Evidence Based Assessment and Treatment of Sports Injuries

Assessment and Treatment of Sports Injuries

Massage therapy as a therapeutic intervention is being embraced by the medical community. Recent recommendations from The American College of Physicians (Chou et al. 2017, Qaseem et al. 2017) and Center for Disease Control (Frieden et al. 2016) represent a monumental shift in pain management.

Physicians, now more than ever, are recommending conservative evidence based treatment including massage, acupuncture and exercise for patients suffering from headaches, low back pain, anxiety and stress.

Massage Therapy for Sports Related Aches and Pains

Sports massage is a clinically-oriented multi-modal approach (manual therapy, remedial exercise and patient education) based on a biopsychosocial model and on the three pillars of evidence based practice (best available evidence, clinical expertise and patient values).

The responses to massage therapy are complex and multifactorial - biological, psychological and social factors play a significant role in the experience and resolution of pain. Massage therapists are uniquely suited to incorporate a number management strategies. Treatments often include, but are not limited to education, reassurance, remedial exercises, classical swedish massage, myofascial mobilization, instrument-assisted soft tissue mobilization, cupping, taping, non-thrust mobilization, strain-counterstrain, muscle energy techniques and neural mobilizations.

Treatments may benefit athletes with the following conditions:

Low Back Pain - Studies have demonstrated that compression at myofascial triggerpoints (MTrPs) significantly improved subjective pain scores compared with compression at Non-MTrPs and the control treatments for patients suffering for back pain. In addition to these findings a number of high quality systematic reviews clearly support the use of massage therapy for back pain.

Neck Pain - For athletes who suffer a whiplash injury or ongoing neck pain, there are a number of systematic reviews that support the use of soft tissue based manual therapy treatment.

Tension Type Headaches - There is good supporting literature for the use of massage therapy for patients who suffer headaches. With manual therapy the goal is to decrease the individual’s headache frequency, intensity, headache duration and acute medication requirements.

Temporomandibular Dysfunction (TMD) - Therapeutic effects of intra-oral and extra-oral massage, and self-care management of temporomandibular dysfunction has been demonstrated in a number of randomized control trials and systematic reviews.

Plantar Heel Pain - Plantar heel pain  is particularly common in runners, it is generally described as sharp or stabbing, and worse in the morning. The pain can decrease with activity, but can return after long periods of standing or after getting up from a seated position. There is evidence that joint mobilisation, calf massage stretching and eccentric loading helpful in improving function and reducing plantar heel pain.

Key Points and Future Discussions

Due to doping regulations, athletes have strict restrictions of what they can put in their bodies, so naturally they look for alternative ways to ease the pain of overexertion. Massage therapists are professionally trained to treat active individuals, they specialize in specific techniques for pre-event, post-event and restorative massage.

For sports injuries, massage therapy has been shown to be a safe, non-pharmacological therapeutic intervention to help alleviate musculoskeletal disorders associated with everyday stress, physical manifestation of mental distress, muscular overuse and many persistent pain syndromes.

Learn more about emerging evidence at the upcoming RMTAO Massage Therapy Conference.