sports massage may be very useful for preventing injuries later. Although runner’s knee affects runners most of all, this sports injury also commonly affects bicyclists and athletes that play basketball, football, soccer, and volleyball.
enables the muscles around the knee to strengthen as they adapt to different environments. For bicyclists, proper body alignment on their bicycle and varying their riding position on occasion should be considered. More generally, an athlete that is able to cross train can rest the muscles that act upon the knee thereby preventing an overuse injury. And, of course, during a competition, a pre- and/or post- Shin splints Another common running injury, noted biologist and running author Daniel Leiberman estimates 35 percent of all running injuries are shin splints (clinically referred to as Medial Tibial Stress Syndrome, or MTSS). Shin splints is a generic term for the pain, inflammation, and swelling that occurs in and around the tibialis anterior muscle of the lower leg. Pain may also occur along the lateral border of the tibia. Shin splints are further characterized by weakness at the ankle and during dorsiflexion. There are several causes of shin splints, although among athletes the cause is usually due to tendonitis at the upper two-thirds of the lateral tibia from either prolonged bouts of running on hard surfaces or playing sports that require quick stopping and starting motions, such as tennis and basketball. When the cause among athletes is not tendonitis at the upper two-thirds of the lateral tibia, shin splints are often due to the presence of trigger points which may refer pain anywhere along the length of the tibialis anterior and as far as the first phalange (big toe). To treat shin splints, massage therapists can employ cross fiber friction, deep tissue, directional massage, hot stones, myofascial release, stretches and trigger point therapy. Before using deep tissue, hot stones, or trigger point therapy, therapists may wish to attempt the techniques that do not require a lubricant. Cross fiber friction can be applied at the tibialis anterior’s origin and along the lateral border of the tibia. (Cross fiber friction at the lateral border of the tibia will help free the tibialis anterior from any restrictions where the muscle meets the bone.) Therapists should first attempt directional massage and myofascial release from where the inferior tibialis anterior tendon begins to cross from the instep and medial side of the ankle to the lateral side of the ankle and working towards the insertion at the upper two-thirds of the lateral tibia. To perform deep tissue work, therapists should stand next to the massage table facing Shoulder injuries Because it is the most flexible joint in the body, there is a wide variety of injuries that can occur at the shoulder. As far as sports injuries are concerned, though, rotator cuff injuries and adhesive capsulitis (also known as frozen shoulder ) are the two most common shoulder injuries and account for upwards of 20 percent of all sports injuries. Both conditions are generally characterized by continuous pain even at rest, a decrease in shoulder mobility, a decrease in shoulder strength, crackling or popping sounds at the shoulder when moving the arm, and an inability to sleep on the affected shoulder’s side. Dislocated shoulders are the third most common shoulder injury; they involve the previously mentioned symptoms but also include inflammation, swelling, and discoloration. Any athlete displaying symptoms of a dislocated shoulder should be referred to a physician immediately. Dislocated shoulders are contraindicated for massage and will not be addressed here. Rotator cuff injuries typically refer to the partial or full tearing of one or more of the four rotator cuff muscles – infraspinatus, supraspinatus, subscapularis, and teres minor – and are usually the result of repetitive overhead motions such as those performed by swimmers, baseball pitchers, and tennis players. (According to the N ational
the foot of the affected leg. With the hand nearest the foot, massage therapists will rotate the foot of the affected leg towards the other foot so that the tibialis anterior is facing upward. With the opposite arm, therapists gently lean into the muscle at the insertion with a forearm or elbow, being sure to check in with the athlete about pressure and pain levels. Massage therapists should use care; this area of the body is not as sensitive to pressure and pain as other areas, so it is easy to further injure an athlete. Therapists should always allow time for the muscle tissue to soften under their forearm or elbow before slowly gliding their stroke down towards the tendon at the ankle. Hot stones are a good way to soften up the tibialis anterior muscle before deep tissue work. Following up deep tissue work with hot stones is an equally good idea, as the stones may lessen any soreness associated with the deep work. Massage therapists may also search for trigger points anywhere in the muscle during the application of any other technique, however, they are most likely to find one – if present – in the upper half of the muscle close to lateral border of the tibia. Next massage therapists will end treatment for shin splints with a passive or AC stretch, both of which will involve plantar flexion of the foot. Therapists should use a CRAC stretch until the injury is well on its way to recovery. Additional treatment and prevention Besides the common protocol for all sports injuries, runners in particular may wish to either change the type of surface they run on, change the manner in which they run, and/or change their running shoes. An ankle brace or Kinesio tape may help re-stabilize the ankle. This injury occurs more often with runners by a wide margin, followed by tennis players, basketball players, and soccer player. Institute of Health , rotator cuff injuries are the dominant injury among baseball pitchers in particular and baseball players in general.) If an athlete has not been diagnosed by a physician but massage therapists suspect this specific injury, they should identify which rotator cuff muscles are injured. To do this, therapists should ask the athlete to move the arm through the movements specific to each muscle and determine when pain or stiffness occurs. For the infraspinatus and teres minor, pain or stiffness will occur or become worse when externally rotating the arm. For supraspinatus, therapists should have the athlete raise the arm laterally. A subscapularis injury reveals itself when the athlete rotates the arm inward. The opposite motion produces pain in an injured infraspinatus. Treating rotator cuff injuries may involve the use of cross fiber friction, directional massage, hot stones, myofascial release, and trigger point therapy. When applying these techniques, massage therapists should keep in mind two things: First, hot stones are difficult to use on the subscapularis because of its position deep to the axillary fold (under arm). Long, thin stones are best for applying heat to this muscle when an athlete is in the supine position. Second, massage therapists can save time trying to find a trigger point in any given muscle by knowing its pain referral pattern.
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