As technical director of the annual Boston Marathon, Dave McGillivray spends every race day dashing from one crisis to the next. Then as nightfall nears and his duties are wrapped up, he heads back to the starting line, checks the knots on his shoes and begins his own run along the 26.2-mile course.
Bothered by Achilles tendinitis in both heels, McGillivray needed 4 hours and 31 minutes this year to complete his 99th marathon. Among the 100 or so people there to greet him was his massage therapist, with a table set up right there at the finish.
"I was on the table within a minute of crossing the finish line," said the indefatigable McGillivray, 43. "It felt good. It was the ice cream, the immediate gratification."
Had McGillivray finished with the pack earlier, he might have had to wait hours for one of the 170 therapists who worked the race. "It's amazing how this has taken off," he said of post-event massages. "We had to literally turn people away because we didn't have the therapists, space or time to take care of everyone."
Although there aren't any solid figures, sports massage has become hugely popular among both professional and recreational athletes. Testimonials abound on its ability to stave off injuries, untie knotted muscles and speed recovery; middle-of-the-pack marathoners will, amazingly, stand in line after a race waiting for an empty massage table, and many elite athletes wouldn't think of traveling to an important competition without their own practitioner in tow.
That's not likely to change, even though no one can agree on why it works.
A new Canadian study on post-exercise massage has created a stir, throwing into doubt a leading theory that massage increases blood flow and leaving researchers and therapists alike groping for answers. They do agree that there appears to be something (( useful going on -- even if it's more in the mind than the muscles.
The study, published in the May issue of Medicine and Science in Sports and Exercise, the journal of the American College of Sports Medicine, used ultrasound to measure whether massage increases blood flow -- as had long been assumed -- thereby bringing more nutrition and oxygen to muscles and hastening elimination of metabolic wastes (mainly lactic acid) that are a byproduct of exercise. The result, the theory holds, is improved performance and speedy recovery.
Not so fast, say the researchers who tested the effects of three types of massage on 10 recreational athletes. Using ultrasound to measure the diameter of the main blood vessels supplying the muscles and the rate of red blood cells passing through the arteries before and during five-minute massages to the forearm and quadriceps after exercise, the researchers found no significant difference.
"We showed fairly clearly that various types of massage have essentially no effect on blood flow to the muscle," said Peter Tiiden of Wilfred Laurier University in Waterloo, Ontario.
Perhaps surprisingly, not all sports-massage therapists take issue. "The last sentence of the report -- if elevated blood flow is the desired therapeutic effect, then light exercise would be beneficial whereas massage would not -- I totally agree with that," said Rex Baird, a neuromuscular therapist with Repose Massage Therapy Center in Boston.
But Baird says that's not the whole story, citing the study's limited hypothesis.
"My contention is that massage works not just because of elevated blood flow," he said, emphasizing the word flow. "If you have a specific sore spot in a muscle, I think it will definitely increase blood to that area," perhaps because the massage action draws blood from surrounding tissue.
That point seems to have been lost in news reports on the Canadian study.
"Massage doesn't squeeze away the strain of exercise, researchers say," read one lead paragraph. Sports-massage disciples were furious: If I feel better, how dare they say it doesn't work?
But the researchers had said no such thing.
Said Tiiden of his findings, both in the recent study and earlier research: "The only thing that I can say definitively is that massage does not affect blood flow, does not affect elimination of toxins, probably doesn't affect recovery rates over four days. There's probably a lot of other things massage does do."
"It's probably too harsh to say massage doesn't work," agreed Forrest A. Dolgener, director of the Human Performance Laboratory at the University of Northern Iowa in Cedar Falls, who conducted research in 1993 showing massage does not hasten elimination of lactic acid. "But what I would like to see is evidence that it does work, as opposed to just anecdotal information."
What some sports-massage therapists would like to see is better research. While Baird was satisfied with the study, given its narrow focus, Susanne Lane was insulted.
"Why didn't they just massage the fingers and say it didn't work?" asked Lane, a nationally certified sports-massage therapist with Muscle Inc. clinics, who believes the study was flawed in its methodology. "Doing one muscle on a limb is just ridiculous. I mean, you don't walk with one muscle. The body doesn't move in pieces, it moves in harmony.
"I've been doing this for 15 years," Lane scoffed, "and I can feel the muscle change after massage. It gets softer. If that's not blood flow, I don't know what" it is.
Lane, who has coordinated the Boston Marathon massage team for the past 10 years and has worked 125 events altogether, also said the massages done for the study were too brief and consisted of inappropriate strokes, and the study did not indicate whether athletes had sufficient fluids.
Compounding the confusion is that sports massage -- itself a specialty within the realm of therapeutic massage -- has different goals at different times. For example, practitioners say, a pre-event massage of 15 minutes or so seeks to stimulate the nervous system and warm up muscles, while one afterward is gentler and calming, returning muscles to a normal state as quickly as possible.
Longer massages, usually an hour, that go deeper into the muscles and tissue are given during training; this may actually make muscles sore in the name of long-term benefits, which pre- or post-event massage should never do.
And, of course, a cyclist's massage differs in emphasis from a runner's, swimmer's or tennis player's, regardless of how long or when it is administered.
"There are so many variables involved, it makes it challenging to research," says Elliot Greene, a past president of the American Massage Therapy Association, which has urged more research. Agrees researcher Dolgener: "Maybe we haven't done the right combination on the timing of the massage, the duration of the massage, the kind of massage."
Pub Date: 9/30/97