Sports massage principles are not that different than other types of massages for non-athletic populations, given the current evidence about what sports massage could and could not do. The main idea behind sports massage is to help the person return to performing at their sport or task as best as possible within a certain time frame.
While that certainly can be applied to athletes of various levels (e.g. high school, elite, recreational), we can definitely apply the principles to non-athletes, just with a different way of communicating and addressing the issue at hand. A real estate agent, for example, who often drives long hours throughout the week to see clients and inspect properties, might likely get low back pain from sitting a lot in the car. If the pain gets severe enough to warrant medical attention, he/she might seek massage therapy as a way alleviate to symptoms so he/she can get back to work again.
While this sometimes does not address the underlying issue for low back pain (or any type of pain), massage therapy can be the starting line for many cases—within our scope of practice.
In sports massage, we often deal with injuries, but what an injury means to the athlete or client is different than what it means to therapists.
In a 2018 joint study from different universities that was published in Translational Sports Medicine, researchers interviewed 10 elite athletes, 4 coaches, and 5 physiotherapists—all from various sports—about what a sports injury means to them. (1) All of them agree that a common trait of an injury is that it impedes quality performance, and having pain does not equate to being injured.
However, the definition of a sports injury is not always consistent because the meaning to each professional can change with context. For example, an ankle sprain would be an injury to a soccer player or tae kwon do competitor, but for a swimmer, it probably is not because the sprain may not hamper a swimmer’s performance.
Thus, sports injury is “not defined by its symptoms, but on the consequence of sports performance.” (1)
For non-athletes, the core meaning of an injury may be similar to those of elite athletes, but with different context and content, of course. Like the example above about the realtor, the goal is to return to “performing” well—not just in physical tasks, but also mental ones, like making important decisions for a company, teaching at a university, or creating an artwork.
What this means in practice is that we therapists should listen more to what our clients or patients say rather than imposing our narrative and biases about their condition based on what we (think we) know, which can help guide the session. This is part of the evidence-based funnel paradigm that is accepted by many manual therapists on how we should treat patients/clients.
This paradigm does not negate the therapists’ expertise or hands-on skills nor does it undermine the patients’/clients’ experience. As physiotherapist Erik Meira described, “After the first two stages, you should not be sitting there with one perfect, clear answer. You should have narrowed things down to a few reasonable options. At this point, you educate the patient on those options, giving them the pros and cons of each choice along with the best estimate of prognosis for each. Ideally, this is in the form of a decision aid, a simple patient education handout that describes the diagnosis and the different options for treatment.”
Overall, the sports massage therapy approach can be applied to a variety of populations with some adjustments to treatment and communication. What matters more, based on current evidence, is that how can we help our patients/clients get back to doing what they love or what they need to do.
1. Bolling C, Barboza SD, van Mechelen W, Pasman HR. How elite athletes, coaches, and physiotherapists perceive a sports injury. Transl Sports Med. 30 October 2018. https://doi.org/10.1002/tsm2.53