BOX 3: HOW MASSAGE IS THOUGHT TO WORK

n Reduces excessive post-exercise muscle tone and neurological excitability

n Increases muscle range of motion n Increases circulation and nutrition to damaged tissue n Deactivates symptomatic trigger points n Psychological benefits

WITH HIGHER LEVELS OF TRAINING

account for the lack of positive findings (6,20) and may detrimentally influence the interpretation of results (17,26). For further reading on what makes credible research, refer to Heymanson and Hiskins (20).

In a literature review, Tiidus

(27) found evidence to support the psychological benefits of massage. However there is little evidence to support the physiological benefits. In a more recent review of the mechanisms of massage and its effects on performance and recovery, Weerapong et al. (6) found limited evidence in support of massage to improve performance, or to enhance recovery or prevent injury to muscle. In contrast to these findings, Moraska (26) conducted a literature review of sports massage and reported that both tissue healing and a psychological effect may prove to be promising benefits with further research.

Mancinelli et al. (22) studied

22 women college athletes in a randomised pre-test–post-test controlled group design to determine whether post-massage had an effect on DOMS and on physical performance. Using objective methods to measure their degree of soreness and physical performance, Mancinelli found massage to be effective for both decreasing muscle soreness and improving vertical jump height. In a recent study, Moraska (17) used

a field questionnaire study to evaluate the effect of massage on post-race muscle recovery. This involved 317 respondents of a 10-km running race. In conclusion the author reported that the level of therapist training was shown to impact effectiveness of massage

12 sportEX dynamics 2010;23(Jan):10-13

A BETTER EFFECT IS ACHIEVED BY THERAPISTS

as a post-race recovery tool. In other words, a better effect was achieved by therapists with higher levels of training. To summarise the literature, it is fair

to say that there is emerging evidence in support of massage for delivering important psychological benefits (24,27,28). Encouragingly, many authors report positive findings in support of massage for lowering the intensity of soreness during post-exercise DOMS (17,21 22,25,26). In contrast a number of other authors report that there is inadequate evidence to corroborate massage as an effective intervention for improving physiological performance (6,27). Although not discussed in this article, current research suggests that the timing of massage in reducing DOMS symptoms is critical, and suggests that post-event massage should be conducted 2 hours after the activity for the best therapeutic effect (8,9,20,21). Moreover, experience and training in sports massage are important considerations for athletes

Figure 3: Abnormal cross-

linkages between connective tissue fibres

seeking a recovery advantage (17).

THE AUTHOR’S VIEWS AND EXPERIENCES Ideally, sports massage should be evidence-based, derived from the latest robust scientific research, however this is not always possible. This issue was highlighted by Watson (29) who stated “If one looks critically at the full range of physiotherapy treatments, there is simply insufficient evidence to support or reject many of them in all known circumstances.” Perhaps too much emphasis is being placed on establishing “conclusive” evidence in sports massage? Indeed, perhaps we are looking too deeply – and possibly too narrowly – for evidence? What kind of evidence should be considered as adequate or acceptable, and by whom? The researcher, the therapist or the athlete? Bledsoe (30) provides food for thought: “No scientific study can ever ‘prove’ anything; scientific research merely provides evidence to support or

Free movement of normal healthy fibres under tension with good extensibility

Restricted movement of collagen fibres under tension due to abnormal cross- links/adhesions; this limits extensibility