Massage To Go

Typical athletes don't have massage therapists on hand during practices and competition. Here are some event sports massage techniques that athletes can take on the road.

By Ralph Stephens

Ralph Stephens, LMT, NCTMB, is a certified sports massage therapist who has worked with many All-American and Olympic athletes. He is based in Cedar Rapids, Iowa.

Training & Conditioning, 11.7, October 2001, http://www.momentummedia.com/articles/tc/tc1107/massage.htm


Picture a discus thrower who is trying to stay warm for his next event at a track meet. The weather is overcast with intermittent rain and the temperature hovers in the high 40s. He thinks it would be terrific to have a professional massage therapist on hand to keep him loose and warm, but he knows that's out of the question.

Fortunately, there are effective sports massage techniques that you and your staff can administer to your athletes in the absence of a trained massage therapist. Athletic trainers and coaches should also teach these techniques to their athletes. Once athletes understand these techniques, they can administer self-massage and partner-massage as needed and take better care of themselves before, during, and after athletic activity.

The techniques presented in this article are primarily aimed at pre- and post-event situations. Pre-event techniques are designed to stimulate, loosen, and warm up an athlete's tissue. The post-event techniques help to relax, soothe, and stimulate the exchange of fluids in muscles. Pre-event techniques can also be used for situations in which an athlete needs to remain loose and warmed up at halftime or between matches or events, as in the case of the discus thrower mentioned above.

Before discussing these techniques, understand that event sports massage should never be painful. How do you define pain? While the thresholds for pain differ considerably among athletes, a "painful"technique will cause an athlete to tense up and pull away, and the sensation will not be pleasant at all.

PRE-EVENT MASSAGE
The techniques used in pre-event massage should be both stimulating and warming. They are intended to loosen an athlete's tissues, create warmth, and also to create a durable state of hyperemia that will help sustain the athlete throughout the event or practice.

Pre-event massage should also stimulate the nervous system. Therefore, it must be done rapidly, vigorously, and energetically. Older massage literature would call this a very "bracing"type of treatment.

The maximum amount of time that should be spent on the total pre-event massage is 12 minutes. More is not better, especially if the athletes are doing it on themselves. If the massage goes on for too long, the athletes can expend valuable energy and fatigue the nervous system. Get it done, and then get on with the game.

Here are a few examples of appropriate pre-event techniques that I find useful:

Shaking and jostling: Grasp a muscle or muscle group and vigorously shake it (using one hand) or throw it (using two hands) back and forth. On longer muscles, move along the muscle from distal to proximal (toward the center of the body). This loosens up the tissues, increases circulation, and can be effective in warming up arms and legs.

Deep friction: Although deep friction is generally considered to be a sedating stimulus to the nervous system, when done rapidly it becomes neutral to slightly stimulating. Hence, in pre-event massage, this technique is used to warm the tissues and provide a form of passive exercise to the muscles and tissues beneath the skin.

Do not misunderstand the word, "deep."It does not automatically mean hard. Deep friction can either be done very lightly or very hard. Actually, it is best to use light to medium pressure as we do not want to cause pain.

Deep friction can be applied with the entire hand, with the palm of the hand, with heel of the hand, with a loosely clenched fist, or with the fingertips or thumbs. It can be done on both sides of a joint, such as the knee or ankle, at the same time using both hands.

To perform deep-friction massage, engage the skin and slide it over the deeper tissues. Do not slide your hands on, over, or across the skin. Instead, engage the skin itself and slide it over the deeper muscle tissues. This can be done parallel to the deeper muscle fibers (longitudinal friction), in a circular motion over them (circular friction), or across them (crossfiber or transverse friction). Apply enough pressure to engage the skin and perform five to seven movement cycles in one spot, then move over a hand's width and repeat on an untreated area. Around a joint, work until a warming sensation is felt deep in the tissues. Primarily address the muscles and joints which do the most work in the sport about to be performed.

Tapotement: This is a very stimulating stroke that impacts the muscle and stretches it just enough to fire the muscle spindle cell, causing the muscle to contract slightly. This action improves circulation and warms the muscles, preparing them for vigorous, sustained activity.

To apply tapotement, use the knife-edge (ulnar) side of the hand and keep the wrist loose. Strike the muscle rapidly, firmly, and repeatedly, working the length of the muscle and making sure that your impacts hit everywhere on the treated muscle six to 10 times. More than that is unnecessary. You may also use loosely clenched fists, striking the tissues with either the ulnar edge of the hand or the palmar side.

The impact should be firm, penetrating into the muscle tissues, but never so hard as to cause pain. Do not do this directly over joints or boney prominences, because it is effective only on muscle tissues. Also, hitting directly on a joint or bone can be painful.

While tapotement is most commonly done with an alternating left-to-right hand pattern, tapotement can also be done with only one hand, or with both hands impacting at the same time. The effect is essentially the same. Vary the technique based on the athlete's coordination and the practicality of reaching any particular area. Also, be careful: tapotement is so stimulating that after a while it can fatigue the muscle and nervous system, so do not over-treat.

Superficial (palmar) friction: This very simple technique stimulates the nervous system and generates heat. It is done by sliding the palms of the hands rapidly over the skin. The friction of the moving hands will generate heat on the skin. Slide back and forth along the tissue repeatedly until warmth is felt.

This technique can be done with one hand on either side of a body part, such as the thigh or leg, or with one hand only, for instance when treating the other arm or shoulder. This is a great way for athletes who are preparing to compete in cool conditions to warm themselves or to maintain heat during breaks, halftimes, and other lulls in activity.

While this is a very effective technique, it is superficial. The deep-friction stroke mentioned previously is better at creating heat deeper in the body for warming joints.

It is important to understand that pre-event massage techniques do not replace the regular warmup, but they do provide an effective way to augment it. For example, these techniques are effective for maintaining an athlete's heat and 'pumped-up'state after his or her warmups are complete and while he or she is waiting for competition to begin. In the case of significant delays or cool conditions, the techniques may be repeated to maintain the warm and ready state. Having athletes perform these techniques on themselves may also help them focus and avoid tension buildup.

POST-EVENT TECHNIQUES
Post-event techniques will speed an athlete's recovery from intense training or competition, and they can help reduce post-competition soreness. After activities, the athlete's nervous and muscular systems are traumatized and exhausted. Therefore, these techniques need to be slower, lighter in pressure, soothing, and much less bracing than pre-event techniques. Do not spend more than 15 minutes on the total post-event treatment. The following techniques can be applied to many areas of the body, but be sure to include muscle groups that have been particularly stressed in the event or sport:

Effleurage: This is a stroking or gliding motion over the skin, with an overall movement toward the heart to move superficial lymph and venous fluids out of the tissues and back toward the circulatory organs. When self applied, effleurage is most effective and comfortable using the edge of the hand. While the ulnar side of the hand is probably more powerful, sometimes it is easier to use the radial side while grasping slightly with the thumb. A combination of both hands may also be used where practical.

Engage the tissue using a firm but comfortable pressure and slide from distal to proximal. For the lower extremities, work the thigh first, then the leg, then the thigh again. Make three to six passes over each strip (handful) of tissue, starting lightly and working a little deeper with each successive pass.

Deep friction: This is the same deep friction described in pre-event massage. However, for post-event deep friction, the tempo is slower. Working at a slow to moderate pace, shift the skin over the deeper tissues four to six times, then move a hand's width and repeat. Be thorough. Pay particular attention to the tendon capsules and attachments around joints.

When self administered, circular motion is probably the most comfortable for post-event massage, but all three variations (longitudinal, circular, or crossfiber) may be used. The athlete should do whatever is easiest for him or her to perform and whatever feels the best.

Vibration: This technique is stimulating, but if done slowly, it can have a relaxing, loosening effect. Gently grasp the muscle and slowly shake it or rock it back and forth, working along the muscle from distal to proximal (toward the heart). Relax and allow the joints to move some, too.

Post-event massage is not a replacement for an athlete's regular cool-down routine. Moreover, post-event massage should not be started until the athlete's pulse and respiration have normalized. It may be done before or after post-event stretching and it will be beneficial even if it is done two to three hours after the end of competition. The bus ride home can be a great time to do this.

DURING COMPETITION
Massage can also be beneficial at halftimes, between sets, or during brief periods of inactivity. For example, baseball players sitting in a dugout between innings would benefit. Called inter- or intra-competition massage, these techniques can help maintain the athlete's warmed-up state, while keeping the athlete loose and maintaining hyperemic blood flow. However, if an athlete must wait more than two hours between events, games, or matches, he or she should do some post-event techniques to help flush out the tissues and relax. Then repeat the pre-event techniques right before resuming competition.

Inter/intra-competition massage uses pre-event sports massage techniques. However, some pre-event techniques are more useful than others in inter/intra-event applications. For example, the shaking and jostling pre-event technique is particularly useful between competitions because it tends to loosen tissue and stimulate blood flow without taking very long. Or in outdoor competitions where the temperatures are low, the palmar friction technique can be helpful in keeping an athlete warm, such as in the case of a pitcher wanting to keep his or her shoulder warm between innings.

In addition to the massage techniques mentioned earlier, most of which are also examples of self-massage techniques, the following are two techniques that pairs of athletes can perform on each other to remain loose and warmed up before and between events.

The first example is excellent for sports such as wrestling, where upper-body strength and speed are important. To begin, the athletes should stand two or three feet apart, facing each other. Their feet should be shoulder-width apart, and their arms should be hanging at their sides. Have both athletes raise one arm straight up over their heads, (sideward elevation) then lower the first arm, and raise and lower the other arm. Do only one repetition.

Next, have the first athlete grasp the hand of the second athlete, as if they were going to shake hands. Make sure that the second athlete relaxes his or her hand and arm and has no grip. The first athlete then begins to vigorously shake the arm of the second athlete. As this technique is performed, shake and move the treated arm forward and backward, and side-to-side. Keep a rapid vibration going as you move it all around. Do this for 20 to 30 seconds. Then, have the first athlete raise the treated arm over his or her head as before. The athlete should notice a lightness in the arm. It is important that the athlete feel this change to understand how effective this exercise can be. Then, shake out the other arm and rest it. Now, have the athletes trade roles, so the first athlete receives treatment.

The second example is helpful for keeping the legs and hips loose and warmed up between events. To begin, have the first athlete lie on his or her back, legs straight and on the floor. It is important for the first athlete to recline on a comfortable surface that is not cold. Keeping the knee straight, raise the leg as far as possible and return it to the floor. Then repeat with the other leg. Do only one repetition.

Next, have the first athlete bend one knee about 90 degrees so that his or her foot is flat on the floor. The second athlete then kneels down and grabs the first athlete's bent knee, with one hand on the shin, just below the knee and one hand above the knee, just above (proximal to) the patella. The partner vigorously shakes the knee back and forth in a lateral-to-medial movement, causing the calf and hamstrings to flop back and forth. While shaking the knee, the entire thigh/leg should be moved laterally and medially to help loosen up the hip joint. Continue moving and shaking for 20 to 30 seconds.

Return to the straight-leg position and raise the shaken leg. The athlete should notice it is easier to lift the leg and that the range of motion increases. Now, repeat the entire procedure on the other leg. After both legs and hips have been worked on, have the two athletes trade positions so that the second athlete receives treatment.

Whether your athletes are shivering in the rain as they wait to throw the discus or are finishing a soccer match in 90-degree heat, you will find that event sports massage is an effective way to supplement their warmups before competition, to stay warmed up between events, and to recover after exercise. Once your athletes learn to apply event sports massage to themselves and to their teammates, they will gain a physiological and psychological edge that helps them compete. They will also be at less risk for injuries.