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

2. 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.

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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

11. 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

12. 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

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

14. Massage Techniques Effleurage Petrissage Tapotment Vibration
Friction Massage
Myofascial Release
Acupressure

15. 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

16. 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

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

18. 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

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

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

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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. Questions

29. 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):
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):
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):
Starkey C. Therapeutic Modalities. 3rd Edition. Therapeutic Massage. 2004; 16:
Houglum P. Therapeutic Exercise for Athletic Injuries. Manual Therapy Techniques. 2001; 6: