One theory is that muscle knots may be caused by something that goes wrong at the “motor end plate” — where a nerve ending attaches to a muscle cell.9 We don’t know why this happens, or what exactly goes wrong, but there is circumstantial evidence that motor end plates are the “point” in trigger point. That evidence is too complex and controversial to review properly here. It is explored in detail in my book. Some research has suggested that it may actually be possible to physically destroy the motor end plate with strong massage, thereby inactivating the trigger point.10 When it regrows — these are microscopic structures, it doesn’t take them long to heal — the trigger point may be gone.
Injury: in the case of an injury, the recovery treatment will adapt to the healing process of the injury. At the beginning of an injury, massages are more frequent, short and focused on the area. For example, a sprained ankle may need light but bi-weekly work after the acute phase is over. As the injury recovers, massages are more intense, and less frequent. The ankle will receive deeper massages and deeper stretches as it heals. Once the injury is recovered, only one or two check-up massage sessions will be required.
Friction strokes work on deeper muscles than the techniques previously described. The friction technique is a pressure stroke and is the deepest that is used in Swedish massage. The massage therapist applies pressure by placing the weight of his or her body on the flat of the hand and the pads of the thumbs, knuckles, fingers, or the back of the forearms, and then releases the pressure slowly and gently. This movement should be a continuous sliding motion or a group of alternating circular motions.
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Make yourself comfortable. If your therapist wants you to adjust your position, she or he will either move you or will ask you to move what is needed. Otherwise, change your position anytime to make yourself more comfortable. Many people close their eyes and relax completely during a session; others prefer to talk. It’s up to you. It is your massage, and whatever feels natural to you is the best way to relax. Do not hesitate to ask questions at any time.
The main professionals that provide therapeutic massage are massage therapists, athletic trainers, physical therapists and practitioners of many traditional Chinese and other eastern medicines. Massage practitioners work in a variety of medical settings and may travel to private residences or businesses. Contraindications to massage include deep vein thrombosis, bleeding disorders or taking blood thinners such as Warfarin, damaged blood vessels, weakened bones from cancer, osteoporosis, or fractures, and fever.
For theory session, the teaching includes principle of reflexology, physiological effect of reflexology, various reflex points of the feet, chart theory, zones and cross reflexes, relationship of reflex points to body organs, using reflexology for health and complementary treatment as well as contraindications to reflexology. On the other hand, for practical session, the teaching includes the methods to examine the feet, good hygiene practice, and arrangement of treatment sessions, treatment practicality, assessment and documentation of the client's treatment, consultation as well as individualization of client's conditions.15
Quick muscle knot orientation: Muscle knots — myofascial “trigger points” — are a factor in most of the world’s aches and pains. Their biology is still mostly mysterious: conventional wisdom says they are tiny spasms, but they might also be a more pure neurological problem. Regardless, they can cause strong pain that often spreads in confusing patterns, and they grow like weeds around other painful problems and injuries, making them quite interesting and tricky. Although they are well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. For more information about how trigger points might be involved in your own medical history, see PainScience.com’s best-selling tutorial:
Pain relief: Relief from pain due to musculoskeletal injuries and other causes is cited as a major benefit of massage. A 2015 Cochrane Review concluded that there is very little evidence that massage is an effective treatment for lower back pain. A meta-analysis conducted by scientists at the University of Illinois at Urbana-Champaign failed to find a statistically significant reduction in pain immediately following treatment. Weak evidence suggests that massage may improve pain in the short term for people with acute, sub-acute, and chronic lower back pain.
Certain massage therapists have specialized training in techniques that help treat people with injuries, inflammation, tears and limitations. Although more than one massage session is usually needed to provide relief and see improvements in pain, well-trained therapists can usually recommend practices or stretches for you to try at home that can further help improve healing.
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“I decided to go into sports massage when I experienced its effects on me as an athlete,” says McElroy. “Despite having no experience as a competitive runner in high school or college, I joined a team and realized I was pretty good. I trained while working full-time and ran my first marathon, missing the Olympic trial qualifying time by 21 seconds.
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A more recent study looked more at the physical benefits of massage. This study was done with 400 adults who complained of moderate to severe low back pain, lasting 3 or more months. These adults were divided into 3 groups. The first group received a weekly full body massage. The second group received a more targeted massage that focused on specific muscles of the low back and hips. The final group did not receive massage, but instead were prescribed pain medication and muscle relaxants. After 10 weeks, participants in both massage groups reported a greater average improvement in pain and functioning than those who received medication. The type of massage, either full-body or focused, yielded equally beneficial results. At the end of the study, 36-39% of the massage recipients reported that the pain was nearly or completely gone, while in the medicated group only 4% reported that significant decrease in pain level. This bodes well for not only focused but also a full Swedish “relaxation” massage.
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Stop into The Spa at Breckenridge and talk with a massage therapist to see what kind of massage is right for you. We have a diverse menu of that incorporates various methods of massage to treat everything from stress to sore muscles. Consider including massage in your self-care routine. Contact us today to discuss which massage is best for your needs.
Now for some benefits that are not supported by research. The ability of sports massage to help the muscles get rid of lactic acid is not supported in research studies. Many researchers feel this is linked to the fact that sports massage does not increase blood flow to muscles. For example, a 2010 study found that blood flow was actually mechanically impeded by massage and that was a possible reason that lactic acid removal was impaired. A quicker recovery after sports massage is not yet supported by the research. Studies do support that active recovery (low-intensity exercise after work-out) is the best method of decreasing the amount of lactic acid that builds up after exercise and speeds recovery.
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Athletes tend to know their bodies fairly well, so information presented to the therapist seems to be better. Compared to the general client, the athlete is also in good shape and is concerned about getting back to the field of play as soon as possible. Some athletes have an obsessive compulsive behavior about their sport. This generally makes them very compliant with the therapists’ recommendations.
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