UpClose & Personal - Mike McGillicuddy

Since I am from the State of Florida, I must start off by stating that in Florida a massage therapist license does not allowed therapists to diagnose or prescribe. Therefore if I were to examine an athlete prior to them obtaining a medical diagnosis, I could not legally state that the athlete had a muscle strain. It is always better to refer an injured athlete to the proper medical authority for a diagnosis before treatment.

Once an athlete has been diagnosed with a muscle strain, a sports massage therapist still has to assess the injury. The first consideration is to determine if the injury is still in the acute stage. If it is, then to work directly on the site of injury is contraindicated for at least 48 to 72 hours. Usually resting, icing and non-painful range of motion is recommended.

Strains are graded by the degree of severity. First-degree strains are usually the least severe. Second-degree strains are more severe. They can include loss of strength and normal range of motion. Third degree strains are the most severe and involve a complete tear or a severed tendon. Third degree strains usually require surgery.

As I have stated, first degree strains are the least severe. But they can easily bring about second-degree strains if they are ignored. A first-degree strain may make the athlete feel as if they have been pinched or stuck by a needle. Most athletes may feel this slight discomfort and slow what they are doing long enough to see that it is not going to continue or get worse and then proceed. Because of this, first-degree strains often turn into second-degree strains.

In order to treat a muscle strain, the exact site of injury must be located. Sometimes the athlete can point right to the spot that has the greatest discomfort.

At other times, the sports massage therapist must stress test the affected tissue. This is done by asking the athlete to contract the affected muscle while the therapist resists the range of motion. The stress to the affected muscle causes the site of the strain to become sensitive. Stress testing must be done with caution. You would not want to re-injure strain or damage the muscle.

After finding the exact site of injury, simple pressure with range of motion is a great way to start treatment. As the scar tissue begins to form, direct cross-fiber friction to the exact site for about two minutes at a time.

You want to make sure that your pressure is well within the athlete's comfort zone. Two minutes of cross-fiber friction on the site of injury followed by two minutes off, applied three times is usually sufficient for one treatment. Treatments should be applied every other day. The cross-fiber friction treatment is followed by ice treatment and gentle range of motion. As the scar tissue becomes stronger, the exact site of injury becomes more difficult to locate.

If you apply cross-fiber friction too aggressively, the following day the athlete may have pain where you applied the treatment. If applied properly, a cross-fiber treatment may leave the athlete only with some next-day slight sensitivity. Remember your cross-fiber friction treatments should be followed by icing and gentle range of motion.

Sometimes it takes up to six to eight weeks for a strain to heal. Each week the athlete's motion and strength should improve. You have to watch your athletes carefully because they have a tendency to want to go back to competing before the strain has had time to heal properly.

I will be speaking on Sports Injuries and Sports Massage at the first annual Biofreeze Pain Management with the Masters Symposium in Las Vegas, Nevada Sept. 18-21, 2003. It looks to be a great educational event! Master speakers will be George Kosalous, David Kent, James Waslaski and Erik Dalton.
The keynote speaker on Massage Therapy Research will be
Dr. Tiffany Field. Hope to see you in Las Vegas!

For information on the Symposium please call Michael Holloway
at 561-251-0970

I hope the information shared is helpful to you. Feel free to contact me with any of your sport massage questions.

Michael McGillicuddy LMT, NCBTMB
E-Mail SpiritMcG@aol.com