What is massaging?
Massage therapy have been around for decades and research on the topic regarding using it in recovery date back to the 70’s. Cafarelli & Flint defined massage therapy as “mechanical manipulation of body tissues with rhythmical pressure and stroking for the purpose of promoting health and well-being”.’ Massage therapy have been used for various purposes in the sporting world, extending from preparing for events to preventing of injuries. The role it plays in enhancing recovery based on scientific research, is however still a bit indecisive.
So what does the research say?
Massage therapy as a recovery modality have been researched in numerous areas namely:
Here is a summary of the findings:
- Increased Skin and Muscle Temperature
- Very little effect, especially effleurage
- Increased Blood Flow
- Very little effect on localised blood flow, but might be effective in improving blood vessel function
- Blood Lactate Removal
- Very little supportive evidence of this. There have even been studies to suggest that massaging impairs blood lactate removal.
- Hormonal Response
- Some evidence to support decrease in cortisol levels
- Passive Stiffness
- Not consistent evidence on this, but in the cased it did work, it lasted only up to 24hours
- Joint Range of Motion
- Positive effect on increased joint ROM
- Parasympathetic Activity (Relaxation)
- Very effective, although limited studies done on athletes
- Neuromuscular Excitability and the H-Reflex
- Effective to reduce muscle excitability and H-reflex
- Deep massaging seems to be more effective.
- Effects on Pain
- Effective in reducing the perception of pain
- Effective in short term reduction of anxiety
- Very effective
- Perceptionof Recovery
- Effective, but should be noted that it’s only the perception of recovery
- No improvement physiological markers
- Peripheral Neutrophil Levels (White blood cells)
- Not sufficient evidence to support increase neutrophil levels.
- Immunoglobulin A
- Increase in A(IgA) post massage, more so in females than males
- Not sufficient evidence to support increase lymphocytes
There are lots of claims of the benefits of massage therapy in the recovery process, but very little scientific evidence to back it up. The current body of research would suggest that massages post training or game could be beneficial for the following:
· Increase localised blood flow (short duration)
- Increase skin and muscle temperature (short duration)
- Reduce passive muscle stiffness
- Increase joint range of motion
- Increase parasympathetic tone and decrease neuromuscular excitability
- May reduce perception of pain due to increase serotonin and dopamine levels
What is Stretching?
In his book, Stretching for Functional Flexibility, Phil Armiger describes stretching as “the application of force to musculotendinous structures in order to achieve a change in their length, usually for the purposes of improving joint range of motion (ROM), reducing stiffness or soreness, or preparing for (physical) activity.”
Stretching can be either singular acute 30-60sec stretch or chronic in which a series of stretches is performed over days or weeks.
So how does static stretching relate to recovery? First of all we have to look at what recovery is. Recovery in the sporting environment is seen in two parts.
- Body returning to homeostasis (reducing fatigue)
- Adapting to the impose training demand (Supercompensation)
The theory behind post-exercise stretching is that it will enhance recovery in two ways namely,
- Reduce muscle soreness (DOMS)
- Reduce stiffness (restore pre-exercise ROM)
This theory is based on early research that believed unaccustomed exercise leads to increase muscle pain and spasms and cause a reduction in muscle blood flow. Post exercise stretching was believed to interrupt the process of muscle spasm and pain by increasing the blood flow to the area, thus reducing muscle spasm and pain and enhancing the recovery.
So what does the research say regarding the effect of post-exercise stretching?
- Reducing muscle soreness
- Despite its popularity, post exercise stretching has no real meaningful effect on muscle soreness
- Restore pre-exercise ROM
- Effective, but not recommended. Dynamic, pain free ROM movement would be a better choice
- Improve ROM
The problem with post exercise stretching is that for a static stretch to be effective, the stretch need to cause mild discomfort. If you are trying to recover after a session, utilising a method that enhances discomfort seems to be contradictory to what you are trying to achieve (reduce pain). Research has also demonstrated that blood flow, capillary region oxygenation, and the velocity of red blood cells to the muscle decrease during stretching.
It would appear that although static stretching could enhance pre-exercise ROM, it’s not the only recovery modality to do so. As mentioned earlier in part 1 of this article, hydrotherapy, foam rolling and massaging are also an effective tool to enhance post exercise ROM, but without the discomfort that stretching and with additional benefits. There is however no research comparing these different modalities and which one is more effective in re-establishing post exercise ROM.
Another interesting observation regarding chronic static stretching and improved ROM is that it is likely that the muscle increased its stretch tolerance (ability to withstand more stretching force), and not increased muscle length.
So what is the take home message for post-exercise static stretching?
- It has very little effect on decreasing muscle soreness.
- It may improve post exercise ROM, but at the cost of enduring mild discomfort. There are more comfortable tools to use to reach the same outcome like dynamic stretching, mobility exercises, hydrotherapy, foam rolling and massage therapy.
- Static stretching reduces blood flow, capillary region oxygenation, and the velocity of red blood cells to the muscle. This could be counterproductive in the recovery process.
I would suggest that there are more effective and equally practical alternatives for static stretching post exercise to enhance recovery, most of which have been mentioned in part 1 and this article.