Massage and its effect on D.O.M.S.

Massage and its effect on D.O.M.S.

It has been exactly one year since the province of Alberta declared its first COVID-19 case. With each provincial lockdown since, most people have stayed inside and for a lot of us, this has caused a significant struggle in being and staying active. Now with the recent announcement of fitness facilities being allowed to reopen, many people (myself included) are heading back to the gym to get ready for summer activities that are just around the corner. This sudden availability of equipment and workout space has created an increase in exercise which can also mean an increase in soreness post exercise.    

Technically known as Delayed Onset Muscle Soreness, DOMS is never a fun thing to experience, especially when either trying to get back into shape or at the beginning of a fitness journey. I know it is one of the biggest challenges I’ve faced while working out, so I thought I would discuss how massage can help alleviate some of this pain and/or discomfort and support a healthier lifestyle.   

Before we talk about how massage, however, let’s talk more about what DOMS is. While it is agreed upon in both the science and fitness communities that strenuous activity can lead to DOMS, not much is known about why strenuous activity causes it.   

The “Lactic Acid Theory” is widely accepted by most of the fitness industry, and it suggests that lactic acid is the cause of DOMS. This is because, according to some scientists who examined a group of people post exercise, high levels of lactate were found in the participant’s muscle. Lactate was thought to make muscles more acidic, and this acidity seemed to be produced only after exercise. Thus, the scientists concluded that lactic acid must be responsible for resulting pain or soreness (DOMS).    

Since those early studies, the lactic acid theory has been proven inaccurate as we learn more about lactate and cellular respiration. Instead, it is now believed that lactate is not the culprit for making the cells more acidic. Contrary to the first theory, lactate is a ‘base’ rather than an ‘acid’ because it lacks a proton. This lack of a proton means it can only accept protons, not donate them (meaning it can’t make the cell more acidic). When in the recovery phase of an exercise, lactate is turned into what is known as ‘pyruvate’ which is then converted into a fuel source (ATP) or flushed out of the cell*.  

Because of this updated understanding of lactate, scientists no longer believe in the lactic acid theory and its role in DOMS/muscle soreness. A newer theory called the “Muscle Damage Theory” is showing promise and explains that when we perform an exercise, specifically an eccentric exercise, damage to the muscle is created in the form of ‘micro-tears’. These micro-tears cause the body’s pain receptors (nociceptors) to register and send signals to the brain that there is damage to the muscle. The brain then interprets this signal of information and reacts in pain or discomfort. If you would like to know more about this subject, I was suggest checking out this article.   

As both theories still coexist thanks to their respective supporters, we cannot say for certain why pain and/or discomfort happens post-workout, only that it does, and that this can have an impact on our bodies. One thing that has been shown to have some effectiveness in decreasing DOMS is massage. A metanalysis*** conducted in 2017 examined this specifically and proposed three possibilities about massage and positive results it may have on DOMS.   

These include:   

  1. “The effect massage has on the parasympathetic nervous system.” – Massage has an effect on the parasympathetic nervous system (also known as the “rest and digest” system) by having a calming and lowering the effects of the sympathetic nervous system (“fight, flight or freeze”).
  2. “The effect massage has on increasing blood and lymph flow for clearing away biochemical markers of muscle damage.”  – Massage can have a demonstrated effect on the flow of blood and lymph. Skilled massage therapists with specialized training are able to increase the effect of lymph movement in the body. 
  3. “Psychophysiological response massage has on pain.” – The perception of pain is different for everyone and those who have psychological conditions especially, often have an over-stimulus of brain activity. Massage is said to decrease the perpetual focus on that pain and calm the body. A person may book a massage because they are in pain initially, but after the treatment ideally they should experience less pain because their body and brain are able to get relief.

Theralleve therapists know the importance of combining massage and homecare because we understand our clients’ desire to lead active lives, regardless of fitness level or goal. We know there will be times of pain and discomfort, and by understanding the various reasons behind this, we not only aim to treat, but to empower you with tools and knowledge that will provide you a role in your own recovery and overall health journey. Remember, we’re here to support you in and outside of the treatment room because life doesn’t stop after seeing us! 

To discuss your goals for health and fitness and how massage may help, please book in an appointment or send us an email at clinic@theralleve.ca. We look forward to hearing from you!  

   

Definitions:   

Metanalysis: a large review of current research to gauge accuracy and understanding of information presented.***  

Eccentric: An exercise where you are lengthening a muscle while under tension/load. Example: when you are bringing your arm down from a biceps curl.  

DOMS: the soreness typically experienced after a strenuous activity. Usually felt 12-24 hours post-activity, but it can last up to 72 hours.   

  

*Poindexter, C., & Hernandez, C. (2018). DOMS: Why do your muscles hurt days after exercise?  

**Guo, J., Li, L., Gong, Y., Zhu, R., Xu, J., Zou, J., & Chan, X. (2017). Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis. Frontiers in Physiology, 8(747). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623674/

Massage Misconception #1: Pain versus Gain

Massage Misconception #1: Pain versus Gain

You may be familiar with the expression “no pain, no gain.” Well-known to the fitness industry, it promotes the idea that without pain we will never achieve our fullest potential. Even if we are left battered and bruised in the process, we must still be willing to do anything necessary to get an excellent result.   

The massage industry is not immune to this motto either, with many people eagerly lining up ready to hurt because they believe that is what their muscles need. However, this way of thinking is potentially harmful*.  

This is because many of us think that to see the results we want we must really feel it happeningHowever, when we ignore our body’s adverse reaction to something and push through anyway, we are more likely to endure injury or have an area overworked. Yet, as opposed to evaluating what is going on, we largely assume and accept that “this is what is supposed to happen”.   

Let’s say you arrive with a stiff neck and pain between your shoulder blades. Even before I physically assess any muscle, one of the many questions I will ask you is what kind of work you do. Let’s say your answer is desk work. Although some of my attention will be to focus on your back and delve into other details of your health history, my education and experience will tell me to look to your front first. That is, for as much as you might love me to drive my elbow in between your shoulder blades and torque on your neck for the next sixty minutes with the deepest, most intense, and pain-inducing techniques I can muster, I am going to refuse.  

What? Refuse? But it hurts! Hurt me more so I hurt less!!  

I will refuse because more times than not, your pectoral muscles (via your work posture) are likely to be the main culprit and prioritizing them can increase your body awareness and create a more effective massage. Think about it. When we sit in front of a computer all day our shoulders roll inward, our heads crane forward and our backs get stretched and stiff. Everything has moved forward and caved inward.   

If I only focus on where the pain feels most prominent, in this case your mid-back, I am immediately doing you a disservice. Similarly, if I only apply techniques with an intention to satisfy your desire for pain by adding more pain, not only might I (unintentionally) injure you, but I bypass the bodily responses that should be informing my actions in the first place! As your massage therapist, I want your muscles to “let me in” so I can do my work and by the end of the treatment I want you, my client, to not only have a better understanding of the postural imbalances you contribute to daily, but feel empowered using tools you now have, to create better habits. I should not be out to hurt you, and you should not be out to hurt you either.   

Being someone in the business of pain management and relief, my overarching want is to prove that a massage does not have to leave you breathless, squirming in pain, and/or sore for days after you see me. (I have a had at least a handful of my clients shudder as they recall treatments where they asked for pressure that left them hurting.)** 

Muscles deserve attention and the nervous system should be stimulated, but never should either feel under attack. That is why I am always happy when I have a client who originally wanted me to “bring ALL the pain” become noticeably impressed with how pain-free their experience was, and yet their muscles felt “worked” and a longer-term benefit remained.

So, the next time you are in pain and booking an appointment, know that you do not have to be in extreme pain to have a good massage and get the results you want.  

     

*’Harmful’ because in some situations, like someone who has osteoarthritis or who is pregnant, deep pressure is not advised. Always check with your doctor as well as your massage therapist if you are unsure about how your condition(s) can affect your massage.    

**Massage is a shared responsibility and pain is very subjective. Please speak up if you are in pain because if you do not tell us, we do not know. 

Why is homecare an important part of your massage journey?

Why is homecare an important part of your massage journey?

“Homecare” is a word you may have heard at some point, but it is not always common practice in a massage therapy setting and therefore, its importance is not necessarily well known.  

Let’s begin by defining what homecare actually is. Homecare, when provided by a qualified massage therapist, is a set of targeted exercises and/or stretches that are typically given to the client at the end of treatment with the expectation they will be performed at home.   

Sweet! Now that we know what homecare is, why is it important?  

Like chiropractors, physiotherapists, nutritionists, and many more health care professionals, massage therapists utilize homecare as a tool to contribute to a client’s progression or initiate change in the bodily function of the individual after he/she/they leave(s) their appointment.  

Significant to note is that homecare is not necessarily ‘just exercising’. For example, let’s say you are at an appointment with a nutritionist. During the appointment you will probably talk about your goals and what you are currently doing to achieve those goals. Based on all these goals, a nutritionist will create a catered eating plan for you to follow at home. Without proper follow-through on the eating plan — your homecare — your goal will not be achieved so easily. This example illustrates why homecare is such an important part of your health care journey!   

But how does homecare relate to massage? Well, let’s talk a little about both the training of massage therapists and the limited effects of massage therapy.   

In most schools, massage therapists learn all about the anatomy and physiology* of the body. We also learn about utilizing certain techniques and how different pressures can have different impacts on the body. Although this education should result in a better, more tailored massage, the limitations of massage remain; the main one being how long the benefits last.   

Typically, the benefits of massage last for a couple of days to a week at most. We feel good and then it fades. If you wanted to experience those benefits continuously, you would have to get a treatment a couple times a week but in reality, this is not practical financially or timewise. Again, why homecare helps you extend the benefits of the massage until your next treatment.   

Lastly, you may be asking, how do we determine what homecare to assign to our clients?  

Many factors go into choosing which exercises and stretches we give you. Everything from your goals to personal time restraints to any physical limitations you may have to what we have observed during assessment, etc. All play a part, but as always, our goal as your therapist is to help you progress — not to overwhelm you. If something isn’t clear, feels uncomfortable/causes pain, or doesn’t work, tell us. Remember: massage is part of YOUR health journey and we want to help you get the most out of every treatment!  

*Anatomy can be defined as the structures of the body while physiology is the way those structures function.