What exactly is sports massage?

Last time I wrote about what sports massage can and can’t do when your muscles get really sore. But what exactly is sports massage? Does it really do anything that “regular” massage doesn’t? Can any massage therapist do it? Is it only for athletes? What should you expect? For that matter, what should you wear?

So for this week’s Technique of the Week, here is your

Sports Massage FAQ

What exactly is sports massage and why is it different from relaxation massage?

Sports massage and orthopedic massage, which I always use together, are very different from the massage you’re probably used to, even if you’ve gone to a massage clinic and asked for sports massage. They incorporate strokes and techniques from a variety of massage modalities, and focus closely on locomotor tissues (the ones that help you move) and movement patterns. Orthopedic massage includes assessment, goals and other long-term aspects. Sports massage is not just very firm pressure massage.

Sports massage isn’t relaxing. Sorry! You won’t lie under sheets, listen to music quietly and get a full-body massage. I need your participation because there are some techniques that can make a huge difference in your body very quickly, and they involve your brain as well as your muscles. Why? Think about a tight muscle. Why is it hypertonic? Because the nervous system is telling it to be. So we need to involve that to correct the problem. Other mechanical techniques are far more effective when you, the client, are doing certain types of muscle contraction (read more about this on my page.)

Assessment is an important part of this kind of work, so be prepared to spend a short time at the beginning of the massage providing information about your condition and testing some of your movements. Many clients want to rush through this part of the massage so they can get on the table, but please don’t think of this as time away from your massage. Assessment is part of sports massage and will vastly improve your actual time on the table.

What should I wear?

It’s best to wear flexible bottoms (such as running or biking shorts) that allow complete access to your leg muscles if you need leg/gluteal work (no tights, long boxers, etc.). Women who need upper body work should bring a sport bra or (preferably) a string-tie bikini top. You’ll probably be clothed during the massage. Please improve the quality of your massage by dressing appropriately.

Do only athletes and dancers get sports massage?

If you run, work hard, dance hula, paddle, garden, love to take evening walks, or are concerned about your wellness and how your ability to move fits into that, sports and orthopedic massage are for you. We focus on your goals and the muscles and other soft tissues that support you in the specific movements you do on a regular basis, as well as the ones that might make you hurt.

What about injuries?

One of the great things about sports and orthopedic massage is the different techniques that we use to handle injuries. There are many ways to approach a muscle injury and some of them are firm, some are light, some cause a little tenderness, some are totally painless but very effective. Because the goal of sports massage is recovery, not relaxation, it’s ideal for handling many injuries because I’ll choose a touch that’s right for your condition.

Athletes and active people should consider that sports and orthopedic massage can be very effective in helping you recover from chronic injuries or conditions that you feel have ended your ability to participate in an activity, or made it chronically painful.

I approach injuries cautiously. Sometimes, either for your benefit or mine, I feel we need a diagnostic assessment of your injury, and I might suggest you see a physical therapist or other practitioner. I have a network of referrals with whom I’ve had personal experience and trust, or you can ask around to see who your friends and teammates trust.

 

Does it hurt? Will I be sore?

I do not believe that manual therapy needs to be painful in order to be effective, and I am opposed to the widespread use of analgesics like menthol-based products after bodywork to mask muscle pain. If your massage changes the way you move because it made you sore, it caused damage beyond what it was attempting to fix (I wrote about this in my last post on soreness.) At times, your muscles may feel tender to the touch, but you should not have bruises or feel additional pain as you move because of a massage.

Some deep tissue techniques only work if your body is consciously relaxed – this goes back to the involvement of the nervous system in “resetting” muscle tone. Some techniques do cause some short-lived pain, but you should be able to stay relaxed under the pressure being used.

How often can I get massage? Can I get too much?

Athletes, people with chronic health issues, and others get massage up to several times a week and sometimes more. Others make a plan for massage leading up to an event and come less frequently during their off-season. The decision is yours and your therapist should always be willing to answer questions and provide a rationale if she thinks you need more work.

I am lucky to have a network of other practitioners who can treat a variety of physical and psychological issues and I would be happy to introduce you!

Where can I get sports massage?

Good question! Go ahead and book here:

Book a Massage

Is there anything in the world of sports massage, training or wellness you’re interested in learning more about? Let me know what you’d like to read about in Technique of the Week.

Why am I sore? Does massage help?

Go to any athletic event and you’ll see a variety of trendy T’s sporting forms of encouragement along of the lines of “No Pain, No Gain!” You may even admit to owning, or wishfully admiring, one of those “Pain is Weakness Leaving the Body” shirts.

Exercise-related muscle pain that shows up in your calves the next day as you try to get down the stairs is called Delayed Onset Muscle Soreness, or DOMS. What is the point of this muscle pain? Is it necessary? Most importantly (of course!), does massage help it go away?

For starters, the version starring lactic acid as the evil-doer was discredited some time ago. More current research points toward muscle and connective tissue damage that occurs as we tax our muscles beyond what they’re used to. In a nutshell, the hypothesis is that as this exercise-induced muscle damage (EIMD) occurs in muscles under new stress, an inflammatory process results. Inflammatory mediators are released and swelling occurs (on a minor level), and both of these can contribute to the muscle pain you feel. It’s this inflammatory reaction and the resulting damage repair that is believed to help build muscle bulk (hypertrophic adaptation). (This is a wildly “nutshelled” version, science buffs can find a thorough review by Schoenfeld and Contreras below.)

So lots of muscle pain means lots of muscle growth, right?  No. Toss your trendy T-shirt.

The actual soreness you feel is one of many indicators of exercised-induced muscle damage (EIMD) and doesn’t actually correlate very well with other EIMD indicators or with muscle hypertrophic growth. Training status and the type of activity have more effect on whether DOMS occurs. For example, a marathon runner might get really sore, but that kind of non-eccentric muscle stress doesn’t usually result in hypertrophic growth (bulk). Yes, muscle damage is part of building muscle. No, soreness probably isn’t, although trying to eliminate entirely it will likely compromise your workouts.

Why try to get rid of soreness if it’s part of a positive process? Because it hurts, DOMS causes changes to the way you move (altered kinematics). Moving incorrectly, even subconsciously, to avoid pain gets you injured, not just sore. It changes your range of motion and the stresses that are placed on your locomotor tissues (the ones that create movement). While DOMS is the byproduct of something productive, it isn’t necessary or desirable to get really sore trying to prove you worked hard.

Does massage help? It appears that it does, but the timing and the therapists’s skill are important. Most studies I came across compared it either to compression (wear a nice body sock or compression tights) or other remedies like cryotherapy, anti-inflammatories, stretching, and electrical current modalities (TENS units, etc). None of the above therapies had an effect on DOMS except compression and massage.

Massage was shown to lower the intensity of soreness, but none of the other effects of EIMD – which is probably good, since they help create muscle growth while DOMS can adversely affect it. Massage didn’t eliminate DOMS in these studies, but lowering its intensity helps prevent the negative effects of being very sore. Massage needs to be done fairly soon after your effort – which is why we call it post-event massage. If you wait until the next day or two, your massage therapist can still accomplish some great things but she probably won’t be able to lessen the DOMS you’re already feeling. It’s not the typical massage, so make sure your sports massage therapist knows what to do. A traditional therapeutic massage is unlikely to help much and can even contribute to soreness.

And a final interesting study – the massage therapists’s level of education had a strong effect on the reduction of soreness. The lesson – get a therapist who knows what she’s doing!

Being a science nerd, I never trust people who can’t produce their sources, so mine are below. The DOMS review in particular has great information about EIMD, and of course, more sources!

And don’t forget to book your massage:

Book a Massage

References:

Schoenfeld and Contreras. “Is Postexercise Muscle Soreness a Valid Indicator of Muscular Adaptations?” Nat. Strength & Cond. Asc. 2013;35(5):16-21.

Cheung, Hume and Maxwell. “Delayed onset muscle soreness : treatment strategies and performance factors.” Sports Med. 2003;33(2):145-64.

Hilbert, Sforzo and Swensen. “The effects of massage on delayed onset muscle soreness.” Br J Sports Med. 2003 Feb;37(1):72-5.

Moraska. “Therapist education impacts the massage effect on post-race muscle recovery.” Med Sci Sports Exerc. 2007 Jan;39(1):34-7.

Marathoners!

This weekend is the Honolulu Marathon! In honor of all the women (and men) who will run this weekend, I thought I’d provide some story on my favorite pioneer female runners who made it possible. Here are three of my favorites:

#1: Roberta Gibb
Bobbi Gibb is my heroine of running. The first ever woman to run the Boston Marathon did it totally alone. No friends, coaches, family, running clothes, anything – and no number, since they wouldn’t allow her to enter. She snuck onto the starting line and ran it faster than a lot of the men, who to their credit were warm and welcoming. She was finally recognized in 1996 as the official female winner of the 1966, ’67 and ’68 Boston Marathons. She still runs, mostly alone 🙂

#2: Joan Benoit
I have probably watched her historic 1984 marathon win a hundred times. Joan Benoit became the first woman to win the Olympic Marathon when women were finally allowed to run it in 1984. Not only that, but she broke away at mile 3 and ran most of the race by herself.

#3: Katherine Switzer
The one whose efforts made Joan Benoit’s 1984 win possible. She and other greats worked with Avon to organize marathons on 5 continents so that enough countries could qualify female runners to get a women’s marathon into the 1984 Olympics. She became one of the most famous female runners in this moment:

Good luck this weekend, runners! Have fun, be safe – and get massage afterwards!

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If you’re interested in other great stories of the women runners who drove the sport forward, check out Amby Burfoot’s First Ladies of Running.