Massage involves acting on and manipulating the body with pressure – structured, unstructured, stationary, or moving – tension, motion, or vibration, done manually or with mechanical aids. Target tissues may include muscles, 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 hands, fingers, elbows forearm, and feet. There are over eighty different recognized massage modalities. The most cited reasons for introducing massage as therapy have been client demand and perceived clinical effectiveness.