IMPORTANT: Before starting any massage treatment the therapist will check for contraindications (if any apply to you, then massage is not allowed).
What equipment is required?
A lubricant is needed to allow the hands to glide smoothly. Oil is the most commonly used form of lubricant. Do not use too much oil. Enough to allow for smooth, controlled movement is required but too much oil may result in less control over the tissues.
A firm, flat surface to lie on in order to apply pressure. The floor, or preferably a massage table is the best surface. A bed is unlikely to provide a firm enough surface to work on.
How can sports massage help?
The aim of sports massage is to release tension in the muscle and stimulate blood flow and healing. More details on the benefits of sports massage are available.
Massage must not be performed during the acute stage of this injury – usually 48 hours after injury. For grade two and three strains, massage may not be suitable for over a week. This is because if there is still bleeding then heat and massage will increase bleeding, causing further damage.
Technique 1: Effleurage
Aim – light stroking to warm up the area in preparation for deeper techniques.
- With the hands stroke lightly but firmly upwards from just above the heel to the back of the knee.
- Always stroke upwards towards the heart as this is the direction of blood flow. The other way can damage veins.
- Then lightly bring the hands down the outside of the leg keeping them in contact but do not apply pressure.
- Repeat the whole movement using slow stroking techniques, trying to cover as much of the leg as possible.
- Repeat this technique for about 5 to 10 minutes, gradually applying deeper pressure on the up strokes
Technique 2: Petrissage
Aim – kneading movements to manipulate and loosen the muscle fibres more.
- With the hands apply a firm, kneading technique. Try to pull half the muscle towards you with the fingers of one hand whilst pushing half the muscle away with the thumb of the other hand.
- Then reverse to manipulate the muscle in the other direction.
- Work your way up and down the muscle, trying to cover as much of the surface as possible.
- Apply this technique for around 5 minutes, alternating with light stroking (above) occasionally.
Technique 3: Stripping the muscle
Aim – to apply sustained pressure to the muscle, ironing out any lumps, bumps and knots.
- With both thumbs together, apply deep pressure up the middle of the calf muscle aiming to separate the heads (sides) of the big gastrocnemius muscle.
- This technique should be slow and deliberate to ‘feel’ the muscle underneath.
- Repeat this 3 to 5 times in a row, alternating with petrissage for 3 to 5 minutes
- Another similar technique is applied with a single thumb, which can be reinforced with a couple of fingers from the other hand if more pressure is required.
- A great deal of pressure can be applied with this technique. Massage should be deep but not so deep that the athlete tightens up with pain.
- Aim to cover all the muscles in the lower leg, feeling for all the lumps and bumps.
Technique 5: Circular frictions
- With either a single thumb, a reinforced thumb as shown, apply pressure in a circular pattern to any tight spots, lumps or bumps.
- Apply 10 to 20 circular frictions at a time and alternate with stripping and petrissage techniques.
- Frictions can be applied to a specific point in the muscle, or applied over a small area of muscle moving gradually.
- Again, pressure should be firm but not so deep as to cause the muscle to tighten up with pain.
Technique 6: Trigger points
- If the therapist finds any lumps and bumps or particularly sensitive spots then apply deep, sustained pressure to these points using the thumbs. A trigger point is a localised, highly sensitive point in the muscle.
- Increase the pressure on the trigger point until it ranks 7/10 on the pain scale (10 being painful). Hold this pressure until it eases off to 4/10 on the pain scale (usually about 5 seconds).
- Without easing off with the pressure, increase again until it reaches 7/10 on the pain scale once more. Hold until it eases, repeat once more.
- This technique is very hard on the thumbs. It is important to keep the thumb slightly bent (flexed) when applying pressure to avoid damaging the joints.
- The therapist can finish off with more petrissage techniques and then finally effleurage again. The whole process should not last more than half an hour.
- Massage therapy can be applied every day if it is performed lightly however deeper techniques may require a rest day inbetween to allow tissues to ‘recover’.
- For rehabilitation of muscle strains, sports massage is very important in softening / preventing scar tissue forming at the site of injury and re-aligning the new healing fibres in the direction of the muscle fibres. This will help prevent re-injury.