MASSAGE AND DOMS

massage’ consisting of classical Swedish techniques. These were chosen as they were ‘preferred by most physiotherapists’ but no reason was given as to why they are the preferred techniques. The treatment (20 minutes) included 5 minutes effleurage (stroking), 1 minute tapotement (percussion), 12 minutes petressage (knead- ing), and 2 additional minutes effleurage. The timings of the strokes were again standardised by audio cues but no reason was given for these timeframes. Unlike Smith et al (5), there was not a description of where exactly the technique was being applied. The treatment was administered by a physiotherapist ‘approximately’ 2 hours post-DOMS inducement. As the timing of the intervention is described as ‘approximate’, there is the possibility it may not have been consistent between subjects making it difficult to reproduce.

Of the three papers to find that soft tissue therapy had an effect on DOMS symptoms, Farr et al (1) had the poorest methodology and descriptions. The treatment, ‘therapeutic massage’, which was not defined, was administered 2 hours post-DOMS inducement by a ‘trained masseur’ and lasted 30 minutes. The treatment, described simply as ‘predominantly effleurage and petressage techniques’, was administered to ‘all major muscle groups’ of the anterior and posterior leg. The description ‘predominantly’ implies that these were not the only techniques used but no other techniques are described as having been used. No reasoning is given for the use of these techniques and the timing used is not described. It is specif- ically stated that ‘no deep tissue massage was performed’. No expla- nation is given of what ‘deep tissue massage’ is or why this was the case. This study’s treatment would be difficult to reproduce. (As a small aside, this paper also contained a number of editorial errors, the most obvious being a discrepancy in the description of the form of exercise used to induce DOMS. The title of the paper indicates that downhill walking was used to induce the muscle soreness however, in the conclusion it is stated that ‘therapeutic massage was effective in the attenuation of DOMS following bouts of down- hill running’!)

As previously mentioned, a fourth study found the treatment admin- istered to be effective in reducing the symptoms of DOMS but the study used multiple interventions - ‘massage’ being one - and so no conclusions on the effectiveness of ‘massage’ as a treatment can be drawn from this research. The ‘massage’ treatment was given 15 minutes post-DOMS inducement. As there was more than one person administering the treatments, consistency between subjects must be questioned. The treatment was of 15 minutes duration and consisted of 6 minutes effleurage, 0.5 minutes tapotement, 5 min- utes petrissage, and 1 minute at the end of effleurage of decreas- ing intensity. The first 2.5 minutes of the treatment was used for the subject to become familiar with the ‘massage’. In this time the muscles were pressed, shaken and the ‘skin was manipulated’. No explanation was offered as to why these techniques and timings were chosen.

Similar problems with a lack of description were found in the three studies that concluded that ‘massage’ did not have an effect on DOMS (3,6,7). Lightfoot et al (3) used a 10 minute treatment con- sisting only of petressage. This was administered immediately after and 24 hours post-DOMS inducement. The treatment was adminis- tered by a ‘licenced massage therapist’. No reason for the timing was given but two reasons for the technique chosen were offered: ■ firstly, that previous research had not defined techniques used,

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or used several techniques in the one treatment ■ and secondly, because earlier research had shown that deep kneading yielded greatest increases in blood flow although there is no indication why this is to be desired.

Tiidus et al (6) used ‘manual massage’ as the treatment, consisting of superficial and deep effleurage strokes. The treatment was administered ‘within 1 hour’ of completing the exercise bout. This description of the timing of the treatment is as similarly flawed as the research of Hilbert et al (2), in that it may be inconsistent between subjects and not reproducible. The treatment was admin- istered by a ‘registered massage therapist’ who used the flat of the hand to administer 10 minutes of superficial and deep effleurage ‘beginning at the knee and progressing proximally to a point approximately 75% of the distance to the thigh...’. Being ‘approxi- mate’ this description lends itself to possible inconsistency. The method and duration of the ‘massage’ was selected by the therapist to, in his or her opinion, ‘maximise the healing potential of the treatment’. The therapist stated that longer treatment would be counterproductive but did not suggest how or why. The treatment was repeated on days 2-4 of the study but, again, no specific times of day or even the number of times per day were given. It is assumed that the treatment was performed once a day.

Weber et al (7) described the treatment as 2 minutes of light

effleurage, 5 minutes petressage, and 1 minute effleurage. No defi- nition was given for ‘light effleurage’, and just ‘effleurage’.

The 8

minute time frame for the treatment was used as this was the time frame appropriate to another treatment group in this study and so all treatments were of the same duration. The treatment was given immediately post-DOMS inducement and at 24 hours post-DOMS inducement. It was not stated who gave the ‘massage’ in this study and no explanation of why the particular techniques were chosen.

Between the studies of this review the number of treatments given varied from one (1,2,4,5), to two (3,7) and as previously mentioned one study was unclear as to how many times the ‘massage’ treat- ment was given (6). The time of day the treatments were given also varied. The problems found in the ‘massage’ descriptions can be seen across most research involving ‘massage’. But another problem area found within this review was a lack of consistency in the meth- ods used to induce DOMS and the measures of the soreness. A num- ber of methods were used to induce DOMS in subjects, as well as varying areas of the body. There was a little more consistency in the measures of DOMS but still three different pain scales used. All of these pain scales were subjective assessments of the pain, whether through palpation or movement of the muscles being assessed. The subjective nature of this assessment presents some problems when trying to compare results across studies. However, all studies used some form of objective measure also:

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