So apparently I have some kind of soft tissue injury (inflammation). It gets a bit better everyday but it is impossibly stiff to run on. Anyway I’m considering getting a massage but does it actually help? Has anyone ever had an injury go away from massage or is massage mainly just prevention ?
Undoubtedly you will have a chorus of people who pay for massage saying that it does help and many from the majority who don't treat injuries with massage saying that it doesn't. I'm in the latter group based on my own limited experience with massage.
A more scientific view here:
Webby is right. There is no good evidence supporting the general efficacy of massage for athletes, but there are a lot of things to keep in mind:
- "Massage" is not a modality like ice or NSAIDs that can be easily controlled. There are a ton of different massage techniques, and practitioners within different schools will still apply massage in very different ways.
- There are a ton of potential uses for massage, so just because studies looking at, for instance, general inflammation don't show results doesn't mean that particular types of massage don't produce results for particular use cases.
- There may be a placebo effect to massage, but in the context of athletics, the term "placebo" is somewhat slippery. We aren't a body and a brain; we're a complete organism, and the body and brain are tightly integrated. So it's probably a mistake to think of placebos as "fake." For instance, anything that reduces the sensation of pain is by definition a functional pain reliever, even if we don't understand why it works.
For my money, I find two basic uses for massage:
1) I think a general full body sports massage is useful at releasing tension, in the sense that your nervous system relaxes and reduces the activation of muscles. Short stretches (30 seconds, as opposed to the 3-minutes or so you need to actually increase flexibility) can do the same thing. If you have the range of motion you need, but you're in pain because you're tense, massage can help.
2) The other use I find pretty compelling is breaking up specific knots and adhesions in the muscle. This works best with Active Release Therapy, which you can actually do yourself. Find the knot, put a lot of pressure on it, and then move the muscle instead of the lacrosse ball or whatever you're using. Sometimes it's descibed as "flossing" the muscle. I don't know about the research behind it, but I find the anecdotal support so compelling that I don't question that this works.
Your injury does not sound to me like a promising candidate for massage. If it's actually an inflammed, soft tissue injury (a small tear), then you probably just need time. If you have a major competition coming up, then you MIGHT consider getting prescription anti-inflammatories. They will probably make you so tired as to be non-functional for a few days, but they are magic at reducing inflammation. They will NOT help the underlying injury, so they're risky. The inflammation has a purpose. It helps you to heal, but it also makes it harder for you to exercise, so you won't make it worse. Removing the inflammation will remove a major barrier to exercising, but it also removes the safety rails. I've done it once. I went from not being able to run more than 3 miles to making it 16 miles at MP before dropping out. From mile 13-16 I could tell I was aggravating it, so I dropped out before it got too bad. So in my experience it worked, but it wasn't the answer either. I needed more time.
800 dude wrote:
Webby is right. There is no good evidence supporting the general efficacy of massage for athletes, but there are a lot of things to keep in mind:
- "Massage" is not a modality like ice or NSAIDs that can be easily controlled. There are a ton of different massage techniques, and practitioners within different schools will still apply massage in very different ways.
- There are a ton of potential uses for massage, so just because studies looking at, for instance, general inflammation don't show results doesn't mean that particular types of massage don't produce results for particular use cases.
- There may be a placebo effect to massage, but in the context of athletics, the term "placebo" is somewhat slippery. We aren't a body and a brain; we're a complete organism, and the body and brain are tightly integrated. So it's probably a mistake to think of placebos as "fake." For instance, anything that reduces the sensation of pain is by definition a functional pain reliever, even if we don't understand why it works.
For my money, I find two basic uses for massage:
1) I think a general full body sports massage is useful at releasing tension, in the sense that your nervous system relaxes and reduces the activation of muscles. Short stretches (30 seconds, as opposed to the 3-minutes or so you need to actually increase flexibility) can do the same thing. If you have the range of motion you need, but you're in pain because you're tense, massage can help.
2) The other use I find pretty compelling is breaking up specific knots and adhesions in the muscle. This works best with Active Release Therapy, which you can actually do yourself. Find the knot, put a lot of pressure on it, and then move the muscle instead of the lacrosse ball or whatever you're using. Sometimes it's descibed as "flossing" the muscle. I don't know about the research behind it, but I find the anecdotal support so compelling that I don't question that this works.
Your injury does not sound to me like a promising candidate for massage. If it's actually an inflammed, soft tissue injury (a small tear), then you probably just need time. If you have a major competition coming up, then you MIGHT consider getting prescription anti-inflammatories. They will probably make you so tired as to be non-functional for a few days, but they are magic at reducing inflammation. They will NOT help the underlying injury, so they're risky. The inflammation has a purpose. It helps you to heal, but it also makes it harder for you to exercise, so you won't make it worse. Removing the inflammation will remove a major barrier to exercising, but it also removes the safety rails. I've done it once. I went from not being able to run more than 3 miles to making it 16 miles at MP before dropping out. From mile 13-16 I could tell I was aggravating it, so I dropped out before it got too bad. So in my experience it worked, but it wasn't the answer either. I needed more time.
Thanks. What do you mean 'instead of the lacrosse ball'?
Helped me a lot!
robert kraft wrote:
Helped me a lot!
what was your injury?
Massage is extremely helpful for some injuries, some not. It is great for body maintenance. Massage practitioners vary widely - like medical doctors - in skill. Some massage therapists lack the training to do anything more than rub oil on you and soften your skin! Also, like doctors, they have different specialties. Different techniques - deep tissue, shiatsu, acupressure, that - serve different functions. Most professional athlete get massages at least once a week. My massage therapist has a couple pro football players as clients. In season, they get massages at least twice a week. Massage increases blood flow, softens fascia that has stiffened or that "sticks" to the muscles. A good massage therapist and body practitioner can feel where strands of muscles in the hamstrings, etc. have twisted and can untwist them. They can move muscles and fascia to "sit" better around tendons and ligaments. I am a long time runner but no longer compete. I still work out every day - yoga, swimming, biking, weights. I could not do this without regular massage.
In the first two days after a sprain or strain, the protocol is no HARM (heat, alcohol, running or massage). The reason massage is in there is it can cause more harm than good in the first few days. After that there is little evidence to show any benefit. The best things are rest and cross training.
True, massage is not recommended directly following injury because of inflammation. Similarly, massage is not recommended for some diseases because it will basically help send the virus or bacteria around the body. Every case is different. And every massage therapist is different. But for increasing circulation, flushing out workout toxins, relieving nerve irritation, breaking up adhesions, etc., nothing beats it. Almost every professional sports team has a massage therapist on staff. The Olympic track team training centers have massage therapists on staff. And as I mentioned, my massage therapist has among her regular clients, two NFL players and a few athletes in Olympic sports - people who depend on their bodies for their jobs. It works.
I don't get massages and never have but I have used a hardwood rolling pin on my calves to some effect, because it loosens up the knots and for that reason slightly reduces the chances of tears. The tears come from tight muscles and I have noticed that sometimes my calf is bothering me and I'll stop for a few seconds to push on the knot and loosen it up a bit, and then it won't hurt. So, it seems to me that while the rolling doesn't have a clear long-term effect, sometimes breaking up the muscle tissue helps. Also, I found that with piriformis syndrome, some exercises helped a lot but that one thing I could do had an effect like massage on something where it is very hard for massage to help. The knot is very difficult to get at but if you just sit on a stone step or hard chair and move around a bit, you can feel the knot loosening and that was one of several things that I did that allowed me to get over the piriformis, which was not getting better at all before that.
muckedupleg wrote:
Thanks. What do you mean 'instead of the lacrosse ball'?
If you're jamming a lacrosse ball (for example) into a muscle knot, then you'd try to contract that muscle so that your its own activity actually pulls the knot across the stationary ball. It doesn't have to be a lacrosse ball, and different props work better on different parts of the body. A little resistance can help. For instance, if you have a knot in your quad, you might lie face-down with a lacrosse ball on the knot and your knee fully flexed. A friend could then press lightly on your instep while you try to extend your knee. If the ball is right over the knot, this can be pretty excruciating, but it feels better immediately. It doesn't have to be that extreme, though. You can usually figure these techniques out by trial and error, but there are youtube videos as well.
A bunch of definitive answers here without anyone citing even one study...classic.
theres your answer wrote:
A bunch of definitive answers here without anyone citing even one study...classic.
Including yourself. Congratulations pot! And you need to learn the meaning of definitive as it doesn't apply here. Above posters gave their takes, opinions, viewpoints and theories on the efficacy of massage. The very first response admitted you will have folks on both sides, AND cited a study.
I usually only get massages once a year to get over injuries. It does help. I found that I can immediately increase my mileage and pace afterward, and then the injury goes away over the next week or so. Ask for a sports massage with ART: https://www.healthline.com/health/active-release-technique
Physiology studies are bunk precisely because they aggregate a bunch of different cases. Individual observation tells us more and is more generalizable where it involves one method, not a variety of them, and no limit on observation with complete knowledge of what else we are doing--whereas scientists will lack that knowledge and have time limits on observation.
Here's another study that concludes:
"SMR [Self‐Myofascial Release] with a foam roll or roller massager appears to have short‐term effects on increasing joint ROM without negatively affecting muscle performance and may help attenuate decrements in muscle performance and DOMS after intense exercise. Short bouts of SMR prior to exercise do not appear to effect muscle performance."
"Massage" is a bit too broad to make a sweeping statement about its effectiveness for inflammation or injuries of many kinds. From my experience, certain types of massage have been very effective for short-long term treatment of injuries throughout my athletic career.
I started visiting a massage therapist that specializes in active release therapy (ART) in high school after a bad glute/piriformis injury. This type of massage got me back running consistently within a couple weeks after seeing this therapist after about three months of different therapies that didn't improve it at all. I continued running club level/ recreationally into college, and then transitioned into road cycling at a near professional level. I always stayed close enough to home to return for active release therapy as nagging running injuries crept into cycling or crashes resulted in some flare up. I was almost always able to continue training at a high level, and the massage therapy kept me going. At their worst, I would seek treatment once a week for 3-6 weeks and then also go periods of 6 months to a year without needing a visit.
I would caution to say that some of these injuries still nag me after 10 years and still make it hard to run consistently. While ART can get you through big flare ups to continue training, in hindsight I wish I had put more energy towards physical therapy and strengthening. Injuries do not happen for no reason and it is important to address the many possible imbalances that cause these problems for more long-term, sustainable health.
Messed up Calf wrote:
So apparently I have some kind of soft tissue injury (inflammation). It gets a bit better everyday but it is impossibly stiff to run on. Anyway I’m considering getting a massage but does it actually help? Has anyone ever had an injury go away from massage or is massage mainly just prevention ?
'Massage' is kind of nebulous. Triggerpoint therapy has helped me many times with injuries, mostly soccer-related. It can seem like magic.
In my experience massage helps with injury avoidance, not treatment. Once injured, you need a doctor not a massage therapist, unless the "injury" is more of a muscle knot or trigger points.
For anything tendon/ligament or bone related, massage is unlikely to help by itself (may help surrounding structures). For muscle issues however, very often "strains" are more likely to be tender knots, trigger points, or bands of muscle tissue that need to relax, and massage can help with blood flow and release.
In absence of any form of injury I found massage works best, as a preventative measure. A skilled deep tissue therapist can identify tight areas before they start causing problems elsewhere. I've had nearly weekly massages for 5 years now and my injury rate has dropped significantly. I find it particularly helpful on areas I can massage myself, like hamstrings, back of legs, or the very painful ones (calf, quads, groin).
It's expensive though ( I pay $100 all-in per session), but I find it worthwhile and my passion for running, and staying healthy, is worth more. Could I get by with a foam roller, self massage, more stretching? Probably. I also find Tiger Balm to be helpful, as my issues have always been nagging tightness, maybe inflammation..the usual stuff.
Do you guys find yourself more plagued with stress fractures, muscle tears and tendinitis, or are many of us dealing mostly with trigger points and muscle knots?
Messed up Calf wrote:
So apparently I have some kind of soft tissue injury (inflammation). It gets a bit better everyday but it is impossibly stiff to run on. Anyway I’m considering getting a massage but does it actually help? Has anyone ever had an injury go away from massage or is massage mainly just prevention ?
I think deep tissue massages can help in specific situations with prevention and recovery. It sounds like either you are over training or coming back to quickly. Maybe you could incorporate something to help it warm up pre run. I don't think a massage will help you except as a placebo.