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Training / Training Talk

Running Training Talk...............................

The Multi-Faceted Role of Massage In Running
By Melissa Hall, LMT

Runners seek massage for many different reasons, to: relieve soreness, reduce recovery time, increase performance, prevent or recover from injury, and retain balance in the body’s energy systems. Whatever your competitive level, massage is beneficial and should be a regular part of your optimal training plan.

A Physiology Lesson
Exactly how does massage work? Massage works in so many ways, it would be beyond the scope of this paper to explain them all. Not to mention, science is still discovering all the ways in which massage brings healing to our bodies. The intention of this article is to explain some of the major benefits of massage to the circulatory and musculoskeletal systems.

In order to begin, we must first lay a foundation with some discussion of connective tissue. The main tissues we will include are: tendons, ligaments, muscle tissue of the musculoskeletal system, and fascia.

Muscle tissue is contractile in nature. It is this contraction or shortening of the muscle that brings about the movement of our bones. The “harder” the contraction, the more shortening occurs in the tissue, the more force is generated. The degree of muscle recruitment also determines the force generated by the contraction. You may have most memorably experienced this phenomenon when lifting weights. You contract your muscles, but the weight doesn’t budge. So you try a little harder, still nothing. Again, try a little harder, and the weight moves. Your brain was guessing at the number of muscle fibers it needed to recruit in order to move the weight. When the first guess yielded nothing, it recruited increasingly more muscle fibers until there was success. Your brain may have based its guess on muscle memory (you have been working out with this weight recently) or may have made a determination based on no previous input. Healthy muscle tissue is supple and resilient. It has some ability to stretch. And, when relaxed, it should feel soft to the touch.

Fascia is a very special connective tissue. You have fascia in every nook and cranny in your body from the top of your skull down to your pinky toe. It serves many purposes within the body. It holds things in place – like organs, it forms a bath tub for your spinal cord to be washed in cerebrospinal fluid – the meninges, and it wraps and separates numerous parts of the body – like muscles. Have you ever considered how your muscles lay together, one on top of the other and squeezed in next to each other? What keeps them from just mushing all together? Fascia. Consider the front of your thigh. What’s there? Your quadriceps. Quad – meaning four. So, you have four very large muscles on the front of your thigh. Did you ever wonder why you need four muscles to do the one job of extending the knee? Well, each quadricep works with a different timing and force at various stages of knee extension. There is a choreographed dance that occurs within the muscle group as you stand up out of a chair. One portion of a muscle fires, then another, working in harmony for the ultimate goal. Within each muscle, the fibers run in various directions. They do not run just straight up and down from the top of the femur to the knee, but at various angles to allow each muscle to be specialized, affording you virtually limitless choices on when and how to move your body. Because of this, there is relative motion that occurs between each of the four quadriceps. They do not move together at the same time, with the same contractile rate, or in the exact same direction. Thus, the need for fascia – myofascia to be more specific (myo meaning muscle, myofascia being that which is specifically associated with muscles). The myofascia wraps and separates each muscle and allows for the relative motion to occur. Myofascia also absorbs a portion of the stress that we conduct in our bodies when we run. As a matter of fact, laying down additional layers of fascia to handle the increased stress is one of the adaptations that occur in new runners.

Tendons attach the muscles to the bones. I used to wonder exactly how this occurred. What did nature use to complete this attachment – a nail? Well, no, nature is incredibly more intricate than that. Fascia has a fibrous element. It is a fairly fibrous substance, but certainly not the most fibrous. At the end of the muscle belly, the myofascial wrapper comes together and gets increasingly more fibrous until it forms a tendon. This is one end of the intersection at muscle and bone. On the other end, our bones are wrapped in a tight layer of fascia known as the periosteum. Our tendon knits into the periosteum, forming the attachment site. The periosteum is so tight and the knitting is so strong that often the bone itself cracks (stress fracture) and gives before the attachment will.

Ligaments are connections from bone to bone. While muscles create movement, ligaments attempt to restrict movement. For instance, we do not want our knees moving from side to side. We only want them to move forward and backward. Thus, we have an complex system of ligaments in our knee to prevent unwanted motion. Ligaments are incredibly strong due to their highly fibrous nature. Ligaments are neither contractile nor supple in nature.

The Importance of Circulation
When you think of blood what comes to your mind? As a sports massage therapist, the following things come to my mind: oxygen transfer, nutrient delivery, and waste removal. Our blood accomplishes amazing things for us. It is truly our life “juice”. Without circulation of blood, our tissues become necrotic – they die. Our arterial system brings us blood that is freshly supplied with oxygen from our lungs. It is pumped by our heart down into the smallest of all vessels, the capillaries. Here is where the magic transfer takes place. Your blood brings your tissues wonderful things: oxygen, glucose, electrolytes. And, in return, accepts all the metabolic waste products and carries them away. Imagine what would happen to your performance and recovery if your circulation was compromised.

How Massage Affects Your Physiology
Let’s start with the fascia. Personally, I think that affecting your fascia is the most important thing that a massage therapist can do. Why? Because there are many things you can do to affect the other tissues in your body, but there are very few things you can do to affect the fascia the way a good myofascial therapist can. When we exert ourselves, we generate a great deal of heat in our muscles. Fascia is especially sensitive to heat. And, as we all know, we have plenty of that in Florida. As we are exercising, we distort the fascia through our motions and because of the stresses that it absorbs. When we stop exercising and cool down, these distortions can remain in place. Additionally, neighboring fascial tissues can become adhered to one another. The result: loss of circulation, restriction of relative motion of muscles, restriction of muscle contraction. The myofascia surrounding the muscle can have a tourniquet effect, squeezing the muscle and preventing full circulation to occur. If two adjacent muscles are adhered to one another, their relative motion can be limited or prevented altogether. This forces both of the muscles involved to work harder every time you recruit them. Now, they not only have to perform their normal contractile functions but they have to pull against the tissue they are shackled to. All of these lead to decreased performance and increased recovery time. Eventually, they can also lead to injury. A myofascial therapist can remove these distortions and restore the fascia to a healthy state. Adhesions between fascial tissues are very difficult to break up without the physical manipulation of massage – stretching will not break these bonds because it cannot isolate and emphasize the relative motion of its captors.

I recommend a deep tissue technique which will milk any previously trapped metabolic waste products from the muscle once the circulation has been restored via myofascial release. A deep tissue technique will also aid in flushing out stagnant blood and pushing in new blood, fresh with all the necessities to begin revitalizing your muscle tissue. Additionally, it is important that the sarcomeres, contractile units of muscle fiber, are returned to their original length. After a hard effort or a long run, it is common for our muscles to get reprogrammed. We have spent so much time or effort in emphasizing their contraction, that our brain believes that our desire is for them to remain that way. If you will recall, the force generated by our muscles is determined in part by how much of a contraction or shortening occurs. If your muscle tissue is already shortened, then it has less available distance to travel. Thus, a full contraction of a shortened muscle will produce less force. This directly affects your performance! The mantra is “A tight muscle is a weak muscle”. A deep tissue massage will restore those tissues (sarcomeres) to their original length and allow you to optimize your generated forces. As a matter of fact, this lengthening can often be felt in a massage client’s first post-massage workout. Your legs may feel a bit weak or lack power. This is because some tissues may be slightly lengthened beyond what is normal for your body. So, your muscles are having to work harder to make a full contraction occur. Don’t fret. One easy workout should bring all your tissues back to homeostatic length, and then you can let it fly!

Because of their fibrous nature, tendons and ligaments are directly affected by massage only minimally. Tendons are indirectly affected by the fascial and deep tissue work. The tension on tendons is relieved because of this work. It is important for you to know that constant-over tensioning of tendons can lead to tendonitis or even stress fractures. Cross fiber frictioning is a massage technique commonly employed to directly treat tendons and ligaments. One direct effect of this technique is increased blood flow. Because of their fibrous nature, these tissues have very little blood flow (as compared to muscle tissue). This is one reason why it takes injuries in these areas a long time to heal. Additionally, frictioning can be used to treat tendons which have metabolic waste build up near the attachment site (enthesitis).

Injuries are never fun, but they are an inevitability if you run. Especially, if you run long distances or push your pace. Massage cannot knit muscle tissue back together or reattach tendons to bones. But, after the acute phase of the injury is over (usually 48-72 hours), massage can help increase circulation to the area or reduce swelling which will promote the body’s own healing mechanisms. And should you tear a muscle or tendon, in the late stages of healing or even shortly after it is healed, massage can be used to align the scar tissue in the direction of original tissue so that motion is not limited. Massage cannot directly heal an injury but it can decrease your down time.

Timing
When should you schedule a massage? The first thing you should know is that the effects of massage are cumulative. So, if you wait too long between massages, they will not have a building effect on one another. The power of each massage will have to stand alone. This is not to say that one massage session cannot have significant effects on you, but you should not expect it to cure all that ails you, especially if you have had the problem for some time.

I recommend that athletes get a massage before their competition or long run. The reason is two fold: first, I want them to have the best performance possible and second, I want their tissue in optimal condition to reduce the risk of injury. Many people like to come after their event to relieve soreness. Massage can definitely help with that. And, optimally, if you have the time and budget for both, that is the best option. But, if you are like most, you must choose. There are numerous things that can be done after the event to reduce soreness, but nothing can prepare you for the event like a massage. So, I recommend the before massage.

Optimally, if you are training regularly for an event, you should seek a massage once every other week for maintenance and injury prevention. If you are seeking an ambitious goal, such as first place in your age group or qualifying for the Boston Marathon, you may choose to seek massage even more often than that. Pushing your body to the limit six or seven days a week will require you to pay back in kind with massage lest you fall victim to an injury or an ugly overtraining incident. If you are running to stay in shape or just because you are in love with the sport, you may wish to seek massage once every three weeks to a month. If you receive massage on any time scale outside the once a month time frame, just be aware that the condition of your body wasn’t built overnight. It was built during hours and hours of training. So, one hour of massage is not going to undo all that which you strived to incorporate.

I recommend that massage be received several days before an event or long run. Remember the homeostatic return of muscle tissue to its original length? And, what of the time required to rejuvenate tissue that was previously without adequate circulation? It is desirable that you have at the least one, or more desirably, two easy workouts before your event to put your tissues in optimal condition. Post-race massage should be received at the event whenever possible and again later in the week from your regular therapist. Post-event “deep tissue” massage should only be received forty-eight to seventy-two hours after the event. This is because the body has an inherent inflammatory process that it conducts to aid in its healing. This is a necessary process which you do not want to interrupt or, even worse, exacerbate with massage.

Come Prepared
A healthy body is approximately 72% water. In order to get the most out of your massage, you must come hydrated and must hydrate when you leave. Myofascial release and deep tissue massage will release waste products into your bloodstream. These waste products are usually acidic in nature, dropping the pH of your blood. You will want to increase your blood volume by adding to your water intake in the days before, of, and after your massage to dilute your blood. This will help your body maintain a healthy blood pH level and flush all those unwanted toxins from your body.

So, drink up and ease onto the table – give back to the body you ask so much of – it will thank you ten fold!

 

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