contract their antagonist muscle, therapists should be able to move the target muscle into a greater passive stretch. The second type of PNF stretch is the Contract Relax Antagonist Contract (CRAC) stretch. This stretch takes an athlete through several rounds of contracting and relaxing a target muscle while the massage therapist resists the athlete’s ability to move the muscle through its full ROM. Specifically, therapists will first use a passive stretch to take a muscle to the middle of its ROM, then ask the athlete to contract the muscle with 90 percent of their strength for seven to ten seconds while therapists resist the muscle’s contraction. (Therapists should ask athletes to reduce their strength if they cannot hold them in position). When the client relaxes, therapists should be able to draw or push the muscle into a longer passive stretch. Therapists should repeat this cycle one to two times, and then perform the technique on the antagonistic muscle or muscle group. The resulting stretch on the target muscle usually has a greater effect and lasts longer than other methods of stretching. PNF stretches cannot always be performed, though, depending on which muscles an athlete has injured. Trigger point therapy Sometimes referred to as a form of Neuromuscular Therapy (NMT), this technique was developed in the 1940s by Janet Travel when she discovered that the palpation of some irritable muscles bundles (commonly referred to as knots) resulted not only in local pain, but pain distant from the site of palpation as well. Biopsies of these irritable muscle bundles, clinically referred to as trigger points , were electrically active tight spindles of muscle in the general muscle tissue. The tightness and electrical activity found in trigger points helps them to become self-perpetuating; the tightness stimulates an electrical impulse to the muscle spindles and the electrical impulses cause the spindles to contract, causing tightness. Although it is not known what initiates a trigger point, left untreated they may cause chronic pain across broad areas of the body. Trigger point therapy attempts to relieve these sources of pain through a very particular application of pressure: The technique requires holding pinpoint pressure upon the irritable muscle bundle until the trigger point begins to twitch. Once the muscle begins to twitch, massage therapists should apply more pressure until the client says that the pain is about seven to eight on a scale of ten. (The client may also feel pain at a location away from the trigger point at this time if the trigger point is active. Trigger points that do not refer pain away from their general area are considered latent.) Massage therapists should continue to maintain pressure until the twitching stops – indicating that the perpetuating electrical signal has been interrupted – and the pain has subsided to at least a two to three on a scale of ten. As it relates to sports injuries, trigger points are quite common in and around the area of the rotator cuff muscles, although trigger points may occur in any injured muscle. Trigger point therapy should not be used if the athlete is too sensitive to the trigger points being palpated, regardless of how beneficial the technique may be. And, as is the case with deep tissue massage, therapists should avoid trigger point therapy when an athlete has a blood disorder or is taking medication that causes hemophilia (prevents blood from clotting), or, causes thrombophilia (increased blood coagulation) since the latter condition may lead to the development of a thrombosis (blood clot).
petrissage, massage therapists apply moderate to firm pressure to a large area of skin or a muscle group such as the biceps or upper trapezius and lift away from the surface or bone, then squeeze and release in a slow, circular, rhythmic fashion. In relation to sports injuries, this technique usually targets the belly, or ‘meat,’ of a muscle. In cases when an area of the client’s body cannot be petrissaged due to friction burns, cuts, scrapes, or other legions, therapists can apply petrissage using the first two fingers and the thumbs on smaller areas of an affected muscle. Doing petrissage in this manner is not common, but may still effectively increase blood flow and unbind tension when other techniques are ineffective. The technique is rarely contraindicated by itself, though the amount of pressure applied will depend on the athlete’s preference. Sports massage This combination of techniques helps to facilitate athletes’ performance and recovery. Depending upon their needs, athletes may elect to receive a massage prior to an event, after an event, or during their training cycle. Often, athlete will choose to receive a pre-event massage at the site of their competition in order to prepare their muscles for competition. The pre-event massage is characterized by quickly paced strokes such as petrissage, compressions, and vibration in order to stimulate blood flow to the muscles and is usually performed with the athlete fully clothed, ready for their competition. A post-event massage may likewise be performed at the competition site or will otherwise take place within a few hours of competing. Post-event massage focuses on relaxing the body with simple, slower strokes such as effleurage, while also stimulating blood and lymphatic flow with petrissage to reduce recovery time. Massage therapists commonly incorporate stretches into both pre- and post-event massages and will target the muscles particular to the athlete’s sport. Athletes, more than any other particular population, use massage to recover more quickly from injuries; a 2010 study cited in the Journal of Strength and Conditioning Research discovered that even a few moments of targeted massage can improve the range of motion through the hips. In her own studies, Margaret Jones, Ph.D. of the American College of Sports Medicine, noted a decrease in muscle soreness in athletes who received either pre- or post-event massage. Stretches Stretches are used to lengthen muscles thereby increasing an athlete’s ROM and allowing the joints to move more freely. Massage therapists generally use several stretching methods during a session with an athlete; passive (or static) stretching, and two types of proprioceptive neuromuscular facilitation (usually referred to as PNF stretches). With passive stretching, a muscle is pushed or pulled away from its origin so that it is at a greater length than it would be at rest. Massage therapists usually hold his type of stretch for seven to ten seconds, which is the time it takes for muscle fibers to relax into a greater length using this technique. A more effective stretch can be achieved with either of the two PNF stretches. The first is called an Antagonist Contract (AC) stretch. This type of stretch utilizes the reciprocal inhibition reflex to relax a muscle. To do this stretch, first, massage therapists bring the athlete’s target muscle into its shortest length. Then, keeping the muscle at its shortest length, they have the athlete actively contract the target muscle’s antagonist for three to four seconds with approximately 20 percent of the athlete’s strength. Massage therapists should have the athlete repeat the contraction eight to ten times. After this cycle of having the client
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Book Code: MTX1326
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