How does Sports Massage work?

I recently attended the excellent online conference ‘Therapy Live’. One of the talks that really got me thinking was ‘Manual Therapy Justifications’ with Matt Scarsbrook. Matt was talking about this in relation to pelvic health but I realised it could be applied to my practice as a Sports Therapist.

From the first day of my sports massage course around eight years ago, I struggled to believe that using only my hands, outside the body, I am able to increase circulation, breakdown scar tissue and knots in muscles, reduce pain, increase range of motion etc etc etc .

But then we practiced on each other.

And I saw it work.

The areas of my back that had felt tight before the practical sessions no longer felt tight and I could see improvements in those that I practiced on.

Ok so I know it works, but how does it work? I had finished my sport and exercise science degree - so I had a pretty detailed understanding of anatomy and physiology. And I couldn’t understand how rubbing the skin, and even the deep tissue techniques could influence physiological structures of muscles and other tissues.

While studying for my Sports Therapy Masters we were taught how simply manipulating the muscles with our hands we can impact physiological processes; increasing blood flow and changing fibre properties. When I graduated I went on to work in sport and daily I would see manual therapy treatments including massage cause instant improvements in players symptoms, range, strength and ability to train and play.

I am totally for evidence based practice, and I know that systematic reviews and scientific literature continue to find no strong evidence of the benefits of sports massage and continue to oppose a specific biomechanical mechanism of efficacy. Yet, everyday I see it work. Now, I am by no means suggesting that this should be the sole treatment, rehabilitation and exercise programmes are the gold standard for a reason. However a treatment that makes you feel immediately better is a great way to get people started on these programmes. It can help those who are stuck in a cycle of fear-avoidance due to pain, break that cycle and start moving again. Therefore I fully support the idea of using the two approaches together and although those therapists who choose not to use manual therapy are doing so with the best of intentions; if it is more comfortable for you to squat after I have ‘released’ your glute, then quite frankly, I’m gonna do it.

So, why am I telling you all of this? One of the points that Matt made wonde