Soft Tissue Therapy

Sports Massage is a natural therapy that, with the right training, can be performed anywhere with very limited equipment required. Massage can be used for the general relaxation of the musculo-skeletal system as well as being directed into local problem areas, which can help to improve the recovery of the muscular system. Sports people should be aware of the effects of sports massage as it is suggested that it is still one of the best treatments for muscle tensions which can build up from participation in sporting activities. An excellent knowledge of anatomy is required to perform an effective soft tissue massage which may then be beneficial to injury diagnosis and prevention.

Basic Massage Techniques

Effleurage

This is a stroking movement using the hand, with the strokes towards the heart to assist lymphatic and venous flow. Long strokes should be applied, maintaining contact at all times in the direction of the lymphatic and venous flow, and then return to the starting position by sliding the hands back down with little pressure. Effleurage is used to begin a massage as its main effect is to pump the circulation. Effleurage is also used to end the massage to leave a good feeling of warmth and relaxation. Deeper effleurage during the massage can be applied using smaller surfaces of the hand or larger areas using a greater force. Deep effleurage should be applied in a longitudinal and transverse direction using the pad of the thumb, the pads of the fingers, the heel of the palm or the ulnar border of the forearm.

Effleurage can be used to

- improve general circulation

- increase the oxygen and nutrient supply to the skin and muscles

- soothes sensory nerve endings, encouraging relaxation

- produces warmth

- enables the patient to familiarise themself with the therapists touch

- aids in the removal of loose skin cells

- used to start and finish the massage

- links other movements together in the massage

Petrissage

Petrissage is a term used to describe a variety of techniques that lift, compress and stretch the tissues. They also increase the circulation and warm the tissues. Wringing and kneading are the most common, where the tissues are alternatively grasped, lifted and released. Frictions are a form of petrissage that can be used on specific localised problem areas to loosen and mobilise adhesions, and realign scar tissue.

Benefits of petrissage include:

- improve local circulation

- increase lymph flow

- improve absorption of substances within the tissues

- brings nutrients to the area

- loosens adhered or scar tissue

- moves the tissues over the bone

- removes tension from the area, relieving aches and pains

- produces warmth

Tapotement

Tapotement techniques are stimulating percussive techniques which use both hands alternatively, working quickly and rhythmically, and include clapping, hacking, cupping, pounding, tapping and beating. These techniques are also known as percussive movements and they can:

- be extremely stimulating

- cause erythema (reddening of the skin)

- produce localised heat

- stimulate muscle fibres

- increase cellular activity

Recommended Reading

Sport and Remedial Massage Therapy

The Complete Guide To Sports Massage

Understanding Sports Massage

Stretching Therapy: For Sport And Manual Therapies

The Concise Book of Trigger Points

Modern Neuromuscular Techniques

Soft Tissue Release: A Practical Handbook for Physical Therapists

Muscle Energy Techniques

	Considerations To Make When Performing Sports Massage
	Always begin a sports massage with light pressure, gradually increasing in depth, and then finish the massage lightly. Ensure that the client is comfortable and kept covered with towels where possible. Consider any contra-indications towards massage e.g. acute injury such as open wounds, contusions & soft tissue injuries, acute inflammatory conditions such as arthritis, infections (bacterial, viral or fungal) plus any medical conditions such as bleeding disorders, thrombosis, unidentified lumps or tumours or pregnancy. REMEMBER: if in any doubt whatsoever, DO NOT MASSAGE

	Types of Massage
	Pre-event massage is performed in the run up to a sporting activity. The massage is used to compliment the warm up routine, never replace it. The aim of this massage is to increase circulation, encourage oxygen and nutrients to the working muscles, and to stretch the muscle fibres, reducing the risk of injury. The massage will be performed at a fast rate with firm pressure, and is made up of mostly petrissage and tapotement techniques. Post-event massage is performed directly or as soon as the sporting activity has finished. It is used to compliment the cool-down routine, not as a substitute to the cool down. Massage helps to realign the muscle fibres that are naturally torn during exercise, encouraging them to fix quickly without losing flexibility or strength. Post-event massage also aids in working on the blood and lymphatic drainage systems to bring oxygen and nutrients back to the tissues, and remove carbon dioxide and lactic acid from the muscles to prevent stiffness and the risk of DOMS. The massage is performed at a slow speed with a light pressure, mainly using effleurage and some petrissage techniques.
	Corrective massage is performed in-between activity to relieve any aches or pains the athlete may be experiencing, and can also treat injuries, and prevent injuries from occurring. It is recommended that it should be used on a regular basis although a five-day rest period between treatments should be given to allow the muscles to heal. This massage should be adaptable in terms of speed and pressure - sometimes it may need to be relaxing, other times it may need to stimulate the athlete, but usually uses deep effleurage and petrissage techniques.

Other Techniques Commonly Used In Soft Tissue Therapy

		Neuromuscular Technique The application of digital pressure usually applied by the thumb or finger, which aims to eliminate myofascial trigger point activity and produce modifications in dysfunctional tissue, encouraging a restoration of functional normality (Chaitow, 2003)		Soft Tissue Release Engages the autonomic nervous system to correct muscular imbalances, speeds up the healing of muscular injuries, eliminates chronic pain and works on old scar tissue. It uses a simple procedure of shorten the muscle, apply a lock, and then passively or actively stretch the muscle away from the fixed point.

		Post-Isometric Relaxation The muscle energy technique follows the principle that immediately following a period of isometric contraction, a muscle becomes inhibited and relaxed for 5-10 seconds. This technique uses this window to passively stretch the muscles further to allow the nervous system to accept its new tissue length on a temporary basis.		Reciprocal Inhibition This muscle energy technique works on the antagonist muscle, It deals with the reciprocal effect of an isometric contraction on a muscle which results in an inhibitory influence on the antagonist muscle. This technique is particularly useful when stretching a muscle where acute or chronic pain prevents the patient from contracting the muscle.

		Stretching Therapy		Trigger Point Therapy

		Strain Counter-Strain .		Connective Tissue Massage

Qualifications