Massage Therapy for Athletes

More Than Just a Good Back Rub

"Athletes put a lot of stress on their muscles, and massage is nourishing for those muscles," says Rex Baird, a licensed massage therapist in the Boston area. Like other therapists who work with athletes, Baird uses a variety of techniques to soothe sore muscles and enhance flexibility, including:

• Effleurage—vigorous muscle stroking
• Petrissage—kneading and rolling of the muscle
• Tapotement—rapid striking of the muscle (similar to, but gentler than, karate chops)
• Compression—pressure applied over a broad area by pushing down on the muscles with the open palm of the hand
• Trigger point therapy—concentrated finger pressure applied to trigger points to relieve the tension in the surrounding area

  "Trigger points are those knots embedded in the muscle that are hypersensitive to touch and can be the origin of pain radiating throughout the area," explains Baird.

The Power of Touch

"Although researchers have yet to fully identify how it works," Nicholas DiNubile, MD, orthopedic consultant to the Philadelphia 76ers and the Pennsylvania Ballet, believes that "massage is very beneficial for athletes." Among the many physical and mental benefits associated with massage, the following benefits are especially therapeutic for athletes:

Increased circulation—The rhythmically-applied manual pressure of massage enhances the flow of blood and lymph to deliver oxygen and nutrients, and to carry away wastes and toxins. Dr. DiNubile notes that this "can speed recovery and decrease muscle soreness after a hard workout or when recovering from an injury."

Functional scar tissue—"When an athlete treats an injury with rest alone, scar tissue may form in a random pattern and lodge itself within the healthy muscle tissue," explains Baird. "The scar tissue is inhibiting the full potential of that muscle to elongate. However, massage makes this tissue more pliable and aligns it with the muscle fibers, which allows for better healing of the muscle." In addition, massage helps with the microscopic muscle damage from regular exercise that also leaves behind small amounts of scar tissue. The movement and pressure of massage works on the patches of scar tissue to make them functional.

"I was often sore after workouts, but since I've been receiving massage every three weeks or so for the past four years, I find that I can train harder because I feel looser, recover quicker, and experience less pain," says Steve Kempainen of the Central Massachusetts Striders running club.

Muted pain signals—For those experiencing chronic pain, Baird describes the effect of massage as that of a "circuit breaker" between the nervous system and the site of pain. Baird explains, "In immediate response to injury, the nervous system reacts by contracting the muscles. After the initial trauma resolves, however, the nervous system often maintains a message pattern that unnecessarily perpetuates muscle contraction. Massage stimulates receptors that in turn stimulate the nervous system to modulate the signals that have been keeping muscles tense and contributing to pain."

Enhanced flexibility—Dr. DiNubile notes that athletes should take a cue from ballet dancers who have been using massage for years. "A training program that includes thorough stretching and massage can enhance flexibility, as the increased blood flow also serves to improve muscle elasticity and maintain joint mobility."

Quicker rehabilitation—Massage is helpful as part of injury rehabilitation, for example, athletes recovering from ]]>tennis elbow]]> or ]]>Achilles tendinopathy (tednonitis)]]> find that the pressure of massage can help to loosen up tightened muscles.

Not Just a One Shot Deal

Sporadic, post-event massage, such as that available after marathons, does not have much physiological benefit. Studies have shown that light exercise—a brisk walk or easy jog—not a one-time massage, is the best way to speed recovery after a strenuous event. Dr. DiNubile and Baird agree that massage is most effective as part of an athlete's total training program, which includes a healthful diet, adequate hydration, proper stretching, and well-designed workouts.

Good for the Mind and the Body

In addition to the training benefits, athletes seek out massage for the same reason as spa-goers—relaxation. "Massage is a regular part of training for many of the 76ers," notes Dr. DiNubile, "and it's especially helpful before the playoffs, when anxiety is running high in the locker room." Kempainen agrees, "Massage is such a great stress reliever that I'll continue even when I'm no longer running."

Do Not Touch

There are situations in which massage would not be appropriate. These include:

Recent injury—Although massage is effective in morphing scar tissue into functional fibers, athletes should wait until swelling has subsided and bad bruises have healed—about two to three days after injury—before receiving massage.

Circulatory problems—Athletes who suffer from ]]>phlebitis]]> or other circulatory disorders have very fragile veins that can be easily damaged by the direct pressure of massage therapy.

Skin conditions—Athletes should wait until open wounds or contagious skin conditions are resolved before receiving massage.

Bone injury—Massage is contraindicated in patients with significant trauma to the bones or joints, such as fracture or dislocation.

Other conditions—Athletes with infectious diseases, ]]>diabetes]]>, ]]>fibromyalgia]]>, certain ]]>cancers]]>, and some cardiac problems may require a gentler form of massage, or may not be able to tolerate treatment at all; in these cases, check with your physician first.

Is Massage for You?

From soothing tired muscles to calming an overworked mind, the many physical and mental benefits of massage make it a potentially useful addition to any athlete's training program.

If you decide to try sports massage, consider this:

• The therapist will need to know about your current and past medical conditions and exercise routines.
• You will need to undress to a level you feel comfortable with and lie down on a padded table with a sheet draped over your body. The therapist will undrape only the part of your body being massaged.
• Don' be discouraged if you don't leave your first session feeling completely loose and pain free; Kempainen did not feel the benefits until receiving massage several times.
• The cost of a massage varies depending on locality, experience of the therapist, and type of massage, but generally ranges from $50 to $80 per hour (treatments are usually an hour).
• Some insurance plans will cover the cost of a massage that is prescribed by your primary care physician and administered by a licensed therapist.