Massage And Physiotherapy Treatment
We now offer sports massage from Sydney Physio Clinic. Traditionally the use of massage has made up a large amount of the treatment time spent in physio rooms. Regardless of the complaint, be it a sports injury, post-op rehab following surgeries, or for the treatment of sore back and necks, massage has almost always been a substantial player in physio management. Leading the stereotype whereby if you have a soft tissue problem, it is best to see a physio, and if you have a joint problem it is best to see a chiro, and if it is a bone issue see an osteopath…
In the last 10 years or so, the widespread use and reliance on massage as a treatment approach has been a topic of debate, with increased skepticism regarding benefits and relevance of sports massage. Such is the debate that some physiotherapists have ditched using massage as part of their treatment approach completely. So, I wanted to take a quick look at some of the evidence behind massage, gaining some insight into why it historically and still to present day sports massage is such a popular therapeutic approach. As well as explaining how we approach sports massage at Sydney Physio Clinic.
Sports Massage And The Evidence
A quick search on Google tells us the following about massage. Namely that scientific evidence supports sports massage in providing a range of benefits for athletes.
Such benefits include:
- Decreased Muscle Soreness:
A study in the International Journal of Sports Physical Therapy found massage therapy can reduce muscle soreness and improve recovery after exercise. This study was supported by the 2020 review by Davis et al
- Reduced Risk Of Injury:
The use of massage therapy can help prevent injuries, doing so by improving flexibility, reducing muscle tension and promoting improved recovery after exercise… While there is still more research needed to fully understand mechanisms and benefits of sports massage, existing evidence suggests sports massage can be a valuable tool for athletes who are looking to improve both performance and recovery.
- Increased Blood Flow:
Massage therapy has been shown to increase blood flow to muscles massaged, this increased blood flow can help improve circulation, nutrient delivery, as well as reduce inflammation.
- Improved Flexibility:
A study in the Journal of Sports Science and Medicine found massage therapy can increase flexibility and joint range of motion. These things may lead to improved athletic performance. A systematic review (Davis et al, 2020) in the BMJ Open Sport and Exercise Medicine journal also found the use of sports massage could help improve tissue flexibility.
- Reduced Anxiety:
A study in the International Journal of Neuroscience found massage therapy can improve mood and reduce anxiety in athletes.
- Improved sleep:
A study in the Journal of Sports Science and Medicine found massage therapy can improve the duration of sleep and sleep quality in athletes.
- Post-Competition Massage:
At Sydney Physio Clinic we often recommend the use of sports massage in the 24 hours following competitive events. Massage used in this way can help capitalise on all the physiological benefits I have listed above. Relevant events could include things like a marathon or ultradistance event, endurance ocean swim, football finals that move into extra time, powerlifting competitions… It these situations considering the use of sports massage post event to assist in relaxation and recovery.
Can Massage Help To Relieve Pain
The use of massage to promote relaxation, relieve pain and reduce stress is nothing new, and has been used for centuries. There several proposed mechanisms for how massage can improve pain and some scientific evidence to back it. However, massage is a challenging therapeutic approach to create high quality studies on due to it is hard to reproduce the exact same delivery to each research participant and impossible to create a double blind situation to give the study its powerful validity.
The proposed mechanisms on basis behind how sports massage can provide pain relief include:
Reducing inflammation. A study in the International Journal of Neuroscience found massage therapy can reduce levels of the stress hormone cortisol, and increase the activity of the parasympathetic nervous system, the system that is responsible for reducing inflammation.
Increased blood flow. The use of massage can also increase blood flow to the affected area, which in turn can help reduce pain and promote healing. A study in the Journal of Bodywork and Movement Therapies found massage therapy to increase blood flow to muscles, which can help to relieve pain and soreness.
A review of 60 clinical trials, published in the Cochrane Database of Systematic Reviews found massage therapy is effective for relieving pain in different conditions, including neck pain, headaches, and back pain. However, more research is needed to fully understand mechanisms through which massage can help alleviate pain.
What this does mean is that massage can make a great complementary therapy but should not be considered a substitute for medical advice and treatment.
It is important to note that massage should not be used as a substitute for medical treatment, but rather as a complementary therapy to help manage pain and recovery.
Sports Massage Is A Subjective Therapy
The perception of massage is so subjective, some people love massage and some people hate it. And everyone responds differently to pressure what causes discomfort for some or is ticklish for others may be perfect for another… This means the use of sports massage needs to be considered based on individual needs and preference. There is no hidden “reset” button lying deep down in our muscles that needs to be dug out with deep pressure. Massage is subjective and needs to be personalised, that the way it makes the patient feel is the key.
The Idea Of “Good Pain”
Often patients describe the pressure they are feeling associated with massage as being a “good pain” and some people feel they need a degree of this “good pain” in their sports massage. If the sensation feels “good” then it is likely delivering the desired outcome. However, what we want to avoid is the patient putting up with more extreme pain, tolerating significant discomfort in the hope that it will deliver a long-term benefit, as this is rarely how it plays out.
Sports Massage And Relaxation
Sometimes it can be nice to just relax for an hour and not all massage has to fixate on digging into sore muscles. At Sydney Physio Clinic the approach to sports massage is based on our understanding that massage can be a great tool for our patients. Especially so active populations who are already doing lots of movement, stretching and strength work independently. For us, the delivery of massage has to be tailored to the individual, and feel “good” to the patient.