Chronic Injuries and Sports Massage

5/20/2013

For many athletes, the injuries that have the greatest long-term impact are chronic injuries or injuries that occur over time with no obvious incident.  Chronic injuries include things like patellar tendonitis (aka Runner’s or Jumper’s knee), Achilles tendonitis, “shin splints”, shoulder impingement, IT Band syndrome, and bursitis to name a few.

With the exception of bursitis, all of these injuries share one common element.  That element is scar tissue as a result of microtrauma.  Microtrauma can occur from repeated overuse as seen in activities like distance running, swimming, jumping, biking, weight lifting, throwing, or any other activity performed numerous times in succession.  It can also be the result of a single injury such as an acute sprain, strain, or bruise that fails to completely resolve and is exacerbated by continued activity.

Once microtrauma has occurred the body begins the cycle of inflammation and repair.  Inflammation on it’s own is not a bad thing.  It is the body’s way of removing damaged tissues and preparing the site for healing.  Inflammation can cause problems when poorly controlled or when the healing is incomplete.  One of the results of this is the development of excessive or bulky scar tissue.  As the body heals it lays down rudimentary scar tissue without concern for future use.  This scar tissue should eventually be removed and replaced by more refined scar tissue and eventually fully repaired tissue.

It is important that old bulky scar tissue be broken down and removed by the body in order to break the chronic injury cycle.  Anti-inflammatory medications can help break the cycle of bad inflammation and pain, but do not actively address the formation of scar tissue in chronic injuries.  Sports massage, or deep tissue massage, is an intense therapy used to assist the body in breaking down scar tissue so that it can ultimately be removed through the normal cycle of inflammation and repair.

In addition, the use of sports massage can help to re-align collagen fibers as healing occurs.  This re-alignment is important to establish future strength in healthy tissues.  Based on Wolff’s law (and the expanded idea of Specific Adaptation to Imposed Demands), which says that tissues will adapt to the stresses placed upon them, increasing tissue stress during healing (carefully!) will result in a better overall recovery.

The other significant benefit of sports massage is that it decreases the overall muscle hardness.  Muscle hardness might best be described as abnormally high tension within the muscle.  This increased tension predisposes the muscle and tendon to injury.  Post exercise stretching can help reduce this (see the post about cool down and stretching here), but once chronic injuries have begun sports massage may be necessary to decrease muscle hardness to the point where stretching can maintain normal muscle flexibility.

Is sports massage something every athlete needs or should have regularly?   Not necessarily.  Some people never experience these types of chronic injuries and many injuries never become chronic because they resolve on their own.  However, if you are experiencing on-going symptoms that fail to resolve, sports massage (along with rehabilitative exercise) may help speed your recovery and may help prevent a re-injury in the future.

Dr. EagarDr. Eagar is a dual credentialed provider with degrees in sports medicine, chiropractic medicine, and exercise science.  Dr. Eagar owns Active Advantage, a private sports medicine practice with an emphasis on rehabilitation and chronic injury management.  He enjoys answering questions and can be reached at activeadvantagechiro@gmail.com.  For more general information you can visit his website http://www.activeadvantagechiro.com.

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