Why getting massages after soft tissue injuries is a smart idea
Soft tissue injury is the damage of muscles, ligaments and tendons throughout the body (Wikipedia).
Any time the body experiences a soft tissue injury it gets out of balance and its normal gait and posture. Scar tissue (adhesions) develops and can grow and get attach to nerve tissue, organs, and bony structures.
Sprains and strains are considered soft tissue injuries. Sprains are damages to either muscles or tendons. Strains are referred to overstretched ligaments. When any of those body structures are getting injured the body responds with an inflammatory process.
Chemicals get released when we damage soft tissues. That causes blood vessels to expand (dilate), which in turn increases blood circulation. White blood cells and clotting proteins get rushed to the damaged area. White blood cells will take care of bacteria and the debris from damaged cells. Clotting proteins will stop the bleeding as well as protect the neighborly tissue from damage. Lastly the clot will harden to form a scab in the skin.
The effected and injured area is usually red and hot (inflamed), because of excessive fluid built up. That causes pressure on nerves, which in turn sends pain signals out.
Healing comes in different phases:
The “acute” phase can last between 2-4 days and its purpose is to protect the injury from more damages. It is recommended to use the R.I.C.E. method: Rest, Ice, Compress and Elevate the affected area. Doctors may recommend ibuprofen for pain management and body wraps to prevent further injuries as well as to stabilize and to support.
The “sub–acute” phase can last up to six weeks. During that time the body repairs itself. Usually during that time the patient sees physical therapists, chiropractors, and acupuncturist as well as massage therapists to help with healing.
During the “late stage” (remodeling phase), which last between six weeks and three months, the body still determines if the wounded area is strong enough for normal activities and lays down new tissue if necessary.
Beyond three months the “chronic” phase starts and at this point the patients may still experience some kind of pain. Luckily, many patients will never experience that phase. But if they do they need either more therapies, or switch to a different therapy to break the pain cycle and to speed up healing.
What can we as massage therapists and other health care providers do to support and to speed up your healing process?
Physical therapist’s play an important part in the patient’s rehabilitation process by improving their movement, restore function and managing pain. They are referred to by doctors and insurance usually pays for the costs and allows the patient between 6-12 visits. They usually focus on strengthening and stretching the injured area.
Chiropractors are specialized in physical manipulation of the joints and the spine (release subluxations) and to bring back alignment. Some are specialized in sport injuries and have great knowledge of nutritional counseling and orthopedics. There main focus is on aligning and adjustments of different body parts. Most chiropractors work with insurances.
Massage therapists are trained in understanding and treating muscular dysfunction and soft tissue conditions.
Massage Therapists relieve muscle tightness and improve muscle function, decrease scar tissue and pain associated with muscular conditions. They work on “fascia”, which are connective tissue imbedding bones, muscles, tendon, ligaments as well as organs. The massage therapist’s approach and attention is too affecting all those different structures with a positive outcome.
Well educated massage therapist’s have an in-depth knowledge about tissue related sports injury, injuries in general and rehabilitation and recovery.
Ranges of Motion (ROM), active or passive and stretching together with deep tissue work can make a tremendous change in somebody’s healing progress.
Unfortunately massage therapy usually isn’t covered by insurance and it is an out-of-pocket expanse for the patient.
Nevertheless, it may be very beneficial to get massage therapy after an injury, especially when dealing with a more severe injury, to ensure that muscles and connective tissues have been fully released.
After the body has gone thru the acute phase of injury, the massage therapist can start working very lightly on the injured site by performing lymphatic drainage massage strokes. The lymph is a liquid inside lymph vessels, which carries waste and toxins. The lymphatic vessels lay superficial under the skin throughout the body. Draining lymph fluid can help and support speeding up healing and recovery time.
As the patient gets out of the inflammation phase, he/she is getting ready for deeper muscle work. Deep Tissue work is an incredible tool to loosening up muscle tightness and bringing back muscle function.
In deep tissue work the therapist uses different massage techniques and strokes. The pressure is more firm and intense and the massage therapist can use hands, knuckles, thumbs and his/her forearm.
Verbally “checking” on the patient’s pain and discomfort level as well as “watching” for body languages is a key factor in deep tissue work. Everybody is different and therefor experiences pain and discomfort different.
The trick in applying deep tissue work is to go slow and steady and to work with the patient’s body responds, paying attention to the release of tight and knotted areas.
It should be an “energy and body work exchange” between patient and therapist. There is a difference between listening, paying attention and using intuition while applying deep tissue work.
After deep tissue work the patient may experience soreness for a couple of days. He/she should neither be bruised, or feel like a “truck ran over them”.
Feeling looser, refreshed, less pain, more flexible, relaxed, tired but not fatigued, energized, and overall feeling better are all desirable outcomes after massage therapy.
Specific deep tissue work on the injured area together with the focus on an overall imbalance of the body is necessary to heal the body as a “whole”.
It is crucial to not just address and work on the injured area, but instead to view the body as an entire unit.
When muscle function gets disrupted in one part of the body, other muscles have to take over in order to provide functionality. They have to “double up their working load” and that may result in an imbalance and a shift in posture and gait.
For example, after a leg injury like a quadriceps tear, a knee injury, or shin splints all muscles in both legs as well as the pelvic girdle need to be treated. In addition it is always a good idea to look for further imbalances, which can manifest itself in the upper body. Remember, when one body part is out of balance, other body parts may be out of balance as well.
Soft tissue injuries should always be diagnosed and treated by medical doctors first. They may refer the patient out to a physical therapist, massage therapist or, in more advanced cases, to a surgeon.
Physical therapists, chiropractors and massage therapist are all specialists in their own fields ensuring that you as the patient get the help you need in your recovery and healing process.
Conclusion: The entire body is connected and therefore needs to be treated like a “whole” system. Understanding the treatment benefits of different health care providers and their role will help you to make a smart and informed decision about your healing and recovery journey.
Written by Ruth Mueller, May 2016