Monday, January 12, 1997 2:30 pm
Saddleback College Sports Medicine
All Rights Reserved
Massage in the Training Room
By Crystal Blue Hand
If you are thinking about adding the aspect of massage or muscular therapy to your training room without the cost of having a full time therapist the information that follows is a basic guide for student trainers in what I have found useful both in theory and act in starting massage therapy in Saddleback Collages Athletic Training Room.
It is important to remember that most all established massage and muscular therapists have assembled and compiled various massage and acupressure techniques that eventually become their own style. Since most athletic training rooms at the high school and college levels are maned primarily by student trainers I have incorporated a list of simple techniques for general and sports massage that can be used as a base for any student trainer willing to try.
Many people ask ," what does massage do?" Massage in actuality does not do anything to the body. However what it does do is to stimulate and encourage the body to carry out its normal functions. In other words, massage is not something you do to another person, it is a process that you initiate, to which the body then responds. Massage provides the stimulation, and the body does the work.
The therapeutic benefits of massage include loosening of muscular tension, toning and firming the muscles, and stimulating the circulation of the blood and lymph. Through too much or not enough exercise, physical or mental tension, the waste products from muscular activity ( carbon dioxide, lactic acid and urea), can accumulate in the muscles, preventing the fibers from sliding easily over each other and producing an increase in muscle tone. Massage aides in the drainage of these wastes especially lactic acid, freeing the muscle and restoring normal function. Massage works on the muscles and can affect fibrous tissue surrounding the joints, but any skeletal problems will need to be dealt with separately. It is certainly not a cure all ,but can help enormously to help restore balance in helping the body to heal.
Before you start - Training Room Guidelines
1) BE PROFESSIONAL AT ALL TIMES
2)AGREE TO A TIME LIMIT Eg.. 5,10,15,20,30 min.
There have been numerous occasions when I've had to many athletes and too little time, so where before it was first come first serve, I quickly resorted to severity of injury to determine who would be massaged next if at all. Rarely if ever are full body massages done in the training room, it's mostly piece work depending on the nature of the injury.
3) Ask a few questions before the massage begins:
A: Check the persons health and make sure you know any current illnesses, medication or ongoing problems such as neck or shoulder tension.
B: Find out if there are any particular parts of the body they would like massaged, or if there are any areas you should avoid.
***** These are very important and should be done each time you see anyone, no matter how well you think you know them and their injury.
Contradictions
There are circumstances in which you need to be careful, or should not massage at all. Generally if you are sensitive, you will not do any harm.
INJURIES: Do not massage directly over recent scar tissue, injuries or wounds. These will heal by themselves. You can however gently massage around the injury. Fractures and dislocations should be avoided.
ILLNESS: Do not massage directly over a tumor, skin rash or massage a person who has a heart problem. Massage can be very good for the heart but consult a doctor beforehand.
VARICOSE VEINS: Do not massage over varicose veins, simply brush your hands over the leg lightly instead.
PAINS: Be practical, never try to cure. If any person being worked on has persistent aches, pains, muscular or spinal problems, or experiences any sharp pain during massage, consult the team doctor.
Finally, to make sure your movements feel smooth, remove your jewelry (the person your working on should do the same). Be sure you have filed nails. ALWAYS WASH YOUR HANDS BEFORE AND AFTER GIVING A MASSAGE.
LOTION OR OIL
The decision on wether to use a lotion or an oil is dependent on which sport is being worked with at any given time. One rule of thumb though, if its an area that is going to be taped DO NOT USE OIL OR A HEAVY LOTION. I personally like the DULEX line of lotions and if that's not available to me I like Absorbine gels and braces. I prefer these products because I can use them for both land water sports. They don't hinder any taping job and they absorb directly through to the muscle, keeping it warm, even after long periods in the water, or on the field.
SIMPLE TECHNIQUES
EFFLEURAGE: This is the first massage stroke. It is used to spread oil or lotion over the body and to prepare the person by relaxing the surface of the muscles. It also gives you a chance to " feel out" any areas of tension before you start. Effleurage strokes are always gentle, relaxing and reassuring. Use large, sweeping strokes to cover the entire area, with the greater pressure as you work towards the heart and lighter on the downward stroke. Keep your hands relaxed and mold them to the persons muscles.
KNEADING: This is a movement that is a lot like kneading dough. It is done with the hands working alternately, squeezing and rolling the muscles. It is best used over soft, fleshy areas like the buttocks and thighs, but can also be used over smaller areas such as the shoulders or pectorals. The strokes can be done quite firmly, applying extra pressure with the thumbs, but avoid kneading directly over the bone. Make sure the area you are working on is well lubricated with oil or lotion. To little and you may pinch or pull the skin, to much and your hands will slide. Put your body weight behind the strokes, so the movement will not simply come from your hands. This is a deep releasing movement used after strokes to prepare the muscle, and it will loosen and disperse tension effectively.
WRINGING: This involves a pushing and pulling, twisting movement of the hands in opposite directions which has the effect of pressing the muscle in between the hands as they move toward each other. It is used after kneading and squeezing strokes when the muscles have been loosened and is often used to return the hands from one area of the body. As the flesh twists, you can almost feel the tension being wrung and drained from the muscle. Wringing is used in a series of continuous movements on fleshy areas where there is a good bulk of muscle to work with, such as the thighs, calves and back. With lighter pressure it can be used over the arms as well.
PULLING: This is a releasing stroke used to loosen up a whole area rather than a specific group of muscles, and is generally used after kneading. As you preform the stroke you pull against the body weight, so that it moves with your hands. The hands should be kept soft and rounded, beginning the strokes just beneath the body. As they slide up and over you release the muscles. Pulling is always done up the sides of the body, rolling the muscles as you work, and can be used to move from one area to another. You can pull the hands one after the other, for example, at the abdomen, or travel along the body crossing your hands over as you move.
SQUEEZING: Generally the first stroke after effleurage, squeezing is done over the limbs using two hands, or one if the area is small enough. Squeezing movements are used across the shoulders, back and chest, although the strokes may take a different form to accommodate the shape of the body. The stroke is used to tightly squeeze the muscles, loosening tension in preparation for further releasing strokes. Squeezing the limbs is always done up the body toward the heart. Cover the entire length of the muscles in order to get the best results, always easing the pressure as you approach the joints.
OPENING: This uses a spreading movement of the thumbs, or pressure with the heals of the hands where there is a larger muscle area (think of pulling bread apart). The strokes help to disperse tension after deeper releasing strokes. The opening movements move out across the body rather than up or down,although when preforming a sequence you will generally stroke from the top of the body downward. Opening can return the hands to a particular position on the body. It can be interchanged with wringing. You then follow with softer strokes. Cup your hands right around the muscle to make the movements more effective.
CIRCLING: This provides a soft , round movement over the body. The stroke can be used for far reaching release, as over the sacrum, or a soothing, relaxing stroke, for example, over the abdomen. You can either circle with both hands in alternating directions, singularly or with one hand placed over the other. Always keep your hands flat against the skin and very soft, even when you are circling over the bone. Circling can be used either to release or to gently diffuse the effects of kneading and can often be used to replace pulling strokes up the body or to return the attention and your hands from one area to another. It also gives a sense of expansion and movement, such as circling over the ribs.
FRICTION: is another type of circling, this time done with the pads and tips of the fingers or thumbs. It can also be done with the elbow. Friction is a deep pressure stroke. The tight circling movement is preformed while pressing into a specific spot without moving over the skin as a way of applying more pressure. The movement is very precise and is applied over a particularly tight area of muscle, such as the side of the spine, or into or around a joint. The pressure needs to be adjusted to the area you are working on and can be quite gentle where necessary. This method should be applied sparingly to areas where a deep release would be beneficial. Effleurage can also be used as a form of friction for a quick all body warm up especially useful for swimmers.
FEATHERING: Using the tips of your fingers to gently stroke down the body, alternating hands for a continuous rippling effect. It is one of the lightest, softest massage strokes and is used to conclude after you have massaged each section of the body.
RAKING: This is a really wonderful stroke. By forming the hand into a claw- like shape, you then rake down or across the body, the hands shape allows you to apply firm fingertip pressure. Unusually, the more angular your hands the better the movement works. Raking is rarely used on areas of the body other than the back, hips or tops of the thighs, where there is a lot of muscle.
These are basic and simple techniques and can be used singularly or in sequences of two or more depending on the area or areas being worked on. A continuous flow of strokes makes an excellent warm-up for all sports but it is important to choose those that meet the needs of each athlete.
Examples: Back- use effleurage, kneading and raking
Calves\ Hamstrings- effleurage, squeezing, kneading and feathering
To start massage in a training room you only need a few things:
1) a place to work
2) a work bench or table
3) lotions or oil
4) someone willing to learn and preform massage
5) someone to work on- these can be found in mass quantities
Massage in any form is at the same time both mentally and physically draining as well as rewarding, its definitely a trade-off. I enjoy what I do. You might say its good therapy for the therapist.