Physiological Effects of Massage in Sport - Research Paper Example

Running Head: PHYSIOLOGICAL EFFECTS OF MASSAGE Physiological Effects of Massage Under the Guidance of Aims and Objectives of the study The aim of this study is to evaluate the physiological effects of massage in sports. The objectives are to determine the benefits of massage in a athletic setting and also to give scope for further research pertaining to the role of massage in physiological recovery and restoration. Background and rationale Many sports like boxing, cycling, racing, etc., involve repeated performance demanding quick physiological recovery and restoration. Sportsmen use massage as one of the means to achieve this. Although massage has been a common therapeutic modality in sports employed by many cultures all over the world, there is no scientific evidence to prove the usefulness of this therapy (Callagan, 1993). Whatever little research is available suggests that massage improves blood circulation to the muscles, thus causing increased removal of lactic acid which accumulates during stress and exercise and is a cause for fatigue. Infact, there are conflicting reports regarding the benefits gained from this form of treatment. To understand whether massage produces any benefits for athletes, it is important to understand whether it produces any physiological effects. There is very little research in the sports literature pertaining to this topic. Hence the aim of this research is to study the various physiological effects of massage in sportsmen so that the knowledge can be used to evaluate and assess the possibility of benefits of massage therapy to enhance performance and also speed-up recovery Literature review Since ancient times, massaging has been an established technique used for relief of pain and swelling, spasm of the muscles and also restricted movements (Goats, 1994). The oldest mention of this treatment dates back to 2598 BC (Goats, 1994). Despite lack of concrete scientific basis, massage has enjoyed an important role in athletic rehabilitation (Goats, 1994). Currently, this form of therapy is gaining more and more importance and there is lot of research going on to determine the benefits and the mode of action of this treatment. There are basically 2 techniques of massage, namely, the manual techniques and equipment techniques. In manual techniques, various hand motions are practiced on the human body with therapeutic intention. Some of the commonly used manual techniques are effleurage, kneading, petrissage, frictions, tapotement and vibrations and shaking. Equipments can be used to produce effects similar to manual massage. The devices either cause increased pressure at the site of application or cause vibration or both. Advances in equipment massaging have led to hand-held roller therapy, undercurrent massage, hydromassage, pneumatic external compression and therapeutic ultrasound (Goats, 1994). Research has shown that massage therapy produces diverse physiological and therapeutic effects. Massage causes mechanical pressure which in turn increases arteriolar pressure. The rubbing in the therapy causes rise in muscle temperature. Raised muscle temperature and increased arteriolar pressure contribute to increased blood flow. Depending on the type of massage, and the kind of mechanical pressure exerted, massage can cause either a decrease or increase in neural excitability. Other than these changes, massage causes changes in parasympathetic activity as defined by heart rate, variability of heart rate and blood pressure. Massage also causes certain hormonal changes like decrease in cortisol levels. All these physiological changes contribute to the feeling of relaxation It is due to these benefits that massage is regularly used in athletic setting to enhance performance and also to decrease the risk of injury (Weerapong, Hume and kolt, 2005). Failure to maintain force in sports has been attributed to muscle fatigue (Edwards, 1981; cited in Zelikovski et al, 1993). The cause of this fatigue is due to accumulation of various metabolites like lactate, bicarbonate, ammonia and pyruvate (Simonson, 1971; cited in Zelikovski et al, 1993). It has been proposed that enhanced blood flow causes increased oxidation of metabolites and increased outward diffusion from the muscles, thus decreasing lactate and other metabolite levels in the muscle (Hemmings et al, 2000). Though it has been presumed that massage causes speeding up of blood flow to the muscles, research reports pertaining to this are contradictory and offer no conclusion (Hemmings et al, 2000). While some studies have demonstrated that massage increases blood volume, promotes acceleration of muscle and venous blood flow and also causes decrease in the tightness of the muscle, other studies have demonstrated the lack of improved circulation following massage therapy, irrespective of the type of therapy employed with therapeutic intention. Shoemaker, Tiidus and Mader (1997) studied the effects of different forms of massage therapy on the blood flow in various muscles. The results of the study indicated that massage did not cause improvements in the blood flow. Previously, another study by Tiidus and Shoemaker (1995) had already reported the ineffectiveness of massage therapy in the restoration of post-exercise muscle strength in athletic settings. Gupta et al (1996) opined that short term body massage is an ineffective method of lactate removal after exercise and that active type of recovery was a much useful method to enhance lactate removal. Zelikovski et al (1993) studied the effects of muscle massage on the blood levels of various fatigue-causing metabolites. The results of their study proved that massage did not decrease the blood levels of the metabolites, but it did increase the performance level of the subsequent exercise bout by atleast 45%. The researchers proposed that disappearance of the exercise induced fluid accumulation following massage probably led to the improvement in performance. Such an improvement in repeat performance following massage therapy was demonstrated by other researchers too. While Rider and Sutherland (1995) reported improvement in repeat quadriceps performance, Viitsalo et al (1995) demonstrated enhanced neuro-muscular performance with massage treatment. Hemmings et al (2000) reported that massage did not decrease the blood lactate levels in an exercised body. However, their study proved that though there were no physiological benefits following massage, some amount of psychological boost contributed to improved performance. Research on the effects massage on muscle recovery and restoration has produced equivocal results. While some physiotherapists and athletes argue in favor of massage therapy and claim that massaging can optimize performance and aid recovery, others doubt the benefits of this therapy. There are lots of variations in the methodology, massage duration and other aspects which influence the results like standardization of warm up and period of active recovery. Thus, it is very difficult to interpret results of the studies pertaining to this treatment modality. Materials and Methods First of all, ethics committee approval will be taken before the commencement of the study. 20 male football players who will volunteer to participate in the study will be enrolled as participants. The players will be such that they have been regularly playing. The type of study that will be conducted will be a randomized control trial. Criteria for inclusion in the study 1. Male aged above 18 years of age 2. Plays football regularly 3. Gives consent to take part in the study Criteria for exclusion in the study 1. People with psychological or any physical health problems Sampling strategy 20 members from regularly practicing football teams will be contacted and members from those teams who are willing to participate in the study will be enrolled based on the inclusion and exclusion criteria. Research design This will be a randomized control trial. 2 groups will be formed, the study group and the control group. The study group will be subjected to massage therapy while the control group will not be subjected to any treatment. Randomization of participants to the groups will be done using software to avoid bias. 10 participants will be allocated to each group. Consent Consent would be obtained from the patients participating in the study. The consent would be taken in writing after informing the patient about full details of the research proposal prior to including into participation in the research. Data collection method and data analysis plan The participants will enter the laboratory on 3 different occasions one week apart. During the first visit all the participants will be familiarized with the protocol of the study. However, details of randomization will not be let out. Details of dietary intake and intensity and duration of exercise will be recorded 2 days prior to the familiarization visit. The participants will be asked to replicate the same diet and exercise 2 days prior to each of the next 2 visits. All participants will be instructed not to take any medications or alcohol prior to each visit and they were also instructed to exercise heavily on the day prior to the visit. During each setting, the heart rate, blood pressure and temperature of the participants will be recorded and then blood samples will be collected for blood lactate and cortisol levels. These tests will be performed after questioning the participants about compliance with dietary and exercise norms of the study. After the tests, the participants will be subjected to a standardized 5-minute light warm up and a standardized 5 minute- stretching exercise. After this, the participants will be then be asked to complete 6 standardized 30 second high intensity bouts of cycling on a cycle ergometer. Each bout will be interspersed with 30 seconds of active recovery. After all the six bouts, the participants will take 5 minutes of active recovery time. Following this, those in the study group will receive 20-minutes of standardized massage therapy for the legs. Those in the control group will only rest in supine position for 20 minutes. After these 20 minutes, all the above tests will be repeated. This protocol will be repeated during all the 3 sessions and the results will be analyzed statistically. Avoidance of bias Bias in this study will be avoided by strict randomization and adherence to standardized protocols. However, those who receive massage therapy may psychologically feel better and that may impact the physiological results. Implications for practice Since massage therapy is commonly used by physiotherapists and athletes for physiological recovery and restoration in sports, an understanding of the physiological effects of massage can provide fuel for further research pertaining to the benefits of massage therapy. References Callaghan, M.J. (1993). The role of massage in the management of the athlete: a review. Br J Sports Med., 27(1), 28–33. Goats, G.C. (1994). Massage--the scientific basis of an ancient art: Part 1. The techniques. Br J Sports Med., 28(3), 149–152. Gupta, S., Goswami, A., Sadhukhan, A.K., Mathur, D.N. (1996). Comparative study of lactate removal in short term massage of extremities, active recovery and a passive recovery period after supramaximal exercise sessions. Int J Sports Med.,17(2), 106–110. Hemmings, B., Smith, M., Graydon, J., Dyson, R. (2000). Effects of massage on physiological restoration, perceived recovery, and repeated sports performance. Br J Sports Med., 34(2), 109-14. Rinder, A.N., and Sutherland, C.J. (1995). An investigation of the effects of massage on quadriceps performance after exercise fatigue. Complement Ther Nurs Midwifery, 1(4), 99-102. Robertson, A., Watt, J.M., and Galloway, S.D. (2004). Effects of leg massage on recovery from high intensity cycling exercise. Br J Sports Med., 38(2), 173-6. Shoemaker, J.K., Tiidus, P.M., and Mader, R. (1997). Failure of manual massage to alter limb blood flow: measures by Doppler ultrasound. Med Sci Sports Exerc., 29(5), 610-4. Tiidus, P.M., and Shoemaker, J.K. (1995). Effleurage massage, muscle blood flow and long-term post-exercise strength recovery. Int J Sports Med., 16(7), 478-83. Viitasalo, J.T., Niemelä, K., Kaappola, R., Korjus, T., Levola, M., Mononen, H.V., Rusko, H.K., Takala, T.E. (1995). Warm underwater water-jet massage improves recovery from intense physical exercise. Eur J Appl Physiol Occup Physiol., 71(5), 431–438. Weerapong, P., Hume, P.A., and Kolt GS. (2005). The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Med., 35(3), 235-56 Read More