Sports massage is a popular form of treatment for soft tissue injuries. Getting a regular sports massage also forms part of many athletes injury prevention strategy.
We demonstrate simple sports massage techniques for various parts of the body and explain the benefits and effects of massage as well as when it may not be appropriate.
Contraindications of Massage
A contraindication is a situation when massage should not be performed. Continuing with treatment may be more detrimental than beneficial and in some cases may cause serious medical problems. Below we list a number of massage contraindications but do not claim it to be an exhustive list. Always get professional advice.
Open wounds - Any cuts, lacerations or grazes. Obvious really, but it has to be said. You should wait until the scar has properly formed. This is usually between one and two weeks.
Muscle ruptures - In the acute stage these may still be bleeding. Massage will increase bleeding and tissue damage and prolong recovery. After the initial 48 to 72 hours massage may be possible but it will depend on the extent of the injury.
Tendon ruptures - The above also applies to tendon injuries. Complete ruptures will need surgery, not massage.
Muscle and tendon partial tears - Massage may be suitable after a minimum period of 48 hours, longer for more serious injuries.
Contusions - These are impact injuries causing bleeding within the muscle. Massage to a contusion too soon after the injury may cause further damage and may lead to Myositis Ossificans (bone growth within the muscle).
Burns, Chilblains and Broken bones - Massaging all of these will hurt and cause damage. Don't do it.
Periostitis - This is inflammation of the sheath that surrounds the bone. Massage directly to the bone may cause irritation. You may be able to massage the surrounding muscles but stay well clear of the bone.
Rheumatoid arthritis and gout - These are inflammatory conditions. The same rules apply here as to acute injuries. Massage may cause further inflammation.
Bursitis - Inflammation to a bursa. A bursa is a small sack of fluid that helps tendons pass over bones at joints. If there is pain, swelling and redness over the skin then massage should be avoided.
Myositis ossificans - A bad contusion or muscle rupture may begind to calcify (grow bone). Massage will make the damage worse.
Infections of the skin and soft tissue - Bacterial infections, viral infections and fungal infections can be spread to other areas of the body by the therapist. Pain may also result from the infection, not an injury so massage will not help.
Thrombosis - This is a rare but potentially lethal blood clot in a vein. It is common in the calf muscle area. A deep, sore pain in the belly of the muscle may be a thrombosis. If this is massaged, it may dislodge, travel up the veins and damage the heart.
Artificial blood vessels - Artificial blood vessels which are implanted through surgery should be avoided.
Bleeding disorders such as heamophillia - Massage may cause damage to tissues and result in bleeding.
Tumours - If you are unsure of any lumps and bumps in the muscle or skin then leave well alone. Most often these lumps are muscle spasms or fatty tissue. An experienced therapist can usually tell.
Absolutely anything else you are not sure of! - Massage should only be done by qualified therapists and the writers of this site accept no responsibility for injury resulting from actions not under their direct supervision or control!
Benefits and effects of massage
Sports massage can play an important part in the life of any sportsman or woman whether they are injured or not. Massage has a number of benefits both physical, physiological and psychological. It can help maintain the body in generally better condition, prevent injuries and loss of mobility, cure and restore mobility to injured muscle tissue, boost performance and extend the overall life of your sporting career.
Pumping - The stroking movements in massage suck fluid through blood vessels and lymph vessels. By increasing the pressure in front of the stroke, a vacuum is created behind. This is especially important in tight or damaged muscle tissue as a tight muscle will squeeze blood out like a sponge, depriving the tissues of vital nutrients and energy to repair.
Increased tissue permeability - Deep massage causes the pores in tissue membranes to open, enabling fluids and nutrients to pass through. This helps remove waste products such as lactic acid and encourage the muscles to take up oxygen and nutrients which help them recover quicker.
Stretching - Massage can stretch tissues that could not be stretched in the usual methods. Bundles of muscle fibres are stretched lengthwise as well as sideways. Massage can also stretch the sheath or fascia that surrounds the muscle, so releasing any tension or pressure build up.
Break down scar tissue - Scar tissue is the result of previous injuries or trauma and can effect muscle, tendons and ligaments. This can lead to inflexible tissues that are prone to injury and pain.
Improve tissue elasticity - Hard training can make tissues hard and inelastic. This is one reason why hard training may not result in improvements. Massage helps reverse this by stretching the tissues.
Opens micro-circulation - Massage does increase blood flow to tissues, but so does exercise. What massage also does is open or dilate the blood vessels and by stretching them this enables nutrients to pass through more easily.
Pain reduction - Tension and waste products in muscles can often cause pain. Massage helps reduce this in many ways including releasing the bodies endorphins.
Relaxation - Muscles relax through heat generated, circulation and stretching. Mechanoreceptors which sense touch, pressure, tissue length and warmth are stimulated causing a reflex relaxation.
Anxiety reduction - through the effects mentioned above relaxation is induced and so reduces anxiety levels.
Invigorating - if massage is done with brisk movements such as what would be done before an event then this can produces an invigorating feeling.
Professionalism & ethics
There are certain standards of behaviour and attitude that should be expected from your sports massage therapist. We are not all perfect all the time but below are a few simple ideas that you should expect from a professional sports massage therapist.
The sports massage therapist should always wash their hands before beginning a treatment. Even if they have only just washed them they should be washed again so the client knows they have been washed.
As a paying client you should expect the therapist to give you their undivided attention for the duration of the appointment. They should not be stopping to answer the telephone or chat to others.
They should not under any circumstances discuss other clients with you. If they talk freely about them, who knows what they are saying about you once you leave the room?
The therapist should not unload their own personal problems on you. Developing a rapport is important and they should be good listeners but they should keep their own problems to themselves.
Where possible the sports massage therapist should guard against emotional involvement. They will be a good listener, and offer good advice but should keep a professional distance and not become emotionally involved.
The massage therapist should take your views of what is required but should make their own decisions on how treatment should be carried out. They are the qualified professionals so treat them with respect and allow them to do their jobs!
Most sports massage therapists will wear a white coat or uniform. This projects a professional image. It will also prevent unsightly oil stains on clothes. When you are referred to a massage therapist by a doctor or other qualified person then you should expect their instructions to be carried out to the letter and not added to or altered by the massage therapist.
You should not be accepted for treatment by a massage therapist if you are being treated for the same problem by someone else. The massage therapist may interfere with the treatment you have previously had. You should expect the sports massage therapist to keep up to date records of treatments given.
The word myofascial comes from the Latin words 'myo' meaning muscle and 'fascia' meaning band. Fascia is a connective tissue, also sometimes known as fibrous bands, which surrounds all muscles, tendons, ligaments, bones and organs within the body. The fascia consists of a network of hollow tubules made up of collagen and elastin.