Sports massage in research – issues

As the use of massage in sport has grown over the recent years, so too has the amount of research looking at its effects on performance, recovery, mental readiness etc. Over the next few weeks I’m going to be delving into some of this research to show you what the experts have found. However, before I do I want to write this quick post about some of the things that must always be kept in mind when reading research that looks at sports massage.

The first thing to remember is that it is difficult to research the effects of sports massage for a number of reasons. Each massage therapist will massage slightly different; different techniques used, different pressure etc, each person will have their own individual needs and have varying degrees of muscle tension. The reason that this makes research difficult is that everything in academic research is aimed to be standardised. For example, a study looking at carbohydrate loading will standardise how much carbohydrate is eaten, what form is eaten, what it is eaten with, when it is eaten etc. As such, research into sports massage has tried to have standard practices in their studies. Have a look at the table below;

Table 2. Sports Massage Protocol

Time (min:sec) Technique

Supine position

0:00 - 1:00 Compression: lower leg/quadriceps

1:00 - 1:45 Effleurage: ankle to crease of hip

1:45 - 2:30 Thumb effleurage: anterior/lateral aspects lower leg

2:30 - 3:00 Petrissage: quadriceps

3:00 - 4:30 Tapotement: quadriceps

4:30 - 5:00 Effleurage: ankle to crease of hip

Prone position

0:00 - 2:00 Compression: calf/hamstrings

2:00 - 2:30 Effleurage: ankle to upper thigh

2:30 - 3:30 Petrissage: calf/hamstrings

3:30 - 4:30 Tapotement: calf/hamstrings

4:30 - 5:00 Effleurage: ankle to upper thigh

This is taken from a journal article looking at the effects of sports massage immediately after exercise on recovery. Yes, the study has tried to standardise the massage techniques, right down to the second, so much so that an electrical timer was set to go off at the relevant points so that the therapist knew when to move on to the next part of the massage.

However, there are a number of problems with this. First of all, every athlete’s needs will be different. For example, runners with different running styles will have tension in different muscles or even different parts of the same muscle. Therefore it would be stupid to allocate equal time to each part of the leg. If one part is more sore/tired/tense than the other, a good therapist would spend more time on that specific part.

Second, this protocol doesn't mention anything about pressure. In fact, many studies looking at sports massage to aid recovery fail to take into account pressure. One study that has looked specifically at pressure though looked at light stroking, “medium” and “hard” pressure. Clearly it is difficult to quantify massage pressure, but this study found that the “hard” pressure was the only one of the 3 to aid recovery. 

One of the other big problems with research into sports massage is its relevance to practice. For example, the above protocol is 10 minutes. For a recreational runner at the end of a road race, this is about the amount of time they would get and it would be as a little relaxer at the end of a tough run. But what about Mo Farah after the 5K heats at the Olympics? Or the Spanish Football team after the semi-final of the Euros. The difference is that the recreational runner doesn’t have to perform or train the next day or the next few days. If the point of the massage is to aid recovery for an event or training session either the next day or in a couple of days then it would probably need to last longer than 10 minutes.

These are just some of the issues when looking at sports massage in the academic research. For me, there are nowhere near enough studies in the area and a minority of good studies. Yes, there are difficulties with standardisation. But sports massage now needs to be broken down into its different techniques, into different pressures etc to see which is more effective so that it can be optimised in the same way as “warm-ups” before sport have been.

So, there you have a brief introduction of some of the issues of research into sports massage. If you have any questions or comments then feel free to email or write in the comments section.

For sports massage bookings in swansea, visit www.jamiepughperformance.co.uk

Massage Techniques

In this blog I thought it would be a good to introduce some of the different massage techniques used by sports massage therapists, the benefits of these techniques and some of their physiological effects. The four techniques I am going to cover are; effleurage, petrissage, frictions and tapotement. There are other techniques but I thought I would focus on just these four initially rather than bombard you with too much info in one go.

Almost all massage techniques are carried out with the main pressure being directed towards the heart. This helps increase venous and lymphatic flow and ensures that no pressure of blood is being pushed against closed valves causes any damage to blood vessels. The only exception to this is where short strokes are aimed at stretching muscle fibres. Because the strokes are limited, there is no risk of pressure being built up

Effleurage

The first technique I’m going to talk about is effleurage. Effleurage is always used at the start of massage and consists of a variety of stroking movements, usually carried out with the whole palm of the hand and fingers (but can be carried out with the forearm), which may be used with varying pressure according to the purpose and stage reached during the massage.

The basic movements comprise stroking with firm pressure using a wide surface area of the palm of the hand and fingers. On the return, the therapists' hands maintain, light contact and avoid the path taken on the upward stroke. As with all massage, the hands must be relaxed and moulded round the natural contours of the recipient's body. Effleurage is always used to commence any massage session and it has a wide range of purposes that you need to focus on:

• Introducing touch to the client
• Putting the client at ease
• Warming the tissues
• Increasing blood flow
• Stimulating peripheral nerves
• Muscle relaxation
• Palpating tissues

Effleurage should be carried out in a rhythmical and relaxed manner starting with light touch at the start of a session and building up to deeper pressure for increased circulation and stretching of tissues later in the massage. It should not be rushed as it is during this phase you need to begin to focus on any abnormalities in the tissues that may require further attention later in the massage. If the movements are performed too quickly, this will not help the client relax and if a "tender" area is missed, it will almost certainly be more painful when discovered using deeper techniques later! Effleurage is also used to complete the massage finishing with light stroking to relax the patient, particularly if movements that are more painful have been used beforehand.

Petrissage

Petrissage (or kneading) is used on deeper tissues for mobilising fluids, stretching muscle fibres, and inducing relaxation. Some of these techniques are specifically aimed at only deeper tissue and are therefore both ineffective and difficult to perform on narrow parts of the limbs. You must therefore pay particular attention, as with all massage techniques, as to what your purpose is when kneading petrissage is a powerful technique that is particularly effective in mobilising fluids in very deep muscles and applying a good stretch to the fibres involved.

Frictions

Frictions may be used for exploratory purposes, or for deeper and sometimes more painful movements aimed at breaking down lesions, separating muscle fibres, and even breaking down recent scar tissue. When performing frictions for exploratory purposes we tend to use the sensory pad of the thumb to "grasp" the skin and to move this over the underlying surface to feel for any abnormalities (trigger points) to the tissue concerned. This allows us to palpate, particularly around joints and feel for smaller abnormalities in the tissues. When performing frictions for the purpose of separating muscle fibres, breaking down lesions and scar tissues, firstly the client must be warned that these procedures may indeed be painful or at the very least uncomfortable. They only need to be carried out for a very short while. Using vigorous frictions for any longer than this may have a particularly detrimental effect by irritating and even causing inflammation.

Tapotement

Tapotement movements are generally rapid, rhythmic movements by the hands, originating from a relaxed wrist, which strikes the body briskly and alternately, usually at a rate between 4 to 10 strikes per second. The differences come from what part of the massage therapists’ hand is used, as well as the depth of pressure applied.

At the end of a relaxing massage session, the stimulation provided by tapotement brings the client back to a more grounded consciousness and, if done well, does not agitate the body to a point of stress or nervousness.

Categories of Tapotement

· Hacking - This is perhaps the most familiar form of tapotement, often seen in films, especially in sports warm-up scenes. The therapist's hands are held outstretched with palms facing each other. Wrists are kept loose. Both hands alternately strike the client's body, with wrists having a slight rotation as hands rise and fall in rapid succession. Only the ulnar border of hand, and to some extent the tips of the three medial fingers, touch the body. The fingers and hands should remain relaxed at all times.

· Pounding/Pummeling - The main difference between hacking and pounding or pummeling is that the therapist's hands are held in a soft fist with the little finger portion of the hand making contact with the clients body.

· Cupping - In cupping, the therapist forms the palmar aspect of his or her hand into a cup-like shape, by slightly flexing the fingers. These "cups" are then struck against the client's body. The palm of the hand does not touch the body. Only the outer edges that form the rim of the cup come in contact with the client. There is often a distinctive "clop, clop" sound that results when performed correctly.

· Tapping - Tapping is the lightest and most gentle of all the percussive movements and is often performed at a slower rate than the others. The therapist's hands are loose and relaxed. Only the tips of the fingers are used to gently tap the area. This movement can be used on the more delicate areas of the body such as the head and face.

· Plucking - In plucking, the client's skin is gently picked up by the thumb and fingers of each hand in a kind of light pinching or pecking motion. The tissue is picked up and released in rapid, alternating movement, using both hands.

Benefits of Tapotement

1. Tapotement has a hyperemic effect. That is, it increases local blood circulation, which, in turn, helps to warm and soften the underlying tissue. The skin will feel warm to the touch and appear flushed. It is often used to help warm-up an athlete prior to an event.

2. With this technique, nerve endings are stimulated, which produce tiny muscular contractions, resulting in an overall increase in muscle tone. This is thought to happen because of the stroke pressure being registered by the muscle's mechanoreceptors in the fascia and Golgi tendon organ. A reflex action follows, resulting in the contraction of both voluntary and involuntary muscles.

3. Cupping, specifically, can be used over the upper and middle back to loosen mucous in the lungs, and has been helpful with those suffering from cystic fibrosis. Any client appearing to have respiratory problems should be cleared first by his or her physician to make sure massage is appropriate for his or her condition.

4. When used in combination with other massage techniques, tapotement helps to reduce fatty deposits and tone flabby muscle areas

So, there you have a brief introduction of four massage techniques used by sports massage therapists. If you have any questions then feel free to email or write in the comments section.

For sports massage bookings in swansea, visit www.jamiepughperformance.co.uk

What is Sports Massage?

Sports Massage is the term to describe the discipline of using massage for the specific benefit of all sports and exercise participants; although in theory any one can have a sports massage. It covers the management, manipulation and rehabilitation of the soft tissues of the body e.g. muscles, ligaments and tendons.

In particular sports massage involves a variety of particular techniques (which will be covered in the next post) that are used with the overall goal of improving sports performance. That does not just mean having a massage immediately before an event to improve that particular performance. In a similar way to supplements, altitude training and psychological techniques, sports massage is a tool that can be implemented into a sports performer’s regime in order to improve their performance. The massage may be to relieve soreness following an intense training session in order for them to continue their training for the rest of the week. It is natural for athletes to increase the volume and intensity of their training as they look to get better results. However, this will put their muscles, their ligaments, their joints etc under more stress and could lead to injury or burn out. Muscles will get tighter, sore after heavy training and can increase mental stress. Sports massage can reduce the risk of these issues and help keep athletes training at high intensities.

Sports massage may be used when they are injured in order for them to return to training quicker or it may be used in order to prevent injuries. There are many uses of sports massage and, with the right practitioner, it can improve performance.

What are the benefits?

• Improved Circulation
• Removal of Waste Products (e.g. lactic acid)
• Remodel scar tissue
• Decrease muscle tension
• Relax or stimulate the muscles and nerves
• Increase or decrease muscle length
• Improved mental preparation for competition

Over the coming posts I’m going to be coming back to some of these benefits individually to explain how and why sports massage has these benefits.

When is it a good time to have a sports massage?

• After injury
• During intense training periods – weekly/fortnightly/monthly
• Before, after & between competitions
• After travelling
• If you drive a lot
• If you work at a desk for more than 20 hrs per week
• If you need to relax

Hopefully this has been an brief but interesting introduction to the world of sports massage. In the next few posts I’ll be looking at the different techniques used as well as start to look at the research behind sports massage.

But, until then........

For sports massage bookings in swansea, visit www.jamiepughperformance.co.uk

Hello and Welcome

Thanks for making it onto my new blog site. In this post I just want to quickly introduce myself and the blog and the sort of things I will be writing about over the next few weeks/months.

First of all.....who am I?

My name is Jamie Pugh and I am a Sports Massage Therapist, a Strength & Conditioning Coach and a Sports Scientist. I am a Loughborough University graduate and current Swansea City afc intern.

Sport, fitness and health and my passions. I have been playing football since I could walk and have been competitively running for around 2 years, but if it invovles some sort of physical activity, I'm always up for taking part. As well as taking part, I love coaching, volunteering and just watching all things sport.

In terms of performance, the way the body works and the incredible things it can achieve fascinate me and I am always looking to learn about its complex functions and how they can change or be trained. I am not just talking about the elite end of the field. Top end athlete, average Joe rugby player or overwieght middle-aged man; all of these catch my interest and as such I find it enjoyable working with an array of people with a large range of goals.

In terms of the blog.....

as you can see at the top there is a page where you can read more about me and my qualifications and education. There is anothert page outlining the types of services that I offer and the advice I can give. There is also a page about guest writing for this blog. It is always great to learn from others and see things from other people's points of view and so I am always interested in posting guest articles.

The types of blog posts that you will find here will be a range of comments on some of the most recent news and research in the sports/fitness area including sports massage. I will also be blogging about some of my current clients who have kindly agreed to share their story for you tot track their progress.

That's all for now