I’ve rather good at injuries, not only have I fractured my olecranon, but about 18months around I had serve neck pain – torticolis – as a result of staining my trapezius muscle. Physiotherapy sorted the original injury, but couldn’t quite get the muscle permanently pain free. It was suggested that a sports massage might help “losen” the muscle, after all injuries to the muscles of the upper extremity can be more complex due to the nature of the joints there . This is my experience, and take on sports massage
We service our bikes, change our running shoes very 400km, and we have a raft of protein/electrolyte supplements for pre, during and post exercise we take in an almost ritualistic manner. But, in terms of actually looking after the very muscles we love to pummel so much out of the track or on the bike, the best we probably do is a short stretching session after a work out.
For many people thats, fine. However we’ve all had the experience before, after a 10km race for example, even when properly stretched after, of walking for the next few days like we’ve been cut from a 1930’s movie. Sports massages, in addition to the stretches, can help to keep you walking like someone from the digital age after your event, thats a no-brainer, but it can also help to address and prevent a series of sports injuries.
I’ve always considered myself to be a scientist first and a medic secondarily. As a result I’m naturally skeptical, and don’t even remotely buy into unevidenced complementary therapies. Sports massage is a little like that, one person will come at it from a scientific, physiotherapy approach and another from a chiropractic approach – stay away from anyone who mentions you being “out of alignment” – I’ll explain why in the “Science!” section below
But back to the therapy – Sports massages, in my opinion, go hand in hand with bike fits- such as the Guru. Frequently people tweak their bikes to address certain niggles, but sometimes can’t quite address the problem, so a professional bike fit looks at the whole of the rider and their interaction with the bike, and may need to be revisited as a riders training and performance increases. Similarly a sports massage can be used to address sports specific soft tissue issues, such as over use injuries and muscular imbalances which may develop, yet remain unrecognised.
I’m not as unlucky has this post initially sounds – even with the fact that this blog was set up in the wake of my fractured elbow! – about 2 years ago I was on a bouncy castle (it was a “work do”, and I think there was something along the lines of Doctors vs Nurses happening on said bouncy castle…ANWAY…) and in the course of events landed on my head – Doh!
After the party, within a few hours, I developed an excruciating pain on the LEFT side of my neck – I mean nearly not being able to go to work level pain. But the nature of the pain was clearly muscular, I certainly hadn’t broken anything, and we ended up opting for the diagnosis/label of cervical dystonia – basically a neck spasm. With the theory being that when I landed on my neck, I’d hyperextended my neck to the RIGHT, resulting in a strain to trapezius, causing subsequent muscular spasm and pain.
I basically had a REALLY sore neck for about a month, which improved with rather painful physiotherapy. The problem was, that the discomfort never fully disappeared. Even after 18months, there are still several triggers, such as a long session on the bike, which can result in the discomfort coming back
Recognising that something wasn’t quite right with my shoulder, I opted for a local sports massage, looking for someone who was able to provide a Soft Tissue Release
This lead me to The WildMoor Spa, where they allow therapists to use rooms, in their spa department. This does translate to a slightly different vibe when compared the the usual very clinical environment of a physiotherapy clinic!
Remember that the basis of sports massage and the majority of physical therapy like it has the goal, as summed up by Cochran-Fritz (1993) of “manipulation [to] interrupt the pain-spasm cycle by reducing pressure on nerves through an initiated relaxation of local muscles, increasing blood flow and removing chemicals that stimulate pain receptors.”
What doesnt matter is the location or the decor – the important point is a therapist that listens to your problems and helps you identify the issue – which may sometimes be different than what we initially think – and puts in place a plan to address the problem
Soft Tissue Release
When you look at information regarding soft tissue release, there are quite a few buzz words used, which to my mind, dont quite ring true with the underlying physiology – although crucially the outcome is the same.
Soft tissue release, focused deep massage on specific areas of tension – basically this is going to transpire to someone pushing right into the most painful parts of the muscle. Post exercise/sports this tension is actually going to areas of muscle damage and resulting spasm after the exercise.
Remember you’re body is an amazing machine. If you work a muscle hard, it gets damaged, but that is how we grow and increase strength. If that is hurting, its not your body saying “I’m gong to be a spoil-sport” its quite literally saying “this bit needs to heal, dont push me”
That is the very reason WHY we have pain, to try and stop us hurting ourselves.
BUT like antibiotics to help fight off a pneumonia, sometimes your body needs a bit of help, hence soft tissue release.
With my neck, the top of trapezius has been in spasm for quite some time, but the discomfort would worsen when typing for long periods, or crucially cycling on the drops.
The typing issue could be addressed quite easily – stop slouching boy!
I even went as far has a standing desk at the medical school – Oh yes, I put some boxes on a desk! I know, I should basically be employed as a designer at IKEA!
But the pain on the bike was still irritating. I’d have a tolerance of about 1 hour, and then the pain would start on the LEFT side of my neck
The sports massage involved 1 hour sessions working my back, and shoulders.
It was a very interesting experience thats for sure – especially as during the session we also found so tightness in the LEFT side of my lower back, in the region of spinae erector muscles.
Which does make a lot of sense given how I slouch when typing occasionally (SIT UP BOY!)
In the LEFT trapezius, the muscle appeared much tenser, and certainly painful that the RIGHT side, although only in one area, which corresponding to a tender lump I could Laura pressing down on inside the belly of the muscle.
Over the course of 6 sessions, I’m please to say that the discomfort in my LEFT shoulder muscles is almost completely vanished today.
I also seem to have an issue with iliotibial band syndrome on my RIGHT knee – which is probably the most debilitating issue I have – at least the olecranon has healed!
Unfortunately we were unable to make much headway on addressing that. As a result I will be looking at a gait analysis over the next few weeks – so stay tuned for that report/review
Ultimately the problem I had, a painful shoulder following an injury was fixed. By the science behind how that was achieved is certainly harder to quantify, as I’ll go through below
In any regard, the actual experience of going for a sports massage is variable from relaxing to excruciatingly painful depending on which muscle groups Laura was massaging, and depending if I’m been competing in 10km road races, or just riding my bike.
If you’ve sustained a muscular injury, particularly resulting in a spasm as opposed to a sprain. Something like torticolis, piriformis syndrome, achilles tendonitis, you may find some benefit in a Sports Massage looking at Soft Tissue Release.
Much more I can’t really offer in terms of recommendation or opinion as there just isn’t the hard science out there. But if nothing else the sports massage was good value at £45 a session, and I know in pre-ride stretches after a session I was certainly more flexible. Which as may people know and appreciate, maintaining flexibility is highly important to preventing over use injuries on the bike
If you are in the Stratford-upon-Avon area, I can personally recommend Laura – who is happy to discuss muscle related problems, and perform sports massages – her contact is 07505141752
As for the stretches that we should all be doing at home… I’ll let the GCN boys show some of the best examples I’ve seen!
The purpose of this section is to try and explain bits in the above narrative, and my medical interpretation of a lot of the comments on forms and adverts for various massages
- Trigger points and Myfascial knots are, like many things with regard to painful muscles, relatively scientific unknowns. My personal experience (that is a phrase to always treat with caution, as it has the scientific validity of my experience with Unicorns! But it is all I have for this narrative due to a lack of science in this entire area), was of physically feeling a hard lump inside my trapezius during the massages, which when broken down – through several excruciating massages – hasn’t really returned to any degree. Thus I can cycle for 3 hrs before any issue with the shoulder becomes apparent. I personally don’t feel it will ever completely resolve, although I believe that was due to the original injury where I feel I tore some of the muscle fibres in trapezius, which will leave a small amount of permanent scaring. But the spasm was certainly released/improved by the sports massage
- The point is, “muscle knots”, which is how we can to term this lump, haven’t been conclusively proven, and certainly not imaged. Although there is more evidence beginning to point to a physical structure, or more accurately band of spasmed tissue within the muscle – with a new type of MRI – Magnetic Resonance Elastography identifying taut bands within the painful regions of affected muscles
- As for “trigger points”, the systematic reviews (the gold standard in medical evidence) on the subject have drawn blanks, and have not been able to comment due to the poor quality level of the evidence in literature.
A major point is that sports massage is not the same as going to the chiropractor, which with regard to “spinal alignment” has no justifiable place in modern medical care.
- First off, I am talking about in this post is sports massage and NOT Chiropracty, which I view as a pseudoscience. Let me be very clear why that is the case. The whole of chiropratice is based on “alignment”, which initially sounds sensible. If I can have a muscle imbalance, why can’t I have a spine that is out of alignment… You can’t, because of how the chiropracters themselves define what this means: Chiropractic subluxation is the basis of this approach.
- The first word, chiropractic, is really important, as it is now used as a catch all, without any definitive explanation. The second word, subluxation, is a defined medical term meaning partial dislocation.
- The chiropractic theory means a single vertebrae has moved “out of alignment.”
- The chiropractic subluxation has never been demonstrated in medicine – WAIT –
- To cover all angles, there is a condition known as spondylolisthesis where the whole spinal column essentially slips forwards over one vertebrae. But this is not something that can be treated with someone poking and prodding you in the back. This requires spinal surgery, normally involving plates and screws to prevent things slipping further.
Plus we can see a spondylolisthesis on X-rays and MRI
A way of looking at this would be to ask:
- Can a tree fall over – yes – spondylolisthesis.
- Can a section with the tree slip forwards, or backwards, on its own or by force…No – this would be a chiropractic subluxation.
But the defining point here is we CAN, and DO image the spine in medicine. There are lots of XRAYs and MRI’s of spondylolisthesis
– Look here’s one – the image is a link to Radiopaedia.org with plenty of other examples
- There has never been a medically validated imaging of a Chiropractic subluxation.
- Even the journal of Chiropractic & Osteopathy published a paper systematically taking down the concept…But that seems to have been rejected by the people practicing chiropractic…strange that!