Therapeutic Sports Massage

Jennifer Doherty-Restrepo, ATC, LAT

Entry-Level Athletic Training Education Program
PET 4995: Therapeutic Modalities

Physiologic Effects of Massage

Mechanical stimulation of tissues by

rhythmically applied pressure and
stretching
Effects of massage may be either
___________,

or

___________

Effects differ depending on method

utilized, pressure exerted, and
duration of massage

Physiologic Effects of Massage

___________
Effects

sensory and motor nerves locally

Elicits some central nervous system
response (ie: sedation)

___________
Makes

mechanical or histological
changes in myofascial structures through
direct force applied superficially

Reflexive Effects

Attempts to exert effects through

______ and superficial connective
tissues
Contact stimulates _________ receptors
Reflex

mechanism is believed to be an
autonomic nervous system phenomenon

The reflex stimulus causes

Sedation,
Relieves

tension, and
Increases blood flow

Reflexive Effects cont.

Effects on Pain

Effects on Circulation

Modulates pain through Gate Control & Endorphins theories

Increases blood and lymphatic flow

Effects on Metabolism
Does not alter general metabolism
Increases fresh blood and oxygen to area
Assists in removal of lactic acid

Mechanical Effects

Techniques which stretch a muscle,

elongate fascia, or mobilize soft tissue
adhesions/restrictions
Always accompanied by some reflex effects

As mechanical stimulus becomes more effective,

reflex stimulus becomes less effective

Directed at deeper tissues, such as

adhesions or restrictions in muscle,
tendons, and fascia.

Mechanical Effects

Effects on Muscle
Mechanical

stretching of intramuscular
connective tissue to relieve pain and
discomfort associated with myofascial
trigger points
Increases blood flow to skeletal muscle
Slows muscle atrophy following injury
Increases range of motion
Does not increase strength or muscle
tone

Mechanical Effects cont.

Effects on Skin
Increases skin temperature
Increases sweating
Decreases skin resistance to galvanic
current
Mechanically loosens adhesions and
softens scar tissue

Stretches and breaks down fibrous scar

tissue
Breaks down adhesions between skin and
subcutaneous tissue

Psychologic Effects of Massage

Psychologic effects of massage can

be as beneficial as physiologic
effects
___________" modality where
patients feel as if someone is
helping them

Treatment Considerations and

Guidelines

Knowledge of ___________ is
essential
Understanding of existing pathology
Thorough knowledge of massage
principles

Positioning of Clinician

Prevent ___________
Permit free movement of
arms, hands, and body
Evenly distribute weight by
shifting from one foot to
the other
Fit your hands to the
contour of area being treated
Hands should be clean, warm, dry, and soft

Treatment Techniques

Pressure regulation

Rhythm

Determined by the type and amount of

tissue present and patient's condition
Must be steady and even
Strokes should overlap

Duration

Depends on the pathology, size of the

area being treated, speed of motion,
age, size, and condition

Treatment Techniques

Swelling

Begin proximally to facilitate lymphatic

flow
___________
Body part may be elevated if necessary

Direction of forces should parallel

muscle fibers
Make sure patient is warm and in a
comfortable, relaxed position

Massage should never be ___________

Treatment Techniques

Sufficient lubricant should be used

Begin with superficial stroking to spread

lubricant

Begin and end with ___________

Pressure should be in line with venous

flow followed by a return stroke

Equipment Set Up

Table
Linens and pillows
Lubricant

Should be absorbed
slightly by skin but
does not make it slippery
Combination of one part beeswax to three parts
coconut oil
Other types of lubricants that may be used are
olive oil, mineral oil, cocoa butter, hydrolanolin,
analgesic creams, alcohol, and powder

Preparation of Patient

Patient should be in a
relaxed, comfortable
position
Part involved in
treatment must be
adequately supported
Prone, supine, seated
Patient should
appropriately draped

Hoffa Massage

Classical massage technique which

uses a variety of superficial strokes
Effleurage
Petrissage
Tapotment
Vibration

Effleurage

Any stroke that glides

over skin without
attempting to move
deep muscles
Hands are molded to
treatment area
Apply constant
pressure moving
toward _______

Lighter pressure applied

on the return stroke

Every massage begins and

ends with effleurage!

Effleurage cont.

Moderate pressure according to patient

and condition

Deep stroking is a form of effleurage, except it

is given with more pressure to produce a
mechanical effect

Increases venous and lymphatic return

Increases circulation to skin surface

Petrissage

Kneading manipulations
Muscles are gently
lifted, rolled, and
released
Pressure is applied
intermittently
Hands may remain
stationary or move
along length of muscle
or limb

Petrissage cont.

Increases venous
and lymphatic
return
Removes metabolic
waste products
Breaks up
adhesions between
skin and underlying
tissue

Tapotment

Percussion massage
Series

of rapid, brisk blows

Increases circulation and blood flow

Stimulates peripheral nerve endings

Tapotment cont.

Hacking

Tapotment cont.

Hacking
Slapping

Tapotment cont.

Hacking
Slapping
Beating

Tapotment cont.

Hacking
Slapping
Beating
Tapping

Tapotment cont.

Hacking
Slapping
Beating
Tapping
Clapping or
cupping

Vibration

Shaking massage
Tremulous movement
made by hand or
fingers placed firmly
against a body part

Rhythmical trembling
movement will come
from ___________

Hands should remain

in contact with the
body part

Transverse Friction Massage

Technique used for treating chronic tendon

inflammation or connective tissue adhesions
Stimulates ___________ ___________ to progress healing
process
Apply small circular motions penetrating to deeper
tissues
Apply strong pressure in ___________ direction to fibers
for 7 to 10 minutes every other day

Acupresure and Myofascial Trigger

Point Massage

Acupressure points are based on

ancient Chinese art of acupuncture
Myofascial trigger points found in
Muscle

and tendon myofascia

Ligaments and capsules surrounding
joints
Periosteum

Acupressure points and myofascial

trigger points are similar

Acupresure and Myofascial Trigger

Point Massage

Pain results due to inflammatory

response following direct trauma or
overuse
Pain usually referred to areas which
follow a specific pattern
Stimulation of these points has been
demonstrated to result in pain relief

Acupressure Massage Techniques

Locate points from chart

Use fingers, or elbow, to
apply small friction-like
circular motions
Amount of pressure
applied should be
intense and painful
Patient reports a dulling
or numbing effect
Treatment times range from 1-5 minutes at
several points

Myofascial Release

Also called soft tissue mobilization

Techniques used to relieve soft tissue from
abnormal grip of tight fascia
Myofascial restrictions are unpredictable
and may occur in many different planes
and directions
Based on localizing restriction and moving
into the direction of the restriction
Myofascial manipulation is subjective and
relies heavily on the experience of the
clinician

Myofascial Release Technique

Protecting the clinicians hands

Use limited lubricant

Use fist or elbow if necessary

Avoid slipping of hands on the skin

Positoning of the patient is critical

Maximize effects of treatment

Indications For Massage

Increase coordination
Decrease pain
Decrease
neuromuscular
excitibility
Stimulate circulation
Facilitate healing
Restore joint mobility
Remove lactic acid

Alleviate muscle cramps

Increase blood flow
Increase venous return
Retard muscle atrophy
Increase range of motion
Edema
Myofascial trigger points
Stretching scar tissue

Indications For Massage

Adhesions
Muscle spasm
Myositis
Bursitis
Fibrositis
Tendinitis

Revascularization
Raynaud's disease
Intermittent
claudication
Dysmenorrhea
Headaches
Migraines

Contraindications For Massage

Arteriosclerosis
Thrombosis
Embolism
Severe varicose
veins
Acute phlebitis
Cellulitis

Synovitis
Abscesses
Skin infections
Cancers
Acute inflammatory
conditions