ehost/pdf?vid=4&hid=13&sid=b53edf1d-ce65-438c-ab52-d14158569e4a%40sessionmgr109| title = Massage Therapy | publisher = Harvard Men’s Health Watch | date = 2006-09-01 | accessdate = 2007-09-26}} 11 (2) pp.6-7</ref>

The Ancient [[China|Chinese]] book called ''[[Huangdi Neijing]]'' by the [[Yellow Emperor]] recommended "massage of skin and flesh".<ref name=facts>{{cite web| url = http://www.ncbtmb.com/consumers_massage_facts.php|title = Massage Facts| publisher = National Certification Board for Therapeutic Massage & Bodywork | accessdate = 2007-09-27}}</ref>
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 relief]]s 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.<ref name="potts">Potts, Malcolm, & Campbell, Martha. (2002). [http://big.berkeley.edu/ifplp.history.pdf History of contraception]. ''Gynecology and Obstetrics'', vol.6, ch.8.</ref>

In [[Romania]] some illnesses were treated by a massage in which the client was trodden on by a tame bear.<ref name="DER">''[http://dexonline.ro/search.php?cuv=c%C4%83lc%C3%A1&source=12 călcá]'' in the ''[[Dicţionarul etimologic român]]'', [[Alexandru Ciorănescu]], [[Universidad de la Laguna]], Tenerife, 1958-1966</ref>

=== Modern times ===
[[File:2006INGTaipeiMarathon-138.jpg|thumb|right|250px|Marathon runners receiving massages at the 2004 ING Taipei International Marathon]]

'''China:'''
In modern times, massage in China has developed by absorbing western ideas into the traditional framework. It is widely practiced and taught in hospital and medical schools and is an essential part of primary healthcare.<ref>[http://www.365tcm.com/articles/what-is-traditional-chinese-massage.html What is Traditional Chinese Massage?]</ref>

'''United States:'''
Massage started to become popular in the [[United States]] in the middle part of the 1800s<ref name=nccam/> and was introduced by two [[New York]] [[physicians]] based on [[Per Henrik Ling]]'s techniques developed in [[Sweden]].<ref name=harvard/>

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.<ref name=nccam/> Massage was used up until the 1960s and 1970s by [[nurses]] to help ease patients’ pain and help them sleep.<ref>{{cite web | url = http://www.immunesupport.com/library/showarticle.cfm/id/6151/searchtext/massage%20and%20cancer%20pain | title = Hospitals Getting a Grip: Massage Therapy Finds Place in Patient Care for FM and More | last = MacGregor | first = H. | publisher = Los Angeles Times| date = 2004-12-28 | accessdate = 2007-08-31}}</ref>

Because it is illegal to advertise or offer sexual services in much of the United States, such services are sometimes advertised as "massage," hence the rise of the term "massage therapy" in an attempt to provide a distinction between sexual and non-sexual services.

'''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:'''
The [[1996 Summer Olympics]] in [[Atlanta]] was the first time that massage was offered as a core medical service.<ref name=facts/> Massage has been employed by businesses and organizations such as the [[U.S. Department of Justice]], [[Boeing]] and [[Reebok]].<ref>{{cite web | url = http://archives.cnn.com/2000/HEALTH/alternative/12/28/massage.therapy/index.html| title = Massage craze: Hands-on therapy attracting more patients| last = Goodman | first = T. | publisher = CNN| date = 2000-12-28 | accessdate = 2007-08-31}}</ref>

== Equipment ==
[[File:Allianz Arena Massageraum Bayern.jpg|thumb|right|225px|Massage tables]]
[[File:'07 Massage at Novell 620.jpg|thumb|right|225px|Massage chairs in use]]

=== Tables and chairs ===
Specialized massage tables and [[Massage chair|chairs]] are used to position clients during massages. 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.

Ergonomic chairs serve a similar function as a massage table. Chairs may be either stationary or portable models.  Massage chairs are easier for the practitioner to transport 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.

=== Vichy shower ===
A [[Vichy shower]] is a form of hydrotherapy which uses a series of shower nozzles which spray large quantities of water over the client while he or she lies in a shallow wet bed, similar to a massage table, but with drainage for the water. The nozzles may usually be adjusted for height, direction, and temperature.

=== Dry-water massage bed ===
A dry-water massage bed uses jets of water to perform the massage of the client's muscles. These beds differ from a Vichy shower in that the client usually stays dry. Two common types are one in which the client lays on a waterbed-like mattress which contains warm water and jets of water and air bubbles<ref name="spabed">[http://www.youtube.com/watch?v=CKG_Yo0cLqA Dry-water massage bed]</ref> and one in which the client lies on a foam pad and is covered by a plastic sheet and is then sprayed by jets of warm water, similar to a Vichy shower.<ref name="amiaspa">[http://www.circlesoflight.com/alternative/water-jet-machine.html Using a Water Massage Machine]</ref> The second type is sometimes seen available for use in malls and shopping centers for a small fee.

=== Oil ===
Many different types of oils can be used including fractionated [[coconut oil]], [[grape seed oil]], [[olive oil]], [[almond oil]], [[macadamia oil]], [[sesame oil]], [[pecan oil]], and [[mustard oil]]. [[Aromatherapy]] oils such as [[neroli oil]] and [[pine oil]] can also be mixed with [[carrier oil]]s. Salts are also used in association with oils to remove dry skin.

=== Body rock ===
A body rock is a serpentine-shaped tool, usually carved out of stone. It's used to amplify the therapist's strength and focus pressure on certain areas. It can be used directly on the skin with a lubricant such as oil or corn starch<ref>[http://www.youtube.com/watch?v=eYW9LXh_JNQ]</ref> or directly over clothing.

== Massage methods ==
Practitioners of massage include massage therapists, [[athletic trainer]]s and [[Physical therapy|physical therapists]]. Massage practitioners work in a variety of medical and recreational settings and may travel to private residences or businesses.<ref name=nccam/> [[Contraindication]]s 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]].<ref name=nccam/>

=== Acupressure ===
{{Main|Acupressure}}
Acupressure (a portmanteau of "[[acupuncture]]" and "pressure") is a [[traditional Chinese medicine]] (TCM) technique derived from acupuncture. With acupressure physical pressure is applied to acupuncture points by the hand, elbow, or with various devices.

[[Image:tractionmassage.JPG|thumb|right|180px|Indian Traction Massage in marma therapy given in '''Sreepathy cvn kalari''' for [[Spinal disc herniation|intervertebral disc prolapse]]]]

=== Anma ===
{{Main|Anma}}
Anma is a traditional Japanese massage involving kneading and deep tissue work.

=== Ayurvedic massage ===
[[Ayurveda]] is a natural health care system originating in [[India]] that incorporates massage, [[yoga]], [[meditation]] and [[herbal]] remedies. Ayurvedic massage, also known as Abhyanga is usually performed by one or two therapists using a heated blend of herbal oils based on the ayurvedic system of [[Dosha#Tridosha system|humors]].

=== Balinese massage ===
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 aromatheraphy oil throughout the massage. A patient's blood, oxygen and energy flow is said to increase as a result of the treatment.{{Citation needed|date=February 2010}} Balinese hot stones are an option.

=== Barefoot deep tissue ===
Barefoot deep tissue, also known as barefoot compressive deep tissue, or barefoot sports massage, is a blend of Eastern barefoot techniques, such as barefoot Shiatsu massage, coupled with Western manual medicine, encompassing deep tissue, myofascial release, trigger point therapy, transverse friction, compression, tension, shear, PNF, stretching, as well as parasympathetic response, on clothed clients using no oil. [[Dara Torres]], 41-year old Olympian, received barefoot compression massage on a daily basis in her training program.<ref>Aug. 15: Spoiler alerts! From ESPN bureau producer Justine Gubar</ref>

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 elbow or thumb, and is ideal for large muscles, such as in thigh, or for long-duration upper trapezius compressions.<ref>Fix Pain: Bodywork Protocols for Myofascial Pain Syndromes
Author: John Harris, Fred Kenyon ISBN 9780966584318 - ISBN 0966584317 Publication Date: 2002</ref> The unclothed cousins of this modality are Keralite, Yumeiho, Barefoot Lomi Lomi, Fijian Barefoot, Chavutti Thirummal.

Ashiatsu Oriental Bar Therapy, which is a form of barefoot effleurage, combines western science and contemporary American ingenuity, for therapists who specialize in deep tissue work using Swedish techniques performed by the massage therapists feet.

=== Bowen therapy ===
{{Main|Bowen Technique}}
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. It is based on practices developed by Australian Tom Bowen.<ref>[http://www.bowen.asn.au/html Bowen Therapists Federation of Australia]</ref>

=== Breema ===
{{Main|Breema}}
Breema bodywork is performed on the floor with the recipient fully clothed. It consists of rhythmical and gentle leans and stretches.

=== Champissage ===
{{Main|Champissage}}
Champissage is a massage technique focusing on the head, neck and face that is believed to balance the [[chakra]]s.

=== Deep tissue massage ===
Deep Tissue massage is designed to relieve severe tension in the muscle and the connective tissue or [[fascia]]. This type of massage focuses on the muscles located below the surface of the top muscles. Deep tissue massage is often recommended for individuals who experience consistent pain, are involved in heavy physical activity, such as athletes, and patients who have sustained physical injury.  It is also not uncommon for receivers of Deep Tissue Massage to have their pain replaced with a new muscle ache for a day or two. Deep tissue work varies greatly.  What one calls deep tissue another will call light. When receiving deep tissue work it is important to communicate what you are feeling.

The term “deep tissue” is often misused to identify a massage that is performed with sustained deep pressure. Deep Tissue massage is a separate category of massage therapy, used to treat particular muscular-skeletal disorders and complaints, and employing a dedicated set of techniques and strokes to achieve a measure of relief. It should not be confused with “deep pressure” massage, which is one that is performed with sustained strong, occasionally intense pressure throughout an entire full-body session, and not to address a specific complaint. It just so happens that Deep Tissue massage is applied to both the superficial and deep layers of muscles, fascia and other structures. The sessions are often quite intense as a result of the deliberate, focused work. When a client asks for a massage and uses the term “deep tissue”, more often than not he or she is seeking to receive a full-body session with sustained deep pressure throughout. If a practitioner employs Deep Tissue techniques, in fact, on the entire body in one session it would not only be next to impossible to perform; it might lead to injury or localized muscle and nerve trauma, thereby rendering the session counterproductive.

=== Esalen massage ===
{{Main|Esalen Institute}}
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.

=== Hilot ===
{{Main|Hilot}}
Hilot is a traditional healing technique from the Philippines that also includes massage techniques. The massage techniques relax stressed muscles. Hilot also includes joint manipulations to help relax stressed muscles.

Hilot encompasses a wide variety of techniques beyond the treatment of stressed muscles. Hilot can be used to reset sprained joints, diagnose and treat musculoligamentous and musculoskeletal ailments, and even to aid in giving birth and to induce abortion. 

Dislocated joints can also be reset by hilot after an X-ray has been done on affected body parts and medical experts advised that the same body parts are safe to be massaged.

After giving birth, hilot can be done on the mother and the baby born of normal delivery for 10 consecutive days so that they may recover easily. Hilot should not be done on mothers who deliver via caesarian section.

Hilot also uses banana leaves and herbs for enhanced efficacy. 

[[Image:Massage.jpg|thumb|180px|Massage in [[Tarifa, Spain|Tarifa]], [[Spain]].]]

=== Lomi Lomi and indigenous massage of Oceania ===
{{Main|Lomi Lomi}}
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 and milimili.  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 as popo, 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]].<ref>Chai, R. Makana Risser, ed. ''Na Mo'olelo Lomilomi: Traditions of Hawaiian Massage and Healing'', Bishop Museum, 2005; Parsons, Claire D. F., ed. ''Healing Practices in the South Pacific'', 1985, The Institute for Polynesian Studies; Tregear, Edward. ''Maori-Polynesian Comparative Dictionary''.  Lyon and Blair, Wellington NZ, 1891</ref>

=== Medical massage ===
Massage used in the medical field includes [[Lymphedema#Complete decongestive therapy|decongestive therapy]] used for [[lymphedema]]<ref name=nccam/> 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.<ref>{{cite journal |author=Lim SH, Anantharaman V, Teo WS, Goh PP, Tan AT |title=Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage |journal=Ann Emerg Med |volume=31 |issue=1 |pages=30–5 |year=1998 |month=January |pmid=9437338 |doi=10.1016/S0196-0644(98)70277-X |url=}}</ref> However, it is less effective than management of SVT with medications.<ref>{{cite journal |author=Ballo P, Bernabò D, Faraguti SA |title=Heart rate is a predictor of success in the treatment of adults with symptomatic paroxysmal supraventricular tachycardia |journal=Eur. Heart J. |volume=25 |issue=15 |pages=1310–7 |year=2004 |month=August |pmid=15288158 |doi=10.1016/j.ehj.2004.05.011 |url=}}</ref>

=== Meso-American ===
In Meso-America as in other areas of the world an indigenous form of soft tissue and structural massage has developed. Today this art survives thanks to the many Sobadoras/es or Hueseros/as that have handed-down these techniques via oral tradition.

=== Mobile massage ===
Given some of the main benefits of massage, many people prefer to have a therapist come to them to perform the treatment as opposed to visiting the therapist. Amongst other things, this type of treatment has the benefits of allowing the recipient to remain in their own environment with which they are likely most comfortable, to avoid the pre and post stresses of travelling to the therapist to receive their massage and of course to retire directly to a place of rest immediately following their massage. Therapists can bring a dedicated table with them on which to perform the massage or perform the treatment on the floor or the client's own bed. Mobile (or outcall) massages are particularly popular in big cities around the world where life can be more hectic than elsewhere and there are many operators of such services in places like London (eg. TheMassageRooms) and New York.

=== Myofascial release ===
Myofascial release refers to the manual massage technique for [[stretching]] the [[fascia]] and releasing bonds between fascia, [[integument]], and [[muscle]]s 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.

=== Myomassology ===
An integration of techniques including basic [[Swedish massage]], [[aromatherapy]], [[reflexology]], shiatsu, energy balancing, and [[craniosacral therapy]] along with other modalities in conjunction with instruction in nutrition, meditation and [[yoga]]. The term Myomassology was coined by [[Irene Gauthier]] to describe her combined work of [[Swedish massage]], craniosacral therapy, reflexology and body mechanics.

=== Postural integration (PI) ===
{{Main|Postural Integration (PI)}}
Postural Integration (PI) is a process-oriented bodywork combining deep tissue massage with breathwork, body movement and awareness as well as emotional expression.

=== Reflexology massage ===
{{Main|Reflexology}}
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 ===
{{Main|Shiatsu}}
Shiatsu (指圧) (''shi'' meaning finger and ''atsu'' meaning pressure) is a Japanese born therapy that uses pressure applied with thumbs, fingers and palms to the same energy meridians as [[acupressure]] and incorporates [[stretching]]. It also uses techniques such as rolling, brushing, vibrating, grasping and in one particular technique developed by Suzuki Yamamoto, pressure is applied with the feet on the persons back, legs and feet (special set up is required for the "foot" shiatsu).

[[Image:Hot stone massage.jpg|thumb|right|180px|A hot stone massage.]]

=== Stone massage ===
{{Main|Stone massage}}
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 river stones 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, releasing tension.

=== Structural integration===
{{Main|Structural integration}}
[[Structural integration]]'s aim is to unwind the strain patterns residing in your 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 [[Kinesis Myofascial Integration]] and [[rolfing]].

=== Swedish massage ===
Swedish massage uses five styles of long, flowing strokes to massage. The five basic strokes are [[effleurage]] (sliding or gliding), [[petrissage]] (kneading), [[tapotement]] (rhythmic tapping), friction (cross fiber) and vibration/shaking.<ref>{{cite web | url = http://www.massageregister.com/western-massage/swedish-massage| title = Swedish Massage}}</ref> 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.<ref>{{cite journal |author=Robertshawe P.|title= Massage for Osteoarthritis of the Knee|journal=Journal of the Australian Traditional-Medicine Society |volume=13 |issue= 2 |pages=87 |month=June | year=2007 |doi=}}</ref> It has also been shown to be helpful in individuals with poor circulation {{Citation needed|date=August 2010}}. The development of Swedish massage is credited to [[Per Henrik Ling]], though the [[Netherlands|Dutch]] practitioner [[Johan Georg Mezger]] adopted the French names to denote the basic strokes.<ref>{{cite web | url = http://www.massagemag.com/Magazine/2002/issue100/history100.php| title = Pages from history: Swedish massage| last = Calver | first = R| publisher = Massage Magazine| accessdate = 2006-12-25}}</ref> The term "Swedish" massage is not really known in the country of Sweden, where it is called "classic massage".<ref>{{cite web | url = http://www.massageschoolsguide.com/massage_article_swedish_massage.htm| title = Swedish massage: The non-Swedish Origins of Swedish Massage| publisher = MassageSchoolsGuide.com| accessdate = 2008-11-24}}</ref>

[[Image:Thaimassage.jpg|thumb|right|250px|Thai Massage]]

=== Thai massage ===
{{Main|Thai massage}}
Known in Thailand as นวดแผนโบราณ (''Nuat phaen boran,'' {{IPA-all|nûɑt pʰἔːn boːraːn}}), meaning "ancient/traditional massage", Thai massage originated in India and is based on ayurveda and [[yoga]]. The technique combines massage with yoga-like positions during the course of the massage; the northern style emphasizes stretching while the southern style emphasizes acupressure.

=== Traditional Chinese massage ===
Two types of traditional Chinese massage exist - [[Tui na]] (推拿) which focuses on pushing, stretching and kneading the muscle and Zhi Ya (指壓) which focuses on pinching and pressing at [[acupressure]] points. Both are based on principles from [[Traditional Chinese Medicine]].
Though in the Western countries Tui Na is viewed as massage, it is not. Massage of Chinese Medicine is known as Anmo(按摩）, which is the foundation of Japan's Anma.

Tui Na is Chinese Medicine's Physio-Therapy. Utilized for medical purposes instead of relaxation, Tui Na works to correct the patient's problems, from musculoskeletal conditions, to diseases, cancers and even minor and major headaches.

Within the foundation of Tui Na, Traditional Chinese Medicine principles are followed, from Meridian Applications to Herbal Formulas, Qigong Therapy and heated herbal application (Moxa). Technique applications such as friction and vibration are used as well.

=== Trager approach ===
{{Main|Trager Approach}}
The Trager approach combines movement, massage and education.

=== Trigger point therapy ===
Sometimes confused with pressure point massage,<ref name=nccam/> 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.<ref>David G Simons, Siegfried Mense and IJ Russell, Muscle Pain: Understanding Its Nature, Diagnosis and Treatment Chapter: Myofascial Pain Caused by Trigger Points p.205–288 (1st hardcover edition), 2000, Lippincott Williams & Wilkins</ref> and in 2007 a paper was presented showing images of Trigger Points using MRI.<ref>Chen et al., p.2 2007, Archives of Physical Medicine and Rehabilitation</ref> 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.

=== Visceral manipulation ===
One form is Mayan abdominal massage which is practiced in many countries in Latin America. This type of massage was developed by [[Elijio Panti]] of Belize and brought to the United States by Rosita Arvigo. Even though Panti was a respected and well known user of Mayan massage, he did not develop this modality. "Mayan Massage" techniques have been used since before the Spanish conquest and is still practiced today by many Sobadores or Hueseros.

=== Watsu ===
{{Main|Watsu}}
Watsu is the combination of [[hydrotherapy]] and [[shiatsu]] developed by [[Harold Dull]]. 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&nbsp;ft to 4&nbsp;ft (100&ndash;120&nbsp;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)|bodywork]], [[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 therapy|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 ==
[[File:Le massagr au Hamam par Edouard Debat-Ponsan 1883.jpg|thumb|right|250px|''Le massage: scène au Hammam'' by Edouard Debat-Ponsan (1883)]]

Peer-reviewed medical research has shown that the benefits of massage include [[Analgesia|pain relief]], reduced trait [[anxiety]] and [[Depression (mood)|depression]], and temporarily reduced blood pressure, heart rate, and state of anxiety.<ref name= Meta/> Theories behind what massage might do include blocking [[nociception]] ([[Pain#Gate_Control|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]]<ref name=nccam/>, but such effects are yet to be supported by well-designed clinical studies.

Massage is hindered from reaching the [[Gold standard (test)|gold standard]] of [[Scientific method|scientific research]], which includes [[placebo]]-controlled and [[Blind experiment|double blind]] [[clinical trial]]s.<ref name=minn>{{cite web | url = http://takingcharge.csh.umn.edu/therapies/massage/research| title = What Does the Research Say?| last = Evans | first = R. | publisher = Regents of the University of Minnesota| year = 2006 | accessdate = 2007-12-06}}</ref><ref name=anatomy>{{cite web | url = http://www.massagetherapyfoundation.org/pdf/Anatomy%20of%20a%20research%20article.pdf| title = Anatomy Of A Research Article| last = Muscolino | first = J. | publisher = Massage Therapy Foundation| year = 2004 | accessdate = 2007-12-06|format=PDF}}</ref> 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.<ref name=minn/> 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.<ref name=minn/> Massage can employ [[randomized controlled trials]], which are [[published]] in [[Medical peer review|peer reviewed]] [[medical journal]]s.<ref name=minn/> This type of study could increase the [[credibility]] of the profession because it displays that purported therapeutic effects are [[Reproducibility|reproducible]].<ref name=anatomy/>

=== Single dose effects ===
[[Image:Massage Chairs in VivoCity.jpg|thumb|250px|right|Mechanical [[massage chair]]s at [[VivoCity]] in [[Singapore]].]]

* '''Pain relief:''' Relief from pain due to [[musculoskeletal]] injuries and other causes is cited as a major benefit of massage.<ref name=nccam/> In one study, [[cancer]] patients self-reported symptomatic relief of pain.<ref name=ncbi>{{cite journal |author=Cassileth BR, Vickers AJ |title=Massage therapy for symptom control: outcome study at a major cancer center |journal=J Pain Symptom Manage |volume=28 |issue=3 |pages=244–9 |year=2004 |month=September |pmid=15336336 |doi=10.1016/j.jpainsymman.2003.12.016 }}</ref><ref>{{cite journal |author=Grealish L, Lomasney A, Whiteman B |title=Foot massage. A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer |journal=Cancer Nurs |volume=23 |issue=3 |pages=237–43 |year=2000 |month=June |pmid=10851775 |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0162-220X&volume=23&issue=3&spage=237}}</ref>  [[Acupressure]] or pressure point massage may be more beneficial than classic Swedish massage in relieving [[back pain]].<ref name=pmid12076429>{{cite journal | author = Furlan A, Brosseau L, Imamura M, Irvin E | title = Massage for low back pain. | journal = Cochrane Database Syst Rev | volume = | issue = 2| pages = CD001929 | year = 2002| pmid = 12076429 | doi = 10.1002/14651858.CD001929}}</ref> 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.<ref name= Meta>{{cite web | url = http://www.anatomyfacts.com/Research/Massage%20Journal%20Club/January07/Moyer.pdf | title = A Meta-Analysis of Massage Therapy Research.| publisher = Psychological Bulletin | year = 2004 | accessdate = 2008-01-12|format=PDF}}</ref>
* '''State anxiety:''' Massage has been shown to reduce state [[anxiety]], a transient measure of anxiety in a given situation.<ref name= Meta/>
* '''Blood pressure and heart rate:''' Massage has been shown to reduce blood pressure and heart rate as temporary effects.<ref name= Meta/>
* '''Attention:''' After massage, [[EEG]] patterns indicate enhanced performance and alertness on [[mathematical]] computations, with the effects perhaps being mediated by decreased stress [[hormones]].{{Citation needed|date=May 2010}}
* '''Other:''' Massage also stimulates the [[immune system]]<ref>{{cite journal |author=Kuriyama H |title=Immunological and Psychological Benefits of Aromatherapy Massage |journal=Evidence-based Complementary and Alternative Medicine| year=2005 |pages=179–84 |volume=2 |issue=2 |pmc=1142199 |doi=10.1093/ecam/neh087 |pmid=15937558 |last2=Watanabe |first2=S |last3=Nakaya |first3=T |last4=Shigemori |first4=I |last5=Kita |first5=M |last6=Yoshida |first6=N |last7=Masaki |first7=D |last8=Tadai |first8=T |last9=Ozasa |first9=K}}</ref> 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]].{{Citation needed|date=May 2010}} 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]].<ref name=Furlan>{{cite journal |author=Furlan AD, Imamura M, Dryden T, Irvin E |title=Massage for low-back pain |journal=Cochrane Database Syst Rev |issue=4 |pages=CD001929 |year=2008 |pmid=18843627 |doi=10.1002/14651858.CD001929.pub2}}</ref> Furthermore, massage has been shown to reduce pain experienced in the days or weeks after treatment.<ref name= Meta/>
* '''Trait anxiety:''' Massage has been shown to reduce trait [[anxiety]]; a person's general susceptibility to anxiety.<ref name=Meta/>
* '''Depression:''' Massage has been shown to reduce subclinical [[Depression (mood)|depression]].<ref name=Meta/>
* '''Diseases:''' Massage, involving stretching, has been shown to help with [[spastic diplegia]] resulting from [[Cerebral palsy]] in a small pilot study.<ref name="pmid17355474">{{cite journal |author=Macgregor R, Campbell R, Gladden MH, Tennant N, Young D |title=Effects of massage on the mechanical behaviour of muscles in adolescents with spastic diplegia: a pilot study |journal=Developmental medicine and child neurology |volume=49 |issue=3 |pages=187–191 |year=2007 |pmid=17355474 |doi=10.1111/j.1469-8749.2007.00187.x}}</ref> 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.<ref name=Saltmarsh >{{cite journal |author=Saltmarsh, S.|title=Voodoo or valid? Alternative therapies benefit those living with HIV |journal=Positively Aware | volume=3 | issue=16|pages=46 |year=2006 | pmid=16479668|url=http://www.tpan.com/publications/pa/may_jun_05/voodoo.shtml |format={{Dead link|date=March 2010}}}}</ref>

== Regulation ==
{{Globalize|date=April 2010}}
Because the art and science of massage is a globally diverse phenomenon, different legal jurisdictions sometimes recognize and license individuals with titles, while other areas do not. Examples are:
* Registered Massage Therapist (RMT) Canada
* Remedial Massage Therapist (RMT) New Zealand
* Certified Massage Therapist (CMT) New Zealand
* Licensed Massage Practitioner (LMP)
* Licensed Massage Therapist (LMT)
* Licensed Massage and Bodywork Therapist (LMBT) North Carolina

=== Canada ===
In Canada only three [[provinces]] regulate massage therapy:<ref name=overviewca>{{cite web | url = http://nccam.nih.gov/news/upcomingmeetings/abstracts_mt/overview_canada.htm| title = Overview of Manual Therapy in Canada| last = Verhoef | first = M. | publisher = The National Center for Complementary and Alternative Medicine (NCCAM)| date = 2005-06-10 | accessdate = 2007-09-26}}</ref> [[British Columbia]], [[Ontario]], and [[Newfoundland and Labrador]].<ref name=law/> 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, which has the highest education standard in North America.<ref name=overviewca/>

=== China ===
Most types of massage, with the exception of some [[traditional Chinese medicine]] are not regulated in China. Although illegal in China, many of the smaller massage parlors are fronts for prostitution.<ref>[http://gochina.about.com/od/tripplanning/a/prostitution.htm About.com - Traveler Warning: Prostitution in China]</ref> These are called [[Prostitution_in_the_People's_Republic_of_China#Types_and_venues|falangmei]] (发廊妹 "hairdressing salon sisters").

=== France ===
France requires three years of study and two final exams in order to get a license.<ref>[http://answers.yahoo.com/question/index?qid=20100412190941AAmFImG Yahoo Answers: Massage therapy laws in France?]</ref>

=== Germany ===
In Germany Massage is regulated by the Government on a federal and national level.  Only someone who has completed 3,200 hours of training (theoretical and practical) can use the professional title "Masseur und Medizinische Bademeister" or Medical Masseur and Spa Therapist.  This person can prolong his training depending on the length of professional experience to a Physiotherapist (1year to 18 months additional training).  The Masseur is trained in Classical Massage, Myofascial Massage, Exercise and Movement Therapy.  During the training they will study: Anatomy, Physiology, Pathology, Gynecology, Pediatry, Psychiatry, Psychology, Surgery, and probably most importantly Dermiatry and Orthopedics.  They are trained in Electrotherapy, and Hydrotherapy.  Hydrotherapy includes: Kneipp, Wraps, underwater Massage, therapeutic washing, Sauna and Steambath.  A small part of their training will include special forms of massage which are decided by the local college, for example: Foot reflex zone massage, Thai Massage etc.  Finally a graduate is allowed to treat patients under the direction of a doctor.  He is regulated by the professional body which regulates Physiotherapists.  This includes the restriction on advertising and Oath of confidentiality to clients.

=== India ===
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 1995.

=== Japan ===
In [[Japan]], shiatsu is regulated but oil massage and Thai massage are not.<ref>[http://www.thefreedomride.org/2008/09/been-teaching-in-london-and-getting.html Brandon Raynor's blog]</ref> Although prostitution is illegal, prostitutes posing as massage therapists in [[fashion health]] shops and [[pink salons]] are fairly common in the larger cities.

=== Mexico ===
In Mexico massage therapists, called "''sobadores''", combine massage using oil or lotion<ref name="sobadores1">[http://www.liveincostarica.com/blog/2010/05/what-the-heck-are-sobadores-and-pegas.html What the heck are sobadores and pegas?]</ref> with a form of acupuncture and faith.<ref name="sobadores2">[http://www.nydailynews.com/latino/2009/03/25/2009-03-25_mexican_tradition_of_massage_lives_on_in-2.html Mexican tradition of massage lives on in Tijuana]</ref> ''Sobadores'' are used to relieve digestive system problems as well as knee and back pain.<ref name="sobadores1" /><ref name="sobadores2" /> Many of these therapists work out of the back of a truck, with just a curtain for privacy.<ref name="sobadores2" /> By learning additional holistic healer's skills in addition to massage, the practicioner may become a ''curandero''.<ref name="sobadores3">[http://www.massagetherapy.com/articles/index.php/article_id/208/Curanderismo%3A-Mexican-Folk-Healers Curanderismo: Mexican Folk Healers]</ref> 

In many parts of Mexico prostituion is legal and prostitutes are allowed to sell sexual massage. These businesses are often confined to a specific area of the city, such as the [[Zona Norte (Tijuana)|Zona Norte]] in [[Tijuana]].

=== New Zealand ===
In New Zealand, massage is unregulated.  There are two levels of "registration" with [http://massagenewzealand.org.nz/ Massage New Zealand], the professional body for massage therapists within New Zealand, although neither of these levels are government recognised.  Registration at the Certified Massage Therapist level denotes competency in the practice of relaxation massage.  Registration at the Remedial massage therapist denotes competency in the practice of remedial or orthopedic massage.  Both levels of registration are defined by agreed minimum competencies and minimum hours.

=== South Korea ===
In [[South Korea]], only blind and visually-impaired people can become licensed masseurs.<ref>{{cite news| url=http://news.bbc.co.uk/2/hi/asia-pacific/7699114.stm | work=BBC News | title=Blind S Korea masseurs win case | date=2008-10-30 | accessdate=2010-04-05}}</ref>

=== United States ===
In the United States there are about 90,000 massage therapists.<ref name=harvard/> Most states in the United States require a license to practice massage therapy. If a state does not have any massage laws, then the national certification in massage therapy is not required and a practitioner need not apply for a license with the state. However, the practitioner will need to check whether any local or county laws cover massage therapy. 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.<ref name=overview>{{cite web | url = http://nccam.nih.gov/news/upcomingmeetings/abstracts_mt/overview_US.htm | title = Overview of Manual Therapy Use in the U.S. | last = Kahn | first = J. | publisher = The National Center for Complementary and Alternative Medicine (NCCAM) | date = 2005-06-10 | accessdate = 2007-09-26}}</ref> 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.<ref name=nccam/> The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S.

Thirty-nine states, the District of Columbia and four Canadian provinces currently offer some type of credential to professionals in the massage and bodywork field---usually licensure, [http://www.massagemag.com/Resources/massage-laws-legislation.php certification or registration].<ref name=policy/><ref>[http://www.massageregister.com/massage-license-requirements Massage License Requirements]</ref> Thirty-eight states and the [[District of Columbia]] require some type of licensing for massage therapists.<ref name=stellin>{{cite web | url = http://www.nytimes.com/2007/07/15/business/yourmoney/15spa.html | title = Beyond the Body Wrap: What Makes a Spa Stand Out? | last = Stellin | first = S. | publisher = New York Times | date =2007-07-15 | accessdate = 2007-09-20}}</ref> 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]].<ref>{{cite web | url = http://www.ncbtmb.org/about_required_states.php|title = States that require NCBTMB exams| publisher = National Certification Board for Therapeutic Massage and Bodywork| accessdate = 2007-09-27}}</ref> The National Board grants the designation Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). There are two tests available and one can become certified through a portfolio process with equivalent training and experience.<ref>{{cite web | url = http://www.ncbtmb.com/applicants_what_you_need_to_know.php|title = What you need to know| publisher = National Certification Board for Therapeutic Massage and Bodywork| accessdate = 2007-09-27}}</ref> Between 10% and 20% of towns or counties regulate the profession.<ref name=law>{{cite web | url = http://www.naturalhealers.com/qa/massage.html|title = Massage Therapy Law and Licensure and States Regulating Massage| publisher = Natural Healers| accessdate = 2007-09-27}}</ref> 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 regarding sale of sexual services.<ref name=law/><ref name=walsh>{{cite web | url = http://www.massagemag.com/Magazine/2003/issue106/statelaw106.php| title = Massage craze: Hands-on therapy attracting more patients| last = Walsh | first = K. | publisher = Massage Magazine | accessdate = 2007-08-31}}</ref>

In the US, [[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.<ref name=walsh/>

In late 2007, the Federation of State Massage Therapy Boards launched a new certification exam titled the MBLEx. Approximately [http://www.massagemag.com/Resources/massage-laws-legislation.php 13 states] have accepted this certification exam.

== Prevalence in the United States ==
In 1997 there were an estimated 114 million visits to massage therapists in the US.<ref name=overview/> Massage therapy is the most used type of [[complementary and alternative medicine]] in hospitals in the United States.<ref name=policy/>

People state that they use massage because they believe that it relieves pain from [[musculoskeletal]] injuries and other causes of pain, reduces [[stress (medicine)|stress]] and enhances [[Relaxation (psychology)|relaxation]], rehabilitates sports injuries, decreases feelings of anxiety and depression, and increases general well being.<ref name=nccam/>

In a poll of 25-35 year olds 79% said they would like their health insurance plan to cover massage.<ref name=facts/> Companies that offer massage to their employees include [[Allstate]], [[Best Buy]], [[Cisco Systems]], [[FedEx]], [[Gannett]] (which runs [[USA Today]]), [[General Electric]], [[Google]], [[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]].<ref>{{cite web | url = http://www.massagemag.com/News/2007/January/Whole.php| title = First-of-its-Kind Center Treats the Whole Person | publisher =Massage Magazine| date = January 2007 | accessdate = 2007-09-27}}</ref> There were 15,500 [[destination spa|spas]] in the [[United States]] in 2007 with about a third of the visitors being men.<ref name=stellin/>

The number of visits rose from 91 million in 1999 to 136 million in 2003, generating a revenue that equals $11 billion.<ref>{{cite web | url = http://www.nytimes.com/2005/07/21/business/21sbiz.html | title = Now Let Us All Contemplate Our Own Financial Navels | last = Ellin | first = A. | publisher = New York Times| date = 2005-07-21 | accessdate = 2007-09-20}}</ref>

== See also ==
* [[Applied kinesiology]]
* [[Erotic massage]]
* [[Infant massage]]
* [[Mechanotherapy]]
* [[Naprapathy]]
* [[Physical medicine and rehabilitation]]

== Notes ==
{{Reflist|2}}

== External links ==
{{Wiktionary|massage}}
{{Commons category|Massage}}
* [http://www.umm.edu/altmed/articles/massage-000354.htm How Massage Works]

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{{Massage types}}
{{Allied health professions}}
{{nudity}}

[[Category:Massage| ]]
[[Category:Mind-body interventions]]
[[Category:Manipulative therapy]]
[[Category:Orthopedic surgery]]
[[Category:French loanwords]]
[[Category:Massage therapy| ]]

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