Sports Massage- Case Study

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This essay will explore the value of massage in the overall management of an athlete with lateral knee pain, and a diagnosis of Ilio tibial band syndrome.
It will explore the use of massage generally then focus on specific techniques used in myofascial pathologies. It will also describe the techniques employed, the clinical reasoning for their choice and the relevant supporting evidence.
The relevant anatomy will be discussed as well as the proposed influences of massage on these structures using current literature to support these hypotheses.

Massage has been used around the world for thousands of years for rehabilitation and relaxation (Weerapong et al, 2005). Massage is the treatment and practice of manipulation of the soft body tissues with physical, functional, i.e. mechanical, medical/therapeutic, and in some cases psychological purposes and goals. Massage has been defined as “a mechanical manipulation of body tissues with rythmical pressure and stroking for the purpose of promoting health and well-being” (Cafarelli and Flint,1992).
Massage is widely used by the athletic population for a variety of purposes such as injury prevention, recovery from fatigue, relaxation, and to increase performance (Hemmings, 2001). Galloway and Watt (2004) report that at Major Athletic events on average 45% of physiotherapeutic treatment time was spent on massage, 80% of which would come under the ‘sports massage’ category. This led to the suggestion that specifically trained sports masseurs be included in the medical support team.

The popularity of sports massage is not in doubt; however Weerapong (2005) is clear in stating that there is “no evidence that massage can actually improve performance, enhance recovery or prevent muscular injury” (P246). The supporters of massage claim it benefits the individual via biomechanical, physiological, neurological and psychological mechanisms (Cash, 2000).
Despite the evidence athletes, coaches and medical personnel continue to



References: Archer, P. (2006) Therapeutic Massage in Athletics. Lippincott Williams & Wilkins. Brukner, P. and Khan, K. (2006) Clinical Sports Medicine. 3rd ed. McGraw Hill. Cafarelli, E. and Flint, F. (1992) The role of massage in preparation for and recovery from exercise. Sports Medicine 14 (1) 1-9. Cash, M. (2000) Sport and Remedial Massage Therapy. London. Ebury Press. Chaitow, L. and Delaney, J. W. (2006) Clinical Applications of Neuromuscular Techniques Vol 2: The lower Limb. Churchill Livingstone. Drust, B et al (2003) The effects of massage on intra muscular temperature in the Vastus lateralis in humans. International Journal of Sports medicine, 24 (6), 395-399. Dyck, D. Jr. and Boyajain-O’Neill L.A. (2004) Plantar fasciitis. Clinical Journal of Sports Medicine, 14 (5), 305-309. Ellis, R. et al (2007) Iliotibial band friction syndrome--a systematic review. Manual Therapy, 12 (3), 200-208. Fairclough, J. et al (2006) The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. Journal of Anatomy 208 (3), 309-316. Fredericson, M. et al (2002) Quantitative analysis of the relative effectiveness of 3 iliotibial band stretches. Archives of Physical Medicine and Rehabilitation, 83 (5), 589-592. Fredericson, M. and Wolf, C. (2005) Iliotibial band syndrome in runners: Innovations in Treatment, Sports Medicine, 35 (5) 451-459. Galloway, S. D. R. and Watt, J. M. (2004) Massage provision by physiotherapists at major athletics events between 1987 and 1998. British Journal of Sports Medicine 38 (2) 235-237. Gerwin, R. D. et al (1997) Interrater reliability in myofascial trigger point examination. Pain 69 (1-2) 65-73. Gleim, G. W. and McHugh, M. P. (1992) Flexibility and its effects on sports injury and performance. Sports Medicine 24 (5) 289-299. Hemmings, B. (2001) Physiological, psychological and performance effects of massage therapy in sport: a review of the literature. Physical Therapy in Sport 2 (4) 165-170. Langevin, H. M. et al (2007) Dynamic morphometric characterization of local connective tissue network structure in humans using ultrasound. BMC Systems Biology 1 (25) 1-25. Leadhetter, W. (1997) Cell matrix response in tendon injury. Clinical Sports Medicine 11 (3) 533-579. Lucas, K. R. et al (2004) Latent Myofascial trigger points: their effects on muscle activation and movement efficiency. Journal of Bodywork and Movement Therapies 8 (3) 160-166 Messier, S Miller, R. H. et al (2007) Lower extremity mechanics of iliotibial band syndrome during an exhaustive run. Gait & Posture 26 (3) 407-413. Moraska, A. (2005) Sports Massage: A comprehensive review Journal of Sports medicine and Physical Fitness, 45 (3) 370-81. Nishimura, G. et al (1997) MR findings in Iliotibial band syndrome. Skeletal Radiology, 26 (9) 533-537. Noehren, B. et al (2007) ASB Clinical Biomechanics Award Winner 2006 Prospective study of the biomechanical factors associated with Iliotibial band syndrome. Clinical Biomechanics, 22 (9) 951-956. Orchard, et al. (1996) Biomechanics of iliotibial band friction syndrome in runners. American Journal of Sports Medicine, 24 (3) 375-379. Pettit, R. Dolski, A. (2000) Corrective neuromuscular approach to the treatment of iliotibial band friction syndrome: A case report. Journal of Athletic Training, 35 (1) 96-100. Schleip, R. et al (2005) Active fascial contractility: Fascia may be able to contract in a smooth muscle-like manner and thereby influence muscle dynamics. Medical Hypotheses, 65 (2) 273-277. Schleip, R. et al (2006) Passive muscle stiffness may be influenced by active contractility of intramuscular connective tissue. Medical Hypotheses 66 (1) 66-71. Standring, S. (2004) Gray’s Anatomy: the Anatomical Basis of Clinical Practice, 39th ed. Edinburgh: Elsevier/Churchill Livingstone. Travell, J. G. and Simons, L. S. (1998) Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol 1, 2nd Ed. Baltimore, Williams and Wilkins. Thacker. S. B. et al (2004) The Impact of Stretching on Sports Injury Risk: A Systematic Review of the Literature. Medicine & Science in Sports & Exercise 39 (3) 371-378. Wang, H. K. et al (2007) Real-time morphologic changes of the Iliotibial band during therapeutic stretches; an ultrasonographic study. Weerapong, P. et al (2005) The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention. Sports Medicine 35 (3) 235-256.

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