The main aim during treatment is to prevent and manage injury by improving range of movement through reducing pain, increasing flexibility and increasing mobility whilst aiding the body’s natural healing process through a variety of soft tissue techniques that are available.
Each technique can have different benefits and use cases, therefore, following an initial assessment by the Sports Massage Therapist (SMT), an appropriate treatment plan will be devised.
Many factors can affect injury, recovery and repair including Age, Gender, Body Composition, Lifestyle, Previous Injuries and so on, therefore it is important to bear in mind that what works for one won’t necessarily work for another.
It is also important to note that the SMT may refer you to an alternative practitioner depending on the findings of the assessment and consultation. Referrals can include GP, Physiotherapist, Osteopath etc.
Some of the main treatment techniques include:
Soft Tissue Release (STR) - Incorporates both active and passive movement of joints in order to stretch or mobilise an entire muscle or specific parts of a muscle with the primary aim of removing physical adhesion's/restrictions to increase ROM and mobility. The process involves the muscle being placed in a shortened position and a ‘lock’ is applied to the tissue to create a new origin point for the muscle. Whilst maintaining pressure/lock, the joint which affects the muscle is then moved to create a focused stretch. This is done passively by the SMT then actively by the client and continued as required working from proximal to distal positions of the muscle from the joint.
Connective Tissue Therapy - A technique which stretches connective tissue (fascia), manipulating the skin and subcutaneous tissues which can have a beneficial effect upon areas elsewhere in the body. Since the fascia also contains many nerves, blood vessels and lymphatic vessels any improvement in its condition will inevitably lead to improvements in the circulatory and nervous system. SMTs use connective tissue massage to remove myofascial restrictions that occur within this structure to aid circulation and mobility. Connective tissue massage promotes the remodelling of collagen. It is often described as a neural therapy because of its powerful reflex effects. Visible skin and connective tissue zones are stimulated to influence visceral and circulatory functions. This technique differs from many others because it treats the body as a whole rather than focusing on specific areas. Preferably using a flat hand the SMT applies sufficient pressure while moving the tissues slowly in different direction to identify restrictions in the connective tissue. Once a restriction has been detected the tissue should be held at this point until a change in properties have occurred (usually up to 30 seconds) For deeper adhesion's within the fascia the tissue can be pinched with the pads of the SMTs fingers and then held and brought into a crescent shape.
Transverse Frictions - Also, known as cross fibre frictions. They are used to restructure adhesion's in muscles, tendons and ligaments. For this technique on muscular areas, the tissue should be in a relaxed position whereas for ligaments and tendons they should be in a stretched/taut position. The therapist uses reinforced thumbs to friction the area at right angles to the targeted fibres. This treatment can be uncomfortable so the SMT should ensure they monitor the client’s reactions but after a short time it should provide an analgesic effect for the client. Useful for physical realignment of collagen fibres, removal of excessive scar tissue, removal of adhesion's, reduction of congestion in local area, increased circulation and ROM.
Trigger Points - Hyper-irritable spots within a muscle that often results in reduced ROM and muscle weakness. Trigger points can active or latent. The most common is ‘Active’ which is always tender, restricts ROM, causes weakness and refers pain. ‘Latent’ will only be painful when palpated but otherwise may have all of the other characteristics of an active trigger point. The 10 second pressure test can be used to identify TPs. Progressive or constant direct pressure can be applied to the TP temporarily starving the area of oxygen for a short period of time within the client’s pain threshold and then released. Effects of this type of treatment include increased flexibility and contractibility of affected muscle, improved ROM, reduced local pain, reduced referred pain and improved circulation.
Muscle Energy Techniques - These are a form of assisted stretching with the aim of lengthening a muscle that is limited by neurological restrictions. Post-isometric relaxation (PIR) – uses the principle of autogenic inhibition to contract the targeted muscle. Reciprocal inhibition (RI) – uses the principle of antagonistic muscle contraction. The main difference between the protocols for these are that RI doesn’t require contraction of targeted muscle therefore safe to use in early sub-acute phase to support soft tissue repair process. The Therapist takes the muscle to point of bind then releases slightly and asks the client to isometrically contract affected muscle (PIR) or the antagonist (RI) and match the therapist force. Client holds contraction for 10 to 12 seconds and then relaxes whilst therapist gradually increases the stretch on the muscle. Process is then repeated 3 to 4 times, each time increasing the ROM. This technique is mainly used to relax and restore normal tone to hypertonic shortened muscles or strengthen weak muscles but can be used to prepare muscles for further stretching or improve joint mobility. MET is quite a mild form of stretching and therefore useful for rehabilitation work.
This treatment is also available and may be used alongside Sports Massage Techniques to aid the process. It is one of the most common types of massage and is used to promote relaxation by releasing muscle tension.