Massage therapy decreases pain and fatigue after triathlon
An Ironman triathlon is one of the most gruelling events in the world: 3.8km swim, 180km cycle and 42.2km run. Enduring the range of common side effects of competing can be equally gruelling: dehydration, hyponatraemia, musculoskelatal injuries, hypothermia, abrasions, hypoglycaemia and vomiting. When it's all over, competitors would like to know that a massage will help to ease their pain and fatigue.
Interestingly, the existing data about the effects of massage on the resolution of pain and fatigue after exercise to the point of fatigue is somewhat indirect. Most clinical trials on this topic have taken athletes before applying the massage, but the exercise used to bring on fatigue has been short duration, very high intensity exercise, rather than the very prolonged (e.g., 12 hour) exercise required to complete an Ironman triathlon. A recent study has tested whether massage is still improves the resolution of pain and fatigue in the 'real world' setting of an Ironman triathlon event.
This trial randomised 74 Ironman triathletes to massage or control immediately after competing. Even a relatively brief 7-minute sequence of massage techniques significantly reduced pain and fatigue locally at the quadriceps, where the massage techniques were applied. The authors of the study comment that the magnitude of the beneficial effects on pain and fatigue may be able to be increased by extending the duration of the massage.
A clue was also elicited regarding the mechanism by which massage reduces pain and locally perceived fatigue. The amount of pressure over the quadriceps required to elicit pain did not change with massage. This suggests that the benefits of massage cannot be explained by neurological responses based on the gate control theory of pain relief. Possible explanations may be related to physiological responses through the β-endorphin release or catabolite elimination or to psychological pathways where attention and manual contact can lead to a sense of well-being. With respect to fatigue, there can be both central and peripheral sources, with lack of energy substrate and metabolic waste concentration being the most probable causes.
Thus, it can be assumed that the positive effects of massage therapy on perceived fatigue are related to greater localised blood circulation either by mechanical effect or temperature increase, which aid in the removal of metabolic waste. Exhausted athletes may be more interested in the results than the mechanisms. Spending time on the massage table after the event can definitely be recommended.
Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!
> From: Nunes et al., J Physiother 62 (2016) 83-87. All rights reserved to the Australian Physiotherapy Association. Click here for the Pubmed summary.