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 Massage Therapy
Written by Chris Bingley CAT(C), RMT, CSCS
Massage is the manipulation of superficial and deep layers of muscle and connective tissue to enhance the function and promote relaxation and overall wellbeing. Massage involves acting on and manipulating the body with pressure – stationary, or moving – tension, motion, or vibration, done manually or with mechanical aids. Target tissues may include muscles, tendons, ligaments, skin, fascia, joints, or other connective tissues, as well as lymphatic vessels, or organs of the gastrointestinal system. Massage can be applied with the hands, fingers, elbows knees, forearms and feet. There are over eighty different recognized massage modalities.
In professional clinical settings, massage involves the client being treated while lying on a massage table. The massage subject may be fully or partly unclothed, or may choose to remain completely clothed. Parts of the body will be covered with towels or sheets. Certain techniques require the use of lotion while other techniques do not. Traction and moving limbs is also common to massage practice.
Massage Methods
Practitioners of massage typically include massage therapists, athletic therapists, and physiotherapist, although chiropractors, nurses and physicians are also able to perform massage techniques for their patients. Massage practitioners work in a variety of medical and recreational settings and may travel to private residences or businesses. It is important to thoroughly fill out an intake and health history questionnaire prior to receiving any treatment. Sometimes seemingly uneventful preexisting conditions can change the type of treatment you would receive. Having all the necessary information allows the therapist to make an informed decision about what a safe and effective treatment plan should be for your specific set of circumstances.
Some cautions and contraindications to local and systemic massage include, deep vein thrombosis, chronic congestive heart failure, blood pressure irregularities, bleeding disorders, or taking blood thinners such as Warfarin, damaged blood vessels, weakened bones from cancer, osteoporosis, or fractures, rods, pins and wires from previous surgery, open uncovered wounds, fever and infectious conditions.
Myofascial Release
Myofascial release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia, integument, and muscles with the goal of eliminating pain, increasing range of motion and aiding fluid exchange within the tissues. Myofascial release usually involves applying shear compression or tension in various directions, or by skin rolling.
 Swedish Massage
Swedish massage uses five styles of long, flowing strokes to massage. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber) and vibration/shaking. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks. It has also been shown to be helpful in individuals with poor circulation. The development of Swedish massage is credited to Per Henrik Ling, though the Dutch practitioner Johan Georg Mezger adopted the French names to denote the basic strokes. The term “Swedish” massage is not really known in the country of Sweden, where it is called “classic massage”.
Trigger Point Therapy
Sometimes confused with pressure point massage, this involves deactivating trigger point that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (president Kennedy’s physician) and David Simons. Trigger points have been photomicrographed and measured electrically. In 2007, a paper was presented showing images of Trigger Points using MRI. These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this modality is different from reflexology, acupressure and pressure point massage where the typical aim is to rebalance energy systems and stimulate meridian channels.
Deep Tissue Massage
Deep Tissue massage is designed to relieve severe tension in the muscle and the connective tissue or fascia. This type of massage focuses on the muscles located below the surface of the top muscles. Deep tissue massage is often recommended for individuals who experience consistent pain, are involved in heavy physical activity, such as athletes, and patients who have sustained physical injury. It is also not uncommon for receivers of Deep Tissue Massage to have their pain replaced with a new muscle ache for a day or two. Deep tissue work varies greatly. What one calls deep tissue another might call light. When receiving deep tissue work it is important to communicate what you are feeling to the therapist if there is any intolerable discomfort.
 Massage for Sports
The recovery of the athlete is often presumed to occur adequately at a set rate if sufficient rest times, sleep and even meals are incorporated into the training program. What continually develops is that many athletes adhere to the philosophy, which implies “all one needs is rest and all will be well again.” As much as this statement is true, sometimes rest alone isn’t enough and one can be left feeling taxed even after a rest.
The consequence of insufficient restoration or recuperation typically sustained thru sports training is typically referred to as “overtraining”, with the precursor “over reaching”. Both have a series of signs and symptoms that are both physical and emotional in nature. Rest and less strenuous training have been identified as the major cures.
Some of the more enlightened coaches and athletes rely on periodic massage to compliment their training schedules. However, massage should not be seen as the sole means of restoration- nutrition plays a crucial role in muscle recovery and regeneration. Interestingly, the body adapts to regular massage and unfortunately its efficacy diminishes. A skilled therapist will continually change the combination, as well as the rhythm, rate and pressure of the techniques they use with individuals they have been working with for an extended period of time.
Sample Restorative Strategies
· Massage
· Autogenic Training
· Biofedback
· Natural ergogenic aids
· Music Therapy
· Light Therapy
· Aroma Therapy
· Acupressure
· Shiatsu
· Electronic technology and modalities
· Visualization Techniques
· Compression and Decompression Therapy
· Reflexology
· Exercise Therapy
· Hydrotherapy
· Saunas
· Progressive Relaxation
· Meditation
When it comes to sport preparation, many would agree that the Russians could be considered experts. Their training system includes four main elements: periodized physical training, psychological preparation, pharmacology and restoration. While many cultures have been using most of the known restorative techniques for thousands of years, the Russians were able to develop an entire methodology for applying these methods in a highly organized system in sport.
Many of the techniques can be effectively applied outside the realm of sport because they form a general discipline more popularly referred to as stress management. The Chinese, Egyptians, Native Indians, Greeks, and many other cultures have all had traditions of restoration, or healing, with which it is synonymous. The word for therapy comes from the healing specialists of the Greeks, known as ‘therapeutae’. The word for healing also has an Indo-Germanic origin meaning ‘to make whole’.
Now you may be asking yourself: how is regular massage different from sports massage? The main differences found can be found in the setting, the techniques used and their combination (therapist and sometimes condition dependant), the approach to treatment and the consideration of training schedules to optimize results.
Traditionally, sports massage is performed onsite before, during and after a sporting event or competition. The goals of each situation are slightly different, especially the pre and post event massage goals.
The types of techniques chosen by the sports massage specialist ultimately aren’t different from traditional massage anyone from the general public might receive. The major difference comes from the combining of all techniques into therapeutic sequences while performing the techniques with the rhythm, pace, and pressure needed to produce the desired results. Sports therapist must understand the physiological and psychological effects of techniques and their combinations to apply them effectively.
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