Relaxing with massage.

The key to a good massage is a qualified therapist.

It's 6:00 p.m. For may people, it's the end of a hectic, pressure-packed day of meeting deadlines, making decisions, and coping with crises. And an increasing number are finding no better way to sooth the tension than by being in the hands of a massage therapist.

In recent years massage has emerged as a popular health-enhancing therapy for all kinds of people--from the professional athlete who wants to loosen up before a game to the office worker who wants a break from the computer terminal. For some, massage has become as essential to their health regimen as regular exercise and a low-fat diet.

"Touch is a basic nutrient for all human beings," says Leslie Leonelli, a New York City practitioner who has developed specialized applications of massage therapy. "For people of any age, it is psychologically and physically comforting to be touched."

The increasing demand for massage therapy is reflected in the growth of the American Massage Therapy Association (AMTA), the oldest and largest national organization representing the profession. Its membership has tripled in the past five years, and enrollment in curriculum-approved massage therapy schools has nearly doubled since 1986.

"Its time has come," says Ralph R. Stephens, member of the board of directors of the AMTA. "The baby boomer generation has become interested in their health. They want to live longer and stay fit. As a result, they're looking for things that help them deal with the pressures of life. Massage is one of the things that helps do that."

While massage has enjoyed a surge in popularity in the past decade, it's nothing new. The first written record of massage dates back to 3000 B.C. in China. Greek and Roman physicians used it. Hippocrates, considered the father of modern medicine, wrote, "The physician must be experienced in many things, but most assuredly in rubbing."

The methods of massage used today are derived from both Eastern and Western traditions. Eastern methods stretch back to the folk medicine of China and the Ayurvedic medicine of India. Shiatsu, one of today's common massage techniques, originates from these sources, as do other contemporary methods. Modern Western massage has its roots in nineteenth-century Sweden, where a combined hands-on technique with therapeutic exercise became known as the original Swedish massage.

Today's approaches to massage vary. Some therapists focus on one or two systems, while others combine basic techniques to develop their own styles. But most practitioners apply the fundamental disciplines they have learned through formal training. Briefly described, the most commonly encountered methods are:

Swedish massage--perhaps the most popular form of massage in the West. This method uses strokes that smooth and knead muscles, combined with movements of the joints.

Shiatsu--used widely in Japan for more than 1,000 years. The therapist uses stretches and finger pressure along the torso and limbs.

Reflexology--massage centers on the hands and particularly the feet.

Medical massage--treats chronic conditions that result in pain and limited mobility. Constant neck and upper back pain, tennis elbow, carpal tunnel syndrome, sciatica, lower back pain, and chronic pain associated with an injury can be treated by medical massage.

Myofascial release--also known as deep tissue massage. Uses slow strokes and deep finger pressure on tight areas.

Trigger point therapy--sustained pressure is used to relax specific points," of pain and irritation in the muscle tissue.

A skilled massage therapist stretches and loosens muscles and connective tissue, which helps to improve circulation and promote relaxation and a general sense of well-being.

Drawing from traditional therapies, practitioners continue to refine methods and develop new, specialized treatments. Among these are sports massage, massage for singers, massage for pregnant women, and on-site massage.

Sports massage has attracted the attention of professional athletes as well as amateur sports enthusiasts. "I think it's an important adjunct to the total management of the body and the mind of the athlete," says Gary Wadler, M.D., expert in sports medicine and physician to the U.S. Open Tennis Championships. "It enhances the local circulation to remove the metabolic wastes. It helps to break up the local adhesions or scarring in muscle areas that have been used a lot. Clearly it promotes relaxation, makes you feel calm, and gives you a general sense of well-being."

Massage for singers, developed by Leonelli, is a treatment designed to address the needs of people who use their voices extensively. The therapy helps to increase flexibility in the rib cage, enhance respiratory capability, and encourage greater relaxation in the muscles involved in vocal production, according to Leonelli.

Pregnant women have recently recognized the benefits of massage. A special treatment for mothers-to-be helps to soothe and relieve swollen feet and legs, back and neck aches, and other discomfort associated with pregnancy.

Massage therapists are also adding their touch to the work place. On-site massage, in which a practitioner travels with a specially designed chair to the office, is a 15-minute treatment that concentrates on the shoulders, back, neck, and forearms. "To have 15 minutes of massage in the middle of the day goes a lot further than a cup of coffee or a cigarette," says Leonelli.

The key to a good massage is a good massage therapists. A qualified therapist will ask questions to learn about your physical condition and medial history. Always keeping the comfort of the patient in mind, the experienced practitioner will give a massage that suits your body type and needs. A good therapist should also know when to recommend other forms of treatment.

Currently 17 states have laws requiring massage therapists to be licensed or certified in order to practice. While the requirements for certification vary from state to state, most therapists must complete a thorough study of anatomy and physiology as well as extensive classroom training in the theory and practice of massage therapy. To become members of the AMTA, massage therapists must either graduate from an AMTA-approved program or pass an entrance exam.

There are several sources for finding a qualified, experienced practitioner. Many health clubs and Y's have massage therapist on staff. You can get recommendations from health professionals and by contacting the AMTA at 313-761-AMTA.

While most people can enjoy the benefits of massage, health professionals do not recommend massage for people with certain circulatory ailments, especially phlebitis/thrombosis, as well as high fevers, infectious disease, some types of cancer, cardiac problems, inflamed or infected injuries, areas of hemorrhage or heavy tissue damage, and recent fractures or sprains.

Prices for a massage can range anywhere from $40 to $80 for a 60-minute session. Some insurance companies will cover the cost if the therapy is prescribed by a physician, chiropractor, or osteopath.

Massage may not cure the common cold, but it does offer an antidote to the rigors of daily life. "It's a great thing to do for yourself," says Stephens. "It's a therapy that's been around for thousands of years and it's being rediscovered." Jennifer Geertz writes from Stamford, Connecticut.