March 22, 2017



Natural Standard Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Related Terms

  • Mentastics, psychophysical integration, Trager therapy, tragerwork.


  • Trager therapy is a technique that integrates gentle massage and non-strenuous exercises intended to help the body's muscles relax. Through these methods, Trager therapists work to help their patients achieve a state of body awareness, which is known as "psychophysical integration." Trager therapy emphasizes self-awareness of muscles, joints, and physical postures. The goal of the treatments are to assist patients in changing unconscious habits of posture that cause many of the symptoms they are experiencing. Trager theory is based on the idea that accumulated tension is slowly dissipated as body awareness increases.

  • Trager therapy is performed on the premise that muscle abnormalities or tensions caused by stress or physical injury may restrict the ability of muscles to expand and contract. When muscles cannot expand and contract as well as they once did, muscles may begin to remain fixed in one position, and the patient may not be able to move as freely. The patient's mind may also begin to believe that moving freely is no longer possible, and this belief may be an obstacle in the patient's recovery. For instance, a person with stressful circumstances, such as depression or injuries from a car accident, may accumulate tension in their muscles. The accumulated tension may not be obvious at first, but over time the patient may not be able to, for instance, turn their head to the side as far as was once possible. In the philosophy of Trager therapy, healing this restriction in movement may come from helping the patient's mind realize that it is able to soothe the tension in the neck muscles and let go of this tightness.

  • Trager therapy was invented when the young Milton Trager, who overcame a childhood spinal deformity through athletics, helped his boxing coach feel better through massage. This experience inspired the young man to give massage to his father and other individuals in his life with disabilities. Many of them experienced recoveries, and Milton developed Trager therapy through a process of trial and error.

  • Trager therapy is most commonly advocated for individuals with stress, psychosomatic conditions, and/or neuromuscular conditions, such as back pain. Advocates claim that Trager therapy is helpful to these individuals because the accumulated tension in their muscles may increase the intensity and pain of these types of conditions. Trager therapy is aimed at helping patients remove muscle tension, so that the pain and restriction in movement dissipates.

  • Trager therapy is difficult to study in a laboratory setting because treatments are based on changing states of consciousness, perceptions of pain, and subjective states of muscle tension, which are difficult to reproduce or prove.

  • Trager therapy may be a successful form of treatment for individuals who have not benefited from more passive forms of bodywork therapies, such as chiropractic treatment. Every session of Trager therapy includes time for the patient to practice movements that may be less difficult after a massage. This is in contrast to other forms of bodywork, where normally the patient lies passively and receives the treatment and is not instructed to practice movements as a part of the session. Today, the Trager Institute promotes Trager therapy and monitors the certification of its practitioners.


  • Trager therapists begin sessions by discussing the patient's medical history and any current physical problems. Regardless for the reason of coming to the Trager practitioner, emotional problems are also discussed. Creating connections between one's state of mind and one's physical state is a key goal of this modality. Trager therapists believe that difficult or undesirable emotional states may lead to the accumulation of muscular tension in the body.

  • Trager therapy sessions are intended to be a relaxing experience. The demeanor of the therapist is intended to be as calming as their physical approach. The movements are never forced, no oils are used, and the physical technique of the massage and exercises should never be painful. The patient should feel relaxed as the session proceeds.

  • A typical session may last from 60 to 90 minutes. Sessions usually take place between a practitioner and a single patient. The number of sessions a person may need will vary. Doing the exercises taught during the session is considered crucial for success of Trager treatment. Ten to fifteen minutes of the suggested exercises per day are generally recommended.

  • There are always two components to the Trager therapy session: Tablework and Mentastics.

  • Tablework: The first part of the Trager session is called Tablework. During this time, a patient generally removes as much clothing as the person is comfortable with in the area that will be massaged. The patient lies on a special padded table. The practitioner rubs, rocks, shakes, and stretches various part of the body to loosen tight muscles and joints. This type of massage is intended to help the patient reach a state of deep relaxation. Once the muscles are relaxed, the patient may experience patterns of movement that are not possible with very tight muscles. These muscle patterns may cause pain and muscle tightness, and the goal of Tablework is to release these patterns. Tablework should never feel uncomfortable or painful. When the muscle patterns are released, the patient should be able to continue on to the Mentastic exercises in order to re-learn movements.

  • Mentastics: The second half of the session involves learning simple sequences of movements, called Mentastics. The practitioner teaches these movements in order to increase physical mobility and reduce tension. These exercises are not done to improve endurance or strength, but instead they are aimed at helping the patient achieve a relaxed state, both emotionally and physically. Participation in the movements is intended to help the patient's body and mind learn that moving freely does not need to be difficult or painful. This is considered a key step in releasing physical tightness and pain. Movements vary from simply shifting from foot to foot to performing large dance-like movements. Patients are encouraged to let go of self-consciousness in order to fully relax their muscles. These movements are intended to improve the patient's awareness of their body, so that tension is not accumulated in the muscles or joints.


  • Trager therapy is designed to send a message to the unconscious mind that movement can be easy and painless. For this reason, advocates claim Trager therapy may work best for people who have had pain or restriction in movement for a long time. Performing Mentastics after a massage supposedly allows the body to achieve a greater range of motion than before the session. Mentastics are also intended to change the mind's associations of movement from one of pain to one of effortlessness.

  • Trager therapists believe that tension may accumulate in the muscles and joints as a result of stress, accidents, and other causes. Advocates claim that the Trager technique works to relieve this tension and teaches the patient how to prevent tension accumulation in the future.

  • A 2004 study by Foster et al. studied the Trager approach in patients with chronic headache. Patients who received Trager therapy reported a decrease in the frequency of headaches, as well as a decrease in medication usage.

  • A 2002 study by Duval et al. studied the effect of Trager therapy on Parkinson's patients with muscle rigidity. After six weeks of treatment, patients showed increased flexibility in their hands and wrists. Hand and wrist flexibility were the only changed movements that were accounted for in this study.


  • Pregnant women, patients who have a history of blood clots (thromboembolism), or patients who have had joint surgery in the last three months should not receive Trager therapy.

  • Trager therapy is not appropriate for joints that are swollen due to rheumatoid arthritis.

  • Some patients with a history of anxiety or psychological trauma may become anxious as relaxation increases during the session. Patients should communicate these feelings to the Trager practitioner and discuss any psychological history before the session begins.

  • Patients with a history of fatigue or severe muscle tension may feel sore for up to a day after a session. The soreness is thought to be caused by the accumulated tension that has decreased as a result of the therapy.

Author Information

  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).


Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Centers for Disease Control and Prevention. www.cdc.gov.

  2. Duval C, Lafontaine D, Hébert J, et al. The effect of Trager therapy on the level of evoked stretch responses in patients with Parkinson's disease and rigidity. J Manipulative Physiol Ther. 2002 Sep;25(7):455-64. View Abstract

  3. Energy Medicine Institute. www.energymed.org.

  4. Foster KA, Liskin J, Cen S, et al. The Trager approach in the treatment of chronic headache: a pilot study. Altern Ther Health Med. 2004 Sep-Oct;10(5):40-6. View Abstract

  5. Trager Approach. www.trager.com.

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.


March 22, 2017