Massage therapists and sports M.D.s share their pre-appointment tips.
Massage is often written off as a luxury (mostly because of the damage it can do to your wallet), but the pros know that bodywork can make a major difference in performance.
“I usually get a massage three to four times a month, but it depends on the race I am getting ready for and the workload,” says professional distance runner and three-time Olympian Diane Nukuri. “Getting massages and adjustments are very important for me because it helps me recover faster, and it prevents minor injuries.”
For ASICS track-and-field athlete Obsa Ali, seeing a massage therapist has always been part of his training routine. “I utilise sport massages every week during training as well as during race weeks,” he says. “On race day, I go through a prerace treatment and focus on a recovery massage afterward. I think it’s vital to recovery and consistent training to also see a massage therapist after a hard training session.”
A sports massage isn’t just when an athlete gets a massage, though. There are many different styles of massage, and it’s important to understand the nuances so you know exactly what you’re signing up for. “I define a sports massage as manual manipulations of muscle and soft tissue by a qualified professional with the purpose of improving performance in or recovery of sport,” says Julia Iafrate, D.O., a sports medicine doctor and assistant professor in Rehabilitation and Regenerative Medicine at Columbia University Medical Center.
“Compared to a relaxing spa massage, sports massage fixes and corrects problems,” says Kevin McVay, a stretch and sports massage therapist at Tri-Covery in Novi, MI. “So besides injury prevention, the biggest benefit is performance. By loosening your joint, creating space in your hips and ankles, you’re going to feel freer. And when your body is firing on all cylinders, you’re going to be able to train better.”
What Are the Benefits of Sports Massage?
If you ask a sports massage therapist, they’ll tell you sports massage is amazing. If you ask a scientist, though, they’ll tell you the exact benefits are still being studied. They do know that massage is one of the best recovery techniques for reducing delayed onset muscle soreness (DOMS) and perceived fatigue, compared to cryotherapy, compression garments, and electrostimulation, according to a meta-analysis published in the journal Frontiers in Physiology.
Another meta-analysis, which examined 29 studies, published this year in the British Journal of Sports Medicine confirmed those findings regarding DOMS, but “found that massage sports massage specifically does not actually improve performance in terms of sprinting, jumping, strength, endurance, or fatigue,” says Iafrate. “However, there was a statistically significant benefit to flexibility.”
Those improvements in flexibility: That’s going to help your biomechanics when it comes to running, loosening everything up so you can move the most efficiently next time you hit the road, says Iafrate.
Massage also reduced pain intensity in runners’ quads in a study from the Journal of Physiotherapy. Additional research shows that massage can reduce inflammation, making it easier for damaged muscles to recovery postworkout.
“When you exercise, you cause microtears on a cellular level in the muscles, which leads to an inflammatory response,” explains Iafrate. “Massage can maybe help increase local blood flow to those areas, which could help improve your recovery.”
The best part? Massage was shown to be more effective if you believe it will be effective in research published by The International Journal of Therapeutic Massage & Bodywork, and the 2020 meta-analysis in the British Journal of Sports Medicine reiterated that psychological recovery improved with sports massage. (It’s been well-documented, as evidenced by this recent study, just how strong the placebo effect is.)
What Does a Sports Massage Feel Like?
Most people think of sports massage as synonymous with deep tissue massage. That’s not wrong, but sports massage is more of an umbrella term, and your therapist might use some specific techniques.
“Effleurage generally involves using the palm of the hands in more of a stroking motion to move and push blood away from a certain area,” says Iafrate, while “petrissage is more of a kneading movement, so that tends to have a little bit more compression involved and a lot of squeezing and using knuckles, finger pads, thumbs, or even elbows.” Then, the friction technique can be used to penetrate deeper into muscle tissue to heal old injuries, she adds.
It’s important to keep in mind that when it comes to sports massage, pain does not equal gain. “Massage does not have to hurt to be beneficial,” explains Rosemarie Rotenberger, an orthopedic massage therapist in Mertztown, Pennsylvania, describing common philosophies like “just do what you have to do to get it out” and “bite the bullet” as counterproductive. “Therapy occurs when the client’s body is not bracing against the therapist,” she says. So if you find yourself in serious mid-massage agony? Speak up!
“It is your body, your session, your outcome,” advises Rotenberger. “There’s a fine line between pain and discomfort, and it’s unique to the individual.” What’s more, deep pressure is not the same as deep tissue. It’s a common misconception, Rotenberger explains, and in reality, a therapist that is muscle-specific needs to exert little pressure to be effective.
Keep in mind, too, that a little post-massage soreness is normal. But even if your calves are screaming at you when you get off the table, don’t get upset and run home to your foam roller, says Leslie Goldblatt Denunzio, a marathoner and Brooklyn-based massage therapist. Soreness is normal and can even help reveal areas of weakness that should receive future attention. Within 48 hours, the tightness should dissipate, and if the massage was administered correctly, you may even feel like you’re in a new body.
When Should You Schedule Your Sports Massage?
Scheduling a massage often feels like a splurge, but sports massage isn’t the kind of thing you want to leave to the last minute before a race or hold off on until you’re dealing with a nagging issue. “Runners put so much effort into training, but very few athletes put effort into taking good care of the body that helps them perform,” says Anna Gammal, a massage therapist who works with elite runners at the Boston Marathon each year and also massaged athletes at the 2004 and 2012 Olympics. “Massage isn’t a luxury. It’s an investment.”
McVay recommends incorporating regular sports massage—even if it’s just a 30-minute session—every six weeks if you can afford it. “If you stay on a schedule like that, you can attack problems quickly instead of pushing through pain and compounding it,” he says. “We always stress, ‘don’t just come in when you’re hurt.’ It’s a lot more expensive when you have to rehab an injury.”
Scheduling mid-training appointments can reveal places that are tight and places that should be addressed in post-workout stretching, but pre- and post-event massages can specifically aid performance and recovery.
Those who are familiar with massage can benefit from a prerace rubdown in the seven- to two-day window prior to an event, says Denunzio. Getting treatment less than 48 hours prior puts all runners—even those who are massage veterans—at risk of race-day soreness.
After an event, the light-touch, free massages offered at many finish line festivals can help calm the nervous system by allowing the body to commence its natural repair state quicker, explains Rotenberger. Otherwise, racers can schedule a recovery-focused sports massage within several hours up to 48 hours after an event, says Denunzio, although she recommends massage newbies wait three to four days, as they may be too sore within the first few days to fully benefit from (and appreciate) the experience.
If you are dealing with what you think is an injury, though, you should see a sports medicine physician before doing any kind of massage, says Iafrate. “Massage therapists are not [qualified] to diagnose,” she explains, “and what we diagnose could change how the therapist decides to perform massage. It should be very much a team effort in terms of communication.”
What to Know Before You Go
Completely new to massage? Book your first appointment either well before a race—at least a few weeks out—or wait until the day after. “Just like you wouldn’t test out new socks or shoes on race day, you shouldn’t experiment with any prerace bodywork,” says Denunzio.
Before you even book an appointment, you should vet your therapist. Ask questions about the therapist’s education and experience, like “What is your training?” “Do you have a specialty?” “How many years have you been practicing?” and “Do you work frequently with runners?” suggests Gammal. Seek referrals if possible, and ensure s/he is a licensed massage therapist.
Rotenberger recommends a massage therapist specifically trained in orthopedic treatment and assessment, as s/he will know when to refer you to another healthcare professional, in the case that you’re experiencing chronic pain and discomfort not fixable via massage.
The day of, keep your pre-appointment meal light. Aside from the obvious discomfort of lying face down with a full belly, massage naturally slows down your body systems—including the digestive process—which means overeating premassage will likely make you feel “really crappy” on the table, says Denunzio.
Make sure to hydrate before you hop on the table, too. Dehydration can stiffen the fascia and muscles, which translates to a more painful massage. Ensure you’re sipping adequate amounts of H20 before you hop on the table.
As for the commonly held belief that extra liquids are needed post-massage: That’s a myth, explains Gammal. “Massage does not release or flush out any toxins from the body, which means it won’t dehydrate you. Massage helps with recovery from lactic acid but doesn’t get rid of lactic acid.” Postmassage, you can just resume your normal hydration habits.
If you are feeling sore postmassage, says Denunzio, soaking in a concentrated Epsom salt bath later in the day can help continue the cleansing process and offset any soreness.