BY JUSTIN WOODWARD

Massage Techniques seen in the Athletic Training Facility

and their Effects

History of Massage

Massage has been used as a treatment for Illnesses and Injuries since 3000 B.C. Was first used in parts of Egypt and Asia

In 1893 Albert Hoffa wrote the Technik der Massage This outlined the Hoffa Massage in

detail. Hoffa Massage consists of: Effleurage,

Petrissage, Tapotment and Vibrations or Effleurage to end it.

Physiological Effects

Massage is defined as “the systematic manipulation of the body’s tissues.” – Chad Starkey

Effects of Massage can be split into Reflexive and Mechanical Effects

Physiological Effects

Reflexive Effects- Can effect nerves (sensory and motor) locally and cause some effect on the central nervous system

Mechanical Effects- Changes in tissues using direct mechanical force As Mechanical Effects increase, Reflexive effects

decrease

Reflexive Effects

Effects on Pain- Can modulate pain through Gate Theory and Beta

Endorphin Pain controlEffects on Circulation

Some studies suggest that massage can increase blood flow and lymphatic flow- studies are not empirical

Reflexive Effects

Effects on Metabolism Massage has no effect on metabolism According to Martin et al. active recovery is much

more effective in the removal of Lactate from blood when compared to sports massage

The reflex stimulus causes sedation and relieves tension Slower, Lighter strokes will cause greater reflexive

stimulus

Mechanical Effects

Effects on Muscle Increase Range of Motion Removal of Adhesions Mechanical stretching of muscular tissue and fascia Possible increase in Blood Flow No increase in muscle strength No decrease in muscle fatigue Can decrease the severity of DOMS Increase in Venous Return

Mechanical Effects

Effects on Skin Increase in Temperature Possibly increase blood flow

Fast, deep strokes has been shown to have greater effect on blood flow

Assist in the removal of Adhesions between skin and subcutaneous layer

Psychological Effects

Massage can improve mood after intense exercise or injury Can lead to more compliance during rehabilitation

Improved Patient-Clinician Relationship Due to the One-on-one nature of massage, the

clinician must spend individual time with the patientMany athletes believe that massage will

assist them in the healing process, and will see improvements through suggestion.

Massage can reduce anxiety

Massage Guidelines and Considerations

Essentials to Proper Massage Good Knowledge of Anatomy Thorough understanding of the Principles

of Massage Knowing the athletes injury

Clinician and Patient Positioning

Clinician- Should be in a comfortable fairly upright position with

weight distributed evenly Clinician should shift weight to cause most of the

mechanical stimulus to prevent fatiguePatient-

Should be in a comfortable, relaxed, well supported position

Should have injured area exposed and draped any other area which it is necessary

Precautions

Nails should be trimmed To avoid scratching or causing lacerations

Remove all rings, watches, or wrist jewelryHands should be warmLubricant should be used, especially for

effleurage

Contraindications

Any condition in which massage may aggravate it: Infection Malignancies Skin diseases Blood Clots Irritations/rashes Lesions Fractures

Massage Techniques

EffleuragePetrissageTapotmentVibrationFriction MassageMyofascial ReleaseAcupressure

Effleurage

Stroking/Shingling Technique Every massage should start and end with effleurage We want to always have one hand on the patient Want to keep a consistent, rhythmic pattern Want to start with light pressure and gradually

increase pressure The firmer the pressure the less reflexive effects

Effleurage

Effleurage should be done distal to proximal Especially if edema reduction is the goal Patient should also be in a gravity assisted position for

edema reduction

Practice

Break up into Pairs and Practice it yourselves.

Do Effleurage for 2 minutes then switch with your partner

Petrissage

Kneading Technique- pinching and rolling the tissue between fingers Can also can use 1 or 2 hands, grab, roll, lift or apply

pressureMove distal to proximalLess lubricant is needed for this technique to

make it easier to grab skinGreat for removing/preventing adhesions

Practice

Break up into Pairs and Practice it yourselves.

Do Petrissage for 2 minutes then switch with your partner

Tapotment

Percussion Technique- hands should be loose and tap the skin

Stimulates Peripheral NervesTypes-

Cupping Hacking Beating Pinching

Practice

Break up into Pairs and Practice it yourselves.

Do Tapotment for 2 minutes then switch with your partner

Vibration

A fine, small movement, made by hand or fingers placed firmly against a part causing a part to vibrate

Hands should remain in contact and a rhythmical trembling movement will come from arms

Less skilled or inexperienced clinicians may want to use a vibration tool to administer this part of the massage

Practice

Break up into Pairs and Practice it yourselves.

Do Vibration for 1 minutes then switch with your partner

May be difficult, don’t worry if you don’t get this at first, it takes a very skilled hand to do this technique

Friction Massage

Used to treat chronic inflammation of tendons

Rub perpendicular to the fibersGenerally done for 5-10 minutesWill be painful

Objective it to re-start the healing process

Myofascial Release Technique

Relieves soft tissue from abnormal hold of fascia

Cross Hand Technique- cross hands and apply pressure in opposite directions

Can also apply pressure to the muscle and have the patient contract muscle forcing the fascia to stretch and release from the muscle

Practice

Break up into Pairs and Practice it yourselves.

Do Myofascial Release for 2 minutes then switch with your partner Do Cross Hand Method Do Pin and Contract Method

Acupressure

An old Chinese based method to treat aggravated trigger points

Find trigger point noduleApply firm pressure in a

circular motion Can use finger, knuckle, or elbow Will cause pain and numbing effect

Treatment usually lasts 1-5 minutes per trigger point

Questions

References

Hemmings B. Physiological, psychological and performance effects of massage therapy in sport: a review of the literature. Physical Therapy in Sports. November 2001; Vol. 2(4): 165-170

Martin et al. The Comparative Effects of Sports Massage, Active Recovery, and Rest in Promoting Blood Lactate Clearance After Supramaximal Leg Exercise. Journal of Athletic Training. January-March 1998; Vol. 33(1): 30-35

Moraska A. Sports Massage: A Comprehensive Review. Journal of Sports Medicine and Physical Fitness. September 2005; Vol. 45(3): 370-380

Zainuddin Z et al. Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function. Journal of Athletic Training. July-Sept 2005; Vol. 40(3): 174-180

Starkey C. Therapeutic Modalities. 3rd Edition. Therapeutic Massage. 2004; 16: 295-307

Houglum P. Therapeutic Exercise for Athletic Injuries. Manual Therapy Techniques. 2001; 6: 159-172