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Massage & Performance



How can massage therapy enhance performance?


It is critical for an athlete to recover so they are able to perform effectively and efficiently in a competition or training session. In the health and fitness industry, recovery protocols have been gaining popularity through the use of a variety of tools and techniques. In the respect of research, some protocols are supported by evidence and others lack evidence. These recovery protocols include massage, cryotherapy, hyperbaric oxygen therapy, compression garments, stretching, supplementation, medication, and more (Brummitt, 2008; Schleip, 2003). Each may permit valuable enhancement while others provide limited resources for recoverability.



Massage therapy is a physical recovery protocol that has shown many benefits within the soft tissue matrix. It is important to consider myofascial connective tissue, a critical piece within the muscular system (Aboodarda, Spence, & Button, 2015). The myofascial tissue is defined as the dense irregular connective tissue that surrounds muscle, myofibril, and organs around the body (Aboodarda et al., 2015; Schleip, 2003; Shah et al., 2015). At times, our myofascial tissue can create trigger points that can cause musculoskeletal pain (Desai, Saini, & Saini, 2013). A myofascial trigger point is a taut band of muscle tissue that is tender during palpation (Shah et al., 2015). Active myofascial trigger points can result in impulses of pain in the surrounding tissue or specific site of pain (Shah et al., 2015). Therefore, focusing on identifying the cause and correcting the unstable tissue is optimal for complete regeneration and recovery (Desai et al., 2013).



A massage is a soft-tissue manipulation that is practiced by trained therapists with practical experience (T. M. Field, 1998; Tsao, 2007). This technique has been utilized for many years, dating back to 2500 BC (Brummitt, 2008). Historically, massage has been linked to benefits within the reduction of pain and stress management (Kennedy, Cambron, Sharpe, Travillian, & Saunders, 2016). Many individuals lack a true understanding of what massage therapy entails, as it contains other elements beyond mechanical and neurological inputs (Kennedy et al., 2016). These elements can be environmental and psychosocial interactions that can impact the relative outcomes (Kennedy et al., 2016).


Massage therapy has been included as a major component following sporting events to reduce fatigue and aid in recovery (Resnick, 2016). Muscle contraction eventually leads to muscle fatigue from repetitive activities and daily living, therefore it is critical to include soft tissue massage as a complement to training (Shah, 2015). If the treatment is done correctly, it can provide improvements in postural awareness, breathing mechanics, and overall muscle maintenance (Kennedy et al., 2016). Massage can provide physiological and psychological supplemental support towards an individual, thus allowing positive adaptations to occur from the athletic responses.


Massage Therapy

The practice of massage therapy has become a public recognition for the benefits in relaxation, pain threshold, depression, anxiety management, musculoskeletal injuries, and pregnancy (Aboodarda et al., 2015; Beider, Boulanger, Joshi, Pan, & Chang, 2010; Brummitt, 2008; T. Field et al., 2012; Grant et al., 2008). It is believed that massage can help eliminate myofascial trigger points. Myofascial trigger points are a common source of musculoskeletal pain, which negatively affects the muscle spindles. Neurological aspects and improvements within the muscle spindles have shown to be the primary benefits of massage therapy (Aboodarda et al., 2015; Tanaka, Leisman, Mori, & Nishijo, 2002). Other research supports that massage therapy will increase the pressure-pain threshold with regular treatments (Aboodarda et al., 2015). As massage treatments can be used for pain threshold management, this can change our sensations of the tissue during the regeneration process.


This manual approach has shown that five minutes can be sufficient to cause a physiological reaction in the surrounding tissues (Tanaka et al., 2002). Massage therapy has produced changes in balance, neurological, and cardiovascular variables (Sefton, Yarar, & Berry, 2012). Improving an athlete’s balance, neurological, and cardiovascular components should then transfer to game action. When combining massage therapy and a well-rounded strength and conditioning program, may increase our wellness domains (Brummitt, 2008). It is critical for our bodies to be able to react in an unstable environment and return to homeostasis in a timely fashion. Imtiyaz, Veqar, and Shareef (2014) provide evidence that muscle soreness was significantly less following a massage treatment at twenty-four, forty-eight, and seventy-two hours post-exercise. In return, delayed onset muscle soreness was limited by the massage treatment after an exercise protocol (Imtiyaz et al., 2014).


The human body needs to experience all domains of wellness to obtain a relation with optimal transferability. Massage therapy has been also noted to improve our social, emotional, spiritual, environmental, occupational, intellectual, and physical wellnesses (Imtiyaz et al., 2014). As studied in previous years of health education, connecting with one’s domains of wellness can provide perception and sensation of relief. The satisfaction of relief can improve our relationship with homeostasis, potentially reaching a higher state of relaxation.


Athletic Performance

When considering improvements in athletic performance, we need athletes to reach their full recovery potential. Strength training movements with exponential resistance can result in the muscle producing morphological changes within the myofibrils and connective tissue. This can lead to increased inflammatory responses (Franklin, Ali, Robinson, Norkeviciute, & Phillips, 2014). If an athlete has reached a state of full recovery, they may experience an enhancement of overall muscular function. However, a variety of factors can influence an athlete’s determined recoverability.


Injuries are common and can negatively affect the healing process (Eming, Martin, & Tomic-Canic, 2014). To this day, the healing process is still not fully understood. If an athlete is experiencing any minor or major injury, neuromuscular faults are produced. These faults can restrict our biomechanical joint articulation, which can enhance our perception of pain in athletic movements. Therefore, it is important to understand what the primary cause of muscular pain is to produce longevity in an athlete’s career. If an athlete experiences great amounts of pain, this can trigger dysfunctional movement which can lead to a major injury. If an athlete is experiencing myofascial trigger point pain, massage therapy can produce a positive outcome.


Massage Therapy in the Athletic Environment

The practice of massage therapy can be utilized following a training session or event (Patterson, Maurer, Adler, & Avins, 2008). The fatigue and stress that are generated by physical activity can benefit from soft tissue manipulation (Tanaka et al., 2002). The increased intramuscular blood flow after a few minutes of manual therapy can produce a flushing effect for the muscle tissue, possibly producing a quicker recovery (Tanaka et al., 2002). Massage has been suggested to help prepare an athlete for future competitions and increase athletic characteristics (Brummitt, 2008).


If the massage was introduced before a competition, it may increase the peak heart rate, peak VO2, and peak minute ventilation (Beider et al., 2010). If an athlete is able to increase their peak heart rate, we can expect them to potentially increase their peak intensity. Athletes that increase their peak VO2 exchange will produce a rapid oxygen exchange, producing a higher endurance capacity. When we look at our physiological changes, it may increase the athletic edge over the competitor.


There are a variety of massage therapy techniques and sports massage is presumed to be a popular technique for athletes. The term sports massage is classified as a manual technique that can include joint mobilization, stretching and/or post-isometric relaxation, cross-fiber friction, and pressure point massage (Brummitt, 2008). The techniques that are utilized within a sports massage will increase the opportunity of developing an asymmetrical kinetic chain. When integrating massage therapy within sports medicine, we may see an improvement in soft tissue quality. If an athlete can improve their tissue quality, this may prevent the chances of a non-contact injury and improve overall athletic capabilities.


Wrapping It All Up

It has been noted that massage therapy can benefit the overall complexity of the human body. The evidence supports an increase in parasympathetic activity and a decrease in sympathetic activity after the competition (Resnick, 2016). It is critical for our bodies to return to homeostasis after an uncontrolled or controlled stimulus. Massage therapy is suggested to provide relaxation after a competition or training session.


At Linked Fit, we believe massage can provide an improvement in the domains of wellness and transfer towards a higher rate of performance. If an individual is provided with a positive experience, they may increase physiological and psychological variables in relation to regeneration and recovery. Individuals that are fully recovered from a competition or training session, may return to play with full force. In the role of a therapeutic massage, soft tissue manipulation can augment tissue quality. These advancements in tissue quality can reduce the amount of pain for the treatment of myofascial trigger points. Our pain perceptions are controlled by our central nervous system and correcting the issue of myofascial triggers points will manage our pain control system (Shah et al., 2015).



Reference:

Aboodarda, S. J., Spence, A. J., & Button, D. C. (2015). Pain pressure threshold of a muscle tender spot increases following local and non-local rolling massage. BMC musculoskeletal disorders, 16, 265-265. doi:10.1186/s12891-015-0729-5

Beider, S., Boulanger, K. T., Joshi, M., Pan, Y. P., & Chang, R.-K. R. (2010). Measuring the effects of massage on exercise performance and cardiopulmonary response in children with and without heart disease: a pilot study. International journal of therapeutic massage & bodywork, 3(3), 12-16. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21589710

Brummitt, J. (2008). The role of massage in sports performance and rehabilitation: current evidence and future direction. North American journal of sports physical therapy : NAJSPT, 3(1), 7-21. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21509135

Desai, M. J., Saini, V., & Saini, S. (2013). Myofascial pain syndrome: a treatment review. Pain and therapy, 2(1), 21-36. doi:10.1007/s40122-013-0006-y

Eming, S. A., Martin, P., & Tomic-Canic, M. (2014). Wound repair and regeneration: mechanisms, signaling, and translation. Science translational medicine, 6(265), 265sr266-265sr266. doi:10.1126/scitranslmed.3009337

Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. Journal of Bodywork and Movement Therapies, 16(2), 204-209. doi:10.1016/j.jbmt.2011.08.002

Field, T. M. (1998). Massage therapy effects. American Psychologist, 53(12), 1270-1281. doi:10.1037/0003-066X.53.12.1270

Franklin, N. C., Ali, M. M., Robinson, A. T., Norkeviciute, E., & Phillips, S. A. (2014). Massage therapy restores peripheral vascular function after exertion. Archives of physical medicine and rehabilitation, 95(6), 1127-1134. doi:10.1016/j.apmr.2014.02.007

Grant, K. E., Balletto, J., Gowan-Moody, D., Healey, D., Kincaid, D., Lowe, W., & Travillian, R. S. (2008). Steps toward massage therapy guidelines: a first report to the profession. International journal of therapeutic massage & bodywork, 1(1), 19-36. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21589815

Imtiyaz, S., Veqar, Z., & Shareef, M. Y. (2014). To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS). Journal of clinical and diagnostic research : JCDR, 8(1), 133-136. doi:10.7860/JCDR/2014/7294.3971

Kennedy, A. B., Cambron, J. A., Sharpe, P. A., Travillian, R. S., & Saunders, R. P. (2016). Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium. International journal of therapeutic massage & bodywork, 9(3), 15-26. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27648109

Patterson, M., Maurer, S., Adler, S. R., & Avins, A. L. (2008). A novel clinical-trial design for the study of massage therapy. Complementary therapies in medicine, 16(3), 169-176. doi:10.1016/j.ctim.2007.08.001

Resnick, P. B. (2016). Comparing the Effects of Rest and Massage on Return to Homeostasis Following Submaximal Aerobic Exercise: a Case Study. International journal of therapeutic massage & bodywork, 9(1), 4-10. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26977215

Schleip, R. (2003). Fascial plasticity - A new neurobiological explanation: Part 1. Journal of Bodywork and Movement Therapies, 7, 11-19. doi:10.1016/S1360-8592(02)00067-0

Sefton, J. M., Yarar, C., & Berry, J. W. (2012). Six weeks of massage therapy produces changes in balance, neurological and cardiovascular measures in older persons. International journal of therapeutic massage & bodywork, 5(3), 28-40. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23087776

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R : the journal of injury, function, and rehabilitation, 7(7), 746-761. doi:10.1016/j.pmrj.2015.01.024

Tanaka, T. H., Leisman, G., Mori, H., & Nishijo, K. (2002). The effect of massage on localized lumbar muscle fatigue. BMC complementary and alternative medicine, 2, 9-9. doi:10.1186/1472-6882-2-9

Tsao, J. C. I. (2007). Effectiveness of massage therapy for chronic, non-malignant pain: a review. Evidence-based complementary and alternative medicine : eCAM, 4(2), 165-179. doi:10.1093/ecam/nel109

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