Massage
By Gerald W. Bell, Ed.D., PT, A.T.,C./L.


Everyone knows when they have a good massage. Most expect the massage to give total body relaxation, but in athletic competition and especially diving, massage can have a facilitation effect as well as relaxation.

Massage is used to:
1) correct metabolic imbalances;
2) create physiological and mechanical effects;
3) effectively evaluate soft tissue;
4) relieve pain, reduce edema and increase range of motion; and
5) ready the healthy muscle for strenuous activity. However, massage is not a panacea.

Massage is effective in the care of post acute soft tissue traumas such as inflammation of tendons, epicondyle, muscle fibers, bursa, knee ligaments, ankles and general sports injury pain. Massage is also helpful in scar tissue remodeling for mobility and flexibility.

The five basic types of manipulations are performed on soft tissue.
Effleurage: light stroking, every massage begins and ends with effleurage.
Petrissage: more aggressive tissue lifting and compression with squeezing or rolling of soft tissue between the index finger and thumb.
Tapotement is the cupping and hacking with pinching movements for blood flow stimulation. These are done gingerly as not to traumatize the soft tissue.
Friction for stretching underlying tissue, used mostly on scar tissue to facilitate mobility and elongation of underlying structures, cross fiber and cyriax technique are described and last.
Vibration for soothing rhythymical gentle relaxation massage for hypersensative clients.

Massaging Divers the Right Way
Shoulder, Point 1, cross fiber friction, Points 3, 4 Direct pressure each 20 to 30 seconds
Lower Back, Points 1, 2 Direct Pressure with thumb and crossfiber 20 to 30 seconds
Point 3 Compression and direct pressure 30 to 60 seconds.
Hamstrings, Points 1, 2, 3 Direct Pressure and cross fiber friction 20-30 seconds each
Points 4, 5 Compression and kneading 20 to 30 seconds
Points 6, 7 Compression and direct pressure 20 to 30 seconds
Point 8 Compression and knead if cramping 30 seconds
Repeat sequence toward trunk for facilitation of venous blood flow.

References
Baker and Bell: "The Effect of Therapeutic Modalities on Blood Flow in the Human Calf": Journal of Orthopedic Sports Physical Therapy, 13:1, 23-27, 1991.
Bell in Prentice: Ed: Therapeutic Modalities in Sports Medicine, Mosby, 1990, pp. 79-119.
Bell in Prentice: Ed: Rehabilitation Techniques in Sports Medicine, Mosby, 1990, pp. 1-23.

Dr. Bell has served as the coordinator of the CAAHEP Accredited Undergraduate Athletic Training Educational Program since 1979 and the NATA Accredited Graduate Athletic Training Educational Program at the University of Illinois since 1989. He has lectured nationally and internationally on sports injury management protocols, interventions and triage, and research on the efficacy of prevention, modalities and exercise programs. Dr. Bell is a 1991 inductee of the Illinois Athletic Trainers Association Hall of Fame and a 1996 recipient of the Most Distinguished Athletic Trainer Award from the National Athletic Trainers Association.