1. The Benefits of Massage in Sports Medicine
Dayna Elenis AT, ATC, LMT

2. Massage
Massage is the scientific art of manual application of certain movements to the soft tissue of the body to bring about relaxation, pain relief, promote circulation, homeostasis, and general well being.

3. Massage Strokes Effleurage Stroking Friction Petrissage (kneading)
A stroking movement performed with whole hands or palmer surface (deep or superficial)
Stroking
Similar to effleurage but a much lighter touch, performed slow and gentle
Friction
Movement in which the tissues are moved in a cross fiber direction upon the underlying structures (deep or superficial)
Petrissage (kneading)
All movements in which the tissues are grasped, raised from their attachments, and subjected to an intermittent double pressure
Vibration
A trembling movement. This is a high-intensity movement used to stimulate
Tapotement (Hacking, Cupping, Beating, Percussion)
Series of blows administered in rapid succession with the hands striking alternately from the wrist

4. Types of Massage Useful for Sports Medicine
Myofascial Release
CranioSacral
Lymphatic Drainage
Trigger Point Therapy
Reflexology
**These types of massage are just few of many massages that are beneficial for Sports Medicine
Others: Swedish, Thai, Deep Tissue, shiatsu

5. Myofascial Release
A technique that provides sustained pressure into Myofascial restrictions to eliminate pain and restore motion.
What is a Myofascial Restriction?
Tight fascia
Occurs following injury, stress, repetitive micro trauma, inflammation, scarring, and poor posture
Progressively tightens over time if left untreated
Is the underlying cause of most chronic pain problems
There are many different techniques to use for Myofascial release.
All are very light pressure held until you feel the facial movement.

6. What Conditions Does Myofascial Release Help?
Fibromyalgia
Back Pain
Coccyx Pain
Sciatica
TMJ Problems
Whiplash Injuries
Migraines
Neck Pain
Sports Injuries
Disc Problems
Scoliosis
Scar mobilization

7. CranioSacral
Gentle, non-invasive treatment that modifies and corrects restrictions in the craniosacral system
Craniosacral system includes the brain, spinal cord, meninges and cerebral spinal fluid
A physiological system that is responsible for the production, circulation and absorption of cerebral spinal fluid
Since the brain and spinal cord are responsible for the sensory and motor aspects of our being, removal of irritation to these tissues will cause whole body relief and improved function
CranioSacral Rhythm is the movement of bone and tissue in response to the rise and fall of CSF production
Thixotrophic effect of fascia
Thixotropy is shear thinning property. Certain gels or fluids that are thick (viscous) under static conditions will flow (become thin, less viscous) over time when shaken, agitated, or otherwise stressed.
Many techniques!

8. CranioSacral
CranioSacral Rhythm is the movement of bone and tissue in response to the rise and fall of CSF production
Flexion=Filling (towards the feet)
Extension= Emptying (towards the ears)
How to evaluate the status of the CranioSacral system?
Symmetry- synchronicity of flexion and extension (Is it equal?)
Quality- smooth, strength (How does it move?)
Amplitude- ROM (How full or big is the motion?)
Rate-speed, cycles (How fast are the cycles?)
6-12 cycles/min

9. What Conditions Does Craniosacral (CST)Address?
Migraines and Headaches
Concussions
Chronic neck and back pain
Stress and tension related disorders
Motor-coordination Impairments
Brain and Spinal Cord Injuries
Fibromyalgia
TMJ Syndrome
Scoliosis
Orthopedic Problems
ADD/ADHA
Chronic Fatigue

10. Lymphatic Drainage
Gentle, rhythmic bodywork technique used to encourage the flow of fluid out of the tissue and into the lymphatic system.
Pressure is very light, just enough to not slide over the skin, but enough to pull the skin
Rhythm of drainage on average is every 6 seconds and the frequency is 5-7 strokes at each location
Stagnant or limited lymphatic flow can be a factor in many disease processes
Fluid movement= tissue health

11. Effects of Lymph Drainage
Lymphatic Drainage
Effects of Lymph Drainage
Indications
Increase Blood Circulation
Reduction of Edemas
Promotes increased tissue health before surgery
Decrease recuperation time after surgery
Stimulates immune system
Deep relaxation
Endless!
Reduce Swelling
Pre/post surgical
Insomnia
Osteoarthritis
Headaches
Improve athletic performance
Sprains/ Strains
Tendonitis/ Tenosynovitis
Headache
Small cyst, Detox, Cronic Fatigue Syndrome, Vertigo, Fibromyalgia, TMJD, Acne, Eczema, Wrinkles, PMS

12. Trigger Point Release
Myofascial trigger points are small, hyper irritable nodules found in a taut band of muscle where there is decreased circulation and a buildup of metabolic waste products.
Trigger points can produce pain both locally and to specific referral areas
Can be caused by structural imbalances, overuse, injury or stress leading to many pain syndromes
Trigger Points occur because:
Micro damage to sarcoplasmic reticulum causing release of Ach (acetylcholine) -> too much calcium ->shortens sarcomere “knot” -> chemical imbalance “hypoxia”

13. (Latent trigger points can become active trigger points)
Trigger Point Release
Active Trigger Points
Latent Trigger Point
Area may be sensitive even before palpation
When pressure is applied it is painful and will either refer or radiate pain
Symptoms can include pain, tingling, numbness, burning, itching, or other symptoms the client is familiar with
Patient will sometimes jump when point is palpated
90-95% of trigger points
Common that the client is not aware that the area is painful until pressure is applied
Generally will not produce a recognizable pain
When pressure is applied to area it will either refer or radiate pain
(Latent trigger points can become active trigger points)
Does this hurt?
Doe this hurt or radiate to another area of the body?
Do you recognize this pain or is this the pain you have been experiencing?
Yes to all is Active trigger point
No to #3 is Latent trigger point

14. Trigger Point Release Methods to deactivate trigger points
Ischemic compression
Ice therapy
Lymphatic drainage
Positional Release
Muscle energy techniques
Myofascial release techniques
Muscle stripping

15. Reflexology
A holistic method of healing and prevention also known as Reflex Zone Therapy
Involves manipulation of the specific reflex areas and points
Method of application includes direct pressure/compression, massage, movement, range of motion and stretching of the feet and hands
“Reflexology is a science that deals with the principle that there are reflex areas in the feet and hands which correspond to all of the glands, organs, and parts of the body. Reflexology is a unique method of using the thumb and fingers on these reflex areas.” Ingham method
Theory: Massage balances the electromagnetic field in the body
Works by breaking up waste deposits in the blood vessels of the feet, thus improving circulation.

16. Reflexology

17. Reflexology

18. Other Types of Orthopedic Massage
Cross fiber friction
Compressive broadening
with active contraction
with active extension
Muscle Stripping
Static compression
With active extension
Positional Release
Fascial Release
Cross fiber friction: goal is to break up adhesions and or fibrotic tissue. Deep, non-gliding massage stroke. Perpendicular to the fiber direction.
Compressive Broadening: Use thenar eminences, apply pressure and allow hands to spread apart
Muscle Stripping: moves with fiber direction. Slow, deep, specific gliding over muscle.
Static Compression: apply pressure slowly and gently
Positional Release: locate trigger point, push, move limb until pain decreases.
Fascial Release: Grasp tissue until slight stretch, release when tissue releases

19. What is Orthopedic Massage Based On?
Upper Crossed Syndrome
Lower Crossed Syndrome
Strengthen using:
Active Resistance
Tapotement

20. Basic Contraindications
For all massage:
Any acute infection or disease
Acute inflammation
Advanced osteoporosis
Severe varicose veins
Phlebitis
Aneurism
Cancer (check with Doctor first)
Certain prescription drugs
Various Skin conditions
Broken Bones
Contagious disease
Major cardiac problems
Acute anuresis
Serious circulatory problems
Hemorrhage
Skin conditions: open sores, eczema, broken blood vessels, burns, sunburn, lacerations, poison oak or ivy, etc

21. Demonstration Myofascial Release/ Craniosacral
Occipital Condyle Release with Cervical Stretch
Trigger Point Therapy/ Positional Release
Upper Trapezius
Lymphatic Drainage
Knee or Ankle
Reflexology
Knee
Orthopedic (static compression with active contraction)
Sacroiliac Dysfunction
CranioSacral: Always start with vault holds (in head)
Trigger Point: 1. Thermal scan 2. Find “pea”. Does it radiate? 3. Compression (no more than 8/10pn) 4. Stretch!!! Make nice
Lymph Drainage: 1.Active/ Stretch 2. Passive/Return 3. Disengage
Do NOT do massage before competition!!!!

22. References Cisaruk, L. (2010). Foot reflexology.
Gauthier, I. (2009). The science and practice of myomassology. (6th ed.). USA: Irene's Myomassology Institute.
Kelly, R. (2012). Trigger point therapy.
Kelly, R. (2012). Orthopedic Massage.
Kelly, R. (2012). Lymphatic Drainage.
Pillow-White, J. (2012). Introduction to craniosacral techniques.
Stayer, T. (2010). Myofascial Release.