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Evaluating the Benefits of Equine Massage Therapy: A Review of the Evidence and Current Practices
Abstract
Following the lead of human athletic training, equine massage therapy is becoming a more common part of the management of equine athletes and pleasure horses alike. The basic science rationale for massage is supported by research indicating that massage may affect a number of physiologic systems as well as cellular and fascial components of the muscular system. Equine therapeutic massage, or sports massage, employs a number of techniques first developed in humans and has been reported to increase range of motion and stride length, reduce activity of nociceptive pain receptors, and reduce physiologic stress responses. Additional preliminary research indicates that massage therapy also may improve some aspects of exercise recovery. Although important evidence has begun to document the potential benefits of massage therapy for equine athletes, the current review may say less about the true clinical effects of massage therapy than it does about the current state of research in this field. Additional prospective study of massage therapy using sufficient scientific rigor will be necessary to provide veterinarians, trainers, and owners with definitive data and scientifically based confidence in the use of equine massage. In the meantime, the preliminary research, anecdotal positive effects, and case studies indicating potential benefit are not to be ignored; equine massage therapy already plays a valuable practical role in the care and training of many equine athletes.
... The umbrella term includes a wide range of methods, from those that could almost be considered as conventional medicine to those where animal studies are lacking or even suggested to have no effect in animals [2][3][4][5]. The literature reviews published generally state that there is insufficient scientific research to draw any firm conclusions regarding the clinical efficacy of treatments for specific indications for many of CAVM methods [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. The reasons often listed are, a limited number of studies, small sample sizes, lack of control groups, and other methodological limitations, as well as considerable heterogeneity in reported treatment effects [7,10,12]. ...
... The reasons often listed are, a limited number of studies, small sample sizes, lack of control groups, and other methodological limitations, as well as considerable heterogeneity in reported treatment effects [7,10,12]. Additionally, many studies conclude that more research is needed with an evidencebased perspective [2,3,[5][6][7][8][9]12]. As more scientific evidence is gathered, the definitions of these methods may change. ...
... Several therapists and veterinarians stated that they believe that there is scientific evidence that their methods are effective in animals, however, many CAVM methods lack conclusive scientific support for clinical efficacy for specific indications [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. This emphasizes the importance of the initiation of well-designed research studies to ensure evidence-based information. ...
Simple Summary
As the scientific basis for most methods used in CAVM (complementary and alternative veterinary medicine) is not well-founded, there is a need for evaluation of the efficacy as well as safety of many methods. In order to better understand what evidence and knowledge are most urgently needed, we must know what methods are used, by whom and for what reasons. We asked Swedish horse owners, equine veterinary practitioners and CAVM therapists about their use of CAVM. CAVM appears to be common in Swedish horses; most horse owners used it for both prevention and treatment of injuries. The two most frequently used methods were stretching and massage. There is some collaboration between equine veterinary practitioners and CAVM therapists, which might provide an opportunity for proper diagnoses by veterinarians before CAVM therapy. Most of the study participants wanted CAVM to be more regulated, to facilitate communication and ensure animal welfare.
Abstract
Complementary or alternative veterinary medicine (CAVM) includes treatment methods with limited scientific evidence. Swedish veterinarians are legally obliged to base treatments and recommendations on science or well-documented experience, but most CAVM methods are not well documented in animals. The aim of this study was to explore the use of CAVM in Swedish horses. Electronic questionnaires were distributed to horse owners, equine veterinary practitioners and CAVM therapists. Of the 204 responding horse owners, 83% contacted a veterinarian first in case of lameness, while 15% contacted a CAVM therapist. For back pain, 52% stated a CAVM therapist as their first contact and 45% a veterinarian. Only 10–15% of the respondents did not use any CAVM method for prevention or after injury. Of the 100 veterinarians who responded, more than half did not use CAVM themselves but 55% did refer to people who offer this service. Of the 124 responding CAVM therapists, 72% recommended their clients to seek veterinary advice when needed, 50% received referrals from a veterinarian, and 25% did not collaborate with a veterinarian. The two most common methods used by the respondents in all three categories were stretching and massage. Most veterinarians and therapists were not content with the current lack of CAVM regulation.
... In addition to these 25 "trigger points", which can be precisely located bilaterally, trigger points could be discovered on any other muscle however, their location might not be possible as precisely (Teslau 2006). In fact, this system of "trigger points" has been enlarged by many experienced therapists for "trigger points" on the chest, forelimbs and hind limbs (Teslau 2006), the cleidobrachialis muscle (Macgregor & Graf von Schweinitz 2006) as well as on the masticatory muscles involved with chewing or horse-rider communication (Scott & Swenson 2009). The distribution of muscle fibre types varies between the different muscles, suggesting that some are important for postural stability, such as e.g. the deep epaxial muscles or the M. psoas minor, while others, such as the M. psoas major, M. ...
... In both humans and animals, a "sensitive trigger point" or "myofascial trigger point" is precisely localised and develops a taut band, i.e. a bundle of contracted, hard muscle fibres with ischemia, hypoxia, cell damage and inflammatory mediators, along with local and referred pain and a local twitch response (Hong & Simons 1998, Gerwin 2008 With the technique of "trigger point" massage direct pressure is applied to the underlying tissue such as superficial fascia, connective tissue or the muscle tissue of a "trigger point", over a few seconds up to a few minutes until the structure releases (Teslau 2006, Scott & Swenson 2009. Even though different reactions were recorded between several trials, diagnostic palpation does not reduce the pain response of "trigger points" (de Heus et al. 2010). ...
... Sensitive "trigger points" of the pectoral muscles are associated with girth aversion behaviour (Bowen et al 2017). Sensitive muscle "trigger points" and pain have a negative impact on muscle strength and performance as well as motor control (Teslau 2006, Scott & Swenson 2009, Bowen et al. 2017. ...
The aim of the present study was to investigate whether laterality test results obtained on the ground relate to laterality during riding and to examine the influence of human handedness and horse’s laterality on rein tension. The present study contained an online-survey with 686 riders and 1286 horses as well as the comparison of twelve different methods to investigate horse’s laterality on the ground and during riding between five groups of horses (6.553 horses in total) and rein tension measurements with a group of 88 warmbloods, Quarter Horses and mixed breeds (41 right-lateral, 35 left-lateral and 12 without reported laterality) with 65 riders (49 right-handed, 14 left-handed and 2 ambidextrous) in 110 rides (51 in conventional European riding and 59 in Western riding). Rein tension was analysed using Excel and linear mixed models in SPSS. The relation of different laterality test methods among each other was investigated using cross-tabulations, chi²-tests, phi and Cramer’s V, as well as Pearson-correlations. Heritability was determined using uni- and bivariate linear animal models in DMU6. Laterality test results obtained on the ground did not agree with laterality during riding. Only the rider’s assessment of their horse’s laterality and the lateral displacement of the horse’ hindquarters allowed conclusions on laterality during riding. In most populations the majority of horses had their hindquarters displaced to the right. Based on the rider’s assessment of their horse side preference for dressage tasks, no overall direction of laterality could be documented in any population. Right-lateral and ambidextrous horses were more successful overall. Heritability of the lateral displacement of the hindquarters was high in warmbloods and low to moderate level in Thoroughbreds. In dressage and show jumping there seems to be an advantage for both left-lateral and ambidextrous riders as well as left-lateral horses. A direct relation of the lateral displacement of the hindquarters to sensitive muscle trigger points could not be documented. In addition to the stability of rein tension, two aspects of symmetry (quantitative symmetry between left and right rein tension and temporal symmetry of left and right rein tension peaks) were identified that are influenced mainly by human handedness. Horse’s laterality mainly influenced the magnitude of rein tension as well as the symmetry of the inside versus the outside rein. Right-handed riders depended upon their dominant hand while trying to compensate their horse’s laterality and produced more symmetric rein tension with right-lateral horses. In contrast, left-handed riders reacted to their horse’s non-dominant side, regardless of the horse’s direction of laterality. Less rein tension was applied with a more stable and symmetric contact in Western riding compared to conventional European riding.
... Massage therapy is the manipulation of the skin and underlying soft tissues either manually, with an instrument, or with a machine for therapeutic purposes; this includes rubbing, kneading, tapping, and introduction of mechanical vibrations (Haussler, 2009). Therapeutic massage can relieve muscle tightness, increase muscle compliance, increase joint mobility, and decrease stiffness within both muscle and joints (Scott and Swenson, 2009). Equine massage therapy focuses mainly on stress point therapy, trigger point therapy, and myofascial release techniques. ...
... Equine studies focusing on the effects of post-exercise massage on range of motion observed increased range of motion, increased stride length, and decreased stride frequency implying a positive effect on the athletic performance horse (Scott and Swenson, 2009). ...
... Additionally, mechanical pressure from massage increases muscle temperature and arteriolar pressure, fundamentally increasing blood flow. Alterations in heart rate, blood pressure, and physiological hormones as a result of massage therapy can also induce a relaxation response during times of stress and anxiety (Scott and Swenson, 2009). A pilot study by Salter et al (2011) observed significant increases in cutaneous temperatures within five minutes of massage therapy, suggesting increases in blood flow and perfusion directed to the areas being massaged (Salter et al., 2011). ...
... During sub-maximal exercise, glycogen is utilised for energy and lactic acid as a by-product can accumulate in muscles resulting in fatigue and if not appropriately managed, damage to the muscle structure (Smith et al. 1994;Marlin and Nankervis, 2002;Booth 2009b;Scott and Swenson, 2009). When overuse or injury occurs, inflammation onsets initially, then after 48 ...
... hours, blood flow is reduced causing a reduction in oxygen and nutrients to the area; this causes tension and for the affected area to "splint" or contract (spasm), which results in additional pain and damage to other structures (Smith et al. 1994;Sullivan, Hill and Haussler, 2008;Booth, 2009b). This cycle must be broken in order to begin an appropriate healing process; and massage restores circulation and lymphatic drainage (Hemmings et al. 2000), muscle fibres and reduces muscle tightness (Wakeling et al. 2006) and reduces pain (Tiidus, 2000;Scott and Swenson, 2009). ...
... Massage therapy is used regularly as part of a training programme in human athletes, and its therapeutic use within the general population has also grown in recent years (Brummitt, 2008;Scott and Swenson, 2009). The increase in the use of massage therapy in humans is largely down to anecdotal evidence improving perceptions, and observations of improved performance (Tiidus, 2000). ...
Musculoskeletal injuries have been reported to be the main contributor to the interruption or dismissal of a horse’s athletic career. The muscles are responsible for the production of forces involved in movement yet the muscles are often overlooked with regards to preventative maintenance and injury therapy and rehabilitation. Competition legal methods of preventing injury by improving performance are of particular interest. The use of massage therapy as part of a training programme is becoming increasingly popular. The beneficial effects of massage have been widely researched, though much of the research is on the immediate effects, and consistency between studies is lacking. This study was a preliminary investigation in to the effects of a short term massage programme on the gait parameters of riding school horses undergoing the same management and exercise routines. Methods: 15 clinically sound riding school horses at Nottingham Trent University of different breed, age and height were used in a controlled, blind study. The horses were divided in to three groups of five (A, B and C) ensuring a mixture of height, breed and age. Group A received a 10 minute massage each side on the caudal hind limb, once a week for three weeks. Group B received a 20 minute groom following the same procedure; and Group C received no treatment. Video gait analysis was conducted on weeks 0 and 4. Video number 3 of each gait on both reins was chosen for analysis by a sports analysis programme (Kinovea), and scoring by a panel of 16 equine students. Results: A significant increase in stride length symmetry and protraction symmetry was found for group A in the walk (P = 0.0475 and P = 0.0318 respectively). Significant differences were found for kinematic variables between the treatment and control groups in walk, trot and canter. A significant result was found for the panel analysis data for day 1 (P = 0.0055). Panel scoring positively correlated with stride length symmetry on day 1 in walk (P = 0.0058) and maximum hock flexion symmetry on day 2 in canter (P = 0.0473). Conclusions: It can be concluded that a short term massage programme to the proximal hind limb consistently improved gait symmetry within riding school horses compared to a sham treatment and control. An appropriate dosage level for particular results needs to be determined in order to effectively utilise massage within a training programme. Further studies analysing kinetic parameters alongside kinematic parameters will enable further conclusions to be drawn.
... 4 Massage therapy is enjoying increasing popularity in Veterinary Medicine as a valuable ancillary treatment, particularly in Equine Sports Medicine, and is thought to improve performance in athletic horses. 5,6 Increased target tissue blood flow and lactate clearance have been demonstrated in recent studies, suggesting improved postexercise recovery. 7 The benefits of massage therapy are not limited to Sports Medicine and include reduction of muscle tension and soreness, relief of postexercise muscle spasms, increased flexibility and range of motion, and improved general well-being; beneficial effects on myofascial pain relief and trigger point treatment have been highlighted. ...
... 7 The benefits of massage therapy are not limited to Sports Medicine and include reduction of muscle tension and soreness, relief of postexercise muscle spasms, increased flexibility and range of motion, and improved general well-being; beneficial effects on myofascial pain relief and trigger point treatment have been highlighted. 6,8 Literature concerning small animals is scarce. However, techniques originally described for humans and horses can easily be extrapolated to these patients and are thought to induce similar physiological responses. ...
... 15 Mechanical effects of massage therapy play a particularly important role in myofascial release techniques, often applied in Veterinary Medicine. 6 Fascial mechanical properties and tissue reaction to external forces must be taken into account for proper understanding of this manual therapy modality. The gel-like interstitial fluid surrounding fasciae is a thixotropic fluid (i.e., tends to become more fluid and soluble in response to pressure or heat). ...
Massage therapy is becoming increasingly popular in human and animal physiotherapy and rehabilitation. Wider application of the technique led to research efforts aimed at providing scientific support to anecdotal beneficial effects, particularly pain relief. Recent studies have shown that massage therapy alters dopamine and serotonin levels, decreases noradrenaline levels, and modulates the immune system. Psychological effects such as reduction of stress and anxiety, with improvement of depressive patients, have been reported in humans. This article set out to review the major aspects of massage therapy based on recent publications on the topic, and to extrapolate concepts and practical aspects described in human physiotherapy to the veterinary patient, particularly the applicability of different techniques in Small Animal Medicine. Indications of massage therapy in small animals include pain relief, orthopedic rehabilitation, Canine Sports Medicine, intensive care, and management of nonspecific edema. Techniques described in this article were originally intended for use in humans and scientific data supporting anecdotal, beneficial effects in domestic animals are still lacking; this fruitful area for research is therefore open to veterinary professionals.
... free movement in the paddocks, massage and music. Massage promotes general body relaxation and increases the sense of an animal well-being (Scott and Swenson 2009). In horses, the heart rate measured during and immediately after a massage was reduced, and improved behavioural responses were noted (McBride et al. 2004). ...
... Stachurska et al. (2015) showed that relaxation music positively affected the emotional state in race horses. However, little is known how these kinds of relaxation methods reduce long-lasting stress in race horses (Scott and Swenson 2009). ...
... Our results indicate the long lasting effect of the relaxation methods on the salivary cortisol level in the race horses. The positive effect the massage had on the salivary cortisol level determined just after a treatment, was described earlier (Scott and Swenson 2009). In other study, massage reduced the stress level which had been evaluated on the basis of heart rate and behaviour of the horses also during a treatment (McBride et al. 2004). ...
At the beginning of training routine, young race horses are exposed to stressful stimuli. The aim of the study was to evaluate the influence of a relaxing massage which the horses received in the stable, and the influence of music piped into the stable, on the longlasting stress level of the horses. 120 Purebred Arabian horses were studied. They were examined during first racing season, which lasted for six months. At the beginning of the study, the horses were 28-31 months old. The horses were brought to Słužewiec Horse Race Track (Warsaw, Poland) from their familiar studs and were randomly assigned to music (n = 48), massage (n = 48), or control (n = 24) groups. All horses were regularly trained and competed in official races. Once a month, saliva samples were collected from each horse to determine the cortisol concentration. Both music and massage resulted in significantly lower salivary Cortisol concentration compared to control treatment.
... Massage relaxes tightened muscles and reduces both physical tension and emotional arousal (McBride et al., 2004). In particular, classical massage used in sport and veterinary medicine brings therapeutic effects (Scott and Swenson, 2009). Massage reduces pain symptoms in older horses and helps to maintain the flexibility of the body in stressed individuals, thereby decreasing discomfort (McBride et al., 2004;Palmer, 2014). ...
... The considerable number of injuries in racing horses encourages intensive physiotherapeutic treatment, of which massage is the main type (Haussler, 2009;Scott and Swenson, 2009). However, Hesse and Verheyen (2010) found that it is worth preparing horses for such therapy. ...
We analysed the frequency of symptoms and degree of muscle pain in selected body parts of racing horses assessed during classic massage sessions. The influence of horse's sex on obtained results was considered. The potential for the early determination of pain in horses by analysing their behaviour and cardiac parameters during a massage session was also evaluated. The study was conducted on 20 three-year-old purebred Arabian horses during one racing season. In the racing season, cyclic classic massage sessions were performed, during which the frequency of symptoms and the degree of pain in the neck, back, croup, front limbs, and hind limbs were analysed. A behavioural assessment of the horses was conducted, and cardiac parameters were analysed. During massage, the frequency of pain symptoms in front limbs amounted to 26, while in croup, it did not exceed 6. The studied horses were most susceptible to pain in the front limbs and in the back, with greater severity in stallions than in mares. An assessment of the frequency and severity of pain symptoms should not be based on changes in behaviour of horses or on cardiac parameters (HR and LF:HF ratio) during massage sessions. However, these methods can be applied after pain reactions intensify. Meanwhile, qualified masseurs can diagnose slight muscle pain during massage sessions.
... Thus, in practice it is a challenge to find and develop effective treatments which reduce such stress reactions. According to recent studies massage has turned out to be an interesting alternative treatment of not only musculoskeletal disorders but increasingly also a method of stress reduction in horses (Hinds et al. 2004;McBride et al. 2004;Scott & Swenson 2009). The authors have reported that a relaxing massage effectively decreases the concentration of catecholamines and cortisol, reduces arterial blood pressure as well as heart rate (HR) in horses. ...
... The authors have reported that a relaxing massage effectively decreases the concentration of catecholamines and cortisol, reduces arterial blood pressure as well as heart rate (HR) in horses. Moreover, the relaxing therapy has a significant effect on promoting behavioral changes, increasing the sense of well-being in horses (Hinds et al. 2004;Haussler 2009;Scott & Swenson 2009). ...
The objective of this study was to assess the effect of relaxing massage on the heart rate (HR) and heart rate variability (HRV) in young racehorses during their first racing season. In the study, 72 Purebred Arabian racehorses were included. The study was implemented during the full race season. The horses from control and experimental groups were included in regular race training 6 days a week. The horses from the experimental group were additionally subject to the relaxing massage 3 days a week during the whole study. HR and HRV were assumed as indicators of the emotional state of the horses. The measurements were taken six times, every 4-5 weeks. The HRV parameters were measured at rest, during grooming and saddling the horse and during warm-up walking under a rider. The changes of the parameters throughout the season suggest that the relaxing massage may be effectively used to make the racehorses more relaxed and calm. Moreover, the horses from the experimental group had better race performance records.
... 7 The manual techniques used in massage include effleurage, pé trissage, friction, kneading, or hacking, and often vary in the depth or speed of the applied pressure and in the specific tissues or regions of interest. 48 Massage is indicated for a wide variety of conditions in which pain relief, reduction of swelling, or mobilization of adhesive tissues are desired. 49 Massage is generally recognized as a safe intervention with minimal adverse effects. ...
... 50 Massage is contraindicated for acute injuries, open wounds, and skin infections. 48 Clinically, massage and soft tissue mobilization are believed to increase blood flow, promote relaxation, reduce muscle hypertonicity, increase tissue extensibility, reduce pain, and speed return to normal function; however, few controlled studies exist to support these claims. 7,51 There are many anecdotal reports of the beneficial effects of massage on human athletic performance; however, strong evidence in the form of controlled studies does not exist for the effects of massage on preventing injuries, recovery from exercise, or enhancing performance. ...
Manual therapy includes a diverse array of techniques, such as touch therapies, massage, physical therapy, osteopathy, and chiropractic, that were originally developed for use in humans and have been gradually applied to horses. All forms of manual therapy have variable reported levels of effectiveness for treating musculoskeletal issues in humans, but mostly only anecdotal evidence exists in horses. This article explores the scientific literature for evidence of efficacy, safety, and common mechanisms of action of the different forms of manual therapies for potential use in managing acute or chronic pain syndromes in horses. Currently, there is limited evidence supporting the effectiveness of spinal mobilization and manipulation in reducing pain and muscle hypertonicity. Further research is needed to assess the efficacy of specific manual therapy techniques and their contribution to multimodal protocols for managing specific somatic pain conditions in horses.
... Despite soft tissue mobilization being frequently used, there is no consensus regarding its clinical effects in animals. To the best of the authors' knowledge, only a few previous narrative reviews have been published [4,[10][11][12]. Therefore, the aim of the present study is to conduct a systematic literature review of soft tissue mobilization therapies. ...
Soft tissue mobilization is frequently used in the treatment of sport and companion animals. There is, however, uncertainty regarding the efficacy and effectiveness of these methods. Therefore, the aim of this systematic literature review was to assess the evidence for clinical effects of massage and stretching in cats, dogs, and horses. A bibliographic search, restricted to studies in cats, dogs, and horses, was performed on Web of Science Core Collection, CABI, and PubMed. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects. Of 1189 unique publications screened, 11 were eligible for inclusion. The risk of bias was assessed as high in eight of the studies and moderate in three of the studies, two of the latter indicating a decreased heart rate after massage. There was considerable heterogeneity in reported treatment effects. Therefore, the scientific evidence is not strong enough to define the clinical efficacy and effectiveness of massage and stretching in sport and companion animals.
... A narrative review dedicated to massage therapy [16] describes different techniques (effleurage, circular friction, muscle pressure and shaking, skin manipulation, tapotement, petrissage, cross-fiber massage, wringing, classical Swedish techniques, and stroking) as described in the literature, and sometimes associated with stretching, as being beneficial when applied in 10 to 20 min sessions. Haussler [20] described the benefits of massage in alleviating muscle hypertonicity, soft tissue restrictions and pain, and the value of soft tissue mobilization for soft tissue restrictions and pain. ...
Injuries to the locomotor system are a common problem in athletic horses. Veterinarians address these injuries using appropriate medical, surgical, and pharmacological treatments. During or after recovery from the initial injury, horses may be treated for functional locomotor deficits using specific rehabilitation techniques aimed at restoring full athletic performance. This study reviews the literature to identify which rehabilitative techniques have been used most frequently in horses over the past 20 years, the protocols that were used, and the outcomes of the treatments in naturally occurring injuries and diseases. Publications were identified using keyword selection (Equine Athlete OR Equine OR Horse) AND (Rehabilitation OR Physiotherapy OR Physical Therapy). After removing duplicates and screening papers for suitability, 49 manuscripts were included in the study. The majority of publications that met the inclusion criteria were narrative reviews (49%) in which the authors cited the relatively small number of published evidence-based studies supplemented by personal experience. Observational/descriptive studies were also popular (35%). Randomized control trials accounted for only 10%. The most frequently reported rehabilitation techniques were exercise, electrotherapy, and hydrotherapy. The findings highlight the need for further information regarding type of intervention, parameterization, and outcomes of equine rehabilitation in clinical practice.
... Physiotherapy and rehabilitation have become tools of increasing importance in equine and canine medicine (Kathmann et al. 2006;Paulekas & Haussler, 2009) alongside traditional orthopedic treatment in order to treat musculoskeletal problems and to improve quality of life. Stretching, massage, myofascial release, kinesio taping or trigger point therapy are all techniques that are currently being employed by veterinary practitioners (Goff, 2009;Scott & Swenson, 2009;Wall, 2014). In a recent study, the fascia structure of the equine forelimb and the retinacula was documented, revealing differences between human and equine antebrachial fascia (Skalec & Egerbacher, 2017). ...
Fascia in the veterinary sciences is drawing attention, such that physiotherapists and animal practitioners are now applying techniques based on the concept of fascia studies in humans. A comprehensive study of fascia is therefore needed in animals to understand the arrangement of the fascial layers in an unguligrade horse and a digitigrade dog. This study has examined the difference between the horse and the dog fascia at specific regions, in terms of histology, and has compared it with the human model. Histological examinations show that in general the fascia tissue of the horse exhibits a tight and dense composition, while in the dog it is looser and has non-dense structure. Indeed, equine fascia appears to be different from both canine fascia and the human fascia model, whilst canine fascia is very comparable to the human model. Although regional variations were observed, the superficial fascia (fascia superficialis) in the horse was found to be trilaminar in the trunk, yet multilayered in the dog. Moreover, crimping of collagen fibers was more visible in the horse than the dog. Blood vessels and nerves were present in the loose areolar tissue of the superficial and the profound compartment of hypodermis. The deep fascia (fascia profunda) in the horse was thick and tightly attached to the underlying muscle, while in the dog the deep fascia was thin and loosely attached to underlying structures. Superficial and deep fascia fused in the extremities. In conclusion, gross dissection and histology have revealed species variations that are related to the absence or presence of the superficial adipose tissue, the retinacula cutis superficialis, the localization and amount of elastic fibers, as well as the ability to slide and glide between the different layers. Further research is now needed to understand in more detail whether these differences have an influence on the biomechanics, movements and proprioception of these animals.
... Physiotherapy has recently arisen as a complementary rehabilitation tool to the traditional, strictly evidence-based orthopedic treatment in equine medicine (Paulekas & Haussler, 2009), with manual therapy receiving growing attention from practitioners and animal owners. Techniques such as stretching, massage, trigger point therapy, myofascial release or kinesio taping are supposed to address the impairments in the neuromusculoskeletal and myofascial system (Goff, 2009;Haussler, 2009Haussler, , 2010Scott, 2009;Molle, 2016). Although in humans the effectiveness of such therapies was reported, the evidence of their therapeutic potency in horses is mostly anecdotal (Haussler, 2009). ...
Recent advances in human fascia research have shed new light on the role of the fascial network in movement perception and coordination, transmission of muscle force, and integrative function in body biomechanics. Evolutionary adaptations of equine musculoskeletal apparatus that assure effective terrestrial locomotion are employed in equestrianism, resulting in the wide variety of movements in performing horses, from sophisticated dressage to jumping and high-speed racing. The high importance of horse motion efficiency in the present-day equine industry indicates the significance of scientific knowledge of the structure and physiology of equine fasciae. In this study, we investigated the structure and innervation of the deep fascia of the equine forelimb by means of anatomical dissection, histology and immunohistochemistry. Macroscopically, the deep fascia appears as a dense, glossy and whitish lamina of connective tissue continuous with its fibrous reinforcements represented by extensor and flexor retinacula. According to the results of our histological examination, the general structure of the equine forelimb fascia corresponds to the characteristics of the human deep fasciae of the limbs. Although we did find specific features in all sample types, the general composition of all examined fascial tissues follows roughly the same scheme. It is composed of dense, closely packed collagen fibers organized in layers of thick fibrous bundles with sparse elastic fibers. This compact tissue is covered from both internal and external sides by loosely woven laminae of areolar connective tissue where elastic fibers are mixed with collagen. Numerous blood vessels running within the loose connective tissue contribute to the formation of regular vascular network throughout the compact layer of the deep fascia and retinacula. We found nerve fibers of different calibers in all samples analyzed. The fibers are numerous in the areolar connective tissue and near the blood vessels but scarce in the compact layers of collagen. We did not observe any Ruffini, Pacini or Golgi-Mazzoni corpuscles. In conclusion, the multilayered composition of compact bundles of collagen, sparse elastic fibers in the deep fascia and continuous transition into retinacula probably facilitate resistance to gravitational forces and volume changes during muscle contraction as well as transmission of muscle force during movement. However, further research focused on innervation is needed to clarify whether the deep fascia of the equine forelimb plays a role in proprioception and movement coordination.
... The massage also either chafes or relaxes the nervous system. According to Scott and Swenson (2009) massage additionally increases the range of motion and stride length and reduces the activities of nociceptive pain receptors and physiologic stress responses. These are solely the physical impacts. ...
Originally published in the Finnish national thesis page: http://urn.fi/URN:NBN:fi:amk-2016060211662
... Therapeutic massage involves manipulation of soft tissues with the goal of inducing muscle relaxation, increasing soft-tissue extensibility, and reducing pain and joint stiffness. 113 Regular massage can help to decrease pain and improve flexibility (Figure 18-18). Mobilization is a skilled passive movement applied to a joint or related soft tissue at varying amplitudes and depths of penetration. ...
... Feh and Mazieres [10] performed an experimental imitation of allogrooming at preferred versus nonpreferred sites and HR decreased when the preferred site was touched. Controlled studies evaluating the effect of touch therapies on physiological and behavioral variables show promising results, but more are needed to define clinical applications and elucidate the physiological mechanisms involved [11,12]. ...
This study tested Flowtrition, a non-invasive soft touch therapy, on the mean (HRavg) and maximum heart rate (HRmax), surface temperature in three body quadrants, and eight stress related behaviors in horses. Fourteen gelded horses were randomly assigned to a control (CON=5) group or a Flowtrition (TRT=9) group. Each horse underwent four sessions with each session split into three 20-minute stages: Pre, During, and Post. At the end of the Pre stage in which neither group received any intervention, baseline heart rate, temperature, and behaviors were recorded. A During stage followed in which the TRT group received therapy and the CON group was monitored and received no treatment. Within the Post period, both groups were monitored and response variables were recorded. The TRT group experienced a decrease (P < 0.05) of 10 ± 2.7 bpm in HRmax and 4.7 ± 0.8 bpm in HRavg between Pre and Post stages compared to the control group, which experienced no shifts in heart rate. The group receiving therapy showed an increase (P < 0.05) occurrence frequency and total duration of head lowering, licking and chewing, and yawning between Pre and Post stages; the control group showed no behavioral shifts. The results show that Flowtrition induces a more relaxed state in horses as evidenced by a decrease in HR and increase in occurrence and duration of relaxation-related behaviors.
... 44 Improvements in objective measurements of gait have been reported following massage in normal horses, 45 although convincing peerreviewed data are lacking. 46 Further investigation of these techniques is warranted in order to establish a rational basis for treatment of muscle strain injuries in horses. Given the infrequency with which such cases are identified, conducting appropriately controlled, largescale clinical trials may be difficult. ...
To describe the clinical presentation, ultrasound findings, management and outcome in horses with muscle tear injuries of the hindlimbs.
Retrospective case series Procedure Medical records of eight horses were reviewed and information on signalment, history, presenting complaint, physical examination findings and further diagnostic tests were recorded. Diagnosis of muscle injury was determined by the presence of abnormal ultrasound findings, compared with the contralateral limb, and, when required, nuclear scintigraphy. Follow-up information was obtained via telephone interviews with owners, trainers and referring veterinarians.
Muscle tears causing lameness were identified in the middle gluteal (3), semitendinosus (1), semimembranosus (2) and gracilis (2) muscles. Tears were classified by ultrasound imaging as partial (6) or complete (2). The degree of lameness did not appear to be indicative of the extent of injury or of completion of healing. Long-term follow-up was available for seven horses and the outcome was favourable in six cases.
Ultrasonography is useful in the diagnosis and assessment of moderate to severe muscle strain injuries. The prognosis appears to be favourable in most cases, although recurrence of injury and lameness can delay the return to athletic activity and an inferior outcome with persistent gait abnormality may occur.
This article serves as an introduction into integrative case management as it applies to the horse's mental health, pain management, and tissue healing. The integrative philosophy pertains to the combination of conventional Western medicine and complementary and alternative therapies to provide the best patient care possible using currently available evidence. The goal is to improve the health of the patient in a more holistic manner.
The equine transeva technique (ETT), is a novel electrotherapy, which utilises pulsating current electrotherapy to target sensory and motor neurons. The technique may facilitate increased circulation and correction of musculoskeletal issues and injuries, such as tendon and ligament tears and muscle atrophy. Despite the importance of understanding the impact of ETT on horses, no current scientific research exists in this area. This preliminary study investigated the effects of ETT on the musculoskeletal system of the horse, specifically within the Gluteus superficialis (GS). Using surface electromyography, muscle workload was measured in 11 sound and healthy horses of varying breeds and disciplines within the inclusion criteria. Integrated electromyography (iEMG) calculated the percentage change in maximal contractions before and after ETT treatment during one minute trials at 30 s intervals. An ANCOVA determined if these constituted significant changes (Bonferroni adjusted alpha: P≤0.02). Significant differences in muscle workload were found on the left side between pre- and post-treatment readings across trials (P≤0.02), however no significant changes occurred for the right side. The majority of horses (82%; n=9) experienced bilateral changes, with 78% of these (n=7) exhibiting a negative change in muscle workload recorded from the pretreatment condition, which may indicate muscular relaxation. The results suggest ETT may have some effect on muscle workload in the athletic horse, however further research is needed to confirm the effects observed. Future studies should include randomising the side which is treated first, a larger sample size, expansion of temporal variables and consideration of a longitudinal study to determine if these trends accrue over multiple maintenance-purposed treatments.
Previous necropsy studies have shown that up to 60% of sled dogs competing in endurance sled dog races have areas of muscle damage. Human athletes and trainers have maintained a strong belief, based mostly on personal experiences, that massage can be effective for pre-race preparation and expedited recovery between consecutive events. We proposed that massage could lessen the degree of creatine phosphokinase (CPK) release when utilised prior to endurance activities. A randomised crossover study was performed using minimally conditioned sled dogs from a sled dog racing kennel. Each dog in the treatment group received a 14 min massage immediately prior to controlled endurance exercise. The pre-exercise CPK activity was 64±11 IU/l (mean ± standard deviation). The difference between pre-exercise CPK and post-exercise CPK for both groups was expressed as delta CPK. The delta CPK for the massage group was 62±22 IU/l and 74±55 IU/l for the control group. There was no significant change in concentration of CPK be...
The aim of the study was to determine the effect of music featured in the barn, on the emotional state of racehorses. Seventy 3 yr-old Purebred Arabian horses in their first race season were divided into experimental group of 40 horses and control group of 30 horses, and placed in separate barns. The experimental group was subject to specifically composed music featured in the barn for five hours in the afternoon during the whole study. The emotional state in the horses was assessed at rest, saddling and warm-up walk under rider. Measurements were taken six times, every 30-35 days, starting from the beginning of featuring the music. The horse’s emotional state was assessed by cardiac activity variables. The music effect on the emotional state was also considered with regard to the horse’s performance estimated by race records. The cardiac activity variables were compared with repeated measures design, whereas race records were analyzed with ANOVA GLM. The music positively affected the emotional state in race horses. The influence was noticeable already after first month of featuring the music and increased in the second and third months. Despite the fact that later, the variables began to return to initial levels, a positive effect of the music on prizes won by the horses in the experimental group compared to the control group, was found (p<0.05). The results suggest that the music may be featured in the barn, preferably for two to three months as a means of improving the welfare of race horses.
Massage, an ancient Chinese healing art, is widely practiced for symptom relief in hypertensive patients with anxiety, depression, headache, vertigo, chronic pain in neck, shoulder and back. A large number of case series and clinical trials have been published. However, it is still unclear whether massage can be recommended as an effective therapy for essential hypertension (EH). We estimated the current clinical evidence of massage for EH. Articles published before 10 December 2013 were searched using Cochrane Library, PubMed, EMBASE, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Database, Wanfang data and Chinese National Knowledge Infrastructure. Randomized controlled trials comparing massage with any type of control intervention were included. Trials testing massage combined with antihypertensive drugs versus antihypertensive drugs were included as well. Meta-analysis was performed on the effects on blood pressure (BP). Twenty-four articles involving 1962 patients with EH were selected. Methodological quality of most trials was evaluated as generally low. Meta-analyses demonstrated that massage combined with antihypertensive drugs may be more effective than antihypertensive drugs alone in lowering both systolic BP (SBP; mean difference (MD): -6.92 (-10.05, -3.80); P<0.0001) and diastolic BP (MD: -3.63 (-6.18, -1.09); P=0.005); massage appears beneficial for reducing SBP (MD: -3.47 (-5.39, -1.56); P=0.0004) for hypertensive patients as compared with antihypertensive drugs. Safety of massage is still unclear. There is some encouraging evidence of massage for EH. However, because of poor methodological quality, the evidence remains weak. Rigorously designed trials are needed to validate the use of massage in future.Journal of Human Hypertension advance online publication, 3 July 2014; doi:10.1038/jhh.2014.52.
The use of massage (as a potential form of acupressure) has long been documented as a human relaxation aid. However, little scientific research has been carried out into its potential use as a form of stress reduction in the horse. This preliminary study investigated the effect of massage at six different sites (thoracic trapezius [withers], mid-brachiocephalicus, cervical ventral serrate and cervical trapezius [mid-neck], proximal gluteal fascia and proximal superficial gluteal [croup], proximal and mid-semitendinosus [second thigh], lateral triceps, proximal extensor carpi radialis and proximal common digital extensor [forearm], proximal brachiocephalicus, proximal splenius and ear [poll and ears) on stress-related behavioral and physiological (heart rate [HR]) measures in the horse. Ten riding school ponies/horses were massaged at each of the six sites (three preferred and three nonpreferred sites of allogrooming (mutual grooming between conspecifics) and changes in HR and behavior were recorded. The results indicated that during massage, all sites except the forearm resulted in a significant reduction in HR (P < .05) with massage at the withers, mid-neck, and croup having the greatest effect (preferred sites of allogrooming). Massage at preferred sites of allogrooming also elicited significantly more (P < .05) positive behavioral responses compared with the three nonpreferred sites. The practical implications of this study are discussed.
Use of massage therapy by the general public has increased substantially in recent years. In light of the popularity of massage therapy for stress reduction, a comprehensive review of the peer-reviewed literature is important to summarize the effectiveness of this modality on stress-reactive physiological measures. On-line databases were searched for articles relevant to both massage therapy and stress. Articles were included in this review if (i) the massage therapy account consisted of manipulation of soft tissues and was conducted by a trained therapist, and (ii) a dependent measure to evaluate physiological stress was reported. Hormonal and physical parameters are reviewed. A total of 25 studies met all inclusion criteria. A majority of studies employed a 20-30 min massage administered twice-weekly over 5 weeks with evaluations conducted pre-post an individual session (single treatment) or following a series of sessions (multiple treatments). Single treatment reductions in salivary cortisol and heart rate were consistently noted. A sustained reduction for these measures was not supported in the literature, although the single-treatment effect was repeatable within a study. To date, the research data is insufficient to make definitive statements regarding the multiple treatment effect of massage therapy on urinary cortisol or catecholamines, but some evidence for a positive effect on diastolic blood pressure has been documented. While significant improvement has been demonstrated following massage therapy, the general research body on this topic lacks the necessary scientific rigor to provide a definitive understanding of the effect massage therapy has on many physiological variables associated with stress.
Delayed onset muscle soreness is a common problem that can interfere with rehabilitation as well as activities of daily living. The purpose of this study was to test the impact of therapeutic massage, upper body ergometry, or microcurrent electrical stimulation on muscle soreness and force deficits evident following a high-intensity eccentric exercise bout. Forty untrained, volunteer female subjects were randomly assigned to one of three treatment groups or to a control group. Exercise consisted of high-intensity eccentric contractions of the elbow flexors. Resistance was reduced as subjects fatigued, until they reached exhaustion. Soreness rating was determined using a visual analog scale. Force deficits were determined by measures of maximal voluntary isometric contraction at 90 degrees of elbow flexion and peak torque for elbow flexion at 60 degrees/sec on a Cybex II isokinetic dynamometer. Maximal voluntary isometric contraction and peak torque were determined at the 0 hour (before exercise) and again at 24 and 48 hours postexercise. Treatments were applied immediately following exercise and again at 24 hours after exercise. The control group subjects rested following their exercise bout. Statistical analysis showed significant increases in soreness rating and significant decreases in force generated when the 0 hour was compared with 24- and 48-hour measures. Further analysis indicated no statistically significant differences between massage, microcurrent electrical stimulation, upper body ergometry, and control groups.
It was hypothesized that athletic massage administered 2 hours after eccentric exercise would disrupt an initial crucial event in acute inflammation, the accumulation of neutrophils. This would result in a diminished inflammatory response and a concomitant reduction in delayed onset muscle soreness (DOMS) and serum creatine kinase (CK). Untrained males were randomly assigned to a massage (N = 7) or control (N = 7) group. All performed five sets of isokinetic eccentric exercise of the elbow flexors and extensors. Two hours after exercise, massage subjects received a 30-minute athletic massage; control subjects rested. Delayed onset muscle soreness and CK were assessed before exercise and at 8, 24, 48, 72, 96, and 120 hours after exercise. Circulating neutrophils were assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; cortisol was assessed before and immediately after exercise, and at 30-minute intervals for 8 hours; cortisol was assessed at similar times. A trend analysis revealed a significant (p < 0.05) treatment by time interaction effect for 1) DOMS, with the massage group reporting reduced levels; 2) CK, with the massage group displaying reduced levels; 3) neutrophils, with the massage group displaying a prolonged elevation; and 4) cortisol, with the massage group showing a diminished diurnal reduction. The results of this study suggest that sports massage will reduce DOMS and CK when administered 2 hours after the termination of eccentric exercise. This may be due to a reduced emigration of neutrophils and/or higher levels of serum cortisol.
The recovery process in sport plays an essential role in determining subsequent athletic performance. This study investigated the effectiveness of different recovery interventions after maximal exercise. Eighteen trained male cyclists initially undertook an incremental test to determine maximal oxygen consumption. The four recovery interventions tested were: passive, active (50% maximal oxygen uptake), massage, and combined (involving active and massage components). All test sessions were separated by 2 to 3 days. During intervention trials subjects performed two simulated 5 km maximal effort cycling tests (T1 and T2) separated by a 20 min recovery. Performance time for the tests (t1, t2); blood lactate (BLa) during T1, T2, and every 3 min during recovery; and heart rate (HR) during the recovery intervention and T2 were recorded. Combined recovery was found to be better than passive (P<0.01) and either active or massage (P<0.05) in maintenance of performance time during T2. Active recovery was the most effective intervention for removing BLa at minutes 9 and 12, BLa removal during combined recovery was significantly better than passive at minute 3, and significantly better than passive, active, and massage at minute 15. In conclusion, combined recovery was the most efficient intervention for maintaining maximal performance time during T2, and active recovery was the best intervention for removing BLa.
The purpose of this study was to investigate the physiological and psychological effects of massage on delayed onset muscle soreness (DOMS).
Eighteen volunteers were randomly assigned to either a massage or control group. DOMS was induced with six sets of eight maximal eccentric contractions of the right hamstring, which were followed 2 h later by 20 min of massage or sham massage (control). Peak torque and mood were assessed at 2, 6, 24, and 48 h postexercise. Range of motion (ROM) and intensity and unpleasantness of soreness were assessed at 6, 24, and 48 h postexercise. Neutrophil count was assessed at 6 and 24 h postexercise.
A two factor ANOVA (treatment v time) with repeated measures on the second factor showed no significant treatment differences for peak torque, ROM, neutrophils, unpleasantness of soreness, and mood (p > 0.05). The intensity of soreness, however, was significantly lower in the massage group relative to the control group at 48 h postexercise (p < 0.05).
Massage administered 2 h after exercise induced muscle injury did not improve hamstring function but did reduce the intensity of soreness 48 h after muscle insult.
The equivocal findings in the literature on efficacy of massage makes it difficult to assess the requirement for, or justify the use of, specialist massage personnel at major athletics events. However, the use of massage by athletes during training and competition remains popular.
To quantify the amount of their time that physiotherapists devote to massage treatment at major athletics events in an attempt to determine the importance of this treatment modality, and to examine whether the use of massage at athletics events is changing over time.
Data recorded by the head team physiotherapist from 12 major athletics events (national and international events) between 1987 and 1998 were examined. For each event, the data included: total number of treatments administered by the physiotherapist, the treatment modalities used, and the number of attendances for treatment. The amount of massage provided was expressed as a percentage of the total number of treatments for each athletic event, and the pattern of change in use of massage treatment over time was evaluated.
The percentage of time spent providing massage treatment ranged from 24.0% to 52.2% of the total number of treatments made. The overall median percentage of total treatments in the form of massage was 45.2%. No significant increase or decrease in the use of massage as a treatment modality was observed between 1987 and 1998 in the athletics events examined (p = 0.95).
A significant proportion of physiotherapists' time is devoted to the delivery of massage treatment at athletics events. The demand for massage treatment has been steady over the time period, in the events for which data are available, indicating a consistent use of this treatment modality. Given the popularity of massage among athletes, consideration should be given to the use of specialist sports massage staff at major athletics events. Furthermore, it would seem prudent to further investigate the efficacy of the treatment.
Many coaches, athletes and sports medicine personnel hold the belief, based on observations and experiences, that massage can provide several benefits to the body such as increased blood flow, reduced muscle tension and neurological excitability, and an increased sense of well-being. Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms). Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing. Depending on the massage technique, mechanical pressure on the muscle is expected to increase or decrease neural excitability as measured by the Hoffman reflex (neurological mechanisms). Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response (physiological mechanisms). A reduction in anxiety and an improvement in mood state also cause relaxation (psychological mechanisms) after massage. Therefore, these benefits of massage are expected to help athletes by enhancing performance and reducing injury risk. However, limited research has investigated the effects of pre-exercise massage on performance and injury prevention.
Massage between events is widely investigated because it is believed that massage might help to enhance recovery and prepare athletes for the next event. Unfortunately, very little scientific data has supported this claim. The majority of research on psychological effects of massage has concluded that massage produces positive effects on recovery (psychological mechanisms). Post-exercise massage has been shown to reduce the severity of muscle soreness but massage has no effects on muscle functional loss. Notwithstanding the belief that massage has benefits for athletes, the effects of different types of massage (e.g. petrissage, effleurage, friction) or the appropriate timing of massage (pre-exercise vs post-exercise) on performance, recovery from injury, or as an injury prevention method are not clear. Explanations are lacking, as the mechanisms of each massage technique have not been widely investigated. Therefore, this article discusses the possible mechanisms of massage and provides a discussion of the limited evidence of massage on performance, recovery and muscle injury prevention. The limitations of previous research are described and further research is recommended.
Delayed-onset muscle soreness (DOMS) describes muscle pain and tenderness that typically develop several hours postexercise and consist of predominantly eccentric muscle actions, especially if the exercise is unfamiliar. Although DOMS is likely a symptom of eccentric-exercise-induced muscle damage, it does not necessarily reflect muscle damage. Some prophylactic or therapeutic modalities may be effective only for alleviating DOMS, whereas others may enhance recovery of muscle function without affecting DOMS.
To test the hypothesis that massage applied after eccentric exercise would effectively alleviate DOMS without affecting muscle function.
We used an arm-to-arm comparison model with 2 independent variables (control and massage) and 6 dependent variables (maximal isometric and isokinetic voluntary strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness). A 2-way repeated-measures analysis of variance and paired t tests were used to examine differences in changes of the dependent variable over time (before, immediately and 30 minutes after exercise, and 1, 2, 3, 4, 7, 10, and 14 days postexercise) between control and massage conditions.
University laboratory.
Ten healthy subjects (5 men and 5 women) with no history of upper arm injury and no experience in resistance training.
Subjects performed 10 sets of 6 maximal isokinetic (90 degrees x s(-1)) eccentric actions of the elbow flexors with each arm on a dynamometer, separated by 2 weeks. One arm received 10 minutes of massage 3 hours after eccentric exercise; the contralateral arm received no treatment.
Maximal voluntary isometric and isokinetic elbow flexor strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness.
Delayed-onset muscle soreness was significantly less for the massage condition for peak soreness in extending the elbow joint and palpating the brachioradialis muscle (P < .05). Soreness while flexing the elbow joint (P = .07) and palpating the brachialis muscle (P = .06) was also less with massage. Massage treatment had significant effects on plasma creatine kinase activity, with a significantly lower peak value at 4 days postexercise (P < .05), and upper arm circumference, with a significantly smaller increase than the control at 3 and 4 days postexercise (P < .05). However, no significant effects of massage on recovery of muscle strength and ROM were evident.
Massage was effective in alleviating DOMS by approximately 30% and reducing swelling, but it had no effects on muscle function.
To determine the comparative effect of sports massage, active recovery, and rest on promoting blood lactate clearance after maximal anaerobic (supramaximal) leg exercise.
A counterbalanced experimental design with repeated measures was used. The repeated measures were the three treatment conditions. The order of the conditions was determined by random assignment to a counterbalanced test sequence. All data were collected in the Human Energy Research Laboratory at the University of Pittsburgh.
Ten male competitive cyclists volunteered for this investigation.
Serial venous blood samples were drawn and analyzed for blood lactate concentration for each test condition.
There were significant main effects for both absolute and relative values of blood lactate concentration between the three treatment groups and across time within groups.
After supramaximal leg exercise, active recovery produced significant decreases in both absolute and relative measures of blood lactate concentration when compared with the sports massage and rest conditions. No significant difference was found between sports massage and rest for either absolute or relative changes in blood lactate concentration.
To investigate the effectiveness of massage therapy in reducing physiological and psychological indicators of stress in nurses employed in an acute care hospital.
Randomised controlled trial.
Acute care hospital in Queensland.
Sixty nurses were recruited to the five week study and randomly assigned to two groups.
A 15 minute back massage once a week. The control group did not receive any therapy.
Demographic information, a life events questionnaire and a brief medical history of all participants was completed at enrolment. Physiological stress was measured at weeks one, three and five by urinary cortisol and blood pressure readings. Psychological stress levels were measured at weeks one and five with the State-Trait Anxiety Inventory (STAI).
Differences in the change in urinary cortisol and blood pressure between the two groups did not reach statistical significance. However, STAI scores decreased over the five weeks for those participants who received a weekly massage. The STAI scores of the control group increased over the five week period. These differences between the groups were statistically significant.
The results of this study suggest that massage therapy is a beneficial tool for the health of nurses as it may reduce psychological stress levels. It is recommended that further large studies be conducted to measure the symptoms of stress rather than the physiological signs of stress in nurses.
Common methods used to treat back problems in horses need to be assessed objectively.
To measure spinal mechanical nociceptive thresholds (MNTs) and evaluate the effects of chiropractic, massage and phenylbutazone, compared with active and inactive control groups.
Baseline MNTs at 7 sites within the thoracolumbar and sacral regions were measured in 38 healthy mature horses exhibiting no clinical signs of lumbar pain. Horses were assigned to one of 3 treatment groups: instrument-assisted chiropractic treatment, therapeutic massage and phenylbutazone; or 2 control groups: ridden exercise (active control) or routine paddock turnout with no ridden exercise (inactive control). MNT measurements were repeated at 1, 3 and 7 days post treatment. The percentage change from baseline MNT values was calculated within groups.
On Day 7, the median MNT had increased by 27, 12 and 8% in the chiropractic, massage and phenylbutazone groups, respectively. MNT changes of <1% were seen within the active and inactive control groups.
Chiropractic treatment and massage therapy increased spinal MNTs within horses not exhibiting signs of lumbar pain.
Pressure algometry provides an objective tool to evaluate the effects of commonly used, but currently unproven treatment modalities on spinal MNTs. Future studies need to evaluate combined treatment effects and longer-term MNT changes in horses with documented back pain.
Adjuvant massage therapy improves pain management and postoperative anxiety among many patients who experience unrelieved postoperative pain. Pharmacologic interventions alone may not address all of the factors involved in the experience of pain.
Randomized controlled trial.
Department of Veterans Affairs hospitals in Ann Arbor, Michigan, and Indianapolis, Indiana.
Six hundred five veterans (mean age, 64 years) undergoing major surgery from February 1, 2003, through January 31, 2005.
Patients were assigned to the following 3 groups: (1) control (routine care), (2) individualized attention from a massage therapist (20 minutes), or (3) back massage by a massage therapist each evening for up to 5 postoperative days. Main Outcome Measure Short- and long-term (> 4 days) pain intensity, pain unpleasantness, and anxiety measured by visual analog scales.
Compared with the control group, patients in the massage group experienced short-term (preintervention vs postintervention) decreases in pain intensity (P = .001), pain unpleasantness (P < .001), and anxiety (P = .007). In addition, patients in the massage group experienced a faster rate of decrease in pain intensity (P = .02) and unpleasantness (P = .01) during the first 4 postoperative days compared with the control group. There were no differences in the rates of decrease in long-term anxiety, length of stay, opiate use, or complications across the 3 groups.
Massage is an effective and safe adjuvant therapy for the relief of acute postoperative pain in patients undergoing major operations.
Massage is a relaxing and enjoyable diversion for some people. A more recent derivation, massage therapy, has been claimed to have many therapeutic benefits and has been advocated for treating a variety of musculoskeletal problems in animals. Few of those treatment claims are supported by scientific data.
Objectives
The purpose of this study was to investigate the physiological and psychological effects of massage on delayed onset muscle soreness (DOMS).
Methods
Eighteen volunteers were randomly assigned to either a massage or control group. DOMS was induced with six sets of eight maximal eccentric contractions of the right hamstring, which were followed 2 h later by 20 min of massage or sham massage (control). Peak torque and mood were assessed at 2, 6, 24, and 48 h postexercise. Range of motion (ROM) and intensity and unpleasantness of soreness were assessed at 6, 24, and 48 h postexercise. Neutrophil count was assessed at 6 and 24 h postexercise.
Results
A two factor ANOVA (treatment v time) with repeated measures on the second factor showed no significant treatment differences for peak torque, ROM, neutrophils, unpleasantness of soreness, and mood (p > 0.05). The intensity of soreness, however, was significantly lower in the massage group relative to the control group at 48 h postexercise (p < 0.05).
Conclusions
Massage administered 2 h after exercise induced muscle injury did not improve hamstring function but did reduce the intensity of soreness 48 h after muscle insult.
Objective
The purpose of this study was to determine if post-exercise massage has an effect on delayed-onset muscle soreness (DOMS) and physical performance in women collegiate athletes.DesignThis study used a randomized pre-test post-test control group design.ParticipantsTwenty-two NCAA Division I women basketball and volleyball players participated. On the day of predicted peak soreness, the treatment group (n=11) received a thigh massage using effleurage, petrissage and vibration while the control group (n=11) rested.Outcome measuresPaired t-tests were used to assess differences between pre and post massage measures (α=0.05) for vertical jump displacement, timed shuttle run, quadriceps length and pressure-pain threshold in the thigh.ResultsA significant increase (slowing) was found in shuttle run times for the control group (p=0.0354). There were significant changes in vertical jump displacement (p=0.0033), perceived soreness (p=0.0011) and algometer readings (p=0.0461) for the massage group.Conclusions
This study supports the use of massage in women collegiate athletes for decreasing soreness and improving vertical jump.
Part 1 of this two part article showed that immediate fascial responsiveness to manipulation cannot be explained by its mechanical properties alone. Fascia is densely innervated by mechanoreceptors which are responsive to myofascial manipulation. They are intimately connected with the central nervous system and specially with the autonomic nervous system. Part 2 of the article shows how stimulation of these receptors can trigger viscosity changes in the ground substance. The discovery and implications of the existence of fascial smooth muscle cells are of special interest in relation to fibromyalgia, amongst other conditions. An attitudinal shift is suggested, from a mechanical body concept towards a cybernetic model, in which the practitioner's intervention are seen as stimulation for self-regulatory processes within the client's organism. Practical implications of this approach in myofascial manipulation will be explored.
Objectives: Massage is widely used by the athletic population for a variety of purposes such as injury prevention, recovery from fatigue, relaxation, and to increase performance. This paper reviews the scientific literature on the use and effects of massage therapy in sport. Specifically, the review addresses physiological, psychological and performance effects. Method: A literature search was conducted using Medline, Psychlit and Sport Discus databases. In addition, the author's own files were considered. Results: Past studies on blood flow, blood lactate removal and delayed onset of muscle soreness are seen to have produced equivocal results, with blood lactate removal following exercise more efficiently removed through active recovery strategies rather than through massage. Studies on the psychological effects are few in number, however recent research seems to demonstrate massage having positive effects on perceptions of recovery. Few studies exist which assess massage effects on performance, and current findings appear to show little support for the use of massage for performance enhancement. Conclusions: Massage research has been affected by a lack of comparable instrumentation and different research designs that make interpretation and extrapolation of results difficult. It appears the use of massage may largely be based upon anecdotal accounts that convey positive testaments about this form of therapy. The evidence from this review suggests that more scientific research on the effects of massage needs to be undertaken to clarify the precise effects of massage for athletes, however applying scientific principles to the study of massage does pose methodological challenges for the researcher.
In myofascial manipulation an immediate tissue release is often felt under the working hand. This amazing feature has traditionally been attributed to mechanical properties of the connective tissue. Yet studies have shown that either much stronger forces or longer durations would be required for a permanent viscoelastic deformation of fascia. Fascia nevertheless is densely innervated by mechanoreceptors which are responsive to manual pressure. Stimulation of these sensory receptors has been shown to lead to a lowering of sympathetic tonus as well as a change in local tissue viscosity. Additionally smooth muscle cells have been discovered in fascia, which seem to be involved in active fascial contractility. Fascia and the autonomic nervous system appear to be intimately connected. A change in attitude in myofascial practitioners from a mechanical perspective toward an inclusion of the self-regulatory dynamics of the nervous system is suggested.
Massage therapy is commonly used following endurance running races with the expectation that it will enhance post-run recovery of muscle function and reduce soreness. A limited number of studies have reported little or no influence of massage therapy on post-exercise muscle recovery. However, no studies have been conducted in a field setting to assess the potential for massage to influence muscle recovery following an actual endurance running race. To evaluate the potential for repeated massage therapy interventions to influence recovery of quadriceps and hamstring muscle soreness, recovery of quadriceps and hamstring muscle strength and reduction of upper leg muscle swelling over a two week recovery period following an actual road running race. Twelve adult recreational runners (8 male, 4 female) completed a half marathon (21.1 km) road race. On days 1,4, 8, and 11 post-race, subjects received 30 minutes of standardized massage therapy performed by a registered massage therapist on a randomly assigned massage treatment leg, while the other (control) leg received no massage treatment. Two days prior to the race (baseline) and preceding the treatments on post-race days 1, 4, 8, and 11 the following measures were conducted on each of the massage and control legs: strength of quadriceps and hamstring muscles, leg swelling, and soreness perception. At day 1, post-race quadriceps peak torque was significantly reduced (p < 0.05), and soreness and leg circumference significantly elevated (p < 0.05) relative to pre-race values with no difference between legs. This suggested that exercise-induced muscle disruption did occur. Comparing the rate of return to baseline measures between the massaged and control legs, revealed no significant differences (p > 0.05). All measures had returned to baseline at day 11. Massage did not affect the recovery of muscles in terms of physiological measures of strength, swelling, or soreness. However, questionnaires revealed that 7 of the 12 participants perceived that the massaged leg felt better upon recovery.
Misalignments in the body compromise the architectural integrity. At the tissue level, fascia shortens and thickens as the body engages in compensatory strategies to maintain itself upright; these changes are known as myofascial contractions. In physical therapy, there are several methods by which practitioners treat neck dysfunction. However, studies showing the effect of those techniques are limited.
The purpose of this study was to investigate the effect of rolfing structural integration (RSI) in neck motion and pain levels of 31 subjects who received RSI. RSI is a type of therapy that focuses on aligning the human body with gravity.
This retrospective study, over a period of 3 years of clinical practice, analyzes changes in motion and pain levels at the neck for 31 subjects who completed the RSI in 10 basic sessions. Participants were evaluated before and after they received RSI. The data collected included: age, sex, occupation, referral source, diagnosis, height, weight, photographs of postural views, range of motion (ROM), pain, and functional complaints. ROM was assessed with the use of an arthordial protractor. Data analysis using three-way analysis of variance (ANOVA) tested the hypothesis at a significance of 0.5.
The mean pain levels and active range of motion (AROM) of the neck before RSI significantly changed after the treatment (p<0.5): there was a decrease in pain and an increase in AROM. Pain levels/AROM-Age within-subject effect demonstrated significant difference only in pain at best and rotation right; the mean pain levels in the older group decreased by 67%, and the mean AROM for rotation right in the younger group increased by 34%.
In this sample, pain now was reduced more than pain best and pain worst. Increased motion for lateral flexion was more than rotation, extension, and flexion.
This investigation demonstrates that the basic 10 sessions of RSI, when applied by a physical therapist with advanced RSI certification, is capable of significantly decreasing pain and increasing AROM in adult subjects, male and female, with complaints of cervical spine dysfunction regardless of age.
Sport massage, a manual therapy for muscle and soft tissue pain and weakness, is a popular and widely used modality for recovery after intense exercise. Our objective is to determine the effectiveness of sport massage for improving recovery after strenuous exercise.
We searched MEDLINE, EMBASE, and CINAHL using all current and historical names for sport massage. Reference sections of included articles were scanned to identify additional relevant articles.
Study inclusion criteria required that subjects (1) were humans, (2) performed strenuous exercise, (3) received massage, and (4) were assessed for muscle recovery and performance. Ultimately, 27 studies met inclusion criteria.
Eligible studies were reviewed, and data were extracted by the senior author (TMB). The main outcomes extracted were type and timing of massage and outcome measures studied.
Data from 17 case series revealed inconsistent results. Most studies evaluating post-exercise function suggest that massage is not effective, whereas studies that also evaluated the symptoms of DOMS did show some benefit. Data from 10 randomized controlled trials (RCTs) do, however, provide moderate evidence for the efficacy of massage therapy. The search identified no trend between type and timing of massage and any specific outcome measures investigated.
Case series provide little support for the use of massage to aid muscle recovery or performance after intense exercise. In contrast, RCTs provide moderate data supporting its use to facilitate recovery from repetitive muscular contractions. Further investigation using standardized protocols measuring similar outcome variables is necessary to more conclusively determine the efficacy of sport massage and the optimal strategy for its implementation to enhance recovery following intense exercise.
The effect of a combination of a warm-up, stretching exercises and massage on subjective scores for delayed onset muscle soreness (DOMS) and objective functional and biochemical measures was studied. Fifty people, randomly divided in a treatment and a control group, performed eccentric exercise with the forearm flexors for 30 min. The treatment group additionally performed a warm-up and underwent a stretching protocol before the eccentric exercise and massage afterwards. Functional and biochemical measures were obtained before, and 1, 24, 48, 72 and 96h after exercise. The median values at the five post-exercise time points differed significantly for DOMS measured when the arm was extended (p = 0.043). Significant main effects for treatment were found on the maximal force (p = 0.026), the flexion angle of the elbow (p = 0.014) and the creatine kinase activity in blood (p = 0.006). No time-by-treatment interactions were found. DOMS on pressure, extension angle and myoglobin concentration in blood did not differ between the groups. This combination of a warm-up, stretching and massage reduces some negative effects of eccentric exercise, but the results are inconsistent, since some parameters were significantly affected by the treatment whereas others were not, despite the expected efficacy of a combination of treatments. The objective measures did not yield more unequivocal results than the subjective DOMS scores.
This study Investigated the effects of a therapeutic massage on delayed onset muscle soreness and muscle function following downhill walking. Eight male subjects performed a 40-min downhill treadmill walk loaded with 10% of their body mass. A qualified masseur performed a 30-min therapeutic massage to one limb 2 hours post-walk. Muscle soreness, tenderness, isometric strength, isokinetic strength, and single leg vertical jump height were measured on two occasions before, and 1, 24, 72 and 120 hours post-walk for both limbs. Subjects showed significant (p < 0.004) increases in soreness and tenderness for the non-massaged limb 24 hours post-walk with a significant (p < 0.001) difference between the two limbs. A significant reduction In isometric strength was recorded for both limbs compared to baseline 1 hour post-walk. Isokinetic strength at 60 degrees/sec and vertical jump height were significantly lower for the massaged limb at 1 and 24 hours post-walk. No significant differences were evident in the remaining testing variables. These results suggest that therapeutic massage may attenuate soreness and tenderness associated with delayed onset muscle soreness. However it may not be beneficial in the treatment of strength and functional declines.
At present, there is little scientific evidence that postexercise manual massage has any effect on the factors associated with the recovery process. The purpose of this study was to compare the effects of massage against a resting control condition upon femoral artery blood flow (FABF), skin blood flow (SKBF), skin (SKT), and muscle (MT) temperature after dynamic quadriceps exercise.
Thirteen male volunteers participated in 3 x 2-min bouts of concentric quadriceps exercise followed by 2 x 6-min bouts of deep effleurage and pétrissage massage or a control (rest) period of similar duration in a counterbalanced fashion. Measures of FABF, SKBF, SKT, MT, blood lactate concentration (BLa), heart rate (HR), and blood pressure (BP) were taken at baseline, immediately after exercise, as well as at the midpoint and end of the massage/rest periods. Data were analyzed by two-way ANOVA.
Significant main effects were found for all variables over time due to effects of exercise. Massage to the quadriceps did not significantly elevate FABF (end-massage 760 +/- 256 vs end-control 733 +/- 161 mL x min(-1)), MT, BL, HR, and BP over control values (P < 0.05). SKBF (end-massage 150 +/- 49 vs end control 6 +/- 4 au) SKT (end-massage 32.2 +/- 0.9 vs end-control 31.1 +/- 1.3degreesC) were elevated after the application of massage compared with the control trial (P < 0.05).
From these data it is proposed that without an increase in arterial blood flow, any increase in SKBF is potentially diverting flow away from recovering muscle. Such a response would question the efficacy of massage as an aid to recovery in postexercise settings.
The purpose of this study was to examine the effects of active recovery (AR), massage (MR), and cold water immersion (CR) on performance of repeated bouts of high-intensity cycling separated by 24 hours. For each recovery condition, subjects were asked to take part in 2 intermittent cycling sessions; 18 minutes of varying work intervals performed in succession at a resistance of 80 g/kg body weight separated by 24 hours. One of four 15-minute recovery conditions immediately followed the first session and included: (a) AR, cycling at 30% Vo(2)max; (b) CR, immersion of legs in a 15 degrees C water bath; (c) MR, massage of the legs; and (d) control, seated rest. Only the control condition showed a significant decline in the total work completed between the first and second exercise sessions (108.1 +/- 5.4 kJ vs. 106.0 +/- 5.0 kJ, p < 0.05). Thus, AR, MR, and CR appeared to facilitate the recovery process between 2 high-intensity, intermittent exercise sessions separated by 24 hours.
Research into the effects of manual massage on physical performance has proved inconclusive, with studies primarily examining the major muscle groups of the lower extremities. Grip performance is essential for object manipulation, as well as for many grip-dependent activities and sports; but there have been no studies to determine the effects of manual massage on immediate grip performance in healthy subjects. The purpose of this study was to assess the effects of using manual massage to improve power-grip performance immediately after maximal exercise in healthy adults.
This was a pretest/post-test study.
The study took place in a suburban allied health school.
Fifty-two (52) volunteer massage-school clients, staff, faculty, and students participated. Interventions: Subjects randomly received either a 5-minute forearm/hand massage of effleurage and friction (to either the dominant hand or nondominant hand side), 5 minutes of passive shoulder and elbow range of motion, or 5 minutes of nonintervention rest.
Power-grip measurements (baseline, postexercise, and postintervention) were performed on both hands using a commercial hand dynamometer. These measurements preceded and followed 3 minutes of maximal exercise using a commercial isometric hand exerciser that produced fatigue to 60% of baseline strength.
After 3 minutes of isometric exercise, power grip was consistently fatigued to at least 60% of baseline, with recovery occurring over the next 5 minutes. Statistical analyses involving single-factor repeated-measures analyses of variance (p = 0.05) with Bonferroni a priori tests (p = 0.0083) demonstrated that massage had a greater effect than no massage or than placebo on grip performance after fatigue, especially in the nondominant-hand group.
Manual massage to the forearm and hand after maximal exercise was associated with greater effects than nonmassage on postexercise grip performance. The present data do support the use of a 5-minute manual massage to assist immediate grip performance after fatigue in healthy subjects.
The intention of this study was to assess the effectiveness of massage on muscle recovery as a function of therapist education in participants who completed a 10-km running race.
Race participants were offered a 12- to 15-min massage immediately post-event. Participants were randomly assigned to a student therapist with either 450, 700, or 950 h of didactic training in massage. Muscle soreness was recorded by questionnaire using a 0- to 10-point visual scale at time points immediately before and after massage, and 24 and 48 h post-event. Eight hundred ninety-five subjects were recruited, with 317 subjects returning questionnaires from all time points.
Race participants who received massage from student therapists with 950 h of didactic training reported significantly greater improvement in muscle soreness across time compared with those who received massage from therapists with 700 or 450 h of education in massage (P < 0.01). On study entry, there was no difference in muscle soreness (P = 0.99), with a group mean of 4.4 +/- 0.4; at the 24-h measurement, soreness was 2.4 +/- 0.6, 3.7 +/- 0.5, and 3.6 +/- 0.9 for the 950-, 700-, and 450-h groups, respectively (P < 0.01).
Level of therapist training was shown to impact effectiveness of massage as a post-race recovery tool; greater reduction in muscle soreness was achieved by therapists with 950 h of training as opposed to those with 700 or 450 h.
The usefulness of massage as a recovery method after high-intensity exercise has yet to be established. We aimed to investigate the effects of whole-body massage on heart rate variability (HRV) and blood pressure (BP) after repeated high-intensity cycling exercise under controlled and standardized pretest conditions.
The study included 62 healthy active individuals. After baseline measurements, the subjects performed standardized warm-up exercises followed by three 30-second Wingate tests. After completing the exercise protocol, the subjects were randomly assigned to a massage (myofascial release) or placebo (sham treatment with disconnected ultrasound and magnetotherapy equipment) group for a 40-minute recovery period. Holter recording and BP measurements were taken after exercise protocol and after the intervention.
After the exercise protocol, both groups showed a significant decrease in normal-to-normal interval, HRV index, diastolic BP (P > .001), and low-frequency domain values (P = .006). After the recovery period, HRV index (P = .42) and high-frequency (HF) (P = .94) values were similar to baseline levels in the massage group, whereas the HRV index tended (P = .05) to be lower and the HF was significantly (P < .01) lower vs baseline values in the placebo group, which also showed a tendency (P = .06) for HF to be lower than after the exercise. Likewise, diastolic BP returned to baseline levels in the massage group (P = .45) but remained lower in the placebo group (P = .02).
Myofascial release massage favors the recovery of HRV and diastolic BP after high-intensity exercise (3 Wingate tests) to preexercise levels.
To assess the biologic basis of massage therapies, we developed an experimental approach to mimic Swedish massage and evaluate this approach on recovery from eccentric exercise-induced muscle damage using a well-controlled animal model.
Tibialis anterior muscles of six New Zealand White rabbits were subjected to one bout of damaging, eccentric contractions. One muscle was immediately subjected to cyclic compressive loads, and the contralateral served as the exercised control.
We found that commencing 30 min of cyclic compressive loading to the muscle, immediately after a bout of eccentric exercise, facilitated recovery of function and attenuated leukocyte infiltration. In addition, fiber necrosis and wet weight of the tissue were also reduced by compressive loading.
We conclude that subjecting muscle to compressive loads immediately after exercise leads to an enhanced recovery of muscle function and attenuation of the damaging effects of inflammation in the rabbit model. Although these observations suggest that skeletal muscle responds to cyclic compressive forces similar to those generated by clinical approaches, such as therapeutic massage, further research is needed to assess the translational efficacy of these findings.
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