In Mexico massage therapists, called "sobadores", combine massage using oil or lotion[102] with a form of acupuncture and faith.[103] Sobadores are used to relieve digestive system problems as well as knee and back pain.[102][103] Many of these therapists work out of the back of a truck, with just a curtain for privacy.[103] By learning additional holistic healer's skills in addition to massage, the practitioner may become a curandero.[104]
Thai Yoga Massage School in Thailand also offers a foundation for the development of foot reflexologist. It has received authorization from Thai Ministry of Public Health. The course is taught by the vice president of Foundation for Development of Foot Reflexologist Thailand from the beginning until the end of the course. For those who have completed the course and pass the exam, they will be given a membership card of TYMS society which is authorized by Thai Government as the certification and qualification to become a practitioner in reflexology fields.21
Sometimes confused with pressure point massage,[10] 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[71] and in 2007 a paper was presented showing images of Trigger Points using MRI.[72] These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this technique is different from reflexology, acupressure and pressure point massage.
No one really knows how a painful massage can also feel so good at the same time. This is a sensory phenomenon mostly beyond the reach of science — not entirely14 — all we can do is speculate. A main question is whether good pain is good because we expect relief to follow pain, or because positive and negative qualities are being produced simultaneously. My bet is on the latter.

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Research shows that firmer massages with more pressure can result in a significant reduction in arthritis pain compared to lighter massages. Lighter massage tends to be arousing (not relaxing) because often the heart rate goes up. However, with moderate pressure, heart rate usually goes down, and this stimulates relaxation and reduced tension. (13)
It’s just a theory: no one knows if this is actually effective.11 However, it may explain why so many massage patients report a “gets a bit worse before it gets much better” response to quite painful treatments: motor end plates are (painfully) destroyed by strong pressures, and then that tissue is quite sensitive and a bit weak as it heals over a day or two … and then you finally feel much better after that!

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