Easing Tensions

Here’s how to put athletes at ease who may be apprehensive about receiving massage.

By Lorraine Berry

Lorraine Berry is an Assistant Editor at Training& Conditioning.

Training & Conditioning, 10.6, September 2000, http://www.momentummedia.com/articles/tc/tc1006/tensions.htm

Irrefutably, massage therapy can provide many important benefits for athletes. But, for some athletic trainers, it may be more difficult to apply than they realized. While the basic techniques are easy for any ATC to pick up, many people new to administering massage encounter a common stumbling block: apprehensive clients. Like anyone else, athletes may feel skittish or uncomfortable with the idea of being touched.
Alan Alper, ATC, LMT, owner of Massage Associates, in Washington, D.C., and a lecturer in the Exercise Science Department and the staff massage therapist for the Center for Integrative Medicine, both at George Washington University, explains the problem this way. “We have a somewhat ambivalent culture when it comes to touch,” he says, “and athletes are no less prone to having issues about touch [than the general public]. And, for athletes, it’s their bodies that give them their sense of being, more so and more consciously than the rest of the population. And they’re not always comfortable with that.”
If you have an athlete who would benefit from sports massage but is reluctant to let you rub the hurt away, there are some strategies for improving his or her comfort level. The first thing you want to establish is whether the athlete has had any prior experience with massage. If so, his or her nervousness may stem from a bad experience that you must now overcome. If not, then it’s a matter of educating the athlete.
Either way, good communication and empowerment are your greatest tools. That starts before you physically approach the athlete. “Often,” Alper says, “they have such questions as, ‘How much am I going to be naked? How much of my body is going to be touched?’ That’s normal.” Your responses to these questions can go a long way toward putting a client at ease. Tell the athlete what you will be doing, what you’re trying to accomplish, and how much of the body you’re going to be working with.
According to Alper, explaining the process in advance helps to legitimize the need for clients to undress. How much they disrobe, though, must be left up to them. “I explain that they’ll need to undress as much as they’re comfortable with undressing,” Alper says. “They can stay in their gym shorts, or, depending on the setting, they can get under the sheets or cover with a towel—whatever they want. But I let them be in control.” By giving athletes control of the situation, much of their nervousness can be assuaged.
A clinician can also ease athletes’ apprehensions once the massage is initiated. One method Alper teaches his students at GW is particularly effective for putting clients at ease. “The recipient lays face-down and the therapist stands alongside the table and places his or her hands on the person across the shoulder blades and on the low back,” Alper explains. “I instruct the therapist to stay there, let the hands conform to the recipient’s body contours and let the recipient just relax. Generally, within about 10 seconds, the breathing pattern of the person who’s receiving the touch becomes much deeper. You can literally feel the tissues unwind. You’re not stroking or doing any technical manipulations, you are simply engaging in comfortable human touch.”
“If a person was really nervous, you might have to do some massage techniques through the clothing,” he says. “That limits how you can use your hands—you can’t slide and glide as well—but you can do compressions with the broad surfaces of the hands, the palm, the heel of the palm, the length of the fingers, or something like that, or even with just the fingertips you can still do friction massage through the clothing. You may be limited, but it may be a way to ease a person into accepting massage.”
Most people, if they have experienced massage, have received massage geared toward relaxation. The setting is often in a dimly lit room, with soft music in the background. An athletic trainer can create a very different setting for sports massage that will work to lessen an athlete’s discomfort. “When I work with someone, like runners with leg or foot pain, they keep on T-shirts and shorts, because we’re working on limited areas of the body,” he says. “When you limit it in that regard—they don’t have to get undressed, there’s no music, we may have sports talk radio on—it creates a different environment. The cues are not there that would send some signals that people would be concerned about.
“The scope of what you do, the areas you work on, the ways in which you work may be different,” Alper continues. “In that regard, it’s more like going to the doctor’s. The doctor’s reasons for touching you go toward making you better in the long run, so if it doesn’t feel that good, you accept that. Sometimes, clinically oriented massage doesn’t feel that great either. It’s not soothing and relaxing.”
As you work, Alper also suggests telling the athlete both what you’re feeling as you’re working on him or her and what he or she should be expecting to feel. “When I’m doing massage, I am reading tissues and seeing the effect it has on the body,” Alper says. “And I’m looking at his or her whole body to see if he or she is grimacing, or tightening up, or chattering away because he or she is nervous. I also want to have confirmation of what I’m feeling and how I’m proceeding, so I constantly ask for feedback so we’re on the same wavelength.
“I’m also explaining as I go along, ‘That burning you’re feeling right now is because of the fascia stretching and that’s what we’re trying to accomplish,” Alper continues. “The next two or three times I stroke that area, the burning should decrease, and when you get up you should have a greater range of motion.’ Something of that nature. I try to make it educational and a running commentary. It’s their bodies that are being worked on and obviously you want them to be a part of the process.”