Honestly I have difficulties to understand the lack of response from our community

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Permalink Reply by elizabeth mount on March 10, 2012 at 4:00pm

isn't the study completely flawed because they starting massage immediatly after exercise.  I thought we always wanted our athletes to cool down before the sports massage?  So they would then use active or passive recover and then massage for long term recover. 

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Permalink Reply by Boris Prilutsky on March 10, 2012 at 4:47pm

Hi Elizabeth.

You are absolutely correct.below you will find brief review of this subject from my and Dr.Ross' article.

Best wishes.

Boris

After analysis of Western European and American sources we concluded that the problem is a significant misunderstanding and misrepresentation. First of all, Russian scientists always pointed out the importance of four equally important components of rehabilitative massage treatment after vigorous exercises. Failure to include even one of them will ruin all efforts:

1. TIME OF THE TREATMENT
All Eastern-European authors agreed that massage has to be started no earlier than 2-2.5 hours after vigorous exercises.

2. DURATION OF THE TREATMENT
The massage session has to last from 30-40 minutes to 1 hour. During this time the massage therapist works on the athlete’s whole body with special attention to the muscular groups which were overloaded during the exercises or competition.

3. MASSAGE TECHNIQUES
It is best to use the combination of effleurage, kneading, permanent vibration, compression, stretching and long range shaking. However, 40-50% of massage time has to be spent on kneading. With the proper execution of this technique the operator is able to alternate stimulation and relaxation of the massaged muscles. Thus, kneading is the best tool for restoring muscular strength.

4. PRESSURE
The applied pressure has to be significant but without the activation of the pain analyzing system. The threshold of pain varies from one part of the body to another, or even within the borders of the same massaged segment. Thus, the pressure has to be continually adjusted.

All Western articles which reported about the failure of massage therapy to speed up the recovery process were united by one striking similarity. Despite a truly scientific approach to the evaluation of treatment and its duration, these studies neglected to follow the proper protocol:




TIME OF THE TREATMENT  and DURATION .

Cafarell, et al., 1990  immediately after exercise 4 min

Drews, 1990 immediately after exercise 30 min

Wenos, et. al., 1990 48 hours after exercise N/A

Rodenberg, et al., 1994 15 minutes after exercise 15 min

Tiidus, 1995 48 hours after exercise 10 min

Gupta, 1996 48 hours after exercise 10 min

However, one published article on this matter puts everything in the correct perspective. In this study, a group of North Carolina and Virginia authors (Smith, L.L et al., 1994) formulated a protocol based on that of Russian scientists recommendation, proving its value. The authors examined the effect of massage on delayed onset of muscle soreness, and creatine kinase (an enzyme indicator of muscle damage) and neutrophil (an inflammatory white blood cell) count. The authors adjusted their experimental protocol according to the practical recommendations of Russian authors. These authors considered that vigorous exercises damage muscular tissue with the development of aseptic (noninfectious) inflammation and interstitial edema. The body reacts to these events by mobilizing neutrophils to the affected area. Neutrophils enter tissues and start their cleaning job (i.e., phagocytosis) to remove the waste products produced by the muscular injury and inflammation. Their increased concentration also attracts other types of phagocytic cells, macrophages. In the process of phagocytosis, catabolic enzymes are released from neutrophils, additionally damaging already injured muscular fibers. Dr. Smith and associates, through their research, noticed that two major events indirectly support this theory: temporary reduction of neutrophil count and increased concentration of creatine kinase in local blood vessels, and their following emigration into soft tissues as critical elements responsible for the long lasting muscle soreness after vigorous exercises. This study showed that this process precisely matches the 2 hour time limit after vigorous exercise

This is what Smith, et al., had to say in their conclusion:
“During acute inflammation, blood flow slows as vessels dilate in an area of injury. When this occurs, the white blood cells, including neutrophils, are displaced from the central, axial zone of blood flow to the peripheral, plasmatic zone and subsequently marginate along the vessel walls. Since sport massage appears to increase blood flow through the vascular bed, we theorized that this increased flow rate in the area of microtrauma could prevent the typical outward displacement of neutrophils. In addition, we speculated that the mechanical action of sports massage could shear marginated cells from vessel walls and thus hinder emigration of cells from the circulation into tissues spaces. …control group exhibiting a more rapid and steeper increase CK (i.e. creatine kinase) values than the massage group. …sports massage rendered hours after termination of unaccustomed eccentric exercise reduces the intensity of delayed onset muscle soreness and reduces serum creatine kinase levels.”

As we stated above, the reduction and elimination of muscular soreness are not the only goals of Post-Event Sports Massage.

 

elizabeth mount said:

isn't the study completely flawed because they starting massage immediatly after exercise.  I thought we always wanted our athletes to cool down before the sports massage?  So they would then use active or passive recover and then massage for long term recover. 

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Permalink Reply by Gordon J. Wallis on March 11, 2012 at 12:25am

Boris...Maybe you should offer an article to the New York Times?... After all you have the back ground, experience on many levels, and the credentials to get something published in a popular periodical?  I mean really.  

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Permalink Reply by Boris Prilutsky on March 11, 2012 at 11:06am

Hi Gordon.

Thank you for kind words and trust in me. It was at 2010, Both Dr.Ross and myself, didn't  know about this New York Times disgraceful Interview. Thanks to Sue Hitzmann, LMT, it was brought to our attention. Immediately we had purchased Tchaikovsky's  research article , but meantime  started damage control investigation. A lot of our fellows ,massage therapists where   pretty much disappointed, kind of sense of lost. If you will look into the posts within Hitzmann', LMT discussion  , something similar was going on in our community, and especially between massage therapists on east coast , who for short period of time even felt decreased of  income because of this interview.

I and Dr. Ross, understood that most likely New York Times, will not published our scientific review as an respond to Tchaikovsky's massage discreditation interview. I mean general media, not really interested in scientific discussion, but ready to run with some news, especially if it's coming from the mouth of “Prof.”Therefore we immediately wrote scientific review, which allowed to our colleagues to understand unscientific site  of Tchaikovsky's  research. In such a case our guys had an opportunity  to post on their sites data we have proposed, as well to educate clients. According to massive e-mails we have received then, it did work very well, and most important brought back confidence to our colleagues that massage therapy including postevent sports massage, is not only feels good but clinically and scientifically proven medical procedure. I personally was very happy, when one month ago, find  Tarnopolsky/Melov’s  research report, but most important world press release, which educating general public and not less important healthcare professionals, that massage therapy is an medical procedure. Look, we all who consider themselves massage therapists, swimming on one platform, and recently due to recession, we ,all our industry including ,individual massage therapists, massage centers,spa’s started facing significant difficulties. People don't have any more money, for a relaxation massage etc. giving to the fact, that massage therapy is most powerful methodology in stress management(statistically 80 to 90% of doctors visits is related to side effects of stress) our industry should booming. Tarnopolsky/Melov’s  research report allowed us momentum to start working with doctors. The only chance for us to survive, is when we will start getting referrals from doctors, physical therapists etc. Otherwise very soon many of our guys will be out of job. Soon I am planning, to offer medical orthopedic massage/physical therapy aide/chiropractor assistance program, for free preview. I know it will contribute a lot. Interesting enough, that many of these 4hrs  footage was produced more than 20 years ago. On front of the camera I am teaching and explaining and showed techniques saying what these scientists concluded :”Mark Tarnopolsky, MD, PhD :"This study provides evidence that manipulative therapies, such as massage, may be justifiable in medical practice." Dr.Melov: "Our research showed that massage dampened the expression of inflammatory cytokines in the muscle cells and promoted biogenesis of mitochondria, which are the energy-producing units in the cells, the pain reduction associated with massage may involve the same mechanism as those targeted by conventional anti-inflammatory drugs. "

But doctors wouldn't listen to me, even all these years  clinically I have  proved all what I have said. I mean most of my business is doctors referrals as well physical therapist referrals, but massively healthcare community, will tell you massage is good,but… I know maybe some will not agree with me in regards , of how the medical community view our procedure , but matter of the fact that most of us do not receiving enough referrals .Now and because it was published at high  reputation Science Translational Medicine doctors will take you seriously. This is nature of exceptions, and this is our momentum to survive and to make it good.

 when you will  contacting, medical doctors for referrals, you  should state that on February 1 2012,at Science Translational Medicine, was published research article Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage” and of course you have to offer conclusions of scientists I have mentioned above:”

I am working to finish part 2 of my article:” What type of massage therapy should doctors choose to refer their patience for treatments????” Where I will extend much more on my views on the subject we briefly discussed.

Below please find link, to our respond to Tchaikovsky's…… whatever.

Best wishes.

Boris

 

 

http://medicalmassage-edu.com/articles/212-science-of-sports-massage

 

Gordon J. Wallis said:

Boris...Maybe you should offer an article to the New York Times?... After all you have the back ground, experience on many levels, and the credentials to get something published in a popular periodical?  I mean really.  

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