Aims of deep tissue sports massage
In deep tissue sports massage, the therapist has specific aims in mind, and in sport we focus on the individual needs of the athlete. With the ever growing number of people taking part in sport, combined with the increasing competitiveness and intensity of physical exercise, the demand for sports massage is also increasing and becoming more and more recognised as a skill which may aid recovery and enhance performance.
Sports massage does have some aims in common with other forms of massage and it is especially important to have a thorough understanding of anatomy and physiology, in particular the muscular and skeletal systems. By understanding these systems and the effects of exercise, we may also appreciate how massage may benefit the sports person and becomes an integral part of the athlete’s training program.
Athletes who are looking to improve performance and increase their competitive edge do so by adopting a training schedule to enhance their skill, strength, stamina, suppleness and speed. The degree to which they develop and utilise these qualities will depend on other factors such as the level of competition, the sport played, and possibly their position in a team. However, no matter which sport, the aim is nearly always to increase the level of training and thereby subject the body to gradual and controlled overuse.
It is this overuse that may often create problems and imbalances in the soft tissues. If these are ignored and allowed to become chronic, they will not only hinder the athlete’s rate of improvement, but also in many cases their performance may well suffer and ultimately the athlete may be susceptible to developing more conditions that are serious. Certainly if they are unable to perform at their best, they may be more at risk from other more traumatic forms of injury. For example, a player involved in a contact sport who is “carrying” an injury may not have their usual level of agility. The result might be that they might suffer an extrinsic injury because of not being fully prepared for the contact suffered from an unexpected tackle.
Benefits of Sports Massage
Massage, applied skillfully, is the most effective therapy for releasing muscle tension and restoring balance to the musculo-skeletal system. Received regularly this may help athletes prevent injuries, which might otherwise be caused by overuse. A constant build up of tension in the muscles from regular activity may lead to stresses on joints, ligaments, tendons, as well as the muscles themselves.
These muscle imbalances may develop and often go undiagnosed until they are serious enough to cause the athlete discomfort or impede performance. The skilled massage therapist will be able to detect variations in the soft tissues and by using the correct techniques, help the sports person maintain a much healthier physical state.
It may therefore be reasonably claimed that one of the greatest benefits of sports massage is in helping prevent injury.
The three main categories of sports massage that are predominantly used in sport are effleurage, petrissage and frictions. Almost deep tissue sports massage techniques are carried out with the main pressure being directed towards the heart. This helps increase venous and lymphatic flow and ensures that no pressure of blood is being pushed against closed valves causes any damage to blood vessels. The only exception to this is where short strokes are aimed at stretching muscle fibres. Because the strokes are limited, there is no risk of pressure being built up.
Effleurage consists of a variety of stroking movements, usually carried out with the whole palm of the hand and fingers, which may be used with varying pressure according to the purpose and stage reached during the massage. Effleurage is always used at the start of massage.
The basic movements comprise stroking with firm pressure using a wide surface area of the palm of the hand and fingers. On the return, the therapists’ hands maintain, light contact and avoid the path taken on the upward stroke. As with all massage, the hands must be relaxed and moulded round the natural contours of the recipient’s body. Effleurage is always used to commence any massage session and it has a wide range of purposes that you need to focus on:
- Introducing touch to the client (Palpation discover tight muscles)
- Putting the client at ease
- Warming the tissues
- Increasing blood flow
- Stimulating peripheral nerves
- Muscle relaxation
- Palpating tissues
Effleurage should be carried out in a rhythmical and relaxed manner starting with light touch at the start of a session and building up to deeper pressure for increased circulation and stretching of tissues later in the massage. It should not be rushed as it is during this phase you need to begin to focus on any abnormalities in the tissues that may require further attention later in the massage. If the movements are performed too quickly, this will not help the client relax and if a “tender” area is missed, it will almost certainly be more painful when discovered using deeper techniques later! Effleurage is also used to complete the massage finishing with light stroking to relax the patient, particularly if movements that are more painful have been used beforehand.
Petrissage or kneading is used on deeper tissues for mobilising fluids, stretching muscle fibres, and inducing relaxation. Some of these techniques are specifically aimed at only deeper tissue and are therefore both ineffective and difficult to perform on narrow parts of the limbs. You must therefore pay particular attention, as with all massage techniques, as to what your purpose is when kneading petrissage is a powerful technique that is particularly effective in mobilising fluids in very deep muscles and applying a good stretch to the fibres involved.
Frictions may be used for exploratory purposes, or for deeper and sometimes more painful movements aimed at breaking down lesions, separating muscle fibres, and even breaking down recent scar tissue. When performing frictions for exploratory purposes we tend to use the sensory pad of the thumb to “grasp” the skin and to move this over the underlying surface to feel for any abnormalities (trigger points) to the tissue concerned. This allows us to palpate, particularly around joints and feel for smaller abnormalities in the tissues. When performing frictions for the purpose of separating muscle fibres, breaking down lesions and scar tissues, firstly the client must be warned that these procedures may indeed be painful or at the very least uncomfortable. They only need to be carried out for a very short while. Using vigorous frictions for any longer than this may have a particularly detrimental effect by irritating and even causing inflammation.
Soft tissue release technique
Soft tissue technique, performed by osteopathic physicians (D.O.), chiropractors, physiotherapists and massage therapists, is a manual therapy technique directed towards muscles and fascia throughout the body. It involves a doctor/therapist using his/her hands to stretch or relax dysfunctional soft tissue structures. While these techniques can be applied almost anywhere, they are especially useful for the paraspinal musculature that surround each vertebra of the spine. The end goal of all soft tissue techniques is to relax hypertonic muscles and stretch tight fascial structures.
- Pathophysiology of soft tissue dysfunction
- Mechanisms of action
Pathophysiology of soft tissue dysfunction
Trauma, accidents, local inflammation, immobilization and emotional tension all can lead to the local irritation that causes muscle tension. As muscle tension increases a number of problems occur: muscle fibers tighten, blood vessels become compressed, tissue metabolites are retained and local edema occurs. This process eventually leads to limited muscular elongation, restricted joint movement, tendon function restrictions, fascial shortening and a functional disability.
Mechanisms of action
Soft tissue techniques work by affecting a variety of components within the soft tissue structure. These components include the musculature, fascia, vasculature and local nervous system, which will each be described below:
By applying a direct force to tight muscles, the muscles can be stretched or kneaded until relaxation occurs. Similarly, as muscles are stretched, the fascia surrounding each muscle is also stretched until fascial relaxation occurs. Fascia can be specifically treated by using myofascial release techniques if dysfunction is still present after soft tissue techniques have been used.
In relation to vasculature, soft tissue techniques have been shown to increase the amount of circulation to the muscles and fascia. As more blood reaches the tight muscles, the amount of oxygen and nutritional components reaching the muscles increase, as well as increasing the rate of removal of local metabolites and waste products. All of which lead to more rapid healing rates.
The somatosomatic and viscerosomatic neural reflexes can also be decreased through soft tissue techniques.
The choice of technique is based largely on treatment goals. There are three basic methods used when treating with soft tissue techniques:
Traction techniques (or stretching techniques) engage the origin and insertion of the myofascial structures by longitudinally stretching the muscle fibers.
Kneading techniques involve a rhythmic lateral stretching of the myofascial structure much like stretching a bowstring. In these techniques, the origin and insertion of the muscle remain stationary.
Inhibition techniques use sustained deep pressure to promote soft tissue relaxation.
Most often soft tissue techniques are used in combination with other treatment modalities in order to maximize results. This combination applies the principle of synergy to make sure a patient’s somatic dysfunction is as resolved as possible.
Contraindications for Sports Massage
There are times when sports massage could be detrimental rather than beneficial to you. The contra indications to massage are:
- A body temperature over 100°F, or feeling unwell
- Acute Traumas – Open wounds, recent bruising, muscle tears, sprained ligaments, contusions, chilblains, burns
- Tumours – Where there is swelling, which is inconsistent with recent bruising
- Diseased blood vessels – Varicose veins, phlebitis, thrombosis
- Infectious skin disease – Bacterial infection, Lymphangitis, Fungal infection, Viral infections, Herpes
Where you react adversely to massage treatment
Where your symptoms appear to make advice from a doctor advisable
Diabetes – not strictly a contraindication but massage has the same effect as exercise on your blood sugar levels so you need to have appropriate medication available.
Soft tissue techniques are used to resolve dysfunctions commonly described by the mnemonic device “TART” (Tissue texture change, Asymmetry, Restriction, and Tenderness). They are often well tolerated by most patients. Some contraindications include local infection, open wounds or lack of skin and soft tissue integrity. Caution should also be used on patients taking anticoagulants as bruising can occur.