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RESEARCH IN PRACTICE


CONCLUSION As this review has shown, it is not possible to draw any strong conclusions on the effectiveness of soft tissue therapy in the treatment of DOMS from this body of research. We can, however, draw some ‘possible’ conclusions: ■ the timing of the soft tissue therapy post-eccentric exercise appears to be a critical factor in its effectiveness, with two hours post-exercise appearing to be the most effective


■ some looked at serum CK or neutrophil levels (as they are asso- ciated with the inflammatory process that is suggested to be associated with DOMS) (1,2,3,4,5) ■ some functional measures were also assessed, such as peak torque and ROM.


DISCUSSION Initially the purpose of this review was to highlight possible indi- cations for soft tissue therapy in relation to DOMS alleviation. However due to the standard of research available the emphasis has shifted to highlight the need to better define a number of aspects of each study and outline the reasons why further research is so important to our profession.


As previously mentioned, it is difficult to draw any broad conclu- sions from the results of these papers. This is due to the wide range of soft tissue therapy methods used, their description, dura- tion of treatment, timing of intervention and number of treat- ments given. This point is illustrated by the fact that of the seven papers reviewed, four had positive findings and three did not. The nature of research is that no two studies are going to be identi- cal. But if conclusions are going to be drawn from bodies of research then the common themes - in this case DOMS and how it is induced and measured - need to be consistent and comparable. That way the topic of the research, the treatment - soft tissue therapy in this case - should be the only variable not the problem being treated.


To further the research on soft tissue therapy done in this area, using constant methods of


inducing and measuring DOMS, the


treatment could be varied. There are a number of facets of the treatment that could be varied: ■ duration of treatment ■ when it is administered ■ how many times it is administered ■ techniques used.


This is why the description of the methodology is so important. One aspect of treatment that three of the papers with positive findings had in common was the timing of the intervention. Three of these papers (1,2,5) administered the massage treatment two hours post-eccentric exercise. Smith et al hypothesised that this timing may be effective due to interference with the initiation of the acute inflammatory response, one of the suggested contribut- ing factors to DOMS. However, as the cause of DOMS in itself is not well understood, this can only be a hypothesis. Also, the mea- sures of the effectiveness of the treatment (ie. feedback on the effect of DOMS on the subject) should be standardised. Subjective measures such as the pain scales used in these studies are accept- able as long as they are supported with objective measures.


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■ although not consistently shown throughout this research, it would appear that soft tissue therapy can have a beneficial effect in the alleviation of DOMS symptoms post-eccentric exercise


■ further research into the cause of DOMS is needed so that future soft tissue therapy research in the area has a stronger physiological basis to build theories on


■ further research into soft tissue therapy in this area is needed, with better defined treatments and measures of outcomes


■ the soft tissue therapy industry needs to perform these research projects themselves rather than relying on other disciplines.


THE AUTHORS


Nina Heymanson has a bachelor of science degree as well as her advanced diploma in Remedial Massage. Nina spent a year at the Australian Institute of Sport in 2003 on scholarship for soft tissue therapy where the co-author of this article, Brad Hiskins, was her co-ordinator. Earlier this year she worked at the polyclinic at the Melbourne Commonwealth Games and she now travels with the under 21 Australian Netball team.


Brad Hiskins has a BSc and an advanced diploma in soft tissue ther- apy. He has spent 12 years working at the Australian Institute of Sport and has worked at the Atlanta, Sydney and Athens Olympics. Brad was head of soft tissue therapy for Athens and the Manchester Commonwealth Games and Head of Services for this year’s Melbourne Commonwealth Games. He is also on the board of Sports Medicine Australia.


References 1. Farr, Nottle, Nosaka and Sacco. The Effects of Theraputic Massage on Delayed Onset Muscle Soreness and Muscle Function Following Downhill Walking. Journal of Science and Medicine in Sport 2002;5(4):297-306 2. Hilbert, Sforzo and Swensen. The Effects of Massage on Delayed Onset Muscle Soreness. British Journal of Sports Medicine 2003;37:72-75 3. Lightfoot, Char, McDermott and Goya. Immediate Postexercise Massage Does Not Attenuate Delayed Onset Muscle Soreness. Journal of Strength and Conditioning Research 1997;11(2):119-124 4. Rodenburg, Steenbeek, Schiereck and Bar. Warm-up, Stretching and Massage Diminish Harmful Effects of Eccentric Exercise. International Journal of Sports Medicine 1994;15(7):414-419 5. Smith, Keating, Holbert, Spratt, McCammon, Smith and Israel. The Effects of Athletic Massage on Delayed Onset Muscle Soreness, Creatine Kinase, and Neutrophil Count: A Preliminary Report. Journal of Orthopaedic Sports Physical Therapies 1994;19(2):93-99 6. Tiidus and Shoemaker. Effleurage Massage, Muscle Blood Flow and Long-Term Post-Exercise Strength Recovery. International Journal of


Sports Medicine 1995;16(7):478-483 7. Weber, Servedio & Woodall. The Effects of Three Modalities on Delayed Onset Muscle Soreness. Journal of Orthopaedic Sports Physical Therapies 1994;20(5):236-242


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