Massage for Tendinitis

Akaraporn Sakhakorn

Massage for Tendinitis

Tendinitis (also spelled tendonitis) is the painful inflammation of a tendon (fibrous tissue that connects muscle to bone) that often occurs as the result of a repetitive strain or a muscular overuse injury. Massage is a type of manual therapy that can help relieve the pain associated with tendinitis and improve overall function by manipulating the affected area to reduce excessive tension in the connective tissue and muscles, and promote healing.

How Can Massage Help Relieve Tendinitis?

Treatments for tendinitis are intended to heal the injured tendon. Restricted activity, rest, anti-inflammatory medications, elevation, compression, and splinting are the first lines of treatment for tendinitis. Massage for tendinitis may help relieve excessive tension and help prevent the buildup of scar tissue via hands-on manipulation of the affected area. Icing may be done before and after massage to provide optimal relief.

Massage should not be given during the acute stage of a tendinitis injury (which is typically the first 48 hours after injury) and should not be performed when tissues are swollen or visibly inflamed.

Studies have suggested that deep transverse friction massage (also called Cyriax massage) is the type of massage that is most beneficial for treating tendinitis. With this technique, the fingers use short, abrupt, sweeping back-and-forth motions to move the skin but do not slide over it. The goal of transverse massage is to move across a ligament or tendon to mobilize it as much as possible. Transverse massage, when performed before active exercise, can help reduce the pain associated with tendinitis and restore mobility. Transverse massage is generally thought to be safe and effective for treatment of tendinitis, though larger studies are needed to conclusively determine the exact benefits of transverse friction massage for tendinitis.

The Active Release Technique is a patented soft tissue management treatment that reduces adhesions and scar tissue that may form as the result of tendinitis. This muscle manipulation massage technique is used to treat problems that occur with tendons, as well as muscles, ligaments, fascia, and nerves. This specific massage technique combines precisely directed tension by the practitioner with very specific active movements by the patient to release the contacted tissue. Treatments take about eight to 15 minutes for each area being treated and two to ten visits may be needed before full functionality is restored.

What is Tendinitis?

Tendinitis is the pain and tenderness that occur just outside of a joint as the result of inflammation or irritation of a tendon. Tendinitis commonly affects the shoulder (rotator cuff tendinitis), elbow (tennis elbow or golfer’s elbow), wrist and thumb (de Quervain’s disease), hip (iliotibial band tendinitis), knee (runner’s knee or peripatellar tendinitis), and lower calf or ankle (Achilles tendinitis). People with a chronic medical condition such as diabetes may have calcific tendinitis, a buildup of calcium deposits in the joint.

Acute (sudden onset) tendinitis may lead to chronic (long-term) tendinitis (called tendinosis or tendinopathy) if the person does not adequately rest the joint or if the person keeps using the joint while experiencing symptoms.

What Causes Tendinitis?

Repetitive strain injury (also called overuse injury) is the most common cause of tendinitis and may occur more commonly with certain occupations or sports (such as baseball, golf or tennis). It may also be associated with an inflammatory condition, such as rheumatoid arthritis, or may occur as the result of an acute injury, such as an excessive muscle stretch.

How Can Tendinitis be Prevented?

Stretching before and after an activity, cross-training, and avoiding activities that cause excessive stress on the tendons for long periods can help prevent or reduce the risk of tendinitis. Physical therapy that includes range-of-motion exercises as well as flexibility and strengthening exercises also may help reduce the risk of recurring tendinitis.

Finding a Massage Therapist

It is important to seek treatment from an experienced, licensed massage therapist who can assess your condition and recommend the massage techniques that are right for you. Most states regulate the massage therapy profession in the form of a license, registration or certification.

A variety of massage styles incorporate elements of cross fiber and active release techniques to relieve tendinitis. Ask your massage practitioner about their experience with these advanced manipulations for treatment.

Some important questions to ask the massage therapist, as recommended by the American Massage Therapy Association, include:

  • Are you licensed to practice massage?
  • How long have you been practicing massage?
  • Do you have experience in performing deep transverse friction massage for tendinitis?
  • Are you nationally certified in therapeutic massage and bodywork?
  • Are you a member of the American Massage Therapy Association?
  • Where did you receive your massage therapy training?


Additional Resources

National Institute of Arthritis and Musculoskeletal and Skin Diseases

Medline information on Tendinitis.

Brosseu L, Casimiro L, Milne S, et al. Deep transverse friction massage for treating tendinitis. Cochrane Database of Systemic Reviews 2002 Issue 4. Art. No: CD003528.

Everything a Cyclist Should Know About Massage

Massage is an important part of a PRO cyclists routine, but where does it fit into a Semi-Pro’s schedule? This episode covers types, benefits and timing of massage for cyclists.

Video – SPC050 – Everything a Cyclist Should Know About Massage (22:33) Download the MP3

Date: June 26, 201

By: Damian Ruse

Description: Massage is an important part of a PRO cyclists routine, but where does it fit into a Semi-Pro’s schedule? This episode covers types, benefits and timing of massage for cyclists.

As Semi-Pros we know what massage are, after all it’s why we shave our legs right? Yeah right!

Massage to me is still a luxury and an indulgence and used very infrequently. With the rise of mobility information I feel I have most of my major movement issues covered-but it still has it’s place.

We know the pros get them all the time, and maybe you sneak them into your recovery or prep as well, but there is a lot of false information out there surrounding why we should be all massaging it up on regular, so I’m here to address those and to talk about types and timing.

So let’s get stuck in…starting with the types of massages.

Types of Massages for Cyclists

Sports Massage

We’re all aware of the “Sports massage” – also called Manual Therapy. It’s a physical treatment primarily used on the neuromusculoskeletal system to treat pain and disability. It most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.

It’s not just masseurs that use manual therapy, you can get this type of rub from physiotherapists and chiropractors use specifically directed manual force to the body, in order to improve mobility in areas that are restricted; in joints, in connective tissues or in skeletal muscles.

It’s a skilled hands on version of what the mobility work I have spoken about in length. It’s all about solving specific issues that may be plaguing you.

Deep Tissue Massage

Deep tissue massage is designed to relieve severe tension in the muscle and the connective tissue or fascia. This type of massage focuses on the muscles located below the surface of the top muscles. Deep tissue massage is often recommended for individuals who are involved in heavy physical activity (such as yourselves). It is not uncommon for receivers of deep tissue massage to have their pain replaced with a new muscle ache for a day or two.

It’s deep and hard, getting elbows and forearms into the mix, Deep tissue massage is applied to both the superficial and deep layers of muscles, fascia, and other structures. The sessions are often quite intense as a result of the deliberate, focused work.

If a practitioner employs deep tissue techniques on the entire body in one session, it would be next to impossible to perform; it might lead to injury or localised muscle and nerve trauma, thereby rendering the session counterproductive.

The term “deep tissue” is often misused to identify a massage that is performed with sustained deep pressure. Deep tissue massage is a separate category of massage therapy, used to treat particular muscular-skeletal disorders and complaints and employs a dedicated set of techniques and strokes to achieve a measure of relief.

So again it’s another to treat specific areas that you may be having problems with.


Why Should Cyclists Get Massages?

The next question I’m going to answer is why, why would you want to get a massage, and why is it so important to cycling performance. Other than relaxation Massage therapy has numerous benefits for athletes. Believe it or not though, it’s only recently that studies have started being done on what rubs actually do for your body. Aiding recovery is a biggie when thinking about reasons to get a massage. But it may not be for the reason you have always been told.

Dr Mark Tarnopolsky is a researcher and author of a new study just completed at McMaster University in Ontario, Canada. In Feb 2012 he published a largely self-funded study, where Tarnopolsky and co-author Simon Melov performed muscle biopsies on both legs of healthy young men before and after hard exercise, and a third time after massaging one leg in each individual.

As Tarnopolsky and his team began comparing those tissues samples from his subject’s massaged legs versus the tissue from the unmassaged leg, they found that the massaged leg had reduced exercise-induced inflammation by dampening activity of a protein referred to as NF-kb. Additionally, massage seemed to help cells recover by lifting another protein called PCG-1 alpha, which is responsible for producing new mitochondria, the small organelles inside each cell crucial for muscle energy generation.

With the addition of other proteins, all contributed to muscle recovery from massage. This new evidence somewhat refutes the popular belief that massage eases pain by helping the body clear lactic acid concentrations. In fact, the team saw no effect of massage on lactic acid concentration.

The excellent website Save Yourself has this to say this popular belief- “After spending time looking into it, it simply is not true or really even possible for a massage can flush out “toxins” like lactic acid out of your body.”

Ok back to the study, it’s believed to be first work on a cellular level basis to document the true effects of massage on reducing inflammation and helping cells recover. From a cyclist’s perspective, this study confirmed what most of us thought we knew all along. So a massage is not going to flush out lactic acid from your system, but may help with reducing inflammation. That’s one big fat reason right there!

Regular massage can also help manage and prevent injury by bringing awareness to areas of the body that are not functioning or responding as efficiently as possible. If the therapist understands the nature of the various injuries or dysfunctions they can treat the athlete accordingly. Think of it more like body maintenance with a professional running their eye over you rather than taking guesses.

This reason takes commitment though – the real benefits arise from frequent massage therapy and from working with a massage therapist that understands sports massage and your body. I believe that if you are serious about your sport and performance, it is essential to integrate massage therapy into your training program.

The ideal frequency for massage therapy is twice a week for an elite athlete, once a week minimum. For a recreational athlete, it would be once a week to once a month based on need.

In coaching, one of the key components to success is a strong athlete/coach relationship built upon trust and effective communication. Similarly, it is key to establish a relationship with your massage therapist so he not only gets to know your body but also is able to work out with you what type and depth the massage should be for what you need in that microcycle (week) or training cycle. Massage should be periodised, and when you integrate it into your yearly plan, it will really reap huge benefits.

Your therapist should be in tune with your body and should have the experience to know how much is beneficial.


~~read the entire article at the link above

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