Definition of Sports Massage

It can be said that massage itself has an aim of normalising the body, although each person`s body will vary hugely, and that “normal” will include a healthy and fully functioning body.

Competitors or athletes have an aim of improving their performance whatever their level of competition, and the major risk to their performance lies in injury. Sports massage therefore takes the basic concept of massage which includes normalising muscle tone, promoting relaxation, stimulating circulation and giving therapeutic effects on all body systems, and adds to it the prevention of injuries and the assessment and treatment of existing injuries. All of this is produced through the scientific manipulation of the body`s soft tissue.

Many top athletes nowadays have integrated sports massage into their training programmes and as the knowledge of this spreads through to the recreational sportsperson it is likely that sports massage will become more commonplace.

There are various types of Sports Massage, maintenance, injury prevention, event massage and rehabilitation which differ in their aims but their application is not isolated, and aspects of each can be integrated into a treatment depending upon the athletes requirements and situation. Maintenance is part of a regular programme to keep correct muscle tone and flexibility and extend range of motion, whilst injury prevention is more concerned with removing the minor soft tissue issues that could develop into significant problems if untreated, and developing strength to better cope with improved performance. Rehabilitation concerns the healing process after injury to return the athlete to a balanced condition.

Event massage is divided into pre-event and post-event massage.

Pre-Event Massage: Pre-event can be considered as anything between 2 days and a few minutes before the event and will vary accordingly.

Two days beforehand give the opportunity to give a deep, thorough and relaxing massage in order to provide the maximum recuperative benefit from the tapering down process that should precede an event. This is because the deep treatment, including addressing any specific problems of the athlete, can take a couple of days in recovery time, and if given too close to the event may be counterproductive. The relaxation effect can also be detrimental if given too close beforehand as it can withdraw the rapid response an athlete may require to compete.

The closer the event the more the massage is focussed on the muscles to be used in the particular sport and what the athlete themselves requests. The muscles to be used can be ascertained by asking which areas usually hurt after competition.

A popular perception of on-site pre-event massage is that it needs to be stimulating and invigorating to fire up the athlete ready to compete, but the adrenaline released by nerves and anticipation may have already achieved this effect.  Some athletes will require to be more relaxed and calm, for example in shooting or bowls.

On-site massage ideally  should be integrated with the athlete’s warm up routine, especially in the last hour or so. A well prepared athlete will require little or no physical work, but going through a light routine can give a psychological boost. What physical treatment is given is usually given through clothes and without oil, using shaking, squeezing and pressure techniques.

For those who require stimulation the treatment is vigorous to begin to release the power necessary, but for those who require calming should receive a slower treatment, maybe including gentle rocking and shaking motions to induce relaxation. For both it is better not to go too deeply to avoid over relaxation of the muscles. It should always be remembered that the type of sport may affect parts of the body differently and varying approaches can be used on these areas to bring about different effects – thus a sprinter could use relaxation for the neck, shoulders and upper back, whilst receiving stimulation for lower back and legs.

Post-Event Massage:  This differs from pre-event in that the objective is the same for all, a removal of muscle toxins and a stretching to allow the muscles to return to their normal state, hastening the recovery time and permitting resumption of training earlier. All require a slow and thorough routine concentrating on the soft tissue most affected by the event, though it is likely that the athlete will point these areas out as they are accustomed to where it usually hurts.

If ice is available it can be used on inflammation affected areas, working during its application on the surrounding tissue. After a couple of minutes the ice can be removed and the core area lightly massaged to alleviate swelling, before reapplying the ice. This type of treatment should only be carried out if commenced a few minutes after the event as otherwise acute inflammation is a contraindication.

The massage should consist of medium to light pressure to accomplish the toxin removal and be followed by a gentle stretching of the areas affected or sore to either make up for what the athlete has forgotten to do or to add to it.

Effects of Sports Massage

The three effects of sports massage are:-

Physical                               Physiological                             Psychological

These however cannot be produced separately as the therapist is working on a holistic unit, the body, where all its systems are interdependent and the techniques used will produce varying amounts of each effect in each body location.

Physical Effects

Pumping

The body initiates its own pumping action through exercise, i.e. flexing the ankle or more effectively walking  which involves the calf muscles squeezing and therefore pumping blood through the veins and lymph through the lymphatic vessels . The stroking movements made in massage along the flow direction of lymphatic and venous systems vessels replicate this action and assist in their circulations. The pressure caused by massage increases the pressure in the vessels in front of the strokes, thus creating low pressure in those behind, and the resulting pressure differences produce an increased flow of these fluids towards the heart,  and a consequent drawing out of these fluids from deeper tissue.

Where the body`s soft tissue is in a good condition this increased total blood flow has no significant effect, but where its condition is in some way deteriorated by tension or restriction the circulations are impaired,  and their recovery is hastened with the increased blood supply from pumping and will better restore the tissue to a normal healthy condition.

Increased Tissue Permeability

The pores in the cell wall membranes are opened by deep massage, allowing for the exchange of blood fluids, bringing in oxygen and nutrients into the cell, and taking out lactic acid and other waste products accumulated during vigorous exercise, allowing the cell to recover quicker. As the muscle is a ordered collection of cells they as an entity absorb these  nutrients from oxygenated blood and expel their waste products.

Stretching

Nowadays sportspersons are aware of the need to stretch but generally it is a minority who are aware of and make use of sports massage to have a share of the stretching of fascia, muscles and tendons, and it is worth noting that massage can reach deeper areas not affected by normal exercise. To obtain the maximum benefit the tissue is stretched firstly longitudinally and then transversely  to the direction of the origin and insertion, which gives the effect of releasing adhesions and sticky areas and concurrently improving the circulation within the muscle, as the stretched tissue allows more room for the blood vessels to expand and thus more blood can enter and leave the organs, supplying them with oxygen and removing waste products. This extra room can also be utilised by any constricted nerve to release pressure or allow for a better supply of blood. A well stretched body uses less muscle power in order to perform movement. It has less resistance from other contracted muscles, leaving athletes with a feeling of ease and allowing them to use flowing movements in daily tasks or training, thus becoming less tired and possibly aging slower. Stretching of the rib cage allows an increase in air capacity and can encourage a faster or more efficient oxygen / carbon dioxide exchange.

Breaking Down Scar Tissue

Scar tissue can be present in soft tissue from previous injuries or from the tiny breakages and tears caused during repeated vigorous exercise and called “microtrauma”, and can be found in soft tissue. The body`s standard healing process involves laying down a less elastic, almost second grade, poorly vascularised form of tissue, called collagen fibres or scar tissue, to repair the muscle. When this occurs the newly formed fibres can often form and migrate into some of the surrounding undamaged fibres as it knits itself together, forming adhesions or knots in the muscles. This build up could lead to the prevention of the basic operational procedure of muscles, the sliding and shortening process, and conceivably lead to tension and inflexibility, which in turn may well cause referred problems. Deep friction massage, an aspect of Sports Massage, can break down this tissue into smaller particles for phagocytes and lymphatic absorption to occur and will help return normal tissue tension.

Improved Tissue Elasticity

It is known that some repeated vigorous training can produce a result that is not an improvement in the body`s athletic ability but in fact gives little or no improvement whatsoever. This is due to the fact that during this training the muscle can assume a harder and less elastic state, and thus will operate in a less efficient manner. The regular metabolism will decline in a similar manner and the regular tissue in place will begin to atrophy and be replaced with tissue that is more fibrotic and less elastic. This type of tissue is much more prone to injury when required to work hard because of its composition. During sports massage this soft tissue can be stretched almost to capacity and this will help to begin the reverse effect, stretching the scar tissue to become more flexible and encouraging its replacement with more normal fibres.

Opening Micro Circulation

The basic physiology of the body increases heart beat rate and blood circulation when exercising, and although massage can produce the same type of increases to the body part involved it is inferior in volume to the former. However  massage does open the smaller vessels, arterioles and capillaries, and together with the increase in interstitial pressure  improves the exchange of fluids to fatigued or traumatised tissue. When performing deep massage this will cause a release of vasoactive substances creating a dilation of the vessels that bring new fluid more easily to the tissues, including nutrients. The autonomous nervous system controls the size of the vessels, and an increase of microcirculation is also thought possible by light stroking massage via the reflexes.

Physiological Effects

Pain Reduction

The cause of pain during normal movement is when the elasticity of regular soft tissue is compromised and has developed into a more fibrous, shrunken and inelastic tissue. This can be restored to its normal elasticity through massage, and thus blood circulation with its consequent oxygen and nutrient supply  and waste removal achieved . It is this lack of circulation and specifically the non removal of waste products that can bring pain.

Intensive training by athletes can bring about excessive muscle tension which restricts circulation and deprives the tissue of oxygen. This is one of the reasons that this type of training can lead not to better performance but worse. The metabolic waste products accumulate in these tissues and this will in turn cause pain. The surrounding fascia also becomes tight causing increased intrafacial pressure which further restricts circulation. Massage will improve this condition through stretching giving an increase in circulation, restoring elasticity etc. outlined in “Stretching” previously.  The warmth derived from increased circulation can pass into the muscles and fascia helping to ease pain.

Massage stimulates the mechanoreceptors situated close to the skin surface causing a release of endorphins (natural painkillers) which blot out pain sensations in the brain, therefore reducing pain and muscle tension. This is due to the “gate control” theory whereby the signals sent by larger diameter nerves situated close to the skins surface to give notice of immediate sensations take precedence over smaller deep nerves carrying signals related to longer term and less immediate sensations. Thus the pleasant stimulation from massage prevents chronic pain impulses going beyond the dorsal horn of the spinal cord, the location of the “gate control”,  where only one type of signal, the pleasant immediate sensation, takes up the capacity of the spinal nerves to transmit sensation. Apart from massage both heat and cold sensations can block the “gate control” to the persistent pain signals, hence one reason for the use of ice to reduce local pain.

Relaxation

Relaxation of muscles can be achieved during massage through touch, warmth, good circulation and stretching. As outlined in “Pain Reduction” above the mechanoreceptors which sense touch, pressure and warmth are stimulated and so the tissue length, tissue movement and tissue warmth in the muscles and connective tissues are restored. A greater degree of relaxation can be achieved when a large part of the body is treated.

Opening Micro Circulation

See “Opening Micro Circulation” under Physical Effects above.

Balancing Autonomous Nervous System

Objective scientific research in this field is extremely limited and many arguments exist as to the parts of the nervous systems stimulated through massage, to say nothing of the effects via reflex and areas of the body affected. The measurement of effect is further compromised  by the intrusive apparatus used to collect data. Here the effects are only from supposition though massage therapists will vouch for what they can observe and deduce. It is accepted in their field that through massage we reduce muscle tension and nullify pain due to musculoskeletal disorders. We are in fact suppressing  the output from activated mechanoreceptors in muscles and tendons which cause sympathetic nervous system over activity. In some cases this will improve relaxation, mental state  and sleep after strenuous exercise.

Psychological Effects

Invigorating Feeling

When the massage movements are rapid and stimulating, as in a pre event massage, the competitor will feel very aware, pleasantly warm and keen to commence their activity.

Reduces Anxiety

Through the effects mentioned earlier massage can relieve anxiety before and after training or an event.

Confidence in Therapist

From the first moments together with their client a therapist should present a calm and assured manner and seek to inspire confidence and trust from the client and to put them at ease. This approach should not vary whether the client is a top athlete or somebody uninterested in sport. Many of the techniques used in sports massage can be uncomfortable and it is essential to both explain what you intend to do and to monitor the level of discomfort caused to ensure that the client can either authorise you to continue or to request an alteration or cessation of the treatment. The more a client is not put in state of anxiety the more likely it is that their muscles will be as relaxed as possible and thus the treatment will be as effective as possible.

Placebo

This is a psychological benefit because when you  told the athlete what you are about to do you will have also explained how it will help them, especially as you will inform them that your treatment is also geared to the current situation i.e. maintenance, injury recovery, pre or post event massage. This expected help, together with the confidence inspired, will give sportspersons the belief that their performance will improve and move them towards their goals.

Benefits of Sports Massage

An athlete’s training programme will inevitably lead to an accumulation of minor aches and pains as they increase both their duration and level of intensity. Whilst some may turn to drugs as an answer they will find this counterproductive over time, and it is sports massage that is able to remove these complaints and prevent them developing into more serious problems. Thus it can be seen that the benefits of sports massage lie in the fields of injury prevention and recovery from injury.

The regular muscle operation is simple, a contraction followed by a release. If, for whatever reason, the muscle does not release completely, it can easily develop into a knot or spasm. Sports massage has the ability to investigate more thoroughly  these issues and lead to diagnosis and treatment, through manipulation and palpation, and return the tissue to the best condition possible. All muscle problems are similar and only vary in location and degree.

As said, the muscle operation is simple and one in good condition will aid the athlete in achieving their goal, but one in poor condition will hinder this achievement. Only muscles in good condition can provide the perfect synchronisation necessary for the complete coordination and mobility required. Although not proven, sports massage is believed to improve performance and endurance by 20%. which will enable the sportsperson to perform better for a longer period of time, as well as lowering the stress levels placed upon their bodies.

Every sportsperson can train for and achieve a level of maximum performance, a barrier beyond which they cannot improve. Sports massage can assist every sportsperson to move that barrier back and improve their performance further.

Specifically, sports massage will have the following benefits :-

• Maintain the entire body in better physical condition, including reducing muscle tension and maintain muscle tone.
• Promote relaxation.
• Prevent injuries and loss of mobility in potential trouble spots.
• Reduce susceptibility to disease or infection.
• Cure and restore mobility to injured muscle tissue.
• Increase range of motion.
• Boost athletic performance and endurance.
• Decrease muscle stiffness and soreness after exercise.
• Extend both the good health and the overall life of your athletic career.