Some athletes love to receive a massage as much as chowing down on their favorite post-training meal as part of their recovery. Even some massage and physical therapists recommend athletes should get a massage before or after a training or competition. But just how effective is it for performance and recovery? Does sports massage have to be painful or could it be as relaxing as a traditional Swedish? Let’s see what current evidence says.
Sports massage is not just a modality in itself, nor it is like that special “bone setting” technique that Mr. Miyagi used on Daniel-san in the original “The Karate Kid.” It is a mixed bag of different techniques, such as effleurage, petrissage, and cross-fiber strokes, that are very similar to the ones found in Swedish massage. Unlike what some therapists think, sports massage doesn’t necessarily involve the therapist applying bone-deep pressure to the muscles that make clients hiss in pain.
“True sports massage is used only in conjunction with athletics. It is not uncommon for non-athletes to ask for sports massage,” Matthew Pardini explained in an online interview with me, who practiced at in Honolulu, Hawaii, and was a board member of the Hawaiian Massage Association.
“Sports massage has a history of being a rough, aggressive, and painful modality. However, as our understanding of the human body advances, therapists are using less painful and more effective methods of achieving the same results for athletes at all levels.
“For myself, I would like to begin integrating on-site assessment and treatment of my athletes because the best place to understand and correct athletic complaints is in the midst of athletic performance.”
“In practice, sports massage is often used to treat intermittent injuries. The therapist is going to be addressing one or two chief complaints from the client and will work to correct the structural dysfunction causing the complaints,” said Pardini. “Sometimes a specific complaint is not reported, but an athlete wants to maintain optimum body mechanics or attempts to prevent injuries. Little or no lotion at all may be used and sessions are often completed with the client clothed.”
Common claims about sports massage state that it can help reduce blood lactate, alleviate muscle soreness, and speed up recovery. While they sound promising, current evidence does not support these claims well.
Does sports massage help improve
strength and flexibility?
The number of studies on this topic is few, and the results are quite iffy. Jason Brumitt, Ph.D., a physical therapist from George Fox University in Newberg, Oregon, cited several studies in his review that showed limited or no significant improvement in muscle flexibility after a massage session in which dynamic soft tissue mobilization (DSTM) and standard petrissage and effleurage were used. (3) A few studies showed some muscle flexibility improvement, but the effect was transient. In other words, the muscle returned to its pre-massage state and did not maintain its new range of motion after a short period of time.
For grip strength, massage may help recover muscle fatigue better than no massage at all, according to Brumitt. However, there is no strong evidence that massage can help improve strength or performance in other movement patterns, such as Olympic lifting, squats, or sprints.
In fact, Brumitt cited one study that found female college basketball and volleyball players who received a 17-minute massage had increased their vertical jump height, yet they took longer to finish a bout of shuttle runs. (3) There were also flaws, such as a small sample size and a lack of a control group, that made this study unreliable to draw a solid conclusion.
Massage may help improve flexibility for some athletes but only for a short time. For strength improvement, not much effect was demonstrated.
Does sports massage get rid of blood lactate from muscles?
Intuition may make some people believe that massage therapy could somehow “squeegee” fluids out of their muscles or other tissues and remove compounds, such as blood lactate. This substance is produced from carbohydrate metabolism that gets recycled in your body’s energy system. However, numerous studies since the 1990s have failed to support the idea that massage therapy can reduce blood lactate or increase circulation significantly. (4)
One such study was published in Medicine and Science in Sports and Exercise found that massage could impede blood lactate removal after a workout because of the compressive forces applied to the blood vessels. In fact, exercise in the form of active recovery has been shown to reduce blood lactate levels better than massage. (5)
What about getting rid of muscle soreness?
Massage therapy might get a silver medal for reducing muscle soreness when it is compared with other common but less effective techniques to reduce the burning and sometimes painful sensation, such as stretching and cryotherapy. A 2013 study published in the Journal of Strength and Conditioning Research found that elastic resistance training can relieve soreness in the upper trapezius just as well as a 10-minute massage to the same muscle. (6) However, the effectiveness is only marginal, kind of like an aspirin that temporarily stops a headache pain. With two or three days of rest, the soreness usually goes away.
And for injuries?
This is a gray area in which there isn’t a single method that works the best to help athletes recover from an injury. Brumitt stated that there are very little studies that investigates the role of massage in sports rehab.
However, a 2013 systematic review of several systematic reviews that was published in International Journal of General Medicine that examines a series of systematic reviews suggested that massage does have some positive effects on nonspecific low back pain. Still, the review cautioned that the lack of higher quality studies does not guarantee a positive outcome on all low back pain cases. (7)
As for other types of injuries, there is not much evidence that can help therapists to determine if sports massage can help or not.
Then what is sports massage good for?
While it seems to be a no-brainer, massage therapy has been shown to help reduce anxiety and depression. Psychologist Christopher Moyer wrote that adults who received consistent massage had a significant reduction in depression. Even a single massage session can tone down a person’s state anxiety, which is an experience of momentary tension or worrying. (8) If you have chronic “bouts” of worrying, then getting multiple sessions of massage over a period of days or weeks may help.
“Why is it that the athlete feels refreshed or better after a massage? It may have something to do with biochemical markers for pain that have not been measured,” Brumitt explained. He cited a spinal who received neck and upper back manipulation study in which patients who received neck and upper back adjustments had higher levels of oxytocin — a hormone that gives us a “euphoric feeling” —and neurotensin, which is a type of protein that act as a painkiller. (9)
“Could it be that this effect, the manipulation, be similar to that of the manual treatment via massage? It is possible,” Brumitt said.
For athletes, massage therapy could play an important role in alleviating stress and anxiety after they suffered an injury or boost their confidence before a match. It may improve their self-esteem or cope with a dear loss that may affect their performance in the game.
Most athletes are probably more concerned about whether they will continue to play after getting injured than the details about the chemicals in their brain. Caring touch coupled with the interaction between the athlete and the massage therapist may psychologically influence the perception of pain and how well they recover. And so, it doesn’t really matter much if what you do is called “sports massage” or not. What matters more is how well your athletes recover during their healing process from your care.
1. Matthew Pardini, LMT, interviewed on October 9, 2014; updated March 30, 2015
2. Jason Brumitt, PhD, PT, interviewed on October 11, 2014.
3. Brumitt, J. The Role of Massage in Sports Performance and Rehabilitation: Current Evidence and Future Direction.” The North American Journal of Sports Physical Therapy 3 (2008): 7-21.
4. Gupta S. et al., “Comparative Study of Lactate Removal in Short Term Massage of Extremities, Active Recovery and a Passive Recovery Period After Supramaximal Exercise Sessions,” International Journal of Sports Medicine 17 (1996): 106-10. doi: 10.1055/s-2007-972816.
5. Wiltshire EV et al., “Massage Impairs Postexercise Muscle Blood Flow and ‘Lactic Acid’ Removal,” Medicine and Science in Sports and Exercise 42 (2010): 1062-71, doi: 10.1249/MSS.0b013e3181c9214f.
6. Andersen LL et al. Acute Effects of Massage or Active Exercise in Relieving Muscle Soreness: Randomized Controlled Trial. Journal of Strength and Conditioning Research 27 (2013): 3352-9, doi: 10.1519/JSC.0b013e3182908610.
7. Kumar S et al. The Effective of Massage Therapy for the Treatment of Nonspecific Low Back Pain: a Systematic Review of Systematic Reviews. International Journal of General Medicine 6 (2013): 733-741, doi: 10.2147/IJGM.S50243.
8. Moyer C. Affective Masage Therapy. The International Journal of Massage & Bodywork 1 (2008): 3-5.
9. Plaza-Mansano G et al., “Changes in Biochemical Markers of Pain Perception and Stress Response After Spinal Manipulation,” Journal of Orthopaedic and Sports Physical Therapy 44(2014), 231-239, doi:10.2519/jospt.2014.4996.
This article was originally published in the Summer 2015 issues of Massage & Fitness Magazine.