Massage Techniques seen in the Athletic Training Facility and their Effects By Justin Woodward

History of Massage Massage has been used as a treatment for Illnesses and Injuries since 3000 B.C. Was first used in parts of Egypt and Asia In 1893 Albert Hoffa wrote the Technik der Massage This outlined the Hoffa Massage in detail. Hoffa Massage consists of: Effleurage, Petrissage, Tapotment and Vibrations or Effleurage to end it.

Physiological Effects Massage is defined as “the systematic manipulation of the body’s tissues.” – Chad Starkey Effects of Massage can be split into Reflexive and Mechanical Effects

Physiological Effects Reflexive Effects- Can effect nerves (sensory and motor) locally and cause some effect on the central nervous system Mechanical Effects- Changes in tissues using direct mechanical force As Mechanical Effects increase, Reflexive effects decrease

Reflexive Effects Effects on Pain- Effects on Circulation Can modulate pain through Gate Theory and Beta Endorphin Pain control Effects on Circulation Some studies suggest that massage can increase blood flow and lymphatic flow- studies are not empirical

Reflexive Effects Effects on Metabolism Massage has no effect on metabolism According to Martin et al. active recovery is much more effective in the removal of Lactate from blood when compared to sports massage The reflex stimulus causes sedation and relieves tension Slower, Lighter strokes will cause greater reflexive stimulus

Mechanical Effects Effects on Muscle Increase Range of Motion Removal of Adhesions Mechanical stretching of muscular tissue and fascia Possible increase in Blood Flow No increase in muscle strength No decrease in muscle fatigue Can decrease the severity of DOMS Increase in Venous Return

Mechanical Effects Effects on Skin Increase in Temperature Possibly increase blood flow Fast, deep strokes has been shown to have greater effect on blood flow Assist in the removal of Adhesions between skin and subcutaneous layer

Psychological Effects Massage can improve mood after intense exercise or injury Can lead to more compliance during rehabilitation Improved Patient-Clinician Relationship Due to the One-on-one nature of massage, the clinician must spend individual time with the patient Many athletes believe that massage will assist them in the healing process, and will see improvements through suggestion. Massage can reduce anxiety

Massage Guidelines and Considerations Essentials to Proper Massage Good Knowledge of Anatomy Thorough understanding of the Principles of Massage Knowing the athletes injury

Clinician and Patient Positioning Should be in a comfortable fairly upright position with weight distributed evenly Clinician should shift weight to cause most of the mechanical stimulus to prevent fatigue Patient- Should be in a comfortable, relaxed, well supported position Should have injured area exposed and draped any other area which it is necessary

Precautions Nails should be trimmed To avoid scratching or causing lacerations Remove all rings, watches, or wrist jewelry Hands should be warm Lubricant should be used, especially for effleurage

Contraindications Any condition in which massage may aggravate it: Infection Malignancies Skin diseases Blood Clots Irritations/rashes Lesions Fractures

Massage Techniques Effleurage Petrissage Tapotment Vibration Friction Massage Myofascial Release Acupressure

Effleurage Stroking/Shingling Technique Every massage should start and end with effleurage We want to always have one hand on the patient Want to keep a consistent, rhythmic pattern Want to start with light pressure and gradually increase pressure The firmer the pressure the less reflexive effects

Effleurage Effleurage should be done distal to proximal Especially if edema reduction is the goal Patient should also be in a gravity assisted position for edema reduction

Practice Break up into Pairs and Practice it yourselves. Do Effleurage for 2 minutes then switch with your partner

Petrissage Kneading Technique- pinching and rolling the tissue between fingers Can also can use 1 or 2 hands, grab, roll, lift or apply pressure Move distal to proximal Less lubricant is needed for this technique to make it easier to grab skin Great for removing/preventing adhesions

Practice Break up into Pairs and Practice it yourselves. Do Petrissage for 2 minutes then switch with your partner

Tapotment Percussion Technique- hands should be loose and tap the skin Stimulates Peripheral Nerves Types- Cupping Hacking Beating Pinching

Practice Break up into Pairs and Practice it yourselves. Do Tapotment for 2 minutes then switch with your partner

Vibration A fine, small movement, made by hand or fingers placed firmly against a part causing a part to vibrate Hands should remain in contact and a rhythmical trembling movement will come from arms Less skilled or inexperienced clinicians may want to use a vibration tool to administer this part of the massage

Practice Break up into Pairs and Practice it yourselves. Do Vibration for 1 minutes then switch with your partner May be difficult, don’t worry if you don’t get this at first, it takes a very skilled hand to do this technique

Friction Massage Used to treat chronic inflammation of tendons Rub perpendicular to the fibers Generally done for 5-10 minutes Will be painful Objective it to re-start the healing process

Myofascial Release Technique Relieves soft tissue from abnormal hold of fascia Cross Hand Technique- cross hands and apply pressure in opposite directions Can also apply pressure to the muscle and have the patient contract muscle forcing the fascia to stretch and release from the muscle

Practice Break up into Pairs and Practice it yourselves. Do Myofascial Release for 2 minutes then switch with your partner Do Cross Hand Method Do Pin and Contract Method

Acupressure An old Chinese based method to treat aggravated trigger points Find trigger point nodule Apply firm pressure in a circular motion Can use finger, knuckle, or elbow Will cause pain and numbing effect Treatment usually lasts 1-5 minutes per trigger point

Questions

References Hemmings B. Physiological, psychological and performance effects of massage therapy in sport: a review of the literature. Physical Therapy in Sports. November 2001; Vol. 2(4): 165-170 Martin et al. The Comparative Effects of Sports Massage, Active Recovery, and Rest in Promoting Blood Lactate Clearance After Supramaximal Leg Exercise. Journal of Athletic Training. January-March 1998; Vol. 33(1): 30-35 Moraska A. Sports Massage: A Comprehensive Review. Journal of Sports Medicine and Physical Fitness. September 2005; Vol. 45(3): 370-380 Zainuddin Z et al. Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function. Journal of Athletic Training. July-Sept 2005; Vol. 40(3): 174-180 Starkey C. Therapeutic Modalities. 3rd Edition. Therapeutic Massage. 2004; 16: 295-307 Houglum P. Therapeutic Exercise for Athletic Injuries. Manual Therapy Techniques. 2001; 6: 159-172