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Sports Massage: Enhancing Training, Participation and Recovery for Today's Athlete, 2nd Edition: Summary 63
Osteoarthritis Considerations: • Common complication following an injury is decreased stability due to the integrity of the joint being compromised • More pressure is placed on the joint creating more wear and tear on the joint and increasing the risk of osteoarthritis • Cartilage loss can lead to bone degeneration and eventually osteoarthritis • Once the cartilage begins to deteriorate the bones exhibit great fiction with movement and it can lead to Osteoarthritis • Osteoarthritis then results in Inflammation and discomfort within the joint • Osteoarthritis of the knee; avoid working directly on the knee instead perform light superficial effleurage using a flat hand (with no pressure) to try and get some blood flow going and some warmth • Work the muscles proximal and distal to the joint • Arthritis can’t be reversed however nerves stoke to of all aspects of the joint may help to alleviate pain LEARNING TIP! Post and between event massage will address: • Break up adhesions Techniques that may be utilized during a post-event and between event include: • Longer, slower, deeper strokes • Static stretching • PNF • Massaging major muscles groups working tendon to tendon • Corrective muscle imbalance techniques Duration of post-event massage is 20-30 minutes. Static flexibility – moving a muscle into an extended position and holding 20-30 sec. Dynamic flexibility – moving a muscle into an extended position and returning to the starting position with no hold. Examples of stretching techniques include: ○ Static ○ Proprioceptive Neuromuscular Facilitation (PNF) ○ Antagonist activation • Restore muscle balance • Clear metabolic waste • Induce parasympathetic nerve activity • Normalize circulation
PNF techniques are very powerful and effective and the details of how PNF is performed are very important. Key components of PNF include: • Optimal body position of the therapist to protect the integrity of their bodies; maintaining stamina for their case load • Communication - essential to explain to the client the plan for the massage session • Move client into the stretch, perform a static hold for 15-second followed by a 6-second hold (counting down from 6) client resisting the stretch at 20% of their effort (isometric hold) relax and repeat 2-3 times • Not necessary to go beyond 20% because results are seen at this effort and greater effort may result in injury to the client • Going beyond 20% also decreases the stamina of the therapist to be able to perform several sessions in one day • Incorporating PNF into a session - start with one body part and increase from there • Common muscles to stretch: hip flexors and hamstrings but any stretch can be performed using PNF • Range of motion of the stretch it is determine by either a) client expressing they feel the stretch or b) therapist feels the tension barrier whichever comes first • Remember the first rule is to do no harm more aggressive stretching does not necessarily yield greater results Post event and between events sessions should start with hypoactive muscles. Very commonly hyperactive muscles are stretched first however; the benefits of starting with the hypoactive muscles include: • Raising the sensitivity threshold to tolerate input A single session typical lasts 30 minutes and follows these steps in accordance with the most effective techniques determined by the latest research: 1. Client active stretching and self-myofascial release (ex lacrosse balls hold 20-30 sec) 2. PNF stretches 3. Targeted massage work ending in a parasympathetic state • Employing reciprocal inhibition • Lengthening hyperactive muscles
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