The Role of Sports The Role of Sports Massage in Injury Massage in Injury Prevention and Absence Prevention and Absence ManagementManagement

Ben ScottBen ScottBSc (hons) MSMABSc (hons) MSMA

What is Sports Massage?What is Sports Massage?

Soft tissue therapySoft tissue therapy- Muscles- Muscles- Tendons- Tendons- Ligaments- Ligaments

EffleurageEffleurageCompressionCompressionTorqueTorqueVibrationVibrationDermal liftingDermal liftingTapotementTapotementStretchingStretching

Aims to restore muscles to their normal resting lengthAims to restore muscles to their normal resting length

When is Sports Massage Useful?When is Sports Massage Useful?

3 Sports phases:3 Sports phases:

- - Pre-eventPre-event

- - IntermediateIntermediate

-- Post-event Post-event

Injury PreventionInjury Prevention

RehabilitationRehabilitation

RelaxationRelaxation

- - ClinicallyClinically

-- Psychologically Psychologically

Aims to restore muscles to their normal resting lengthAims to restore muscles to their normal resting length

What can Sports Massage do?What can Sports Massage do?

Inadequate clinical research, therefore limited Inadequate clinical research, therefore limited evidenceevidence

Massive anecdotal evidenceMassive anecdotal evidence

Restores muscles to their normal resting lengthRestores muscles to their normal resting length

Helps maintain optimum muscle conditionHelps maintain optimum muscle condition

Effective in treating back painEffective in treating back pain

Reduces risk of Occupational Overuse SyndromeReduces risk of Occupational Overuse Syndrome

Decreases Delayed Onset Muscle Soreness (DOMS)Decreases Delayed Onset Muscle Soreness (DOMS)

Effective in treating Chronic Compartment SyndromeEffective in treating Chronic Compartment Syndrome

AbsenceAbsence

UK Health and Safety Executive on Fire Service UK Health and Safety Executive on Fire Service absence:absence:

““The injury and ill health rates are above average”The injury and ill health rates are above average”

““Scope for significant improvement”Scope for significant improvement”

Absence statisticsAbsence statistics

Local government (inc. police and fire)Local government (inc. police and fire) 10.9 10.9 days/yeardays/year

£644£644 /employee/year /employee/year

Private servicesPrivate services 6.8 6.8 days/yeardays/year

£568£568 /employee/year /employee/year

Manufacturing servicesManufacturing services 8.4 days/year8.4 days/year£624£624 /employee/year /employee/year

Australian public sector (2001-02) = any one day Australian public sector (2001-02) = any one day 1 in 201 in 20 employees absent (unscheduled leave)employees absent (unscheduled leave)

In 2005 the local government absence rate was unchanged In 2005 the local government absence rate was unchanged from 2004from 2004

Absence statistics cntd….Absence statistics cntd….

Size of agency = Size of agency = Rate of absence Rate of absence

Size of agency = Size of agency = Length of absence Length of absence

Small % of employees account for bulk of sick leaveSmall % of employees account for bulk of sick leave

e.g. e.g. 20% - No days20% - No days

17% - 17% - 10 days 10 days

The vast majority of people The vast majority of people want want to get back to workto get back to work

Main causes of absenceMain causes of absence

HealthHealth LifestyleLifestyle AccidentsAccidents CultureCultureFamilyFamilyManagement ActionManagement Action Work relatedWork related

Minor illnessMinor illness

Back painBack pain Musculo-skeletal injuries Musculo-skeletal injuries StressStress Recurring medical Recurring medical conditionsconditions

Absence ManagementAbsence Management

3 Main strategies:3 Main strategies:

- Record absence statistics- Record absence statistics

- Early intervention- Early intervention - Targets / Benchmarking- Targets / Benchmarking

““Early medical intervention will significantly speed up Early medical intervention will significantly speed up recovery and reduce absence due to sickness and ill-health” recovery and reduce absence due to sickness and ill-health” (Worcester NHS Trust)(Worcester NHS Trust)

““Reducing absence is not just about policies and procedures. Reducing absence is not just about policies and procedures. It is about skills and roles” It is about skills and roles”

Sports Massage can provide necessary skills and play an Sports Massage can provide necessary skills and play an important roleimportant role

Role of a Sports Massage Role of a Sports Massage PractitionerPractitioner

Absence preventionAbsence preventionAssessmentAssessment

AdviceAdvice

TreatmentTreatment

Maintenance bodyworkMaintenance bodywork

Relaxation / RevitalisingRelaxation / Revitalising

Absence limitation / reductionAbsence limitation / reductionAssessmentAssessment

AdviceAdvice

TreatmentTreatment

ReferralReferral

Sports Massage as an early Sports Massage as an early interventionintervention

Without Sports MassageWithout Sports Massage With Sports massageWith Sports massage

What level of qualifications are What level of qualifications are there in Sports Massage?there in Sports Massage?

3 Levels of qualification:3 Levels of qualification:Government funded vocational training ‘level 3’Government funded vocational training ‘level 3’      - ITEC, VTCT, Premier IQ qualifications      - ITEC, VTCT, Premier IQ qualifications      - predominately run in local FE colleges though some private       - predominately run in local FE colleges though some private

providers run these awardsproviders run these awards      - the National Occupational Standards are currently       - the National Occupational Standards are currently

written that those graduating are qualified to work ‘under written that those graduating are qualified to work ‘under supervision of doctor or physiotherapist’, so not covered supervision of doctor or physiotherapist’, so not covered to work as self-employed/independent practitioners to work as self-employed/independent practitioners

(although (although many do!)many do!)

Private training providers – ‘self-regulated’ - standards vary Private training providers – ‘self-regulated’ - standards vary enormously, there are even some online massage courses enormously, there are even some online massage courses available!available!

SMA accredited courses – SMA assures standards and quality of SMA accredited courses – SMA assures standards and quality of training and as such the graduates have met the minimum training and as such the graduates have met the minimum requirements for 'independent practice'requirements for 'independent practice'

ReferencesReferences

Absence Management, A Survey of Policy and Practice 2005. Absence Management, A Survey of Policy and Practice 2005. Chartered Chartered Institute of Professional DevelopmentInstitute of Professional Development

Absence Management in the Australian Public Service. Absence Management in the Australian Public Service. Audit Report No. Audit Report No. 5252, , 2002-032002-03

The effects of Massage on delayed onset muscle soreness. The effects of Massage on delayed onset muscle soreness. Br J Sports Med Br J Sports Med 2003; 2003; 3737,72-75,72-75

Effects of Massage on delayed-onset muscle soreness, swelling and recovery Effects of Massage on delayed-onset muscle soreness, swelling and recovery of muscle function. of muscle function. J Athl Tr 2005 Jul-Sep; J Athl Tr 2005 Jul-Sep; 4040(3), 174-180 (3), 174-180

Preliminary evidence of the short term effectiveness of alternative treatments Preliminary evidence of the short term effectiveness of alternative treatments for lower back pain. for lower back pain. Technol and Healthcare; Technol and Healthcare; 1313(6), 453-462(6), 453-462

Effective physical treatment for chronic lower back pain. Effective physical treatment for chronic lower back pain. Orthop Clin North Orthop Clin North Am 2004 Jan; Am 2004 Jan; 3535(1), 57-64(1), 57-64

A review of the evidence for the effectiveness, safety and cost of A review of the evidence for the effectiveness, safety and cost of acupuncture, massage therapy and spinal manipulation for back pain. acupuncture, massage therapy and spinal manipulation for back pain. Ann Ann Intern Med 2003 Jun 3; Intern Med 2003 Jun 3; 138138(11), 898-906(11), 898-906

Massage treatment for back pain. Massage treatment for back pain. BMJ 2003 March 15; BMJ 2003 March 15; 326326(7389), 562-563(7389), 562-563