the break, so long as the client does not experience pain while the area is massaged. Burns Many athletes experience friction burns (minor first-degree burns) by coming into contact with either playing surfaces such as a wood floor or grass court, or other athletes. Massaging a burn is often painful and may lead to further injury, thus, massage is locally contraindicated. The gentle application of soothing topicals whose ingredients include aloe vera, beta carotene, chamomile, hydrocortisone, or Vitamin E, however, is permissible with the athlete’s consent. Bursitis Bursae are small fluid filled sacs that cushion the space between muscles, tendons, and bones near joints. On occasion, usually through frequent, repetitive motions, bursae become painful and inflamed; a condition known as bursitis . Bursitis commonly occurs near the glenohumeral joint (shoulder joint), at the elbow, at the trochanter (the hip at the head of the femur) and less commonly at the knee and posterior ankle near calcaneus (heel bone). Contusions Athletes that play contact sports often suffer contusions, an injury in which a physical impact damages muscle fibers and connective tissue. The damage may be severe enough to cause blood pooling, which is characterized by a noticeable discoloration and inflammation of the skin. R.I.C.E. (see below) is the immediate response for contusions. Deep tissue massage for contusions should be avoided for 48 hours after the injury occurs or until the injury site is no longer painful to touch and any swelling has subsided. Hernias Due to the forces athletes in contact sports are subjected to, hernias – the protrusion of an organ through its containing wall or cavity – are not uncommon for athletes. Hernias may be extremely painful and they should never be corrected by attempts to push an organ back into place. Only a physician should attempt to correct a hernia. Hernia rehabilitation should be conducted only under the guidance of a physician or physical therapist. Hernias are usually corrected with surgery, or in the case of a sports hernia (in which a muscle, commonly the adductor magnus, ruptures at the pubis/pubic tubercle), under the guidance of a physical therapist. Inflammation The often painful redness and puffiness of skin and joints can have a variety of causes, as inflammation is one of the body’s first lines of defense against pathogens and disease. When it comes to athletes, though, inflammation usually results from blunt force trauma, or a muscle, tendon, or ligament tear. In this case, inflammation is the body’s attempt to remove damaged tissue. This attempt to remove damaged tissue is more specifically referred to as acute inflammation , where the body’s response to a physical blow sees plasma and white blood cells pool in the injury site. On occasion, this type of inflammation lasts longer than it should and leads to chronic inflammation in which healthy tissue is destroyed alongside damaged tissue, prolonging or halting the rehabilitation process. In general, inflammation can be treated with icing the site of inflammation for up to 20 minutes at a time and/or compressing the site of inflammation with a sports wrap to reduce blood flow in the area. Kinesio tape
that blood and other bodily fluids can move more freely thereby speeding recovery. When applied properly, Kinesio Tape can allegedly improve ROM, improve strength, and reduce pain and inflammation. The tape is sweat-proof and water-resistant and will stay applied for three to five days making it a popular alternative to sports wrapping. Muscle tear Similar to contusions, this phrase means exactly what it suggests, a tear or tears of the muscle fibers due to overexertion, being overstretched, or physical impact. Muscle tears may be minor, damaging only small blood vessels, or major, separating a muscle and its tendon from its origin or insertion. (Major muscle tears require surgery to repair.) Muscle tears are characterized by pain even when the muscle is resting, and bruising, redness, swelling, and weakness of the affected muscle. R.I.C.E. (see below) is the immediate response for muscle tears. Therapists should avoid deep tissue massage for muscle tears for 48 hours after the injury occurs or until the injury site is no longer painful to touch and any swelling has subsided. Myositis ossificans This condition is particular to young athletes who have not yet completed puberty. In some instances, young athletes who suffer contusions or muscle tears may have their bodies repair damaged muscle tissue with bone tissue instead. Myositis ossificans may be indicated by a hard lump in a muscle. This condition can be very painful and severely limits a muscle’s strength and ability to stretch. Preliminary studies indicate that the application of massage therapy will worsen this condition. Therefore, massage is contraindicated without the approval of a physician. Sprain When ligaments (the fibrous tissue that connects bone to bone) are forced to stretch beyond their normal ROM – for example, hyperextension of the knee – the resulting tear is known as a sprain . Sprains may be characterized by pain, inflammation, and the inability of a joint to bear weight, align correctly, or move a limb below the site of the sprain. Strain Generally less severe than sprains, there are two types of strains. First, when the musculotendinous junction (the area where a muscle starts becoming tendon) is forced into a stretch beyond its normal ROM and suddenly or forcibly contracted, the resulting tear is known as an acute strain . Mild strains that build up over time from constant overuse or repetitive stress at a joint – for example, a tennis player continuously volleying with force – result in chronic strains . In general, strains may be characterized by pain, inflammation, muscle spasms, a reduction in strength, and a reduced ROM near the strain. An athlete working with a physician may have their sprain or strain categorized according to the severity of the injury. A mild, Grade I sprain or strain describes a minor over-stretching or tearing of a ligament or muscle. A moderate, Grade II sprain or strain describes a partially torn but still intact ligament or muscle and some degraded joint stability. A severe, Grade III sprain or strain indicates that there is a fully torn ligament or muscle and therefore, no joint stability. Massage therapists may work with the first two grades of sprains and strains once the acute phase of the injury has passed. They will not treat the third grade of sprains and strains, though, as only surgery can repair this level of injury. Of course, once surgery has been completed and an athlete’s rehabilitation phase begun, therapists may help an athlete recover by loosening the muscles, reducing the scar tissue, and increasing the blood flow around the injury. Fighting inflammation may also be aided by making changes to the athlete’s diet; foods and spices such as berries, garlic, oily fish, olive oil, dark leafy vegetables, nuts, peppers, and turmeric have all been shown to reduce inflammation in the body. R.I.C.E. This is an acronym for rest, ice, compression, and elevation. R.I.C.E. is the default treatment for the first 72 hours of an acute injury. ‘Rest’ means taking the time to recuperate, allowing time for healing thereby reducing the potential for aggravating the injury. ‘Ice’ means applying ice or a cooling pack to the injury site for at least 10 minutes but no more than 20 minutes to fight
More generally known as elastic therapeutic tap e, Kinesio Tape became very popular among athletes after its exposure during the 2008 Summer Olympics when it was worn by beach volleyball player Kerri Walsh. Although only recently popular, Kinesio Tape was invented over two decades ago as a replacement for sports wraps. Kinesio Tape not only physically supports muscles during activity, it also lifts the skin away from muscle tissue so
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