Ian Itec Masseur Central London

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Month: February 2016

Pre-Event (Sports Massage)

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The role of massage in athletics is growing. It is a very common occurrence to see sports massage therapists at events ranging from 5K fun runs to the Olympic games.rem1

Sports massage involves the application of therapeutic massage and stretching to assist an athlete’s performance and recovery from activity. However, there are different types of sports massage based on when you give the massage in relation to the competition:

  • Immediately before competition (Pre-Event)
  • Between competitions on the same day (Inter-Event)
  • Immediately after competition
  • During the training program

When approaching these different types of sports massage, I prefer to focus on the purpose of the massage to direct me to the appropriate techniques. In this article, I will discuss the Pre-Event and Inter-Event sports massage.

The purpose of the pre-event sports massage is to prepare the athlete for high-intensity activity. The athlete is in the final stages of preparation and our job is to get the muscles loose without decreasing their psychological focus or causing significant physiological changes to their bodies. It is important to keep in mind that for this massage we are not looking to correct dysfunction or reduce stress, two primary goals of a typical massage therapy. Sounds crazy, doesn’t it? But it is true in this situation.

Psychological Benefits

Besides the physiological benefits of massage, a pre-event sports massage can provide many unique psychological benefits to the athlete. First, they may gain the confidence that any perceived muscle issues are being corrected, leaving them to compete at their highest level. They may also believe that they are getting something that the other athletes are not receiving, and thus getting an edge-up on competition.

Further, many athletes make massage part of their pre-game ritual. When they come in for their pre-event massage, it helps them focus because it is part of their pre-event routine, similar to listening to a specific song before every competition. Athletes are commonly very habitual and superstitious, so when building a relationship with an athlete, I would advise to stay consistent with your pre-event massage routine. Don’t make any drastic changes do what you do with them, or you may have a negative impact on their mental focus.

Finally, during a pre-event massage it is definitely not the time to point out any problems you have noticed. For example, don’t tell an athlete about to compete “boy, your right hamstring is really tight today.” The last thing we should do is draw their attention to a specific body part!

Pre-Event Timing

A pre-event massage is performed the day of the competition, usually between 30 minutes to 2 hours before competition. Some massage therapists suggest 1-2 hours before, but in general, you want to give the athlete at least 30 minutes from the end of the massage to the start of their competition. The duration of the sports massage should be just 10-20 minutes in length.

Pre-Event Techniques

The techniques I utilize in my pre-event massage are: Effleurage, compression/broadening, petrissage (kneading), ROM, Active Isolated Stretching, vibration, and tapotement (percussion). If you use oil/lotion on them before they compete, be sure they are able to wipe or wash off the excess, as it could interfere with their heat regulation through their skin. When working at the NCAA track championships, I would often perform the pre-event massage at the hotel and encourage the athletes to take a quick shower to wash off any excess oil.

All techniques should be performed at an up-tempo pace. Remember, we are not trying to soothe the athlete before competition. Keeping the pace of the effleurage and petrissage quicker than you would in a normal massage can even help to psych-up the athlete before competition.

When performing pre-event massage, the therapist should avoid using deep pressure on the athlete. Although some studies have found no change in performance following a pre-event massage (1), a study published in the British Journal of Sports Medicine (2) found a decrease in muscle force production of the knee extensors immediately following a lower limb massage. From personal experience, I have received feedback from track athletes that deep work makes their legs feel “dead” and unresponsive following deep tissue work.

Further, we do not want to perform relaxation techniques. At the time of the pre-event massage, the athletes are trying to get “hyped-up” for competition, and soothing Swedish massage techniques can inhibit the sympathetic nervous system and potentially harm their performance.

Finally, right before competition is not the time to achieve significant increases in flexibility, as the athlete is not used to the increased flexibility, and they may not have adequate strength in this new range of motion. Any work to improve range of motion should be saved for the therapeutic sports massage sessions you provide in the weeks leading up to competition, when the athlete will be able to properly adapt their neuromuscular control to these changes. Just remember, they’ve gotten this far with the flexibility they have, now is not the time to make big changes.

Inter-Event Massage

The inter-event massage is a massage performed between multiple competitions on the same day. Sports such as swimming, tennis, wrestling, track and field, softball, baseball, and volleyball often require athletes to compete in a tournament format, with a short rest between bouts. An inter-event massage has been shown to improve muscle recovery between repeated bouts of strenuous exercise (3)(4).

The main difference between a pre-event and inter-event massage is duration. While a pre-event massage is given for just 10-20 minutes, an inter-event massage should be even more brief (about 10 minutes). This type of sports massage should focus on just the main muscles stressed during the previous competition. So, be sure to talk with your athlete about the event they just finished to see what they felt during it and customize your work to help them feel they have recovered as best as they can before competing again.


1. Goodwin JE, Glaister M, Howatson G, Lockey RA, McInnes G. Effect of pre-performance lower-limb massage on thirty-meter sprint running. J Strength Cond Res 2007; 21 (4): 1028-31.

2. Hunter AM, Watt JM, Watt V, Galloway SD. Effect of lower limb massage on electromyography and force production of the knee extensors. Br J Sports Med 2006; 40 (2): 114-8.

3. Brooks CP, Woodruff LD, Wright LL, Donatelli R. The immediate effects of manual massage on power-grip performance after maximal exercise in healthy adults. J Altern Complement Med 2005; 11 (6): 1093-101.

4. Ogai R, Yamane M, Matsumoto T, Kosaka M. Effects of petrissage massage on fatigue and exercise performance following intensive cycle pedaling. Br J Sports Med 2008; 42 (10): 534-8.


Physical Therapy

neck-shoulder-painDoctors often prescribes physical therapy as part of the patient’s treatment and recovery. Many people think of physical therapy as some type of gentle, guided exercise to strengthen a tired body and it often is but when it comes to rejuvenating tissues and muscle, physical therapy massage is a great additional way to achieve optimal results. A healthy person can benefit from and relax with a massage because the therapist will work to knead out the knots, but for someone who has been injured, even a gentle touch can lead to excruciating pain. That is why a licensed physical therapist, one who has earned a bachelor’s or master’s degree in physical therapy, should be the only person to work with clients who need help to get back on the mend.

While massage therapists have a good understanding of anatomy and physiology, it almost goes without saying that a physical therapist has an even greater understanding of the way the body works, and what to do when it isn’t working well.

Think of a physical therapist as the health care equivalent to a car mechanic you need a skilled professional tinkering with your car’s engine and various parts, and it’s the same with a physical therapist when it comes to doing all the right things when it comes to working with injured patients. Physical therapists go to college for a degree, but many take classes in massage or even become licensed massage therapists as well. The combination of the two fields into physical therapy massage can result in quite the lucrative career, especially since doctors prescribe physical therapy for a host of ailments and injuries one does not have to be a professional athlete in order to undergo physical therapy. While massage therapy might be more for relaxation, physical therapy massage is a gentle way of rejuvenating the body and returning it to the healthier state it enjoyed before injury or disease.

Six Massage Techniques to Remove Scar Tissue

scar-tissueScars develop on the skin’s surface as the result of burns, deep lacerations or a variety of other injuries that penetrate or interrupt the skin’s integrity. Possessing an amazing capacity to heal and regenerate, the skin forms a scab over a wound within three to four days following an injury. By day ten the scab typically shrinks and sloughs off as the body focuses on laying down collagen fibers to strengthen the former site of injury. The damaged tissue can be in recovery between three months to over a year before it returns to full strength. Additionally, some diseases or skin disorders (such as acne) may also result in scar tissue formation. While scars can result from a variety of traumatic events to the skin, they share some common characteristics. As a general rule, the earlier and more consistently scar tissue is exercised, massaged and warmed, the less possibility of developing any long-term concerns.

Scar Traits

While the degree of scar formation varies from person to person, there are some distinguishing characteristics:

  • Becomes hard and non-pliable
  • Bands of fibers on or below the surface
  • Skin tightens or shortens. When crossing a joint, this contracture may limit range of motion, comprise function or cause deformity.
  • Becomes dry and reopens to form a wound if not managed properly. This is especially true for skin grafts, which do not produce oil or sweat.

While the body’s formation of scar tissue is an awesome demonstration of self-preservation, the resulting fibrous mass can set the stage for problems down the road. Composed primarily of collagen, scar tissue’s fibrosity prohibits adequate circulation. In addition to the physical limitations of collagenous tissue, the lack of blood flow and lymph drainage occurring in scar tissue makes it vulnerable to dysfunction. The resulting abnormal stress on a scar’s surrounding structures may include:

  • Nerve impingement
  • Pain
  • Numbness
  • Limited range of motion and flexibility
  • Postural misalignment
  • Muscle atrophy
  • Tissue hypoxia
  • An increase in potential for future injury

In fact, some professionals believe that scar tissue is the root of a majority of physical imbalances. Bodyworkers addressing scar tissue early in its development can help minimize any of the preceding secondary scar tissue problems.

Two Phases

A scar’s healing progression consists of two phases, immature and mature.

  • Immature – Immediately after a wound heals, the scar is immature. During this period it may be painful, itchy or sensitive as nerve endings within the tissue heal. While it is typically red in appearance, most scars fade to normal flesh color with maturation. Exercise, massage and heat application will have the greatest positive effect on an immature scar.
  • Mature – Depending on the size and depth of the wound, scar tissue will cease production 3 to 18 months following wound healing. When scar tissue is no longer produced, the scar is considered mature. While techniques to reduce scar tissue in a mature scar are effective, a more disciplined and vigorous approach is necessary

Six Techniques

As soon as the wound is knitted, massage therapy can be performed. During the initial immature stages of wound recovery, it is imperative that a gentle approach be taken. The following six techniques are well-known ways bodyworkers can improve scar tissue:

  1. Manual Lymph Drainage optimizes lymphatic circulation and drainage around the injured area. Gentle, circular, draining motions within the scar itself or a firm stretch to the skin above and below the scar, first in a straight line and then in a circular motion, are two drainage techniques. Placing the fingers above the scar, then making gentle circular pumping motions on the scar also helps drain congested lymph fluid. As the massage therapist gently works down the scar, the tissue will feel softer. Drainage techniques should not hurt or make the scar redden.
  2. Myofascial Release helps ease constriction of the affected tissue. To stretch the skin next to the scar, place two or three fingers at the beginning of the scar and stretch the skin above the scar in a parallel direction. Then move the fingers a quarter of an inch further along the scar and repeat the stretch of the adjacent tissue, working your way along the scar. An alternative method is to follow the same pattern of finger movements using a circular motion instead of straight stretches. Work your way along the scar in a clockwise and counter clockwise fashion.
  3. Deep Transverse Friction can prevent adhesion formation and rupture unwanted adhesions. Applied directly to the lesion and transverse to the direction of the fibers, this deep tissue massage  technique can yield desirable results in a mature or immature scar. Never progress beyond a client’s comfort level.
  4. Lubrication of the scar helps soften and increase its pliability. Mediums such as lotion, castor oil, vitamin E oil or other oil can prevent the scar from drying out and re-opening.
  5. Stretching aids in increasing range of motion. This is most important when approaching scars that cross over a joint. Scar tissue will lengthen after being stretched, especially if the stretch is sustained for several seconds and is combined with massage.
  6. Heat Application helps the pliability and flexibility of the scar. Common tools used to apply heat are paraffin wax, moist heat packs or ultrasound.


Massage therapists must use their training and best judgment when deciding whether or not to proceed with scar massage. While treatment is most effective when a scar is still in its immature phase, it is also a wise time to seek physician permission. A few additional cautions for immature scars include:

  • Take extreme care with radiated tissues, as the skin is delicate and can break easily.
  • Aside from friction massage, do not continue if your actions cause pain or increase tissue redness.
  • Never perform massage on any open lesions.
  • To prevent accidental sliding of the fingers, apply a lubricating medium after your primary work.

As a massage therapist, always keep in mind that scar tissue may be at the root of the physical imbalance you are preparing to address. If a scar is found to play a part in your client’s dysfunction, consider combining the six scar-reducing techniques described earlier. Not only can you minimize a scar’s appearance with bodywork, yet you can therapeutically correct the cause of your client’s physical ailments.

How does massage work?

physical-therapy-icon (1)For centuries, human touch has been shown to be emotionally and physically healing. Particular massage techniques may either stimulate or calm the body’s muscles and tissues to create a desired effect. When a practitioner massages soft tissue, electrical signals are transmitted both to the local area and throughout the body. These signals, in combination with the healing properties of touch, help heal damaged muscle, stimulate circulation, clear waste products via the lymphatic system, boost the activity of the immune system, reduce pain and tension, and induce a calming effect. Massage may also enhance well being by stimulating the release of endorphins (natural painkillers and mood elevators) and reducing levels of certain stress hormones.

What happens during a massage therapy session?massage works

At your first massage therapy session, the practitioner will ask you about any symptoms you may have (like low back pain) and will also ask questions about your medical history. The practitioner may also initiate a discussion about what you expect to achieve from the massage session.

The therapist leaves the room while you undress and lie down on the massage table. A sheet is draped over your body during the session and moved only to expose the part of the body being worked on at any given time. Massage oil or lotion is often used to reduce friction between the practitioner’s hands and your skin. The room is kept warm and free of distractions. The therapist will ask whether they are applying too much or too little pressure. Soft music may be playing in the background.

The manner in which a practitioner massages your body depends on the problem being treated. A massage session can last from 15 – 90 minutes and may include a schedule of follow up visits, depending on the severity of your situation.

What is massage good for?

In general, researchers believe massage supports healing, boosts energy, reduces recovery time after an injury, eases pain, and enhances relaxation, mood, and well being. It is useful for many musculoskeletal problems, such as low back pain, osteoarthritis, fibromyalgia, and sprains and strains. Massage may also relieve depression in people with chronic fatigue syndrome, ease chronic constipation (when the technique is performed in the abdominal area), decrease swelling, alleviate sleep disorders, and improve self image. In the workplace, massage has been shown to melt away stress and enhance mental alertness. One study found that deep tissue massage reduced blood pressure levels (an average reduction of 10.4 mm Hg in systolic pressure and a diastolic pressure reduction of 5.3 mm Hg). Other studies show that massage may have immediate beneficial effects on pain and mood among patients with advanced cancer.

Clinical studies show that massage relieves chronic back pain more effectively than other treatments (including acupuncture and conventional medical care for this condition with education via books and videos) and, in many cases, costs less than other treatments. Mothers and newborns also appear to benefit from massage. Mothers trained to massage their infants often feel less depressed and have a better emotional bond with their babies. Newborns who receive massage from their mothers also tend to cry less, and are more active, alert, and sociable. Premature babies who receive massage therapy have been shown to gain weight faster than preemies who do not receive this type of therapy. Infants who receive massage regularly may also sleep better, be less gassy or colicky, and have better body awareness, as well as more regular digestion.

Clinical studies also show that massage may be an effective treatment for young children and adolescents with a wide range of health problems, including:

  • Autism: Autistic children, who usually don’t like being touched, show less autistic behavior and are more social and attentive after receiving massage therapy from their parents.
  • Atopic dermatitis/eczema: Children with this scaly, itchy skin problem seem to experience less redness, scaling, and other symptoms if receiving massage between flares. Massage should not be used when this skin condition is actively inflamed.
  • Attention deficit hyperactivity disorder (ADHD): Massage may improve mood in children with ADHD and help them feel less fidgety and hyperactive.
  • Bulimia: Studies show that adolescents with this eating disorder feel less depressed and anxious after receiving massage therapy.
  • Cystic fibrosis: Massage may reduce anxiety and improve respiration in children with this lung condition.
  • Diabetes: Massage may help regulate blood sugar levels and reduce anxiety and depression in children with diabetes.
  • Rheumatoid arthritis: Children with juvenile rheumatoid arthritis (JRA) have been shown to experience less pain, morning stiffness, and anxiety as a result of massage therapy.
  • Labor: Studies suggest that massage helps reduce anxiety during labor. A bonus: massage increases oxytocin, a hormone known to facilitate bonding.

Are there any risks associated with massage?

In general, massage is considered safe. Pain or other rare negative side effects are generally caused by an extremely vigorous massage technique.

Women should be very cautious about receiving massages during pregnancy. If you are pregnant, be sure to find a therapist specifically trained to perform massages on pregnant women.

Even though massage is a useful technique to help regulate blood sugar over time, if you have diabetes, you should check your blood sugar after receiving a massage because it may be too low. Plus, if you have diabetes and you are receiving massage on a regular basis, you should check your blood sugar frequently to evaluate changes over time.

Should anyone avoid massage?

People with these conditions should avoid massage:

  • Heart failure
  • Kidney failure
  • Infection of the superficial veins (called phlebitis) or soft tissue (called cellulitis) in the legs or elsewhere
  • Blood clots in the legs
  • Bleeding disorders
  • Contagious skin conditions

If you have cancer, check with your doctor before considering massage because massage can damage tissue that is fragile from chemotherapy or radiation treatments. People with rheumatoid arthritis, goiter (a thyroid disorder characterized by an enlarged thyroid), eczema, and other skin lesions should not receive massage therapy during flare ups. Experts also advise that people with osteoporosis, high fever, few platelets or white blood cells, and mental impairment, as well as those recovering from surgery, should avoid massage. Check with your doctor.

Tell your massage therapist about any medications you are taking, as massage may influence the absorption or activity of both oral and topical medications.

What is the future of massage?

More research is needed to determine how effective massage therapy is, which health problems improve the most from this technique, and whether it is more cost effective than other types of treatment. Although massage is usually offered in the community by private practitioners, it is slowly being integrated into a variety of health care settings, such as hospice care facilities and hospitals.