SPORTS MASSAGE WHAT AND WHY?

is used during split events (that is, between heats or stage races) and after travel. See Box 1.

THE EFFECTS OF INTENSE TRAINING ON SOFT TISSUE Part 1 of this article examined the role of massage in the treatment of soft-tissue injuries, but here we will look at the effects of intense training on soft tissue. In periods of intense training, the body may not recover fully between training sessions; this can often lead to over-training and result in reduced performance and increased susceptibility to soft tissue

BOX 1: MAIN AIMS OF SPORTS MASSAGE IN ATHLETES

Events

To prepare for training To prepare for competition To aid recovery post-event

To condition between heats or stage races

Regularly To condition

To reduce injury risk by “touch” identifying early signs of tissue abnormalities

For injuries To assist in treatment To assist in rehabilitation

a) Isometric contraction - muscles contract but do not shorten

no movement

injury (9). Athletes who engage in a sudden increase in intensity of training often experience delayed-onset muscle soreness (DOMS) which is predominantly attributed to eccentric muscle action (18,20,21,22) which is an overall lengthening of muscle as it develops tension and contracts to control motion performed by an applied force (Fig. 1). DOMS is often cited by athletes as being detrimental to their performance, although the mechanism of DOMS and its effect on performance remain elusive. Intense training also causes prolonged elevation of muscle tone and this is felt by the athlete as muscle “tightness”. It is thought that hard training and abnormal muscle tone have numerous undesirable effects (Box 2). They may impair the delivery of nutrients and oxygen to the cells and slow the removal of metabolites. Biomechanical abnormalities may arise, particularly if muscle tightness creates imbalances and asymmetry. Increased tone also limits extensibility and shock absorbency of soft tissue and therefore predisposes the tissue to strain. Fatigue associated with hard

training also impairs proprioceptive mechanisms and may directly trigger nociceptors (pain receptors). Previously inadequately treated soft tissue areas can cause irritation. Repetitive microtrauma of these same areas may cause bulky connective tissue formation and cross-linkages to develop (Fig. 3), which further compromise muscle function and flexibility. Ultimately, these effects can impair training and competition (23).

b) Concentric contraction - muscles contract and shorten to lift the weight

movement

PERCEIVED EFFECTS AND BENEFITS OF SPORTS MASSAGE IN RELATION TO TRAINING

Many coaches, athletes and sports medicine personnel believe that

c) Eccentric contraction - muscles contract but lengthen to control the lowering of the weight

movement

BOX 2: EFFECTS OF INTENSE TRAINING THAT MAY IMPAIR TRAINING AND COMPETITION

n Delayed-onset muscle soreness (DOMS)

n Prolonged elevation of muscle tone

n Fatigue and impaired pain reception

Figure 1: Types of muscle contraction www.sportEX.net

n Bulky connective tissue formation in untreated injuries

Intense training

Prolonged elevation of muscle tone and muscle “tightness”

n Biomechanical abnormalities

n Impaired delivery of nutrients and oxygen to cells

n Slow removal of metabolites

n Imbalances and asymmetry

n Limited extensibility

n Reduced shock

absorbency Figure 2: Effects of intense training

massage can provide benefits such as increased blood flow, reduced muscle tension, decreased neurological excitability, and an increased sense of well being (6). Massage is thought to work in a number of ways (Box 3) (23) by reducing excessive post-exercise muscle tone, by increasing the muscles’ range of motion, increasing circulation and nutrition to damaged tissue and by deactivating symptomatic trigger points. Most crucially, regular massage is often seen as preventative. It offers a very important opportunity for the massage therapist to identify any soft tissue abnormalities, which – if left untreated – could progress to injury and loss in performance. As most appropriately described by Briggs (21) “the ‘hands-on’ sensitivity and touch become very powerful tools in diagnosis … to recognise those conditions which may need referral to other professionals”.

A BRIEF REVIEW OF THE LITERATURE

Much of the research conducted to date in sports massage has proven to be equivocal and anecdotal (2,18,19). Research has been flawed by poor study design (12), by methodological variations and by poor experimental control (6,7,9,18,24). Furthermore, the research dilemma can be also attributed to inconsistencies in the descriptions of massage, undefined parameters (1,20,21,25) and inadequate therapist training (26). Poor study design and inconsistencies may

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