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

Abstract

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.

Comparing the Effects of Rest and Massage on Return to Homeostasis Following Submaximal Aerobic Exercise: a Case Study

“…(1) Massage, a mechanical manipulation of body tissues with rhythmical pressure and stroking, is often used to promote health and well-being, with the benefit of increasing parasympathetic activity and decreasing sympathetic activity in a rested state, indicating a reduced stress response. (2,3) The manual manipulation of massage is associated with increased parasympathetic activity, which indicates an improved level of homeostasis. (4) While there are no well-established techniques for evaluating parasympathetic activity, heart rate variability (HRV), the ability of the heart to modulate in response to the fine control of the parasympathetic nervous system, is often used to reflect the influence of the autonomic nervous system (ANS) on heart rate.…”

“…Many of the claims made about massage lack empirical data. (2) Despite the lack of conclusive scientific evidence, massage is often provided as a part of major sporting events, prior to competition, during competition, and afterwards, in an attempt to overcome fatigue and help recovery. (2,7) A review of related literature found few studies with empirical evidence about postexercise massage on humans.…”

“…(2) Despite the lack of conclusive scientific evidence, massage is often provided as a part of major sporting events, prior to competition, during competition, and afterwards, in an attempt to overcome fatigue and help recovery. (2,7) A review of related literature found few studies with empirical evidence about postexercise massage on humans. In one study, postexercise massage was shown to induce changes on the cellular level in the muscles to decrease inflammation and promote recovery; however, autonomic function was not assessed.…”

A Descriptive Study of the Practice Patterns of Massage New Zealand Massage Therapists

“…In ancient times and throughout the world, massage was often considered to be a medicinal practice, and it has been practiced in many forms (3,4) . Today, MT still incorporates a variety of styles (for example, relaxation or clinical massage) (5)(6)(7) , and it is used to treat symptoms associated with a wide range of chronic (8) , clinical (7,9,10) and sporting (11)(12)(13) conditions. Massage may be used as an adjunct or standalone therapy by a number of health care providers such as nurses (14,15) , physiotherapists (physical therapists) (16,17) , other complementary and alternative medicine (CAM) providers (18,19) , and massage therapists (20) .…”

Orthopaedic sport biomechanics – a new paradigm

“…In 1996, Magee and McFarland (1996) postulated that advanced computer technology in 21 st century will allow accurate diagnosis for sports medicine, as well as prediction of various surgical or physical therapy treatment outcomes. In the recent decade, there is emerging research utilizing sports biomechanics as a tool for sports injury prevention and management (Ubell et al, 2003;Weerapong et al, 2005). This is a synergy of orthopaedics and biomechanics in the research and development of sports medicine.…”