Massage can be a powerful tool, if used correctly, in recovering from an injury. Usually, there are two types of massage used in physical therapy: relaxation and structural. Although we use relaxation massage on occasion, we primarily rely on structural massage to assist with recovery. Structural massage focuses on correcting soft-tissue abnormalities.
After an injury, or surgery, the body directs the muscles in the area of the injury to go into a protective spasm (sustained contraction). The body does this to help protect the area from further damage. This is often called “muscle guarding”. A muscle will also go into a spasm if it is irritated, such as from over use, or if the corresponding nerve is irritated. A muscle will also stiffen/shorten up (not a spasm) from prolonged disuse/rest.
We use massage primarily to help break-up scar tissue, move edema away from the area, relax a muscle spasm and promote healing. Reducing scar tissue is essential for proper healing. If an injury heals up with a lot of scar tissue, the repair is significantly weaker and is more like to re-injure. A good example of this is recurring hamstring injuries. From my experience, people that have chronic hamstring injuries (to the same muscle) also have a significant build-up of scar tissue at the injury site. Scar tissue is important early in the healing phase and should be replaced with normal (and stronger) tissue as healing progresses. Unfortunately, unless the muscle is stressed (stretched and strengthened) properly during recovery, the body has little incentive to get rid of the scar tissue. Massage can physically break down scar tissue, and when used together with stretching, is very effective in reducing scar tissue.
The physical stress of massage will also encourage the tissue (muscle, tendon, ligament) to be structurally stronger. Edema (swelling) can be physically pushed out of the area with massage. Edema can disrupt healing and cause cells the area to die, so reducing edema will help speed up recovery.
A muscle that is in spasm does not function well, and is usually painful. Exercise (stretching, range of motion, strengthening) is more effective and better tolerated when the muscle is relaxed. The direct pressure of massage on muscle will cause muscle to relax. Since exercise/fatigue can cause a muscle to spasm, we usually end our therapy sessions with massage. We may start with massage though, if edema or muscle spasm is interfering with exercise.
Massage technique is very important for this type of massage to be effective. This is why C.O.A.S.T. only employs highly trained (hundreds of hours of training and continuing education, plus a minimum of 5 years practical work) massage therapists. Skilled massage is one of the reasons our patients are able to recover quickly from injury.
Visit our Massage Therapy page for information about what COAST Physical Therapy Services has to offer.