Sports Massage - a perspective from Steve Dickenson (Sports & Remedial Massage Specialist)
What is sports massage?
There is both much confusion over what a Sports Masseur is and what one does or can offer. This is due to the fact that there are so many people practicing ‘massage' and so many practitioners with different skills and levels of experience.
My first point is that I choose my title to be that of ‘Sports & Remedial Massage Specialist', not that this sheds any great light on what I do however!. I also believe that ‘Sport' is just an extreme, short burst of everyday activity we choose to do and in my practice (being that I am self employed and not employed by a sports club or organization) I treat approximately 60% everyday situations and approximately 40% true sporting requirements whether they be for a specific injury or for an ongoing training regime.
A Sports massage is ideal to treat injuries and as well as a preventative treatment dealing with the health of muscle and connective tissue, range of movement, tone, symmetry, balance of muscle and quality of posture.
I further define my role as ‘the manipulation of soft tissue to release tension, reduce pain, restore range of movement and promote good condition'. This is achieved through a range of techniques I possess and carry around in my ‘tool bag', some of which are effective on some people, some of which are not. It is then down to me to work with my clients to find the right tools to unravel their current injury situation or assist them with their training program. Essentially the ‘manipulation of soft tissue' in my books means moving muscles, tendons, ligaments and connective tissue around in a range of ways to achieve the desired effect.
What techniques does a sports massage practitioner use?
As practitioners, our backgrounds, training and working experiences do make our individual ways of working quite different. When you couple this with the varying shapes and sizes of clients, their own tolerance levels and their differing requirements treatments can alter tremendously. This can include the standard ‘massage' techniques, stroking through muscles groups or picking specific muscles out and creating movement within them in different directions or at varying depths and strengths. It could also be the isolation of a muscle or muscle groups and stretching them in any number of ways with client participation, passive/subtle movements along the muscle body or indeed deep into specific areas as deemed appropriate. Working into specific areas concentrating efforts to break down tensions or ‘adhesions' may be required or separating the layers of connective tissue may be the key to remedy the situation in hand. When looking at and treating the injury or symptoms, root causes are also carefully considered and this may lead the treatment into other areas around the body. Some of these areas may seem quite a strange to work on to begin with given the case scenario and therefore advising the client is always something that I try to achieve in the most simplistic, understandable way.
Any area is treatable and every case is different given the variables that present themselves which means that no two treatments are alike. Given that we have an in depth knowledge of how the body works and an experience bank built up over years of practice, injuries can be successfully treated or training schedules can be followed to allow the very highest levels of performance possible. This does not mean that every one is immediately responsive, gains benefit straight away or can be cured in one session however, although in some cases this is the case and it is my goal to provide the very best of treatment and advice as to the way ahead.
If there is pain or discomfort, loss of mobility or restriction of movement we, as soft tissue specialists, can treat and hopefully cure. If there is a sporting activity or a training schedule being followed regular treatments can enhance performance and an ongoing relationship with the practitioner can only make this even more effective. Similarly our everyday working lives and lifestyles create the same set of problems and these, in the same way, can also be treated successfully.
Necks, Backs, Shoulders and Legs may be broad terms as areas treated frequently but in amongst these titles lay a whole host of problems and challenges. An injury may in fact be one muscle miss firing or tense and other muscles may be over working to compensate so treatments as previously mentioned more often than not will work on the site of pain or dysfunction but also on opposing sides or compensatory muscular action sites plus surrounding imbalanced and compromised areas. The tri athlete may commonly suffer with IT Band problems and the office worker neck, shoulder and arm complaints and feet, hands, chest and abdominal muscles are treated every now and then.
I treat males, females the young and old following a code of conduct and etiquette. For minors, parental consent and presence are required at all times and if required a chaperone is allowed to accompany a client. Clients need to feel comfortable and confident in the professionalism, manner and ability of the practitioner and simple communication is key.
What training does a Sports Massage Practitioner do?
My training was with the London School of Sports Massage and I was very pleased with the tools I left with. The course was part time, lasting the best part of a year, with weekend attendance every month and home study and lots of ‘hands on' practice to complete. This ended with two practical test sessions and two written examinations (including an Anatomy and Physiology paper) plus 5 study papers submitted at various intervals during the year and a treatment log giving a minimum of 100 hours work with brief explanations. The real training started post qualification gaining experience with real life clients with real problems calling on you to solve and seek advice!
My own background was in Medical Scanning albeit on the business side so I had a fair amount of knowledge of the medical profession and who does what as well as having seen inside many bodies with orthopaedic scan requests. I had a lot of contact with orthopaedic consultants and radiologists, seen presentations by them and hosted seminars with them presenting their work and how scanning plays a part in this to an audience of physical therapists (including Chiropractors, Osteopaths and Physiotherapists) which helped me a lot. I had also been a keen cyclist in the past and had had a few injuries which had been successfully treated by a combination of he above and for the last 10 years had practiced Astanga Yoga which gave me a much better understanding of the body and its capabilities and just what muscles act on what joints and the benefits of stretching and body work. Of course there are many schools and courses offering basic massage, sports massage and workshops on specific techniques. However I do think that whatever the course passed the real learning comes through the experience gained with numbers of clients and situations presented. I personally feel that my course gave me a great grounding and many tools to use in my everyday work. I now belong to an association to keep in touch with what is happening in my profession who also hold my Insurance cover and gain CPD (continuous professional development) through my work alongside and contact with a couple of Osteopaths and a Chiropractor plus my ongoing contact with my medical scanning past with whom I retain links.
How does Sports Massage Therapy work with other types of treatment?
In an ideal world all forms of physical therapy would work harmoniously alongside one another but sadly this is not always the case and I do also believe that sometimes the general public is unaware of what each practice actually offers. I have witnessed all kind of responses to me as the Sports & Remedial Massage Practitioner other professions, both positive and negative, and I feel that this has as much to do with individual personalities as it does with what we actually do or can offer. In addition at the end of the day everyone is extremely busy with their own work and life and there often is simply not the time in the day to get to know the masseur calling or contacting every now and then. I have also seen interaction (through my previous medical management working life) between Consultants (between Surgeons and Medics as well) and General Practitioners and Physical Therapists and in the latter group the differences and divisions between Chiropractors, Osteopaths and Physiotherapists. Once again sometimes this has been positive and sometimes negative. I have worked with ‘friendly' fellow professionals in Physical Therapy at varying degrees of success but know exactly what I can bring to the therapy table to assist with patient care and management.
When the synergy between practice and professionals works together they produce magnificent results and I have assisted with the preparation of athletes under the direct control of a Sports Club Physio and I have helped pre Osteopathy treatment with soft tissue element ahead of their work. I have also received referrals from Osteopaths and Chiropractors to work on patients soft tissue complaints in tandem to their own treatment as part of the ongoing plan to restore the patient to good condition. In turn, knowing what each practice offers and knowing what individual an Chiropractor, Osteopath or Physiotherapist can produce (by getting to know them) I can refer patients back to them that I know my treatment alone will not be the final answer in the equation. I have also heard of many GP's (Medical Doctors) who have advised patients to seek assistance from someone such as myself without actually being able to offer recommendation but I have also heard many cases when any form of Physical Therapy is almost ridiculed!. Luckily I have also met very supportive GP's who have an interest or play sport who are more interested and have suggested that certain patients or contacts of theirs seek out ‘soft tissue manipulation' (or massage). Of course attitudes have changed a lot over the years and the path to recognition for many specialties continues as it does in my own field and at the end of the day the thing I like to do best is offer my own blend of skills and experiences to try and help people who take the plunge and seek help and advice for their current pain, restriction or sporting endeavor.
What job opportunities are available for Massage Therapists?
There are many opportunities and ‘jobs' possible for the Sports Masseur and circumstance and desire plays a big part into which route your career follows. In the first instance the profession is not an easy way of making a living!. The work is physically demanding and in addition depending on what sort of person you are, talking to clients about their ailments and just talking to clients full stop can be pretty hard going mentally also. On top of this clients expectations are high and we live in a world where people want/demand instant results and value for money, especially when your marketing materials state that you can achieve if not miracles, a hell of a lot!
I had some experience with a part time football club and have seen and spoken to people who have worked on a full time basis with professional clubs and the like but chose myself to be independent and work with individuals. This is mostly to do with my family life and commitments and therefore I would view traveling with a football club, as an example, as a younger, single person's life. I do have affiliations to some sporting clubs however but this is on an independent basis and not too forceful so that at the end of the day members have choice and my service is not rammed down their throats. I also work at an Osteopathic Clinic and a Chiropractic Clinic where patients are referred as part of their ongoing treatment plan or as an alternative source of treatment where my skills would better serve the situation. This I enjoy immensely and gives me the varied working day that retains my interest. It does take time to build a practice and I find that now I have a number of regular clients that have came from various sources through plodding the streets and telling as many people as I possibly could at the start of my career on what I could do, preaching the value of my services constantly adapting the tone of my message; to where I am now which is a mixture of recommendation through word of mouth or direct referral. This does not mean that I would not turn down an offer from a sports club if it were presented to me and I could fit it in. It does mean however that I would not actively pursue such opportunities by cold calling. I do try to continue to market myself as you have to but as things progress the need to on a day to day basis diminishes and as the practice is accepted evermore and your reputation as someone who can deliver grows, then keeping busy becomes easier.
How do you work out pricing?
Charging is something that varies from region to region I am sure and I have small differences to my rates for different reasons. For example a home visit has a certain ‘base rate' in my mind but I often offer an incentive if lets say a group of runners congregate at one place regularly for their treatment and offer a discount. Clinics often take a percentage for use of rooms and therefore the rate will reflect this. Some people charge a higher rate for half an hour but personally I do not and actually do not encourage 30 minute slots as I always feel rushed; once again this does not mean that I do not see some clients only for half an hour. At the end of the day I feel that I offer good value for money and if this is the case and you can provide what people are after the rate is immaterial. I appreciate that it is a big step for anyone to take to seek treatment and I try my best to give the very best service and explain to them in the easiest way possible what I am doing, my thoughts on their situation and the way forward.
(Prices for sports massage therapy in the UK are often in the region of £25 and £40 per hour)
How is Sports Massage regulated?
The subject of governing bodies for my profession is somewhat frustrating but no different to any other collective of professionals. I personally am a member of the ‘Sports Massage Association' and I do this to a) keep in touch with what is happening in the industry b) retain my insurance and probably most importantly c) be represented!. If I were being honest I hear only snippets of what is happening in the big wide world in terms of how we are being promoted as a medical profession and have spoken to professionals in others fields (such as Physiotherapy, Chiropactric & Osteopathy) who may be further down the road of formal acceptance but share the same divisions and politics and endless debate. I understand that there are many other associations which splinter and form or argue the toss on who is the real deal and admire those who take part and enter into the fray on this matter. Personally I am happy to just be out there in the field providing good service to my clients, solving problems and using my experience to do the very best for people who see me whilst developing my skills by keeping in touch with other professionals.
For f urther information visit our sports massage section.
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