Many think of massage therapy as a tool for relaxation and stress management, and that’s absolutely the case. Today, though, I’d like to discuss the benefits of massage as part of an overall personal training package. The combination of fitness, conditioning, stretching and rest with professional manual therapy has enormous benefits for mobility and performance.
What is mobility?
Mobility is the ability to move or be moved freely and easily. Mobility is critical to the quality of a person’s life in the sense that it not only allows for continuous movements of joints and tissues through their normal, healthy range but it also determine’s one’s ability to engage in activities of one’s choice. Studies show that a loss of mobility is correlated with depression, particularly in older adults.
How is mobility lost?
Typically, we lose mobility either through a traumatic injury causing impairment to a joint or soft tissue, or by the accumulation of changes that result from not challenging our musculoskeletal system in a normal, healthy ranges. This is the corollary of the “move it or lose it axiom”.
A good example of the latter can be seen in those with latissimus dorsi (“lat”) restrictions. We possess the traces of a primate body which was adapted for hanging and swinging from trees, through quadrupedal bodies that moved with a semi-erect posture, pulling along with the arms. Modern humans for the most part spend most of their times with their arms below shoulder height. We build our homes so we don’t need to reach up, and seldom in normal life to we hang or pull ourselves upwards or forwards (swimmers and gymnasts notwithstanding). As a result, there is a lack of challenge to the shoulder extension musculature and the result is a “caving in” of the upper body, with a loss of range of motion in overhead shoulder flexion and a loss of strength in shoulder extension (think of swinging the arms overhead in a yoga sun salutation or doing pull-ups).
What are the effects of lost mobility?
Loss in ranges of motion affect the resting position of joints. This leads to postural dysfunction which can contribute in varying degrees to musculoskeletal pain syndromes. Restrictions in mobility also encourage individuals to use “trick movements” in order to circumvent restrictions, but these trick movements can create further strains and dysfunction. Take for example, the case of the shortened overhead reach. An individual may bend sideways in order to increase their reach without challenging their shoulder. In the long term, that might lead to problems in the low back.
This brings us to performance. Whether you are an athlete or a mover (martial artist, dancer, yoga practitioner, gym goer, etc.), your body achieves its best performance when it can move without restriction or pain through the most efficient planes of movement in the natural patterns. Pain and restriction contribute significantly to loss of strength and the ability to apply strength to the movement of weight (either the body’s own weight or an external weight). I have witnessed a client increase their ability to perform a pectoral butterfly press by 20 pounds after five minutes of trigger point therapy. Simply, that person’s nervous system would not allow full strength to be applied with the degree of pain and limitation in the muscle.
How does massage therapy help?
At the least, massage therapy is associated with pain reduction, the remediation of tension and an increase in circulation to soft tissue. However, there are a number of very effective specialized techniques massage therapists can apply to increase mobility.
Stretching, particular with the use of Proprioceptive Neuromuscular Faciliation (PNF) is effective in changing the length of muscle tissue. Shortened muscle prevents joints from going through their full range of motion and the ability of a muscle to contract is moderated amount of overlap between the microscopic filaments in the muscle fibers. A skilled therapist can help balance the length of muscle so that joint movement is not inhibited and so that maximum strength, power and endurance are achieved.
Joint mobilization is a technique which dates back to the time of the ancient Greeks and is used to increase the small, internal movements of joints within their capsules. Without these internal movements, the larger external joint movements are hindered with a subsequent loss of mobility. Chiropractors work intensively with what are called high-grade (large movement), high-velocity (quick movement) mobilizations, but massage therapists are trained to work with smaller, more gradual movements that are nonetheless very effective in increasing functional range of motion.
Myofascial release is a somewhat generic term that refers to the treatment of contractile tissue (muscle) within the matrix of the stretchy, fibrous connective tissue which binds the parts of the body together. Fascia in particular is the term for the connective tissue which surrounds and permeates the muscle, bone and membranes of our musculoskelatal system, including that which wraps the layers of the skin to our frames. Various traumas and injuries as well as metabolic processes can bind parts of the fascial matrix so that instead of stretching and moving with freedom, the fascia and all the tissue to which is is bound become more resistant to movement. A clear example of this type of binding (sometimes referred to as “adhesion”) is frozen shoulder (adhesive capsulitis), wherin the fascial matrix of the shoulder joint shrinks and tightens around the bone, massively restricting shoulder range of motion. A skilled massage therapist can apply numerous techniques to fascia to encourage the breakdown of improperly adhered fascia while encouraging the body to repair itself in a more functional pattern.
Remedial exercise is an important component of a treatment plan for contemporary massage therapists. Therapists commonly offer exercises to complement the hands-on work and boost the effectiveness of the treatment. Resistance and isometric exercise are used to strengthen weaker muscles, while self-stretching is recommended to lengthen shortened muscles. Self-massage can be taught for clients to maintain their mobility gains while range of motion exercises can be given to make sure impaired joints are progressively moved into a more natural, healthy range.
The scope of practice of massage therapists in Ontario includes the assessment and treatment of soft tissue to “develop, maintain, rehabilitate or augment physical function.” The potential for augmentation of function, including that of mobility and performance is tremendous and for this reason massage therapy and other manual treatment should be considered an important part of a training program, whether for an athletes or for anyone interested in better, more comfortable and more graceful movement.