The role of massage in the management of the athlete: a review

Comparative Efficacy of Robotic and Manual Massage Interventions on Performance and Well-Being: A Randomized Crossover Trial

BACKGROUND

Manual massage (MM) interventions can improve psychophysiological states of relaxation and well-being. In this context, robotic massage (RM) represents a promising, but currently understudied, solution.

HYPOTHESIS

Both MM and RM would improve flexibility of the hamstrings and lumbopelvic muscles and promote a psychophysiological state of relaxation through decreased sympathetic activity.

STUDY DESIGN

Single-blind randomized crossover trial.

LEVEL OF EVIDENCE

Level 2.

METHODS

A total of 21 participants experienced 2 massage interventions targeting back soft tissues. During a first condition, the intervention was performed by a physical therapist, whereas during a second condition the intervention was performed by a robot. We collected objective and subjective indexes of performances and well-being before and after each massage intervention. We also collected physical therapists' self-reports of perceived fatigue, tension, and ability to maintain the massage routine.

RESULTS

Skin conductance decreased from the pretest to the posttest in both conditions (partial R2 = 0.44, 95% CI [0.30, 1.00], P < 0.01), although the decrease was more pronounced after MM. Whereas both interventions were associated with improved subjective sensations, eg, pain, warmth, well-being (partial R2 = 0.08, 95% CI [0.06, 1.00], P < 0.01), MM yielded additional benefits compared with RM. The physical therapist reported greater fatigue and tension and reduced perceived massage efficiency along with repeated massage interventions. MM outperformed RM to elicit a psychophysiological state of relaxation.

CONCLUSION

RM exhibited a pattern of changes comparable with that of MM, for both objective and subjective indexes of relaxation and well-being.

CLINICAL RELEVANCE

RM could represent a prophylactic option to prevent the onset of counterproductive fatigability in physical therapists.

Acute Effects of Short-Term Massage Procedures on Neuromechanical Contractile Properties of Rectus Femoris Muscle

Background and Objectives: In many sports, maintaining muscle work at an optimal level despite fatigue is crucial. Therefore, it is essential to discover the most efficient way of recovery. This study aimed to evaluate and compare the acute effects of four different recovery methods on muscle neuromechanical properties. Materials and Methods: The research was conducted using a randomized, quasi-experimental, repeated-measures design. Fourteen healthy and active male students of the Faculty of Sport and Physical Education (age 25.1 ± 3.9 years) were included in this study. The tensiomyography was used to evaluate muscle responses after four different types of short-term recovery methods (passive rest, percussive mechanical, vibro-mechanical, and manual massage) on the rectus femoris muscle on four occasions: baseline, post fatigue, post recovery and prolonged recovery. Results: The ANOVA revealed that muscle fatigue decreased maximal vertical muscle displacement (Dm) and muscle contraction time (Tc) in post fatigue compared to the baseline. The most important finding shows that only the vibro-mechanical massage resulted in an increase in Tc in the prolonged recovery compared to the post fatigue (p = 0.028), whereas only manual massage showed no differences in Dm from the baseline in post-recovery (p = 0.148). Moreover, both manual and vibro-mechanical massages increased Dm and Tc in prolonged recovery, indicating no differences from the baseline (all p > 0.05), thus showing signs of muscle recovery. Percussion mechanical massage and passive rest did not show indices of muscle recovery. Conclusions: Manual massage could induce immediate positive changes in Dm by reducing muscle stiffness. In addition, vibro-mechanical and manual massage improved muscle tissue by rapidly returning Dm and Tc values to baseline at prolonged recovery measurement (5 min after the fatigue protocol). These findings can benefit sports practitioners, and physical therapists in developing the best recovery method after muscle fatigue.

Effects of percussion massage therapy, dynamic stretching, and static stretching on physical performance and balance

BACKGROUND

Percussion massage therapy is a popular approach in sport medicine for physical therapists, but few researchers have investigated the comparison with other intervention methods.

OBJECTIVE

This study aimed to examine the comparison of the effects of dynamic stretching, static stretching and percussive massage therapy on balance and physical performance in individuals.

METHODS

The participants who were 18-25 years of age, able to perform performance tests, did not have any orthopedic surgery, did not have problems during running and sudden turning, and did not have a professional sports history were included in the study. Participants were assigned randomly to three groups as dynamic stretching (DS) (n= 16), static stretching (SS) (n= 16) and percussive massage therapy (PMT) (n= 16) groups. Horizontal jumping test, T drill test and balance measurements on a single leg with open and closed eyes of all participants were recorded before and after applications.

RESULTS

When the values of the pre and post-treatment of all groups in the study were compared, significant improvements were observed in the t-test, horizontal jumping test and right/left foot balance with eyes open in DS group (p< 0.05). Significant improvements were observed in all values in the PMT group (p< 0.05). In the comparison of the differences between the groups, PMT group values were more significant than the SS group in all parameters.

CONCLUSION

Percussive massage therapy would be an alternative that can be used to increase the performance and balance of individuals before exercise.

The Effects of Massage Therapy on Sport and Exercise Performance: A Systematic Review

BACKGROUND

A massage is a tool that is frequently used in sports and exercise in general for recovery and increased performance. In this review paper, we aimed to search and systemize current literature findings relating to massages' effects on sports and exercise performance concerning its effects on motor abilities and neurophysiological and psychological mechanisms.

METHODS

The review has been written following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. One hundred and fourteen articles were included in this review.

RESULTS

The data revealed that massages, in general, do not affect motor abilities, except flexibility. However, several studies demonstrated that positive muscle force and strength changed 48 h after the massage was given. Concerning neurophysiological parameters, the massage did not change blood lactate clearance, muscle blood flow, muscle temperature, or activation. However, many studies indicate pain reduction and delayed onset muscle soreness, which are probably correlated with the reduction of the level of creatine kinase enzyme and psychological mechanisms. In addition, the massage treatment led to a decrease in depression, stress, anxiety, and the perception of fatigue and an increase in mood, relaxation, and the perception of recovery.

CONCLUSION

The direct usage of massages just for gaining results in sport and exercise performance seems questionable. However, it is indirectly connected to performance as an important tool when an athlete should stay focused and relaxed during competition or training and recover after them.

Effect of Vibration Massage and Passive Rest on Recovery of Muscle Strength after Short-Term Exercise

Background: The aim of the study was to compare the effect of vibration massage and passive rest on accelerating the process of muscle recovery after short-term intense exercise. Methods: Eighty-four healthy men aged 20 to 25 years participated in the study. Study participants performed isometric (ISO-M Group) and auxotonic (AUX-M group) contraction exercise in the lower limbs. Vibration massage was administered after exercise in the first recovery period. In the same period, controls rested passively, without the support of vibration massage. To assess the effectiveness of the applied vibration, a 4-fold measurement of the maximum force of the muscles involved in the exercise was performed under conditions of isometric contractions on a leg press machine set at an angle of 45° degrees upwards. Results: Differences in maximum strength during isometric contraction were found compared to baseline in favor of the groups subjected to the experimental vibration massage. Differences were demonstrated in muscle strength between the study groups (p < 0.005). The second period of passive rest in all groups did not bring significant changes in the values of maximal lower limb strength. Conclusions: Properly selected characteristics of the vibration effect can be an effective method in accelerating recovery and regaining lost motor capabilities of muscle groups fatigued by exercise. This offers the potential to shorten rest periods between sets of repetitions in training or between training units.

Effects of a Massage Protocol in Tensiomyographic and Myotonometric Proprieties

Background: Pre-competition massage is usually used to improve athletic performance and reduce risk of injury. Despite its usual use, the effects of pre-competition massage on neuromuscular function have barely been studied. The aim of this study is to evaluate the effects of the pre-competition massage over the gastrocnemius neuromuscular function. Method: The study is a quasi-experimental clinical trial thirty healthy athletes were enrolled in the study. Subjects received an intervention in one leg (experimental), consisting of a massage, and no intervention in the opposite leg (control). From all values of neuromuscular function, the following were analyzed: contraction time (Tc) and maximal displacement (Dm) by tensiomyography, and stiffness and tone by myotonometry. Results: Main effects of pre-competition massage on neuromuscular function include a significant (p < 0.05) increase in Tc and Dm variables, as well as a reduction in stiffness and tone. Conclusion: Data shows an increase in Tc and maximal radial displacement (Dm) variables, as well as a reduction in stiffness and tone. More quality studies are needed to draw clear conclusions about the effects of pre-competition massage.

Effect of sports massage on performance and recovery: a systematic review and meta-analysis

Objective

Massage is ubiquitous in elite sport and increasingly common at amateur level but the evidence base for this intervention has not been reviewed systematically. We therefore performed a systematic review and meta-analysis examining the effect of massage on measures of sporting performance and recovery.

Design and eligibility

We searched PubMed, MEDLINE and Cochrane to identify randomised studies that tested the effect of manual massage on measures of sporting performance and/or recovery. We performed separate meta-analyses on the endpoints of; strength, jump, sprint, endurance, flexibility, fatigue and delayed onset muscle soreness (DOMS).

Results

We identified 29 eligible studies recruiting 1012 participants, representing the largest examination of the effects of massage. We found no evidence that massage improves measures of strength, jump, sprint, endurance or fatigue, but massage was associated with small but statistically significant improvements in flexibility and DOMS.

Conclusion

Although our study finds no evidence that sports massage improves performance directly, it may somewhat improve flexibility and DOMS. Our findings help guide the coach and athlete about the benefits of massage and inform decisions about incorporating this into training and competition.

Acute effects of static stretching and massage on flexibility and jumping performance

OBJECTIVE

The purpose of this study was to evaluate the effects of static stretching and the application of massage on flexibility and jump performance.

METHODS

Thirty-five athletes studying Physical Education at University (mean age 23.6±1.3 years, mean height 177.8±6.3 cm and mean weight 72.2±6.7 kg) performed one of three different warm-up protocols on non-consecutive days. Protocols included static stretching [SS], combined static stretching and massage [SSM], and neither stretching nor massage [CONT]. The athletes performed flexibility, countermovement jump (CMJ) and squat jump (SJ) tests.

RESULTS

SS and SSM protocols demonstrated 12% (p<0.05) and 16% (p<0.05) respectively greater flexibility than the CONT protocol. SJ and CMJ performances were significantly decreased 10.4% (p<0.05) and 5.5% (p<0.05) respectively after the SS protocol. There was no significant difference between SSM and CONT protocol in terms of SJ and CMJ performance.

CONCLUSION

This research indicates that whereas static stretching increases the flexibility it decreases the jumping performance of the athletes. On the other hand, the application of massage immediately following static stretching increases flexibility but does not reduce jumping performance. Considering the known negative acute effects of static stretching on performance, the application of massage is thought to be beneficial in alleviating such effects.

A community-based survey on massage therapy in Saudi Arabia

Massage therapy (MT) is the physical manipulation of the soft tissues. It primarily consists of manual or hands-on techniques such as applying fixed or movable pressure, holding, and moving muscles and body tissues. MT is beneficial for pain relief, sport-related injury rehabilitation, stress reduction, and to address psychological disorders. MT is the most prevalent form of complementary and alternative (CAM) therapy worldwide. The aim of this study was to evaluate the knowledge, attitudes, and perceptions regarding MT among the Saudi community. A cross-sectional online survey using WhatsApp©, Google Forms©, Facebook©, and Twitter© was conducted among the general community of the Kingdom of Saudi Arabia (KSA) to assess the knowledge, attitudes, and perceptions regarding MT. Data was collected using a 20-item, self-administered questionnaire consisting of a series of both closed-ended and Likert-type questions. A total of 436 respondents completed the survey. Most of the respondents were female 84.2% (n = 367). Approximately 65% resided in the central region of KSA. The majority of the respondents, 81.4%, believed that MT is effective, 27.7% thought that MT leads to complications, and more than half of the residents, 55.7%, believed that patients should consult with their physicians prior to MT. The most common reasons for MT were to treat muscle pain, for relaxation purposes, to treat bone and joint pain, and backache relief, which were reported by 49%, 20%, 19%, and 16% of the participants, respectively. The knowledge, attitudes, and perceptions of the Saudi population towards MT are insufficient in some aspects. The establishment of community-based health education programs to improve knowledge of MT is recommended.

Acute Effects of Transdermal Administration of Jojoba Oil on Lipid Metabolism in Mice

Background and objectives: Aroma therapy is a complementary therapy using essential oils diluted with carrier oils. Jojoba oils have been widely used as carrier oils. However, limited information is available regarding their effects on blood biochemical parameters. This study aimed to investigate the effect of transdermal administration of jojoba oil on blood biochemical parameters in mice. Materials and Methods: Eight-week-old male hairless mice were randomly divided into naïve control and treatment groups. In the treatment group, mice were topically administered 4 μL of jojoba oil, per gram of body weight, on the dorsa 30 min before euthanasia. Thereafter, serum biochemical parameters were assayed, and gene expression was analyzed in various tissues via a real-time polymerase chain reaction. Results: Serum non-esterified fatty acid (NEFA) levels increased significantly 30 min after topical application of jojoba oil (p < 0.05). Atgl was significantly upregulated in the liver (p < 0.05), and Atgl upregulation in the liver was positively correlated with serum NEFA levels (r = 0.592, p < 0.05). Furthermore, a trend of decreasing fatty acid trafficking-related gene (FABPpm, FATP-1, FATP-3, and FATP-4) expression in the skin after topical application of jojoba oil (p = 0.067, 0.074, 0.076, and 0.082, respectively) was observed. Conclusions: Serum NEFA levels were elevated 30 min after transdermal administration of jojoba oil. The mechanisms of elevated serum NEFA levels might be related to both enhanced lipolysis in the liver and reduced fatty acid trafficking in the skin.

Effects of different recovery methods on postboxing sparring fatigue substances and stress hormones

This study aimed to investigate the effects of static rest, massage, aromatherapy, and acupoint acupressure on the levels of fatigue substances and stress hormones produced after a session of boxing sparring. The study was conducted on female adolescent boxers (n=12) who underwent four recovery methods with a 7-day rest period between each session. The order of these methods was decided randomly. Prior to each method, the participants performed five rounds of 4-min boxing sparring, and the maximal intensity was set as 70%-80% of the maximal heart rate. The effects of the four recovery methods on the blood levels of fatigue substances and stress hormones after boxing sparring were investigated. Static rest, massage, aromatherapy, and acupoint acupressure significantly decreased the lactic acid levels. The creatine phosphokinase levels decreased in the aromatherapy and acupoint acupressure groups, while the lactate dehydrogenase levels significantly decreased in the massage, aromatherapy, and acupoint acupressure groups. Further, the levels of stress hormones, cortisol, and epinephrine, showed no significant changes after massage and acupoint acupressure. However, a significant decrease in the cortisol level was observed in the aromatherapy group and an increasing trend was observed in the cortisol level in the static rest group. The adrenocorticotropic hormone level significantly decreased in the aromatherapy group and showed a decreasing trend after the participants received massage or acupoint acupressure. High-intensity exercise results in not only physical, but also psychological fatigue. Massage and aromatherapy can improve the physical and psychological stabilities and performances of athletes.

Acute Effects of Lateral Thigh Foam Rolling on Arterial Tissue Perfusion Determined by Spectral Doppler and Power Doppler Ultrasound

Hotfiel, T, Swoboda, B, Krinner, S, Grim, C, Engelhardt, M, Uder, M, and Heiss, R. Acute effects of lateral thigh foam rolling on arterial tissue perfusion determined by spectral Doppler and power Doppler ultrasound. J Strength Cond Res 31(4): 893-900, 2017-Foam rolling has been developed as a popular intervention in training and rehabilitation. However, evidence on its effects on the cellular and physiological level is lacking. The aim of this study was to assess the effect of foam rolling on arterial blood flow of the lateral thigh. Twenty-one healthy participants (age, 25 ± 2 years; height, 177 ± 9 cm; body weight, 74 ± 9 kg) were recruited from the medical and sports faculty. Arterial tissue perfusion was determined by spectral Doppler and power Doppler ultrasound, represented as peak flow (Vmax), time average velocity maximum (TAMx), time average velocity mean (TAMn), and resistive index (RI), and with semiquantitative grading that was assessed by 4 blindfolded investigators. Measurement values were assessed under resting conditions and twice after foam rolling exercises of the lateral thigh (0 and 30 minutes after intervention). The trochanteric region, mid portion, and distal tibial insertion of the lateral thigh were representative for data analysis. Arterial blood flow of the lateral thigh increased significantly after foam rolling exercises compared with baseline (p ≤ 0.05). We detected a relative increase in Vmax of 73.6% (0 minutes) and 52.7% (30 minutes) (p < 0.001), in TAMx of 53.2% (p < 0.001) and 38.3% (p = 0.002), and in TAMn of 84.4% (p < 0.001) and 68.2% (p < 0.001). Semiquantitative power Doppler scores at all portions revealed increased average grading of 1.96 after intervention and 2.04 after 30 minutes compared with 0.75 at baseline. Our results may contribute to the understanding of local physiological reactions to self-myofascial release.

Deep soft-tissue massage applied to healthy calf muscle has no effect on passive mechanical properties: a randomized, single-blind, cross-over study

Background

Massage is often applied with the intention of improving flexibility or reducing stiffness in musculotendinous tissue. There is, however, a lack of supporting evidence that such mechanical effects occur. The purpose of the study was to investigate the effect of massage on the passive mechanical properties of the calf muscle complex.

Methods

Twenty nine healthy volunteers aged between 18 and 45 years of age had their calf muscle compliance and ankle joint dorsiflexion range of motion (ROM) measured using an instrumented footplate before, immediately and 30 minutes after a ten minute application of deep massage or superficial heating to the calf muscle complex. Repeated measures analysis of variance was used to determine differences between testing sessions and the types of intervention. Reliability testing for the measurement method was conducted using analysis of variance both within and between testing sessions.

Results

There was no significant change in calf muscle stiffness or ankle dorsiflexion range of motion with or without the application of calf massage. Inter- and intra-session reliability were very high, ICC > 0.88 (p < 0.001).

Conclusions

Although individuals’ perception of a change in tissue characteristics following massage has been reported, there was no evidence that soft tissue massage led to a change in the passive mechanical properties of the calf muscle complex. The findings of this study suggest that the use of massage to increase tissue flexibility prior to activity is not justified.

Perception about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia

[Purpose] To report perceptions about the importance and use of therapeutic massage as a treatment modality among physical therapists working in Saudi Arabia. [Subjects and Methods] A 21-item structured questionnaire was used to assess various domains including the demographic and professional characteristics of physical therapists and their perceptions about the importance and use of therapeutic massage in their daily practice. The questionnaire was uploaded online and the web link was sent to 140 members of the Saudi Physical Therapy Association (SPTA). [Results] The overall response rate was 86%. Among the respondents, 31% reported occasional use of therapeutic massage in their clinical practice, and 55% reported to have received formal training for therapeutic massage. Use of therapeutic massage was more common among female physical therapists. [Conclusion] Many physical therapists working in Saudi Arabia consider therapeutic massage to be an important treatment modality, but its use is relatively limited, either due to the time and effort required to dispense it, or the lack of scientific evidence for its efficacy.

Foam rolling as a recovery tool after an intense bout of physical activity

PURPOSE

The objective of this study is to understand the effectiveness of foam rolling (FR) as a recovery tool after exercise-induced muscle damage, analyzing thigh girth, muscle soreness, range of motion (ROM), evoked and voluntary contractile properties, vertical jump, perceived pain while FR, and force placed on the foam roller.

METHODS

Twenty male subjects (≥3 yr of strength training experience) were randomly assigned into the control (n = 10) or FR (n = 10) group. All the subjects followed the same testing protocol. The subjects participated in five testing sessions: 1) orientation and one-repetition maximum back squat, 2) pretest measurements, 10 × 10 squat protocol, and POST-0 (posttest 0) measurements, along with measurements at 3) POST-24, 4) POST-48, and 5) POST-72. The only between-group difference was that the FR group performed a 20-min FR exercise protocol at the end of each testing session (POST-0, POST-24, and POST-48).

RESULTS

FR substantially reduced muscle soreness at all time points while substantially improving ROM. FR negatively affected evoked contractile properties with the exception of half relaxation time and electromechanical delay (EMD), with FR substantially improving EMD. Voluntary contractile properties showed no substantial between-group differences for all measurements besides voluntary muscle activation and vertical jump, with FR substantially improving muscle activation at all time points and vertical jump at POST-48. When performing the five FR exercises, measurements of the subjects' force placed on the foam roller and perceived pain while FR ranged between 26 and 46 kg (32%-55% body weight) and 2.5 and 7.5 points, respectively.

CONCLUSION

The most important findings of the present study were that FR was beneficial in attenuating muscle soreness while improving vertical jump height, muscle activation, and passive and dynamic ROM in comparison with control. FR negatively affected several evoked contractile properties of the muscle, except for half relaxation time and EMD, indicating that FR benefits are primarily accrued through neural responses and connective tissue.

Sportmen’s experiences at a somatology clinic receiving a sport message

Sportsmen are increasingly visiting somatology clinics for massages prior to an aerobic sports event. Massage is frequently utilised prior to an athletic activity, as a means of enhancing performance. Massage is known to have both calming and stimulating properties, thereby possessing the potential to benefit performance in numerous different circumstances. In the context of sportsmen visiting somatology clinics, it is unclear how men experienced the benefits of a massage by a therapist in the somatology environment, prior to participating in an aerobic sports event. The purpose of this qualitative, exploratory, descriptive and contextual study was to explore and describe the experiences of men regarding sports massage in a somatology clinic prior to an aerobic sports event. Purposive sampling was used to select eight (8) men, aged between 25 and 50 years, who received two massages within two weeks prior to participating in an aerobic sports event. The data were collected through in-depth, unstructured, individual interviews and field notes until saturation of data was achieved. Trustworthiness was ensured by utilising the principles of Lincoln and Guba’s model. The men experienced the sports massage as relaxing and giving perceived holistic beneficial effects. They described their experience during the massage and during and after participation in an aerobic sports event. A sports massage brings about psychological, physical, and spiritual effects during and after participation in an aerobic sports event.Sportsmanne besoek toenemend somatologieklinieke vir masserings voor ’n aërobiese sportsbyeenkoms as ’n manier om prestasie te bevorder. Massering is bekend vir beide die kalmerende en stimulerende eienskappe daarvan, en daarom beskik dit oor potensiële voordele vir prestasie in verskeie omstandighede. In die konteks van sportsmanne wat somatologieklinieke besoek, is dit steeds onduidelik hoe mans die voordele van ’n massering by ’n somatologieterapeut voor hul deelname aan ’n aërobiese sportsbyeenkoms ervaar. Die doel van hierdie kwalitatiewe, ondersoekende, beskrywende en kontekstuele studie was om die ervaringe van mans ten opsigte van ’n sportsmassering in ’n somatologiekliniek voor ’n aërobiese sportsbyeenkoms te ontdek en te beskryf. Doelbewuste steekproefneming is gebruik om agt mans, tussen 25 en 50 jaar oud, wie twee masserings binne twee weke voor deelname aan ’n aërobiese sportsbyeenkoms ontvang het, te selekteer. Die data is deur in diepte, ongestruktureerde onderhoude en veldnotas ingesamel totdat dataversadiging bereik is. Vertrouenswaardigheid is deur die gebruik van die beginsels van Lincoln en Guba se model verseker. Die mans het hul ervaring tydens die massering, asook tydens en na hul deelname aan die aërobiese sportsbyeenkoms, beskryf. Hulle het die sportsmassering as ontspannend ervaar wat holisties voordelige effekte meebring. Die massering het psigologiese, fisiese en geestelike voordele teweeggebring.

Sports massage with ozonised oil or non-ozonised oil: Comparative effects on recovery parameters after maximal effort in cyclists

OBJECTIVES

To study the effects of passive rest (PR) and sports massage with (SMOZO) and without (SM) ozonised oil on sports performance psycho-physiological indices in competitive amateur cyclists after 3 pre-fatiguing Wingate cycle and post-recovery ramp tests.

DESIGN

An intra-subjects experimental design with repeated measures.

SETTING

Department of Human Anatomy and Physiology, University of Padua.

PARTICIPANTS

Fifteen male competitive cyclists (age: 27 ± 3.5 years, body weight: 77.6 ± 8.3 kg, height: 178 ± 7.7 cm) were studied.

MAIN OUTCOME MEASURES

Subjects' power output (P), heart rate (HR), Visual Analogue Scale (VAS) score and blood lactate (BL) clearance in response to PR, SMOZO and SM recoveries were compared.

RESULTS

There were no significant differences in cyclists' heart rate patterns in the three experimental conditions (p > 0.05). After SMOZO recovery, athletes showed a higher Pmax (p < 0.05) and a lower perceived fatigue VAS score (p < 0.033) in the ramp test. Blood lactate decreased more at T2 (mid-time point of treatment) and T3 (final time point of treatment) than T1 (beginning of treatment) compared to SM and PR conditions.

CONCLUSIONS

These findings suggest that use of ozonised oil during sports massage increases blood lactate removal, improves performance and reduces the perception of fatigue in cyclists from 3 Wingate tests.

Implementation of matrix rhythm therapy and conventional massage in young females and comparison of their acute effects on circulation

OBJECTIVES

To examine and compare the effects of massage and matrix rhythm therapy in young women on the peripheral blood circulation.

DESIGN

Randomized, double-blind, controlled trial.

SETTING

Pamukkale University in Denizli, Turkey.

PATIENTS

Fifteen healthy women age 19-23 years.

INTERVENTION

Matrix rhythm therapy was applied to the left lower extremity for a single 30-minute session. At least 1 week later, massage was applied to the left lower extremity for 30 minutes in a single session. The same physiotherapist applied both sessions.

OUTCOME MEASURES

The blood velocity (cm/s), artery diameter (mm), and blood flow (ml/min) of the popliteal and the posterior tibial arteries were measured with color Doppler ultrasonography. All images were evaluated by the same radiologist.

RESULTS

After matrix rhythm therapy and massage application, blood velocity, artery diameter, and blood flow in arteries increased. However, matrix rhythm therapy caused a more prominent increase in the amount of blood flow in the popliteal and in the posterior tibial artery than did massage. After matrix rhythm therapy application, the average increases in the blood flow rates in the popliteal and the posterior tibial arteries were 25.29%±16.55% and 34.33%±15.66%, respectively; after the massage, the increases were 17.84%±17.23% and 16.07%±10.28%, respectively.

CONCLUSION

Matrix rhythm therapy and massage increased peripheral blood flow in young women. Matrix rhythm therapy method resulted in more prominent increases.

Massage impairs postexercise muscle blood flow and "lactic acid" removal

PURPOSE

This study tested the hypothesis that one of the ways sports massage aids muscle recovery from exercise is by increasing muscle blood flow to improve "lactic acid" removal.

METHODS

Twelve subjects performed 2 min of strenuous isometric handgrip (IHG) exercise at 40% maximum voluntary contraction to elevate forearm muscle lactic acid. Forearm blood flow (FBF; Doppler and Echo ultrasound of the brachial artery) and deep venous forearm blood lactate and H+ concentration ([La-], [H+]) were measured every minute for 10 min post-IHG under three conditions: passive (passive rest), active (rhythmic exercise at 10% maximum voluntary contraction), and massage (effleurage and pétrissage). Arterialized [La-] and [H+] from a superficial heated hand vein was measured at baseline.

RESULTS

Data are presented as mean +/- SE. Venoarterial [La-] difference ([La-]v-a) at 30 s of post-IHG was the same across conditions (passive = 6.1 +/- 0.6 mmol x L(-1), active = 5.7 +/- 0.6 mmol x L(-1), massage = 5.5 +/- 0.6 mmol x L(-1), NS), whereas FBF was greater in passive (766 +/- 101 mL x min(-1)) versus active (614 +/- 62 mL x min(-1), P = 0.003) versus massage (540 +/- 60 mL x min(-1), P < 0.0001). Total FBF area under the curve (AUC) for 10 min after handgrip was significantly higher in passive versus massage (4203 +/- 531 vs 3178 +/- 304 mL, P = 0.024) but not versus active (3584 +/- 284 mL, P = 0.217). La(-)- efflux (FBF x [La-]v-a) AUC mirrored FBF AUC (passive = 20.5 +/- 2.8 mmol vs massage = 14.7 +/- 1.6 mmol, P = 0.03, vs active = 15.4 +/- 1.9 mmol, P = 0.064). H+ efflux (FBF x [H+]v-a) was greater in passive versus massage at 30 s (2.2 +/- 0.4e(-5) vs 1.3 +/- 0.2e(-5) mmol, P < 0.001) and 1.5 min (1.0 +/- 0.2e(-5) vs 0.6 +/- 0.09e(-5) mmol, P = 0.003) after IHG.

CONCLUSIONS

Massage impairs La(-) and H+ removal from muscle after strenuous exercise by mechanically impeding blood flow.

Comparison of active and electrostimulated recovery strategies after fatiguing exercise

The purpose of this study was to compare an electrostimulated to an active recovery strategy after a submaximal isometric fatiguing exercise. Nineteen healthy men completed three sessions (separated by at least 4 weeks) which included a knee extensors provocation exercise consisting of 3 sets of 25 isometric contractions. Contraction intensity level was fixed respectively at 60%, 55% and 50% of previously determined maximal voluntary contraction for the first, second and third sets. This provocation exercise was followed by either an active (AR) recovery (25 min pedaling on a cycle ergometer), an electrostimulated (ESR) recovery (25-min continuous and non-tetanic (5 Hz) stimulation of the quadriceps) or a strictly passive recovery (PR). Peak torques of knee extensors and subjective perception of muscle pain (VAS, 0-10) were evaluated before (pre-ex), immediately after the provocation exercise (post-ex), after the recovery period (post-rec), as well as 75 minutes (1h15) and one day (24h) after the exercise bout. Time course of peak torque was similar among the different recovery modes: ~ 75% of initial values at post-ex, ~ 90% at post-rec and at 1h15. At 24h, peak torque reached a level close to baseline values (PR: 99.1 ± 10.7%, AR: 105.3 ± 12.2%, ESR: 104.4 ± 10.5%). VAS muscle pain scores decreased rapidly between post-ex and post-rec (p < 0.001); there were no significant differences between the three recovery modes (p = 0.64). In conclusion, following a submaximal isometric knee extension exercise, neither electrostimulated nor active recovery strategies significantly improved the time course of muscle function recovery. Key pointsThree sets of submaximal isometric contractions at 60%, 55% and 50% of MVC induced an early fatigue without DOMS but did not lead to exhaustion.In comparison with passive recovery, active and electrostimulated recovery did not lead to significantly higher MVC torques 24h after the exercise bout.No significant differences were demonstrated between the effects of passive, active and electrostimulated recoveries on muscle pain after repeated submaximal isometric contractions.

The role of massage in sports performance and rehabilitation: current evidence and future direction

BACKGROUND

Massage is a popular treatment choice of athletes, coaches, and sports physical therapists. Despite its purported benefits and frequent use, evidence demonstrating its efficacy is scarce.

PURPOSE

To identify current literature relating to sports massage and its role in effecting an athlete's psychological readiness, in enhancing sports performance, in recovery from exercise and competition, and in the treatment of sports related musculoskeletal injuries.

METHODS

Electronic databases were used to identify papers relevant to this review. The following keywords were searched: massage, sports injuries, athletic injuries, physical therapy, rehabilitation, delayed onset muscle soreness, sports psychology, sports performance, sports massage, sports recovery, soft tissue mobilization, deep transverse friction massage, pre-event, and post exercise.

RESULTS

RESEARCH STUDIES PERTAINING TO THE FOLLOWING GENERAL CATEGORIES WERE IDENTIFIED AND REVIEWED: pre-event (physiological and psychological variables), sports performance, recovery, and rehabilitation.

DISCUSSION

Despite the fact clinical research has been performed, a poor appreciation exists for the appropriate clinical use of sports massage.

CONCLUSION

Additional studies examining the physiological and psychological effects of sports massage are necessary in order to assist the sports physical therapist in developing and implementing clinically significant evidence based programs or treatments.

Acute effects of two massage techniques on ankle joint flexibility and power of the plantar flexors

The purpose of this study was to determine if three minutes of petrissage and tapotement forms of massage would influence plantar flexors' flexibility, and muscle power. Nineteen participants were randomly subjected to three conditions (control and two massages) before performing two power tests. Prior to the intervention, subjects completed ankle joint flexibility assessments. The conditions were; (1) control, where subjects lay prone and had a therapist's hands resting, (2) vigorous petrissage, and (3) tapotement applied at a rate of 4Hz; all on the triceps surae. Following completion of the intervention, subjects immediately completed a post- ankle joint flexibility test, followed by a drop-jump and concentric calf raise. The power measures were; concentric peak force, rate of force development, and drop-jump height / contact time. The data showed a significant increase (p < 0.05) in ankle joint angle on the right leg and a corresponding tendency on the left. No significant change was seen with the power measures. Results suggest that massage can increase plantar flexors' flexibility without a change in power and thus may be an alternative to static stretching during an athletic warm-up. Key pointsThree minutes of petrissage and tapotement forms of massage increased ankle flexibility.Massage did not adversely affect jump power measures.Massage may be an effective alternative to static stretching as a component of a pre-event warm-up.

Comparison of recovery strategies on muscle performance after fatiguing exercise

OBJECTIVE

The objective of this study was to assess the influence of different relaxation modes: stretching (ST), active recovery (AR), and passive recovery (PR) on muscle relaxation after dynamic exercise of the quadriceps femoris.

DESIGN

Ten healthy male volunteers between 24 and 38 yrs of age participated in this study. After the warm-up, subjects performed three sets of dynamic leg extension and flexion (at an angle of 20-110 degrees) at 50% of previously determined maximal voluntary contraction (MVC), with 30 secs. of rest between sets. Immediately after completing the leg exercise, one of the relaxation methods was applied, in a randomized order (AR, PR, ST). Then, subjects performed isometric knee extension at 50% of MVC to the point of fatigue, and surface electromyogram (EMG) of the vastus lateralis muscle was measured.

RESULTS

After AR, the mean MVC was significantly (P < 0.05) higher than after PR and ST. Moreover, there was no difference in MVC between AR and baseline (P > 0.05). Total time of the effort during EMG measurement was significantly lower for all three recovery modes than at baseline. During the effort after both PR and ST, there was no significant increase in motor unit activation, but a significant increase was noted after AR (P < 0.05). There was no difference in frequency between any of the recovery modes and baseline (P > 0.05).

CONCLUSION

The results of this study suggest that the most appropriate and effective recovery mode after dynamic muscle fatigue involves light, active exercises, such as cycling with minimal resistance.

Therapist education impacts the massage effect on postrace muscle recovery

PURPOSE

The intention of this study was to assess the effectiveness of massage on muscle recovery as a function of therapist education in participants who completed a 10-km running race.

METHODS

Race participants were offered a 12- to 15-min massage immediately post-event. Participants were randomly assigned to a student therapist with either 450, 700, or 950 h of didactic training in massage. Muscle soreness was recorded by questionnaire using a 0- to 10-point visual scale at time points immediately before and after massage, and 24 and 48 h post-event. Eight hundred ninety-five subjects were recruited, with 317 subjects returning questionnaires from all time points.

RESULTS

Race participants who received massage from student therapists with 950 h of didactic training reported significantly greater improvement in muscle soreness across time compared with those who received massage from therapists with 700 or 450 h of education in massage (P < 0.01). On study entry, there was no difference in muscle soreness (P = 0.99), with a group mean of 4.4 +/- 0.4; at the 24-h measurement, soreness was 2.4 +/- 0.6, 3.7 +/- 0.5, and 3.6 +/- 0.9 for the 950-, 700-, and 450-h groups, respectively (P < 0.01).

CONCLUSION

Level of therapist training was shown to impact effectiveness of massage as a post-race recovery tool; greater reduction in muscle soreness was achieved by therapists with 950 h of training as opposed to those with 700 or 450 h.

Effect of Manual Lymph Drainage on the Course of Serum Levels of Muscle Enzymes After Treadmill Exercise

OBJECTIVE

Improving muscular recovery after exercise is an important topic in sports medicine. The aim of the present study was to evaluate the effect of manual lymph drainage on the course of serum levels of muscle enzymes after an extended treadmill exercise.

DESIGN

Fourteen recreational athletes (seven women, seven men) were included in the study. The participants underwent a graded exercise test on a treadmill ergometer to determine the individual anaerobic threshold (IAT). Seven days after the graded exercise test, all subjects performed 30 mins of treadmill exercise at an intensity equivalent to IAT. The subjects were randomized into two groups of seven persons. One group was treated with manual lymph drainage (ML), whereas the control group (CG) received no treatment after the endurance exercise at IAT level.

RESULTS

After an increase immediately after exercise, a fast decrease in lactate dehydrogenase (LDH) and in aspartate aminotransferase (AST) concentration was observed, with significantly lower values for LDH after 48 hrs in the subjects having received lymph drainage treatment. The course of creatine kinase (CK) levels was comparable, but did not reach significance.

CONCLUSION

Manual lymph drainage after treadmill exercise was associated with a faster decrease in serum levels of muscle enzymes. This may indicate improved regenerative processes related to structural damage of muscle cell integrity.

The Immediate Effects of Manual Massage on Power-Grip Performance After Maximal Exercise in Healthy Adults

OBJECTIVE

Research into the effects of manual massage on physical performance has proved inconclusive, with studies primarily examining the major muscle groups of the lower extremities. Grip performance is essential for object manipulation, as well as for many grip-dependent activities and sports; but there have been no studies to determine the effects of manual massage on immediate grip performance in healthy subjects. The purpose of this study was to assess the effects of using manual massage to improve power-grip performance immediately after maximal exercise in healthy adults.

STUDY DESIGN

This was a pretest/post-test study.

SETTING

The study took place in a suburban allied health school.

SUBJECTS

Fifty-two (52) volunteer massage-school clients, staff, faculty, and students participated.

INTERVENTIONS

Subjects randomly received either a 5-minute forearm/hand massage of effleurage and friction (to either the dominant hand or nondominant hand side), 5 minutes of passive shoulder and elbow range of motion, or 5 minutes of nonintervention rest.

OUTCOME MEASURES

Power-grip measurements (baseline, postexercise, and postintervention) were performed on both hands using a commercial hand dynamometer. These measurements preceded and followed 3 minutes of maximal exercise using a commercial isometric hand exerciser that produced fatigue to 60% of baseline strength.

RESULTS

After 3 minutes of isometric exercise, power grip was consistently fatigued to at least 60% of baseline, with recovery occurring over the next 5 minutes. Statistical analyses involving single-factor repeated-measures analyses of variance (p = 0.05) with Bonferroni a priori tests (p = 0.0083) demonstrated that massage had a greater effect than no massage or than placebo on grip performance after fatigue, especially in the nondominant-hand group.

CONCLUSIONS

Manual massage to the forearm and hand after maximal exercise was associated with greater effects than nonmassage on postexercise grip performance. The present data do support the use of a 5-minute manual massage to assist immediate grip performance after fatigue in healthy subjects.

The Effect of Effleurage Massage in Recovery From Fatigue in the Adductor Muscles of the Thumb

OBJECTIVE

The aim of this study was to investigate the effect of local effleurage massage on the recovery from fatigue in the small hand muscles.

METHODS

This study was a within-subject repeated measure design. Twelve healthy, right-handed volunteer male subjects with a mean age of 25 +/- 2.8 years were recruited into the study from a university population. Subjects were randomly allocated to a rest or massage protocol. Subjects undertook the alternate protocol at a subsequent session. All subjects underwent baseline dynamometry testing of isometric thumb adduction (nondominant hand) before undertaking a fatigue-inducing task of the thumb adductors. Subjects then underwent either 5 minutes of massage applied to the first dorsal interspace or 5 minutes of rest. Subjects were then retested.

RESULTS

The maximal force recorded after the massage protocol was not significantly different from the maximal force recorded after the rest protocol, with a mean difference of only 0.63 N (95% confidence interval, -12.55 to 13.80 N; P = .92). The maximal gradient of force development after the massage protocol was not significantly different from the maximal gradient recorded after the rest protocol, with a mean decrease in gradient of 19.48 N/s (95% confidence interval, -117.33 to 156.30 N; P = .77).

CONCLUSIONS

Effleurage massage was not an effective intervention for enhancing the restoration of postfatigue F(max) and G(max) in the small muscles of the hand. The wide variation in response to this massage protocol may support the notion that there is no universal effect of effleurage massage in enhancing recovery from fatigue.

Effects of sport massage on limb girth and discomfort associated with eccentric exercise

CONTEXT

Sport massage is often used to help prepare for exercise, expedite recovery from muscle soreness, and enhance athletic performance. However, the effect of sport massage on recovery from delayed-onset muscle soreness is unknown.

OBJECTIVE

To determine the effect of a short sport massage treatment on intramuscular swelling and pain in response to eccentric exercise.

DESIGN

We used a 2 x 8 (treatment x time) repeated-measures design to compare triceps surae muscle girth and pain ratings over the 72 hours after eccentric exercise.

SETTING

University research laboratory.

PATIENTS OR OTHER PARTICIPANTS

Nineteen healthy, college-aged subjects.

INTERVENTION(S)

Delayed-onset muscle soreness was induced with several sets of eccentric triceps surae contractions at 90% of the estimated concentric, 1-repetition maximum weight. Subjects returned on 3 consecutive days after eccentric exercise with a cycle ergometer for active rest treatments. In addition, 1 leg received the sport massage.

MAIN OUTCOME MEASURE(S)

Girth measurements were taken at 5.08 cm (2 in), 10.16 cm (4 in), 15.24 cm (6 in), and 20.32 cm (8 in) below the knee joint line, and pain was assessed with a visual analog scale before and after all 4 sessions.

RESULTS

No interaction was noted between treatment and time for any girth or pain measurements, and no main effect was seen for treatment.

CONCLUSIONS

Sport massage did not reduce girth or pain in the lower leg after eccentric exercise within 72 hours.

The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention

Many coaches, athletes and sports medicine personnel hold the belief, based on observations and experiences, that massage can provide several benefits to the body such as increased blood flow, reduced muscle tension and neurological excitability, and an increased sense of well-being. Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms). Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing. Depending on the massage technique, mechanical pressure on the muscle is expected to increase or decrease neural excitability as measured by the Hoffman reflex (neurological mechanisms). Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response (physiological mechanisms). A reduction in anxiety and an improvement in mood state also cause relaxation (psychological mechanisms) after massage. Therefore, these benefits of massage are expected to help athletes by enhancing performance and reducing injury risk. However, limited research has investigated the effects of pre-exercise massage on performance and injury prevention. Massage between events is widely investigated because it is believed that massage might help to enhance recovery and prepare athletes for the next event. Unfortunately, very little scientific data has supported this claim. The majority of research on psychological effects of massage has concluded that massage produces positive effects on recovery (psychological mechanisms). Post-exercise massage has been shown to reduce the severity of muscle soreness but massage has no effects on muscle functional loss. Notwithstanding the belief that massage has benefits for athletes, the effects of different types of massage (e.g. petrissage, effleurage, friction) or the appropriate timing of massage (pre-exercise vs post-exercise) on performance, recovery from injury, or as an injury prevention method are not clear. Explanations are lacking, as the mechanisms of each massage technique have not been widely investigated. Therefore, this article discusses the possible mechanisms of massage and provides a discussion of the limited evidence of massage on performance, recovery and muscle injury prevention. The limitations of previous research are described and further research is recommended.

Evaluating the influence of massage on leg strength, swelling, and pain following a half-marathon

Massage therapy is commonly used following endurance running races with the expectation that it will enhance post-run recovery of muscle function and reduce soreness. A limited number of studies have reported little or no influence of massage therapy on post-exercise muscle recovery. However, no studies have been conducted in a field setting to assess the potential for massage to influence muscle recovery following an actual endurance running race. To evaluate the potential for repeated massage therapy interventions to influence recovery of quadriceps and hamstring muscle soreness, recovery of quadriceps and hamstring muscle strength and reduction of upper leg muscle swelling over a two week recovery period following an actual road running race. Twelve adult recreational runners (8 male, 4 female) completed a half marathon (21.1 km) road race. On days 1,4, 8, and 11 post-race, subjects received 30 minutes of standardized massage therapy performed by a registered massage therapist on a randomly assigned massage treatment leg, while the other (control) leg received no massage treatment. Two days prior to the race (baseline) and preceding the treatments on post-race days 1, 4, 8, and 11 the following measures were conducted on each of the massage and control legs: strength of quadriceps and hamstring muscles, leg swelling, and soreness perception. At day 1, post-race quadriceps peak torque was significantly reduced (p < 0.05), and soreness and leg circumference significantly elevated (p < 0.05) relative to pre-race values with no difference between legs. This suggested that exercise-induced muscle disruption did occur. Comparing the rate of return to baseline measures between the massaged and control legs, revealed no significant differences (p > 0.05). All measures had returned to baseline at day 11. Massage did not affect the recovery of muscles in terms of physiological measures of strength, swelling, or soreness. However, questionnaires revealed that 7 of the 12 participants perceived that the massaged leg felt better upon recovery. Key PointsMassage does not appear to affect physiological indices of muscle recovery post exercise.Massage does appear to positively influence perceptions of recovery.More research needs to be completed on the purported benefits of massage.

Effects of massage on limb and skin blood flow after quadriceps exercise

PURPOSE

At present, there is little scientific evidence that postexercise manual massage has any effect on the factors associated with the recovery process. The purpose of this study was to compare the effects of massage against a resting control condition upon femoral artery blood flow (FABF), skin blood flow (SKBF), skin (SKT), and muscle (MT) temperature after dynamic quadriceps exercise.

METHODS

Thirteen male volunteers participated in 3 x 2-min bouts of concentric quadriceps exercise followed by 2 x 6-min bouts of deep effleurage and pétrissage massage or a control (rest) period of similar duration in a counterbalanced fashion. Measures of FABF, SKBF, SKT, MT, blood lactate concentration (BLa), heart rate (HR), and blood pressure (BP) were taken at baseline, immediately after exercise, as well as at the midpoint and end of the massage/rest periods. Data were analyzed by two-way ANOVA.

RESULTS

Significant main effects were found for all variables over time due to effects of exercise. Massage to the quadriceps did not significantly elevate FABF (end-massage 760 +/- 256 vs end-control 733 +/- 161 mL x min(-1)), MT, BL, HR, and BP over control values (P < 0.05). SKBF (end-massage 150 +/- 49 vs end control 6 +/- 4 au) SKT (end-massage 32.2 +/- 0.9 vs end-control 31.1 +/- 1.3degreesC) were elevated after the application of massage compared with the control trial (P < 0.05).

CONCLUSION

From these data it is proposed that without an increase in arterial blood flow, any increase in SKBF is potentially diverting flow away from recovering muscle. Such a response would question the efficacy of massage as an aid to recovery in postexercise settings.

The effects of massage on delayed onset muscle soreness

OBJECTIVES

The purpose of this study was to investigate the physiological and psychological effects of massage on delayed onset muscle soreness (DOMS).

METHODS

Eighteen volunteers were randomly assigned to either a massage or control group. DOMS was induced with six sets of eight maximal eccentric contractions of the right hamstring, which were followed 2 h later by 20 min of massage or sham massage (control). Peak torque and mood were assessed at 2, 6, 24, and 48 h postexercise. Range of motion (ROM) and intensity and unpleasantness of soreness were assessed at 6, 24, and 48 h postexercise. Neutrophil count was assessed at 6 and 24 h postexercise.

RESULTS

A two factor ANOVA (treatment v time) with repeated measures on the second factor showed no significant treatment differences for peak torque, ROM, neutrophils, unpleasantness of soreness, and mood (p > 0.05). The intensity of soreness, however, was significantly lower in the massage group relative to the control group at 48 h postexercise (p < 0.05).

CONCLUSIONS

Massage administered 2 h after exercise induced muscle injury did not improve hamstring function but did reduce the intensity of soreness 48 h after muscle insult.

The effect of massage on localized lumbar muscle fatigue

BACKGROUND

There is not enough evidence to support the efficacy of massage for muscle fatigue despite wide utilization of the modality in various clinical settings. This study investigated the influence of massage application on localized back muscle fatigue.

METHODS

Twenty-nine healthy subjects participated in two experimental sessions (massage and rest conditions). On each test day, subjects were asked to lie in the prone position on a treatment table and perform sustained back extension for 90 seconds. Subjects then either received massage on the lumbar region or rested for a 5 minute duration, then repeated the back extension movement. The median frequency (MDF), mean power frequency (MNF), and root mean square (RMS) amplitude of electromyographic signals during the 90 second sustained lumbar muscle contraction were analyzed. The subjective feeling of fatigue was then evaluated using the Visual Analogue Scale (VAS).

RESULTS

MDF and MNF significantly declined with time under all conditions. There was no significant difference in MDF, MNF or RMS value change between before and after massage, or between rest and massage conditions. There was a significant increase in fatigue VAS at the end of the 2nd back extension with rest condition. There was a significant difference in fatigue VAS change between massage and rest condition.

CONCLUSIONS

A significant difference was observed between massage and rest condition on VAS for muscle fatigue. On EMG analysis, there were no significant differences to conclude that massage stimulation influenced the myoelectrical muscle fatigue, which is associated with metabolic and electrical changes.

Effects of massage on physiological restoration, perceived recovery, and repeated sports performance

BACKGROUND

Despite massage being widely used by athletes, little scientific evidence exists to confirm the efficacy of massage for promoting both physiological and psychological recovery after exercise and massage effects on performance.

AIM

To investigate the effect of massage on perceived recovery and blood lactate removal, and also to examine massage effects on repeated boxing performance.

METHODS

Eight amateur boxers completed two performances on a boxing ergometer on two occasions in a counterbalanced design. Boxers initially completed performance 1, after which they received a massage or passive rest intervention. Each boxer then gave perceived recovery ratings before completing a second performance, which was a repeated simulation of the first. Heart rates and blood lactate and glucose levels were also assessed before, during, and after all performances.

RESULTS

A repeated measures analysis of variance showed no significant group differences for either performance, although a main effect was found showing a decrement in punching force from performance 1 to performance 2 (p<0.05). A Wilcoxon matched pairs test showed that the massage intervention significantly increased perceptions of recovery (p<0.01) compared with the passive rest intervention. A doubly multivariate multiple analysis of variance showed no differences in blood lactate or glucose following massage or passive rest interventions, although the blood lactate concentration after the second performance was significantly higher following massage (p<0.05).

CONCLUSIONS

These findings provide some support for the psychological benefits of massage, but raise questions about the benefit of massage for physiological restoration and repeated sports performance.

Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review

BACKGROUND

Delayed onset muscle soreness (DOMS) is a frequent problem after unaccustomed exercise. No universally accepted treatment exists. Massage therapy is often recommended for this condition but uncertainty exists about its effectiveness.

AIM

To determine whether post-exercise massage alleviates the symptoms of DOMS after a bout of strenuous exercise.

METHOD

Various computerised literature searches were carried out and located seven controlled trials.

RESULTS

Most of the trials were burdened with serious methodological flaws, and their results are far from uniform. However, most suggest that post-exercise massage may alleviate symptoms of DOMS.

CONCLUSIONS

Massage therapy may be a promising treatment for DOMS. Definitive studies are warranted.

The comparative effects of sports massage, active recovery, and rest in promoting blood lactate clearance after supramaximal leg exercise

OBJECTIVE

To determine the comparative effect of sports massage, active recovery, and rest on promoting blood lactate clearance after maximal anaerobic (supramaximal) leg exercise.

DESIGN AND SETTING

A counterbalanced experimental design with repeated measures was used. The repeated measures were the three treatment conditions. The order of the conditions was determined by random assignment to a counterbalanced test sequence. All data were collected in the Human Energy Research Laboratory at the University of Pittsburgh.

SUBJECTS

Ten male competitive cyclists volunteered for this investigation.

MEASUREMENTS

Serial venous blood samples were drawn and analyzed for blood lactate concentration for each test condition.

RESULTS

There were significant main effects for both absolute and relative values of blood lactate concentration between the three treatment groups and across time within groups.

CONCLUSIONS

After supramaximal leg exercise, active recovery produced significant decreases in both absolute and relative measures of blood lactate concentration when compared with the sports massage and rest conditions. No significant difference was found between sports massage and rest for either absolute or relative changes in blood lactate concentration.

Manual massage and recovery of muscle function following exercise: a literature review

There is currently little scientific evidence that manual massage has any significant impact on the short- or long-term recovery of muscle function following exercise or on the physiological factors associated with the recovery process. In addition, delayed onset muscle soreness may not be affected by massage. Light exercise of the affected muscles is probably more effective than massage in improving muscle blood flow (thereby possibly enhancing healing) and temporarily reducing delayed onset muscle soreness. This paper reviews current scientific evidence on the use of manual massage to affect: 1) muscle damage caused by eccentric muscle action; 2) retention and recovery of muscle strength and performance following "eccentric-mechanical" muscle damage; 3) reduction of delayed onset muscle soreness following "eccentric-mechanical" muscle damage; and 4) recovery of muscle strength and performance following anaerobic exercise. Because manual massage does not appear to have a demonstrated effect on the above, its use in athletic settings for these purposes should be questioned.

Warm underwater water-jet massage improves recovery from intense physical exercise

The effects of warm underwater water-jet massage on neuromuscular functioning, selected biochemical parameters (serum creatine kinase, lactic dehydrogenase, serum carbonic anhydrase, myoglobin, urine urea and creatinine) and muscle soreness were studied among 14 junior track and field athletes. Each subject spent, in a randomized order, two identical training weeks engaged in five strength/power training sessions lasting 3 days. The training weeks differed from each other only in respect of underwater water-jet massage treatments. These were used three times (20 min each) during the treatment week and not used during the control week. During the treatment week continuous jumping power decreased and ground contact time increased significantly less (P < 0.05) and serum myoglobin increased more than during the control week. It is suggested that underwater water-jet massage in connection with intense strength/power training increases the release of proteins from muscle tissue into the blood and enhances the maintenance of neuro-muscular performance capacity.