Mountain Massage, LLC
Taking Your Health and Performance to New Heights

Common Sports & Repetitive Movement Conditions

   

Therapist performing chair massage.

Below is a list of common sports and repetitive movement conditions that can be successfully alleviated and/or managed with massage therapy. Massage therapy, combined with other forms of treatment, i.e. physical therapy, chiropractic treatment, orthopedic treatment, etc., can help the individual achieve faster and long term, sustainable recovery from certain conditions. For more chronic conditions, massage therapy can assist the individual to lead as active a life as possible, improve athletic performance and prevent disruption caused by the condition.

 

Glossary of conditions listed in order of appearance below

plantar fasciitis

"shin splints," "Charlie horse" in calf muscles, and Achilles tendonitis

strains and sprains

piriformis syndrome

low back pain and lower cross syndrome

frozen shoulder (adhesive capsulitis) and shoulder impingement syndrome

thoracic outlet syndrome

upper cross syndrome/forward head posture

whiplash

tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis)

carpal tunnel syndrome

pain associated with osteoarthritis and/or scoliois

temporomandibular joint pain (a.k.a. "TMJ") 

Plantar Fasciitis

The plantar fascia is a thick sheet of connective tissue that stretches from the heel bone to the middle of each toe on the sole of the foot. This “sheet” functions to help support the arch of the foot. When this structure becomes overused, commonly from long periods of standing and/or walking, it becomes irritated and inflamed causing burning, pain and discomfort all along the sole of the foot. In some cases, the pain can refer up the entire length of the lower leg. Untreated, plantar fasciitis can lead to heel spurs.

Common activities associated with plantar fasciitis are: running, excessive walking, hiking, dancing, excessive standing and biking up hills.

How massage can help:  In acute plantar fasciitis, massage can assist in stimulating the movement of fluids to reduce swelling; maintain as much pain-free joint mobilization as possible to prevent the tissues in the sole of the foot from adhering to one another (called “adhesions”); realign tissue fibers to stimulate healing and to provide neurological input (via massage and joint mobilization) to minimize inhibition of the muscles.

In chronic cases of plantar fasciitis, massage can help dissolve adhesions, restore flexibility, reduce pain and restore range of motion to the joints.

 “Shin splints,” “Charlie horse” in calf muscles, and Achilles tendonitis

“Shin splints,” also known as medial tibial stress syndrome, occur often after running, hiking with collapsed arches/flat feet, and/or experiencing micro stress fractures along the tibial/shin bone. The pain occurs along the edge of the tibia where the muscles in that area attach to the bone.

“Charlie horse” of the calf muscles is another way to say muscle spasm. This can be quite painful and is often caused by overuse of the muscles, dehydration and/or electrolyte and mineral depletion.

Achilles tendonitis is inflammation of the Achilles tendon (the connective tissue that stretches from the heel to the lower portion of the calf muscles. The pain is often felt in the heel of the foot.

Common activities associated with shin splints, Charlie horse in the calf, and Achilles tendonitis are: running, excessive walking, jumping, working out strenuously without warming up and stretching first and sudden movement, i.e. sprinting.

How massage can help: When treating any of the aforementioned conditions, a combination of cryotherapy (cold), thermotherapy (heat), range of motion techniques, muscle energy technique (relaxing tense muscles and strengthening weak muscles) and manual massage would be applied. * In any case of suspected bone stress fracture, a physician’s approval must be obtained before massage can be administered.

Strains and Sprains

A “strain” is an injury that involves over-stretching or tearing of a structure where muscle and tendon converge in the body, e.g. where the hamstring muscles cross over on both sides of the back of the knee joint and join with the lower leg bones. This occurs often when the muscle is stretched and suddenly contracted, e.g. during running and/or jumping. The result is often muscle spasm, muscle weakness, limited of range of motion and pain.

A “sprain” is the stretching or tearing of a ligament (the connective tissue structure that joins bone to bone) or a joint capsule (structure that helps give stability to joints). Sprains usually occur when a joint is forced beyond its range of motion, e.g. rolling or twisting an ankle. Sprains range in severity. The more severe the sprain the more likely immobilization and possibly surgery may be required – thus making massage contraindicated (not advisable).

Common activities associated with strains and sprains are: running, walking, hiking, biking, jumping, throwing, kicking

How massage can help: In acute cases of strains and sprains, R.I.C.E. (Rest, Ice, Compression and Elevation) is recommended. In more chronic cases, massage can assist in reducing adhesions, improving range of motion, relaxing tense muscles, strengthening weak muscles, improving circulation and speeding up the healing process so that the individual can enjoy an improved activity level.

Iliotibial Band Syndrome

The iliotibial band is the ligament that runs along the outside of the thigh from the hip to the outside of the knee. The “IT band,” as it is often called, functions to stabilize and help move the knee. When this band becomes inflamed, pain is often felt on the outside of the knee and is often misdiagnosed as a knee injury. A MRI can assist in correct diagnosis. The pain can often be severe and disrupt aerobic exercise activity, especially running.

Common activities associated with iliotibial band syndrome are: running, biking

How massage can help: Massage, that incorporates MET (muscle energy technique) for the hip flexors and slow deep tissue techniques for the IT band, can be very beneficial and effective to reduce swelling, improve strength and flexibility to the band and alleviate pain in the hip and lateral knee.

Piriformis Sydrome

The piriformis muscle is a muscle that is deep to the gluteus maximus and runs obliquely from the side of the sacrum to the greater trochanter (which is the large bony protrusion off the side of the top end of the femur, below the iliac crest of the pelvis). When the piriformis muscle becomes inflamed and/or tight it can compress the sciatic nerve, causing achy pain in the buttock and down the back of the thigh. When the piriformis muscle is to blame for sciatic pain the condition is often called “false sciatica.”

Common activities associated with piriformis syndrome are: sitting for long periods of time, e.g. a long car or plane trip; desk work, or by overuse because of pelvic misalignment.

How massage can help: using a combination of muscle energy technique, myofascial release and range of motion exercises (of the hip joint) will help to decrease inflammation and tightness (hypertonicity) of the muscle and thus decrease pain related to compression of the sciatic nerve.

 Low Back Pain and Lower Cross Syndrome

Low back pain is unfortunate an extremely common occurrence in the general population and one of the most common reasons that people seek medical care in the U.S. According to a Mayo Clinic study conducted from 2005 – 2009, “back pain” was determined to be the third most common reason patients visited their general practitioners.  (Mayo Clinic Proceedings Volume 88, Issue 1 , Pages 56-67, January 2013).

Lower cross syndrome (LCS) is quite simply muscle imbalances in the lower back (lumbar) and sacral regions. The muscles that tend to be involved in this syndrome are the iliopsoas (iliacus & psoas muscles), the lower erector spinae (muscles that run parallel to the spine), the piriformis, the rectus femoris (large thigh muscle of the quadriceps group), the tensor fasciae latae (located on the side of the upper hip), the quadratus lumborum (the muscle responsible for “hiking up” the hip), the adductors (inner thigh muscles), and hamstrings (back thigh muscles). LCS usually involves several of the aforementioned muscles being tight while at the same time the opposing muscles are weak, causing an imbalance of the low back and hips. LCS can result in achy low back pain, among other discomforts.

Common activities/issues associated with low back pain and lower cross syndrome are: excessive sitting or excessive standing, obesity, poor posture, joint dysfunction, emotional tension, various diseases (e.g. rheumatologic conditions) and pelvic/abdominal disorders.

How massage can help: combined with muscle energy technique (strengthening weak muscles and relaxing tight muscles) and myofacial release techniques  (deep tissue massage techniques that work the deeper layers of the body’s tissues), massage can help reduce inflammation, improve circulation, decrease pain and break down any adhesions (folds of tissue that have stuck together) that have developed in the tight muscles.

Frozen Shoulder (adhesive capsulitis) and Shoulder Impingement Syndrome

Frozen shoulder, also known as adhesive capsulitis, is a condition involving the joint capsule of the shoulder becoming fibrotic – excess fibrous tissue develops. Adhesions within the joint capsule also form – meaning that the folds in the capsule stick together. When the shoulder joint becomes fibrotic and develops adhesions, the joint loses range of motion and more specifically, becomes difficult to rotate to the outside (externally) and lift the arm up and out from the body.

Shoulder impingement syndrome is a condition involving the compression of the supraspinatus muscle (a muscle in the rotator cuff group, located on the top of the shoulder in between the clavical and the trapezius), the subacromial bursa and the biceps tendon between two bony regions – the head of the humerus and the coracoacromial arch (top of the scapula that forms the top of the shoulder). Impingement syndrome is most commonly caused when an individual falls on their shoulder or an outstretched hand.

Common activities associated with frozen shoulder/adhesive capsulitis and impingement syndrome are: injuries that affect the shoulder

How massage can help: massage can help improve range of motion by working to break up adhesions, strengthen weak muscles and relax tight muscles; improve circulation with the joint by using joint mobilization techniques combined with gentle passive and active stretching.

Thoracic Outlet Syndrome

Thoracic outlet syndrome involves compressing the brachial plexus (a network of nerves originating near the neck and shoulder) between muscle and bone resulting in pain, numbing and tingling down the arm. There are two types of thoracic outlet syndrome: “costoclavicular syndrome” (the space between the clavicle and first rib becomes compressed because of rounded shoulders or history of trauma to the clavicle) and “pectoralis minor syndrome” (sustained contraction of the pectoralis minor muscle which results in compression of the brachial plexus).

Common activities/issues associated with thoracic outlet syndrome are: hunched or rounded shoulders, frequent playing of stringed instruments (guitar, cello, violin), excessive driving, boxing, working as a massage therapist

How massage can help: in combination with muscle energy techniques (relaxing the tight muscles – in this case, the pectoralis minor muscle and neck muscles, especially the scalene muscles; and strengthening the weak muscles which in this case are the upper back muscles), massage can improve circulation to the various affected muscle groups, dissolve any adhesions and release any trigger points in the excessively tight muscles.

Upper Cross Syndrome/Forward Head Posture

Upper cross syndrome (resulting from forward head posture) develops from an excessively slumped forward posture during which the individual is simultaneously maintaining eye site straight ahead, e.g. working on a computer at a desk, creating an inward (or lordotic) curve in the cervical spine. This posture creates short/tight muscles in the upper shoulder and neck (trapezius, levator scapula) and pectoralis major and minor (chest muscles); and weak muscles in the deep neck muscles responsible for flexing the neck forward and muscles in the mid-back and upper side chest muscles (seratus anterior and lower trapezius). The muscles located between the shoulder blades can also become weak. Forward head posture is one of the most common causes of neck pain (Hendrickson, T. p.190). 

Common activities associated with upper cross syndrome/forward head posture are: spending long hours working at a computer, maintaining poor posture over a long period of time, any activity that involves stooping while simultaneously looking forward

How massage can help: Massage combined with muscle energy technique and other deep tissue techniques can help to strengthen weak muscles and relax tight muscles; can help to “retrain” the body to correct poor posture over time with the aforementioned techniques.

Whiplash

Whiplash is often caused by a sudden movement of the neck from forward flexion to backward hyper-extension, e.g. when an individual is rear-ended in a motor vehicle accident. Whiplash involves injuries to the soft tissues of the neck. However, in more severe cases the discs in the cervical spine can be affected. The primary symptoms are neck stiffness and pain, decreased range of motion in the neck, headache, dizziness, referred pain to the shoulders – numbness and tingling can also occur.

Common activities associated with whiplash are: rear-end collision, fall from a horse, bike or down stairs

How massage can help: A visit to the massage therapist for whiplash should only occur AFTER the individual has been examined by a physician to rule out cervical spine injury. If the cervical spine has not been damaged, a massage therapist can assist the individual with improving range of motion – especially cervical and thoracic rotation, decreasing swelling and, in chronic cases, dissolve adhesions, improve circulation and work to strengthen weak muscles and relax tense muscles.

Tennis Elbow (lateral epicondylitis) and Golfer’s Elbow (medial epicondylitis)

Tennis elbow (lateral epicondylitis) and golfer's elbow (medial epicondylitis) are considered acute episodes related to chronic conditions. An acute episode of tennis elbow involves tears in the wrist extensor muscles and an acute episode of golfer's elbow involves tears in the wrist flexor muscles and pronator muscle. The chronic aspect of tennis elbow is related to a degernerative condition caused by repeated gripping. The chronic aspect of golfer's elbow is also related to degerative condition, but is instead related to repetitive wrist flexion and pronation. 

Common activities associated with tennis elbow and golfer's elbow are: any activities involving repetitive wrist flexion, extension, and pronation, e.g. throwing, gripping, pitching - golf, tennis, baseball

How massage can help: Combined with muscle energy technique, massage can help reduce hypertonicity (excessive tightness) in the wrist flexor and/or extensor and pronator muscles, break up adhesions - especially at the attachment sites of these muscles; improve and restore range of motion, decrease pain and swelling. 

 

 Carpal Tunnel Syndrome

The "carpal tunnel" of the wrist is composed of the eight carpal bones and the transverse carpal ligament/flexor retinaculum. The median nerve, which serves the forearm flexor and thenar muscles (muscles in the palm of the hand and the base of the thumb), runs through the carpal tunnel. When the protective lining of the ligaments in the carpal tunnel become inflammed, commonly because of overuse of the finger flexor muscles, the tunnel structure can compress the median nerve causing tingling, numbness, weakness and pain in the, wrist, hand and fingers. This inflammatory condition is called "carpal tunnel syndrome."

If the condition is not treated early, the transverse carpal ligament can become thickened and broadened and as the median nerve is chronically pressed it loses its ability to function effectively resulting in chronic numbness, tingling, weakness and pain in the fingers, hand and wrist. 

Common activities associated with carpal tunnel syndrome are: repetitive trauma to the area, a genetic predisposition to the disorder, the shape of the tunnel itself, overuse of wrist and finger flexors, and/or excessive, prolonged vibration of the area, e.g. truck driving with hand resting on the gear shift (vibrating while truck is moving or idling); excessive typing. 

How massage can help: In combination with muscle energy technique and myofascial release techniques, massage can help reduce the tension and increase extensibility of the tissues in the wrist. Massage techniques can also increase extensibility of the transverse carpal ligament to help decompress the tunnel off the nerve. The muscles on both sides of the forearm, hand and fingers will also be massaged and worked to release excess tension and improve overall movement in those areas. 

Pain Associated with Osteoarthritis and/or Scoliosis

Osteoarthritis is also referred to degenerative joint disease. Osteoarthritis in the spine results in degeneration (or wearing down) of the protective cartilage on the end of and between (discs) each vertebra. The cartilage serves to cushion and protect the joints and when this degenerates, bone spurs can form and press down on nerves causing pain, tingling (down the extremities), numbness, stiffness and weakness. 

Scoliosis is a lateral curvature of the spine. The causes vary from injury, to congenital, to abnormal muscles and nerves or to an unknown cause. 

Common activities associated with osteoarthritis and scoliosis are: falls, repetitive stress on the spine, genetics combined with age, gravity and poor posture

How massage can help: Often the muscles of the back are affected because of the misalignment of the spine - one side of the muscle group is tense and the muscle group on the opposite side of the spine is weak. When the spine and corresponding muscles groups are out of balance many other muscles groups and joints are affected, e.g. hips, neck, shoulders, knees, ankles and the joints in the feet. Massage, combined with muscle energy technique, gentle stretching and joint mobilization, can help to decrease tension in the muscles, strengthen weak muscles, improve joint mobility, decrease pain and increase range of motion in the joints. 

Temporomandibular Joint Pain (commonly referred to as “TMJ”)

The temporomandibular joint helps to create the "hinge" of the jaw - where the lower jaw (mandible) and the skull meet just in front of the ear. Temporomandibular joint pain can have several causes from arthritis in the joint to stress of the joint caused by overuse, i.e. grinding or clenching the teeth during the night. The symptoms range from pain in the joint, earaches, headaches, neck pain and clicking or popping sounds in the joint when chewing, or opening and closing the mouth. 

Activities associated with temporomandibular joint pain are: chewing, any activity during which the jaw/mouth is opened and closed (chewing, singing, speaking), grinding and clenching teeth

How massage can help: Interestingly, forward head posture (slumped posture) is also directly linked to increased tension in the temporomandibular joint. Therefore, it is not surprising to understand why massage treatment of TMJ pain not only involves work on the muscles in the TMJ area, but also work on the muscles of the neck, shoulder, chest, entire back (emphasis on muscles in upper back) and entire thoracic area. Massage treatment in this area can help to release tension, dissolve adhesions, release trigger points that may have developed, strengthen weak muscles, decrease inflammation and improve circulation to restore function. 

BIBLIOGRAPHY

Apfelbaum, Ananda. Thai Massage: Sacred Bodywork, New York: Avery, A member of the Penguin Group, 2003. 

Biel, Andrew. Trail Guide to the Body: A Hands-On Guide to Muscles, Bones and More, 4th Ed. Boulder, CO: Books of Discovery, 2010.

Clay, James H. & Pounds, David M. Basic Clinical Massage Therapy: Integrating Anatomy and Treatment, 2nd Ed. Philidelphia, PA: Wolters Kluwer, Lippincott Williams & Wilkins, 2008. 

Hendrickson, Thomas. Massage and Manual Therapy for Orthopedic Conditions, 2nd Ed. Philidelphia, PA: Wolters Kluwer, Lippincott Williams & Wilkins, 2009. 

Johari, Harish. Ayurvedic Massage: Traditional Indian Techniques for Balancing the Body and Mind. Rochester, VT: Healing Arts Press, 1996. 

Mattes, Aaron L. Active Isolated Strengthening: The Mattes Method, Sarasota, FL: Aaron L. Mattes, 2006.

McGillicuddy, Michael. Massage for Sport Performance, Champaign, IL: Human Kinetics, 2011.

McLaughlin, Craig. The Bodyworker's Muscle Reference Guide, Crested Butte, CO: Body Guide, 1996.

Phaigh, Rich & Perry, Paul. Athletic Massage, New York, NY: Simon & Schuster, Inc., 1984.

Riggs, Art. Deep Tissue Massage: A Visual Guide to Techniques, Berkley, CA: North Atlantic Books, 2007.

Salvo, Susuan G. Massage Therapy: Principles & Practice, 4th Ed. St. Louis, MO: Elsevier Saunders, 2012.

Walker, Judith. Neuromuscular Therapy I & II, St. Petersburg, FL: Health Source, 1989.

Associated Bodywork & Massage Professionals
© Copyright 2017 Mountain Massage, LLC. All rights reserved.