The Benefits of Massage in Sports Medicine Dayna Elenis AT, ATC, LMT

Massage Massage is the scientific art of manual application of certain movements to the soft tissue of the body to bring about relaxation, pain relief, promote circulation, homeostasis, and general well being.

Massage Strokes Effleurage Stroking Friction Petrissage (kneading) A stroking movement performed with whole hands or palmer surface (deep or superficial) Stroking Similar to effleurage but a much lighter touch, performed slow and gentle Friction Movement in which the tissues are moved in a cross fiber direction upon the underlying structures (deep or superficial) Petrissage (kneading) All movements in which the tissues are grasped, raised from their attachments, and subjected to an intermittent double pressure Vibration A trembling movement. This is a high-intensity movement used to stimulate Tapotement (Hacking, Cupping, Beating, Percussion) Series of blows administered in rapid succession with the hands striking alternately from the wrist

Types of Massage Useful for Sports Medicine Myofascial Release CranioSacral Lymphatic Drainage Trigger Point Therapy Reflexology **These types of massage are just few of many massages that are beneficial for Sports Medicine Others: Swedish, Thai, Deep Tissue, shiatsu

Myofascial Release A technique that provides sustained pressure into Myofascial restrictions to eliminate pain and restore motion. What is a Myofascial Restriction? Tight fascia Occurs following injury, stress, repetitive micro trauma, inflammation, scarring, and poor posture Progressively tightens over time if left untreated Is the underlying cause of most chronic pain problems There are many different techniques to use for Myofascial release. All are very light pressure held until you feel the facial movement.

What Conditions Does Myofascial Release Help? Fibromyalgia Back Pain Coccyx Pain Sciatica TMJ Problems Whiplash Injuries Migraines Neck Pain Sports Injuries Disc Problems Scoliosis Scar mobilization

CranioSacral Gentle, non-invasive treatment that modifies and corrects restrictions in the craniosacral system Craniosacral system includes the brain, spinal cord, meninges and cerebral spinal fluid A physiological system that is responsible for the production, circulation and absorption of cerebral spinal fluid Since the brain and spinal cord are responsible for the sensory and motor aspects of our being, removal of irritation to these tissues will cause whole body relief and improved function CranioSacral Rhythm is the movement of bone and tissue in response to the rise and fall of CSF production Thixotrophic effect of fascia Thixotropy is shear thinning property. Certain gels or fluids that are thick (viscous) under static conditions will flow (become thin, less viscous) over time when shaken, agitated, or otherwise stressed. Many techniques!

CranioSacral CranioSacral Rhythm is the movement of bone and tissue in response to the rise and fall of CSF production Flexion=Filling (towards the feet) Extension= Emptying (towards the ears) How to evaluate the status of the CranioSacral system? Symmetry- synchronicity of flexion and extension (Is it equal?) Quality- smooth, strength (How does it move?) Amplitude- ROM (How full or big is the motion?) Rate-speed, cycles (How fast are the cycles?) 6-12 cycles/min

What Conditions Does Craniosacral (CST)Address? Migraines and Headaches Concussions Chronic neck and back pain Stress and tension related disorders Motor-coordination Impairments Brain and Spinal Cord Injuries Fibromyalgia TMJ Syndrome Scoliosis Orthopedic Problems ADD/ADHA Chronic Fatigue

Lymphatic Drainage Gentle, rhythmic bodywork technique used to encourage the flow of fluid out of the tissue and into the lymphatic system. Pressure is very light, just enough to not slide over the skin, but enough to pull the skin Rhythm of drainage on average is every 6 seconds and the frequency is 5-7 strokes at each location Stagnant or limited lymphatic flow can be a factor in many disease processes Fluid movement= tissue health

Effects of Lymph Drainage Lymphatic Drainage Effects of Lymph Drainage Indications Increase Blood Circulation Reduction of Edemas Promotes increased tissue health before surgery Decrease recuperation time after surgery Stimulates immune system Deep relaxation Endless! Reduce Swelling Pre/post surgical Insomnia Osteoarthritis Headaches Improve athletic performance Sprains/ Strains Tendonitis/ Tenosynovitis Headache Small cyst, Detox, Cronic Fatigue Syndrome, Vertigo, Fibromyalgia, TMJD, Acne, Eczema, Wrinkles, PMS

Trigger Point Release Myofascial trigger points are small, hyper irritable nodules found in a taut band of muscle where there is decreased circulation and a buildup of metabolic waste products. Trigger points can produce pain both locally and to specific referral areas Can be caused by structural imbalances, overuse, injury or stress leading to many pain syndromes Trigger Points occur because: Micro damage to sarcoplasmic reticulum causing release of Ach (acetylcholine) -> too much calcium ->shortens sarcomere “knot” -> chemical imbalance “hypoxia”

(Latent trigger points can become active trigger points) Trigger Point Release Active Trigger Points Latent Trigger Point Area may be sensitive even before palpation When pressure is applied it is painful and will either refer or radiate pain Symptoms can include pain, tingling, numbness, burning, itching, or other symptoms the client is familiar with Patient will sometimes jump when point is palpated 90-95% of trigger points Common that the client is not aware that the area is painful until pressure is applied Generally will not produce a recognizable pain When pressure is applied to area it will either refer or radiate pain (Latent trigger points can become active trigger points) Does this hurt? Doe this hurt or radiate to another area of the body? Do you recognize this pain or is this the pain you have been experiencing? Yes to all is Active trigger point No to #3 is Latent trigger point

Trigger Point Release Methods to deactivate trigger points Ischemic compression Ice therapy Lymphatic drainage Positional Release Muscle energy techniques Myofascial release techniques Muscle stripping

Reflexology A holistic method of healing and prevention also known as Reflex Zone Therapy Involves manipulation of the specific reflex areas and points Method of application includes direct pressure/compression, massage, movement, range of motion and stretching of the feet and hands “Reflexology is a science that deals with the principle that there are reflex areas in the feet and hands which correspond to all of the glands, organs, and parts of the body. Reflexology is a unique method of using the thumb and fingers on these reflex areas.” Ingham method Theory: Massage balances the electromagnetic field in the body Works by breaking up waste deposits in the blood vessels of the feet, thus improving circulation.

Reflexology

Reflexology

Other Types of Orthopedic Massage Cross fiber friction Compressive broadening with active contraction with active extension Muscle Stripping Static compression With active extension Positional Release Fascial Release Cross fiber friction: goal is to break up adhesions and or fibrotic tissue. Deep, non-gliding massage stroke. Perpendicular to the fiber direction. Compressive Broadening: Use thenar eminences, apply pressure and allow hands to spread apart Muscle Stripping: moves with fiber direction. Slow, deep, specific gliding over muscle. Static Compression: apply pressure slowly and gently Positional Release: locate trigger point, push, move limb until pain decreases. Fascial Release: Grasp tissue until slight stretch, release when tissue releases

What is Orthopedic Massage Based On? Upper Crossed Syndrome Lower Crossed Syndrome Strengthen using: Active Resistance Tapotement

Basic Contraindications For all massage: Any acute infection or disease Acute inflammation Advanced osteoporosis Severe varicose veins Phlebitis Aneurism Cancer (check with Doctor first) Certain prescription drugs Various Skin conditions Broken Bones Contagious disease Major cardiac problems Acute anuresis Serious circulatory problems Hemorrhage Skin conditions: open sores, eczema, broken blood vessels, burns, sunburn, lacerations, poison oak or ivy, etc

Demonstration Myofascial Release/ Craniosacral Occipital Condyle Release with Cervical Stretch Trigger Point Therapy/ Positional Release Upper Trapezius Lymphatic Drainage Knee or Ankle Reflexology Knee Orthopedic (static compression with active contraction) Sacroiliac Dysfunction CranioSacral: Always start with vault holds (in head) Trigger Point: 1. Thermal scan 2. Find “pea”. Does it radiate? 3. Compression (no more than 8/10pn) 4. Stretch!!! Make nice Lymph Drainage: 1.Active/ Stretch 2. Passive/Return 3. Disengage Do NOT do massage before competition!!!!

References Cisaruk, L. (2010). Foot reflexology. Gauthier, I. (2009). The science and practice of myomassology. (6th ed.). USA: Irene's Myomassology Institute. Kelly, R. (2012). Trigger point therapy. Kelly, R. (2012). Orthopedic Massage. Kelly, R. (2012). Lymphatic Drainage. Pillow-White, J. (2012). Introduction to craniosacral techniques. Stayer, T. (2010). Myofascial Release.