ABOUT SPORTS MASSAGE
1 AN INTRODUCTION TO SPORTS MASSAGE
WHAT IS SPORTS MASSAGE?
Sports massage is a form of massage involving the manipulation of soft tissue to benefit a person engaged in regular physical activity. Soft tissue is connective tissue that has not hardened into bone and cartilage and includes skin, muscles, tendons, ligaments and fascia (a form of connective tissue that lines and ensheathes the other soft tissues). Sports massage is designed to assist in correcting problems and imbalances in soft tissue that are caused from repetitive and strenuous physical activity and trauma. The application of sports massage, prior to and after exercise, may enhance performance, aid recovery and prevent injury.
WHERE DID SPORTS MASSAGE ORIGINATE?
Massage is recorded as one of the earliest forms of physical therapy and was used over 3,000 years ago in China, India and Greece. Its popular use in the Western world is largely due to the work of Per Henrik Ling (1776–1839), who developed the form of massage now known as Swedish massage. Ling developed a style of massage and exercise to help fencers and gymnasts, gaining international recognition in the process. Many of his ideas have formed the foundations of modern sports massage. Today, there are many forms of massage available to assist us in maintaining our health and well-being. Sports massage has been accepted in other countries for many years while in the UK, the practice only became known and more widely used in the 1990s. Very few courses were available until then (see
THE BENEFITS OF SPORTS MASSAGE
HOW DOES SPORTS MASSAGE BENEFIT PEOPLE WHO EXERCISE?
Sports massage benefits people who exercise by assisting in the processes of overcompensation and adaptation. During and after exercise, the body’s systems adapt to cope with the increased stresses placed on them. These adaptations affect the muscles, the bones, the tissues, the nerves and the brain. In the right measure and at the right frequency, regular exercise enables the body to cope with increased levels of stress (overload), which allows the body to exercise at higher intensities or for longer durations. This is possible because of a process called overcompensation. While the body is recovering from overload as a result of exercise, the body overcompensates to increase its power of resistance to future stress.
How the body overcompensates or adapts to exercise depends on the type of stress placed on it. Training programmes for fitness or sport are based on the principle of specificity, which states that the adaptations will be specific to the type of stress. For example, a soccer player, who requires bursts of explosive power over short distances, will need a training programme that includes specific exercises to improve speed. On the other hand, a marathon runner, who requires a high level of aerobic efficiency to complete the long distance, needs a training programme that focuses on improving endurance.
The manipulation of soft tissue prior to and after exercise promotes physical, physiological, neurological and psychological changes that aid performance and particularly recovery. Some examples of the benefits for the exerciser are:
•the release of muscle tension and pain;
•improved drainage of waste products such as acetic acid and carbon dioxide;
•reduced discomfort from DOMS (delayed onset muscle soreness) as a result of vigorous exercise;
•improved posture and flexibility.
Further details on the effects of exercise and sports massage on the body, and on how sports massage can aid the exerciser (hereafter referred to as the ‘athlete’), are explained in Part Two of this book, The science of sports massage
WHO CAN BENEFIT FROM SPORTS MASSAGE?
Anyone who engages in physical activity for the purpose of sport or fitness – irrespective of age, level of fitness or level of training – can benefit. Athletes with injuries or problems that are inhibiting performance will find that the stimulatory effects of sports massage encourage the healing process. Recreational and competitive athletes following a regular training programme will benefit during recovery, and through the early detection of any problems arising from training stress. Athletes engaged in sporting events or competitions can benefit before, during and after the event, depending on whether the need is for the release of muscle tension, relief from soreness, relaxation, etc.
SPORTS MASSAGE AND SPORTS THERAPY
Sports massage is one of the skills used in the practice of sports therapy. In addition to massage, sports therapy also includes the management and treatment of sports injuries, exercise therapy and rehabilitation, and sports nutrition.
IS SPORTS MASSAGE A RECOGNISED FORM OF THERAPY?
Sports massage has become more popular as the number of people participating in sport and fitness and the physical demands placed on athletes has increased. Many athletes are being introduced to sports massage and are increasingly aware of the benefits. Acceptance in the UK has gained momentum since the 1990s with sports massage now being well established within the curricula of many nationally recognised courses.
Sports medicine research has revealed more about the effects of exercise and injury on the human body and its systems, and these scientific advances have been employed in the study of sports massage. As a result, sports massage is becoming more widely accepted by athletes, sports scientists, coaches and industry bodies as a means of enhancing performance, aiding recovery and preventing injury.
The title of someone performing sports massage has changed since its introduction to the UK. Currently, sports-massage therapist and sports-massage practitioner are recognised, although the current trend is towards soft tissue therapist, so we have used this term when referring to the skilled person applying the techniques throughout the rest of this book.
Although there is no government-regulated body for sports massage, the Sports Massage Association was formed in 2002 and has gained recognition for establishing benchmark standards for sports-massage practice. Further details are at the end of this book (see Useful Contacts
HOW IS SPORTS MASSAGE DIFFERENT FROM OTHER MASSAGE?
While other forms of massage, such as Swedish or holistic massage, have some aims in common with sports massage – such as physical and mental relaxation – sports massage is specifically designed to assist active people in their sport or fitness activities. A soft-tissue therapist is concerned primarily with:
•muscular and skeletal alignment;
•how exercise affects the body’s systems;
•and how massage can promote or reduce these effects for the benefit of the athlete.
Many of the aims of sports massage, such as injury prevention and the promotion of recovery from exercise, are therefore quite different from the aims of other forms of massage.
WHEN IS SPORTS MASSAGE CONTRAINDICATED?
Contraindications are circumstances in which sports massage might or would be detrimental to an athlete’s health and well-being, so it is vital to know what they are and understand how to assess them.
The soft-tissue therapist must ask about some contraindications prior to starting as a preliminary check. Others will become evident if present, by observation and palpation (see Chapter 8
) during the treatment session. Once you have asked your questions, a good way to complete your history-taking is to verbally summarise your client’s history and then add: ‘Are there any injuries or conditions that we have not yet covered, and are you taking any medication that you have not yet told me about?’ This is all-encompassing and will prompt your client to tell you about anything that might have been missed. If the client does have a condition which may be contraindicated, and you feel that they should be referred back to their GP, try to raise the subject tactfully and without alarming them. Reassure them by saying that you are not medically trained, and it would be wise to have a GP check this for you.
Sports massage can be contraindicated in any of the following circumstances.
WHEN THE CLIENT HAS A TEMPERATURE OVER 37.5°C (100°F), OR IS FEELING UNWELL
In these circumstances, the onset of illness may be accelerated by massage. If there is an excess of toxins in the body that is causing the client to feel unwell, both exercise and massage will increase the circulation of these toxins and exacerbate the condition. It is therefore advisable to refrain from both exercise and massage to allow the body’s defence mechanisms time to deal with the infection and to recover.
Open wounds, recent bruising, muscle tears, sprained ligaments, contusions, chilblains and burns must be avoided during what is known as the acute healing phase. During this time, the damaged soft tissue will be undergoing the early stages of repair and therefore is susceptible to further trauma as the newly forming structures will be weak and vulnerable. For further information about soft tissue healing and injury management, see Chapter 12
Look for any sign of skin infections on the surface of the skin such as swelling, redness, heat or pain. Any attempt to massage in the vicinity of these areas may spread the condition. The infection may also be passed on to you and possibly others.
Where there is swelling which is inconsistent with recent bruising, avoid this area until you know what the cause is. If in doubt, advise the client to check with their doctor. This may be a tumour, which is an abnormal mass of tissue. If the tumour is malignant – a term used to describe a condition getting progressively worse, and spreading – massage may encourage the spread to secondary sites.
DISEASED BLOOD VESSELS
Phlebitis refers to a condition of inflamed veins, often accompanied by blood clots (see below).
A thrombosis is a blood clot, commonly occurring in the deep veins of the back of the legs where it is known as a deep-vein thrombosis. When a thrombosis is dislodged, it can have serious, even fatal, consequences if it reaches the heart or lungs. This is a condition that is usually predisposed by a number of factors, including:
•a period of prolonged bed rest;
•varicose veins (see below);
•an impact injury;
The condition may be detected by using the following as a guide: when you apply pressure to the area you will feel particularly firm swelling in a localised area, and the client will experience pain. There may also be some swelling or discolouration distally – below the site – as blood collects behind the thrombosis.
WHEN THE PATIENT REACTS ADVERSELY TO TREATMENT
If a person reacts adversely to treatment and there is no apparent reason, stop the massage and seek ...