so that they remain available to apply appropriate treatment techniques. With reference to appropriate techniques, a good knowledge of both the sport-specific and fitness training physical demands that are placed upon the athlete is vital to provide a sound understanding of what is happening to the body and the processes it is going through. This helps to ensure that each technique is used with reasoned application and not with a “because that’s the way it’s always been done in the past” approach. The unreasoned or ‘rehearsed-routine’ approach can harbour a number of risk elements that could potentially reduce performance, adversely affect recovery times or worse still increase the risk of injury. To expand on the last point, because of the tight scheduling and need to sustain the flow of training being delivered, very often the practitioner will be treating the athlete at the end of the training day or occasionally at what would be a natural break, such as a stop for liquids and lunch. This could be around the middle of the day because to avoid training in the higher summer temperatures training sessions might start as early as 6am. It is important to know what has been done before the treatment and what will be done after to ensure the best treatment is provided and to illustrate this I have used a fairly typical example below. If, for example, the person on your treatment couch has

just come straight from a heavy session for the legs they will not then want a deep tissue sports massage on that area. It would be likely to be very painful and also not be the most effective approach for recovery of the tissues. That type of deep tissue work would normally be reserved for treatment sessions some hours after training or better still, on a day of rest from training.

In this instance a general flush-through of the area

would be more suitable, using a technique with both hands simultaneously encompassing as much of the leg musculature as possible and using a moderately light pressure, working with repeated strokes towards the heart, continuing through the whole leg anteriorly and posteriorly. Whilst this will not provide a total flush-through of all of the tissues, as there will be some dissipation of blood back through vessels away from the site of application, it will assist with accelerating the clearance of much of the physiological by-products of training from the tissues and promote repair and recovery of those tissues. What this technique also allows, especially when

Dave is a typical massage practitioner, working full time but in a number of different environments. Here is a typical schedule for a day from August 2007 when the cricket and rugby seasons overlap. No one ever said it was an easy job!

BOX 1: THE WORKING DAY 08.00 Begin treatments at cricket club. A fairly calm atmosphere working on a one-to-one basis with individuals prior to the days play. 10.00 Finish at cricket club and travel to rugby club 10.30 Begin treatments at rugby club. Working with a team of practitioners within a lively and intense atmosphere, merely a reflection of some of the differences between the two sports.

treatments are repeated over time, is an opportunity to survey the tissues for any developing areas of concern such as areas of abnormally high muscle tone, development of adhesions, focal tenderness etc, providing an early-warning system that can then be dealt with and hopefully avoid injury or loss of training time.

Any potential areas of concern identified during the flush-through should be reported to the physiotherapists for monitoring and if appropriate, treated at the time. This is a point at which the type of sport would influence how the treatments are applied. Within rugby, because of the size of the training squad and number of players requiring treatment in a short space of time, a team of practitioners would work simultaneously providing brief flush-through treatments that effectively assists player recovery and also provides a screening service. The lower number of players in cricket often means that the players will have longer sessions with an individual practitioner during which a flush-through and more specific work would be done to prepare them for the next training session or for further treatment with the physiotherapist.

For an area of concern, such as high focal muscle

tone, an appropriate technique to use straight from the training session would be neuromuscular technique (NMT) sometimes referred to as digital ischaemic pressure. It is a technique that causes temporary ischaemia in the area and stimulates an interaction with the golgi tendon organs and muscle spindles. This provides a physical relaxation in the tissue nociceptors which provides an analgaesic response, lessening the discomfort felt and improving the ability of the muscle to lengthen safely thereby lessening the risk of injury and helping to maintain performance.

The method is an application of pressure directly into the affected area using a supported thumb where the top thumb applies the pressure whilst the bottom thumb is passive and used to palpate for a reaction within the tissues. It is applied gradually and usually perpendicular to the skin but that may vary according to other structures such as bone close to the site of application. It is used with reference to a pain- scale perception by the patient (0 = no pain, 10 = unbearable) usually to a maximum level of 7 and maintained at that pressure for long enough for the pain reference to drop, preferably to zero, during which a palpable relaxation of the tissues should be noted.

These are just a couple of simple techniques that can 16 sportEX dynamic 2008:16(Apr):15-17