RESEARCH REVIEW

Massage – what’s the latest evidence?

assigned to either a 30 minute rest period or 30 minutes of effleurage and pettrisage to the back (this protocol is described in detail). A Profile of Mood States (POMS) questionnaire was completed by each par- ticipant before and after this 30 minute period. The Wingate test was then per- formed and total work, peak power, mini- mum power, mean power, time to peak power and fatigue rate were determined. All subjects were familiar with the test beforehand and completed a third POMS questionnaire following the test. Each subject completed the procedure on a separate occasion following the rest pro- tocol if they had previously followed the massage one, and vice versa, thereby act- ing as their own controls.

The results showed an increase in anaero- bic performance with respect to total work and mean power in the massage group. Interestingly, and contrary to the study hypothesis, massage had no effect on mood state. The back was purposefully chosen as the area for massage in the study rather than the lower limb as this could have had a physiological effect rather than a psychological effect on the Wingate test.

The results suggest that a carefully designed massage protocol may be benefi- cial to prepare an athlete for anaerobic activity. Athletes who might benefit from this could be screened to see if they respond in a positive manner to this inter- vention.

Evaluation of the effect of two massage techniques on hamstring muscle length in competitive female hockey players D Hopper, M Conneely, F Chromiak, E Canini, J Berggren, K Briffa Physical Therapy in Sport 2005;6: 137-145

Weerapong et al (2005) presented only www.sportex.net

three studies investigating the effect of massage on ROM and of these, only one was an RCT. This study investigates the biomechanical effects of massage, com- paring the ‘classic’ technique with a dynamic soft tissue mobilisation (DSTM) massage technique that has not been pre- viously investigated.

Thirty-nine hockey players were randomly assigned to the classic or DSTM group. Hamstring muscle length was evaluated using two well validated techniques, pas- sive straight leg raise (PSLR) and passive knee extension (PKE). Each player was also randomly assigned to the order of hamstring testing. Players were tested over a three day period, day one acted as a control, day two the intervention peri- od. The control and intervention periods lasted for eight minutes. Each player had hamstring length evaluated before and after these periods, and again on day three, 24 hours following the interven- tion. The descriptions of the study design and hamstring testing procedure are illus- trated well.

The results showed that hamstring length as measured by PKE was improved in both groups immediately post-massage, but that this was not maintained 24 hours fol- lowing the intervention. The authors acknowledge that one, eight minute peri- od of massage may not reflect an athlete’s normal massage protocol, and a series of massage interventions should be evaluat- ed to see if there is a cumulative effect for carry over. The authors also highlight the difficulties in comparing the literature on massage when factors such as pressure, time, speed and technique parameters are not mentioned in the methodology.

One final point is that this study does show that massage can increase muscle length, albeit for a short period of time. However, and the authors allude to this, it

is the ‘so what?’ factor, and what does this mean clinically? The fact is, the clinical implications for injury preven- tion are unknown, but the results could be used to justify a treatment approach for someone presenting with tight hamstrings.

Effects of massage on delayed-onset muscle soreness, swelling, and recov- ery of muscle function Z Zainuddin, M Newton, P Sacco, K Nosaka

Journal of Athletic Training 2005;40:174-180

This paper adds to the weight of evi- dence that massage can reduce the sensation of soreness in eccentrically induced upper limb DOMS. Additionally, the results demonstrated no effect on muscle strength as evaluated by iso- metric and isokinetic strength tests.

While I have not gone in to any detail with regards to this paper, readers may want to look at the abstract or full text which can be downloaded from the Journal of Athletic Training web site at: http://www.nata.org/jat/readers/archi ves/40.3/i1062-6050-40-3-174.pdf

Last, but not least, I would like to point out a commentary on this paper written by Russell Stevens and pub- lished in the same issue (186-190). This raises some interesting general ideas and questions for clinicians read- ing research, on how to interpret the results and decide if it is going to change your practice.

Dr Zoe Hudson MCSP, PhD, is editor of the Journal of Physical Therapy in Sport. She is associate director and senior clinical lecturer of the Department of Sports and Exercise Medicine at The Royal London Hospital.

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