Sports Massage

Sports massage is an approach to manual therapy that developed as a way to prevent and manage soft tissue strains and injuries. Sports massage is not a single technique but includes a range of approaches to bodywork and deep tissue massage. It usually focuses on a specific part or area of the athlete's body as distinct from a full-body massage.

Sports massage has several different purposes. It is used to prepare athletes physically and psychologically for competition, assist their recovery after the stress of major events, help them maximize the benefits of training, support overall physical fitness, and prevent injuries to muscles and joints during workouts or competitions.

According to the American Massage Therapy Association (AMTA), sports massage can be used to treat individuals who participate in sports for recreation and those in physically demanding occupations, as well as professional or college-level athletes. The number of clients who seek specialized sports massage in the United States has grown since the 1980s, as has the number of massage therapists. The AMTA estimated that there were between 185,000 and 200,000 massage therapists in the United States as of 2016, although the number of those who specialize in sports massage is not known. About 16% of the adult population in the United States has received at least one session of therapeutic massage in the last year.

The four basic types of sports massage are classified according to the times when they are used:

Therapists specializing in sports massage may either work for sports teams or set up private practices. A sports massage specialist who works for a professional sports organization is part of a health care team that includes the team physician/medical director, the athletic trainer, and a physical therapist. The sports massage therapist generally works under the supervision of the medical staff. Sports massage therapists in private practice may treat a mix of clients ranging from professional athletes who are referred to them to amateur and recreational athletes who need rehabilitation for injuries and advice about injury prevention.

The practice of sports massage is tailored to the individual athlete, with a typical assessment following the HOPS format, which stands for history, observation, palpation, and special tests:

Since the early 2000s, a form of self-administered sports massage has developed using foam rollers to relieve the discomfort of delayed-onset muscle soreness (DOMS) and general muscle stiffness. As of 2016, most foam rollers sold to the general public were between 12 in. and 26 in. wide and about 6 in. in diameter, and came in various densities. The user places the foam roller under the affected muscle or muscle group rolls it until a tender area is located, and then uses his or her body weight to place pressure on the tender area for 30–60 seconds. Like sports massage directed by a therapist, the foam roller breaks down scar tissue, loosens tissue adhesions, and stretches muscles and tendons.

Modern sports massage began in 1812, when a Swedish fencer and gymnast named Pehr Henrik Ling combined the techniques of what is now called Swedish massage with a set of exercises he used in training. Ling called his approach kinesiotherapy. In the early twentieth century, sports massage was widely used in Europe after a Finnish runner named Paavo Nurmi brought his personal massage therapist with him to the 1924 Olympics in Paris and won five gold medals. Sports massage, however, remained little known in the United States until 1972, when a Finnish runner named Lasse Virén set records at the Summer Olympics in both the 5,000-meter and 10,000-meter races. Virén credited deep friction massage with his victories.

In the United States, an orthopedic physician named James Cyriax set out to develop a series of deep friction massages for athletes in the 1970s that are still used in twenty-first-century sports medicine. In 1980, a book titled Sports Massage generated widespread interest in North America in therapeutic massage for professional and college-level athletes. In 1985, AMTA formed a National Sports Massage Team and introduced professional certification in sports massage for people already certified as massage therapists. AMTA continues to provide professional certification for sports massage therapists through online courses and continuing education. Online courses in sports massage cost between $62 and $125, as of 2016, depending on the course.

The benefits of sports massage include:

Contraindications for sports massage include a number of conditions and disorders:

In general, sports massage therapists without formal medical training will seek advice from a qualified health professional if they encounter any structural abnormalities in the muscles or overlying tissues that they cannot identify.

Little preparation is required for sports massage other than an evaluation by a sports message therapist and a determination of the body location and depth of massage required. As sports massage is typically focused on a specific body part, it is not usually necessary for the person receiving the massage to disrobe completely.

Athletes receiving pre-event sports massages do not require aftercare, as they will be entering competition within a short time after the massage. Following post-event, restorative, or rehabilitative sports massages, athletes will usually undress and shower to remove the oils (if any) used during the massage, dress, and resume their usual activities.

Apart from a slight risk of an allergic reaction to massage oils, sports massage has few risks when administered by a properly trained and certified therapist.

Sports massage is widely accepted as of 2016 in North America and Europe as a form of treatment for active adults, including those in physically demanding occupations, as well as competitionrelated and rehabilitative care for athletes. The growing number of massage therapists and physical therapists seeking specialized certification in sports massage indicates increased interest in the field, as does the expansion of the profession in general. The US Bureau of Labor Statistics predicts greater than average growth of massage therapy as a job category through 2026.

Research into the techniques and benefits of sports massage is carried on in Europe, Canada, and the United States, with most of the research being done in Europe. Much of the academic research as of 2016 is concerned with evaluating the claims made for the benefits of sports massage, with researchers reporting that some claims need further corroboration. Three clinical trials were underway in the United States as of late 2016, one evaluating the benefits of sports massage in brain tumor patients, the second evaluating sports massage as therapy for injured military veterans, and the third studying sports massage in the rehabilitation of ankle injuries.

As of 2016, few systematic reviews have been conducted on foam rollers as a form of self-directed sports massage because the technique is relatively new. Several preliminary studies of small groups of collegeage athletes, however, indicate that the rollers are effective in reducing DOMS.

Sports massage may be administered by either physical therapists with specialized training or massage therapists who have completed specialty certification in sports massage. Physical therapists in the United States are college graduates with postgraduate education leading to a Doctor of Physical Therapy (DPT) degree. Licensure requires completing a clinical internship and passing the National Physical Therapy Examination or NPTE. Specialization in sports massage follows licensure and consists of a residency in sports therapy that lasts between 9 and 36 months. To obtain board certification as a sports massage specialist, the physical therapist must pass an examination administered by the American Board of Physical Therapy Specialties.

Massage therapists in the United States and Canada are high school or college graduates who have completed a course of study (typically 650–1000 hours) at one of more than 300 schools or programs accredited by the Commission on Massage Therapy Accreditation (COMTA). In most states in the United States, massage therapists who have completed an accredited course in massage therapy or who have been certified by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) must still obtain licensure from the state in which they practice. Thirty-nine states accept NCBTMB certification as a basis for licensure, but others require the massage therapist to pass a state licensure examination. Specialized credentialing in sports massage is offered through a program administered jointly by the AMTA and the NCBTMB; it consists of the completion of six online courses followed by a hands-on workshop.

Rebecca J. Frey, PhD