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View Full Version : how long after deep tissue work should you wait before exercising?


andy mac
09-17-2005, 04:34 PM
the ART chiro (active release tech) i've been saying says i can exercise straight away after deep tissue work. i would have thought it's better for the area to settle down a bit first? maybe for 24 or even 48 hours?

i don't want an excuse to slack but i've always understood you want a muscle to not be sore before going at it.

any wise thoughts much appreciated!

nb: ART:

http://www.activerelease.com/about.asp

Too Tall
09-17-2005, 06:16 PM
What do I know?! I am a deep tissue massage therapist for aboot 15 yrs. The advice I give athletes is to NOT exercise hard for 24-48 hrs. it may greatly reduce benefits of massage AND not likely you can get max performance out of those muscles. Feedback I've gotten over the yrs. from athletes confirms my recommendations. Comments like "oh man I tried to do some intervals and had NOTHING in my legs" lead me to think it is good advice to back off for 24 to 48. If you are not sore go for it, you are correct. However, light exercise esp. cardio that does not challenge muscles worked deeply the day or two before is a GREAT idea...gets the garbage out faster!

Hope that helps.

sirroada
09-17-2005, 11:48 PM
I am a chiropractor who uses ART and other forms of deep tissue work. The research I have read, and my clinical experience have shown me that it is best to get right out and exercise. The rational for this is that when ART or any other form of deep tissue work is perfomed the muscle fibers are seperated, and wrung out. This can cause small amounts of intramuscular bleeding (bruising) which can lead to the formation of new adhesions. So the purpose of exercise is to retrain the muscle fibers and to "teach" them to directionalize appropriately. That is, to pull in a linear fashion without forming a scar (adhesion). The exercise also improves circulation to the area which helps to cycle out waste products produced during deep tissue massage (lactic acid and other metabolites). THE CRITICAL KEY HERE IS: do not, and I repeat, do not expect to be able to go 100%. A good rule of thumb is to exercise at 60-70% of your max out put for 48 hours following treatment. Also, stay well hydrated with an optimum amount of electrolytes during these workouts to prevent cramping. If you go 100%, it is my opinion that you will overwork and fatigue the muscles and that produces a new set of issues to deal with. Remember, the purpose of ART is to reduce tissue adhesions, scarring and hypertonicity (tightness) by breaking up the adhesions and retraining the muscle fibers to directionalize appropriately. If you don't exercise or use the muscles right away you are forgetting a very critical component of the therapy.

lnomalley
09-18-2005, 12:40 AM
as a consumer of deep massage work i can tell you what i do.. i listen to my body.. and i usually ride a rest day/recovery work out in zone 1/2...for a half an hour or so.

the deep messages are pretty traumatic and oyu have to give yourself a chance to recover... maybe gently flush out the toxins.

that's what i do.

The Spider
09-18-2005, 01:22 AM
Guys,

any instructions you tell your clients about intense exersise before a massage?

Thanks

yzfrr11
09-18-2005, 08:00 AM
Massage does not affect muscle physiology. It is only touchy feely nice-nice. But what do I know, I am only a Harvard trained orthopaedic surgeon.

Too Tall
09-18-2005, 09:22 AM
Touchy feely nice? Wow, that's kind of high handed ;)
Swedish massage is fantastic for fast recovery from hard workouts and it is legal :)

lnomalley
09-18-2005, 10:54 AM
Massage does not affect muscle physiology. It is only touchy feely nice-nice. But what do I know, I am only a Harvard trained orthopaedic surgeon.


no offense but in your infinite knowledge you are saying that all the d1 teams that incorporate massage into the daily care of their riders are doing it to be touchy feely? clearly Harvard isnt what it advertises itself to be. i've had more potentially incompetent (like this) advice from more surgeons than any other kind of practitioner. the idea that only one "western" modality of medicine is effective and that all other possibilites or interventions are 'touchy feely' is an insult to reality.. whether the intervention is a scalpel or a human hand.. if the patient's presenting symptoms are eliminated the intervention worked.

my knee surgery was less effective than the massages i've used as treatment. and not only that, the massages addressed the structural issues that were creating my problems where the surgery was just cutting away the residue of an issue and not addressing its source.

i've had harvard trained orthopaedic surgeons want to open me up to fix things that my rather gifted masseur worked out for me (serious lower back injuries from serious crashes with serious medical names).... and my impression the only thing that was touchy was the surgeon's lack of ability to conceptualize without a surgical intervention on his mind. frankly accupuncture worked more effectively for the pain management than the 7 root blocks. massage healed the injury.

narrow mindedness is not a trait I want in my 'harvard' trained physician...and i am willing to bet that there are legit journal articles that i can dig up around the bookstacks that can suggest a physiological response to touch.

and yes i have fancy letters after my name too... i just wish more physicians would approach reality with enough confidence in their education to understand that other modalities of treatment are often times as if not more clinically effective. this is typical of a lack of generosity of knowledge that has left too many of us with experiences that tend to discredit the 'experts' while they tell us only their treatment interventions have a real clinical effect.

my injuries and resultant treatment experiences are different from what you were taught... yes massage is touchy feely! yup. is it effective? yup.
did it address clinical issues. yes. had i done surgey i don't think i could say the same thing. in fact, i rarely take a surgeon's word as expert. surgery is effective... but like all medical interventions, its still a blunt tool at work in a complex body.

sirroada
09-18-2005, 11:10 AM
Inomalley
You tell em' man. I am all for surgery...if it is needed. However, there are a million and one things that can be done prior to surgery that can be just as, if not more effective. Mr Harvard doc, the majority of my patients are failed back surgeries. Go figure. Maybe, you need to open up your mind to caring for the patient, not just pushing your fix.

RABikes2
09-18-2005, 01:21 PM
Thank you Inomalley, sirroada, and TT.

RA
LMT (19 years)

andy mac
09-18-2005, 01:23 PM
A few thoughts and some more detail as the guy who asked the initial question…

1. my ART chiro said I could jump back into gym work straight away. I was skeptical but tried it. The muscles, vastus medials/sartorius/gracilis weren’t ready for it and I just re-aggravated them, so I won’t try that again.

2. I have been trying to walk home after my treatment, about an hour over rolling terrain, to turn over the muscles and work out the junk etc.

3. A few years back I was having patella fermoral issues. I eventually ended up seeing one of the big Bay Area orthopedic surgeons who has worked with a ton on the big name pro athletes from that region as well as some US ski team members etc. He scheduled surgery to clean it up.

By chance I was at a wedding and met the physio for the Australian Olympic Cycling Team (who is currently the national mountain biking champ too! http://www.topbike.com.au/physio.htm).

She looked at me and said me knee was sore because my glutes, hips etc were tight and that was causing my leg to be pulled out of line when I was cycling. She said the proposed surgery wouldn’t address the issue and all I needed to do was stretch. I took her advice, cancelled the surgery, stretched my butt and the problem went away.

Obviously there are good and bad surgeons out there, just ask for a second opinion before slicing and dicing.

4. Without wanting to blow my own horn, I was a pro athlete for 5 years (not cycling, thus the recurring stupid questions from me on this forum) and I’ve found massage got me through many races.

I know tons of pro athletes across a range of sports, I even dated an Olympic medalist, and they all use massage as part of their routine. So does some Texan bike dude I’ve been told.

5. If you think massage is touchy feely, I would like to introduce to Lee, my 250 pound South African female masseuse. She could take down any Ultimate Fighter with one hand.

6. Thanks to everybody for contributing. I find this stuff more interesting than bagging on sloping TT's or black socks.

7. I sometimes use black socks.

8. yzfrr11, please limit the number of Harvard bumper stickers on your car to 5 or under

zap
09-18-2005, 04:52 PM
sirroada,

A bit off topic, but any thoughts on using ART on tendons? I still have scar tissue in my patellar tendon close to the tibia insertion point. Slight OSD doesn't help but one has to work with what one grew up with.

My chiro also does ART but am looking for opinions from others. I get a little nervous about messing with tendons.

Last year my ortho wanted to go in and clean the crap up. I decided at that time to make some adjustments to my cleats and saddle height, stretch more, massage some and see how it goes. The tendon still gets tight with say, one all out 15-20 minute effort, but I really can't complain. But I wouldn't mind doing more speed work to get back some of my old, ummm, zip.

So I think I need to loose some of the scar tissue. But without the knife!

Oh. Fish oil helps too.

Tailwinds
09-18-2005, 05:05 PM
No one can convince me that deep tissue massage isn't capable of breaking down some muscle tissue. I'll never forget the time I showed up at the state crit 2 days after a deep tissue massage -- DUH! :crap:

It's also fixed a few problems for me... like restoring range of motion after injuries and helping pain go away.

Of course, sometimes a "touchy-feely" massage is a nice indulgence if you're into that whole relaxation thing. I am.

sirroada
09-18-2005, 08:04 PM
sirroada,

A bit off topic, but any thoughts on using ART on tendons? I still have scar tissue in my patellar tendon close to the tibia insertion point. Slight OSD doesn't help but one has to work with what one grew up with.



By OSD I will assume you mean Osgood Schlatters Disease/Disorder. I use ART all the way up to the muscle/tendon interface but I don't usually work the tendons because they are comprised of different tissue types which physiologically don't respond to ART like muscle tissue does. Have you tried ultrasound or transfrictional massage?

rpm
09-18-2005, 11:22 PM
sirroada and TT--

I'm new to the forum, and I have a question for you guys. I'm curious how positional release therapy, aka spinal release therapy, compares with ART and deep muscle massage. For the past ten years I've had spinal facet locking from steroid-induced osteoporosis. I stretch to loosen the facets several times a day, and do core work, but tight spots accumulate over time. Once or twice a year, I see a physical therapist who uses positional release therapy, which is amazingly gentle, and helps a great deal. (As gentle as it is, it's still a workout. I once went to the gym right after a treatment, and I was totally wiped out, so I'm in the camp of going easy for 24 hours after a treatment.)

The problem is that physical therapy isn't intended for long-term treatment of chronic problems, and it's a hassle to get a referral each time and explain to my insurance company that I wasn't in an auto accident. I'd like to find a massage therapist or chiro who can loosen me up on a regular basis, and I'm wondering whether ART or deep massage might help. Chiros scare me--I have this vision of some ex-linebacker crunching my thin vertebrae into dust. Is that a concern with these techniques?

By the way, sirroada, I'm more or less in your neighborhood. Are you, by chance, going to the Headwaters 100 in Park Rapids this weekend? It's my favorite group ride, where I set my all-time century pr in the citizens' road race. They've revived the citizens race this year, but I'll be content to do the 75 mile option and take in some of the prettiest scenery in the country.

sirroada
09-18-2005, 11:53 PM
RPM,
Postional release therapy has to do with counterstrain or finding the postion of comfort and maintaining that for a period of time. I must admit that I am not as well researched about PRT as I am about ART. From what I understand, MFR, or myofascial release therapy may also be employed. MFR differs from ART in a couple of ways. With MFR the practitioner will put varying degrees of pressure into a muscle along its length while the muscle is stationary. ART has to do with lengthening the muscle under pressure. It really depends on what the patient responds to the most...some respond to ART, some to MFR.
As far as being afraid of chiropractors...well I know the stereotype as well, I hear it all the time, but let me reassure you that current chiropractic techniques are far more advanced than the "bone crunchers" of old. Emphasis is placed upon postioning the bone and applying a quick, short thrust to move it into postion. I have adjusted 87 year old women with osteoporosis without any issues arising. Of course, every case is different. I would encourage you to look into chiropractic because when we adjust the low back we specifically release the facet joints which could help with your condition. Technique advancement has also brought about the development of the Activator, a device used to gently manipulate joints without any twisting, pushing or cracking and it has been shown to be quite effective. This may be appropriate in your case.
Good luck at the Headwater. I won't get a chance to be up there. Hopefully next year! If you have any questions about the information I've given you feel free to private message me.

Kane
09-19-2005, 01:40 AM
Massage does not affect muscle physiology. It is only touchy feely nice-nice. But what do I know, I am only a Harvard trained orthopaedic surgeon.

No offense, but the answer is that you know little or nothing about conservative care.

vaxn8r
09-19-2005, 02:23 AM
Inomalley,

You could take a cue from Kane. No offense but you come on awfully strong when others disagree with your views.

The Spider
09-19-2005, 03:49 AM
Andy Mac,

You had a meeting with a miracle worker...we've had guys that were in so much pain that they considered quitting the sport....only to have Emma have them back on the saddle in days! She told one mate of mine that he shopuld start seeing results by 10 days and wanted a report at 2 weeks. 3 days later he was already reaping the benefits.

Boy was I shocked when I was barracking at the Nationals to hear her name!

Anyone going to help as far as pre-massage exercise is concerned? How hard, how long before etc

Too Tall
09-19-2005, 07:40 AM
Spider, if I understand the question? You are asking what sort of massage pre-race is appropriate? Good old Swedish massage is the ticket esp. a few hrs. before a race. Great if you can get it.

RPM - Tough call. The person who is treating you is 99% of the solution. Deep tissue therapists who are really really good are very hard to find....I've tried myself and despite the fact I am a DT therapist I only know one person who has the skills to work on me. Good DT therapists tend to burn out, it is hard work and also requires excellent knowledge of human anatomy / physiology. Interview potential DT folks and ask alot of questions. In the meantime are you familiar with foam rollers and small ball work for MFR? I'm thinking that a 6"X3' foam roller could do wonders for rolling out out back on a daily basis...a good self help tool.

zap
09-19-2005, 11:20 AM
sirroada,

Yes, I have Osgood Schlatters disorder. Disease sounds a bit much for this issue, but I'm not a doc. The problematic Patellar tendon is also smaller than it's brother.

I did have a series of ultrasound treatments last year shortly after the mri confirmed the problem. Probably need to continue treatment.

My chiro did use the Graston technique on the patellar tendon once but it just did not feel right for a few days after the "manipulation". I don't know if this odd discomfort is normal and more treatment is needed to get things back to on track.

I've done some transfrictional massage work on my own and it seems to loosen up some stiffness I get every other day.

Still seeking conservative care.

Thanks

rpm
09-19-2005, 11:34 AM
In the meantime are you familiar with foam rollers and small ball work for MFR? I'm thinking that a 6"X3' foam roller could do wonders for rolling out out back on a daily basis...a good self help tool.[/QUOTE]

Too Tall--
I appreciate the tip on the rollers--there's some at my gym that I can try out, and I'll look up some exercises. I do carry a mini-stretcher with me when I ride--two raquetballs held together with adhesive tape. When I stop, I run my spine up and down on it, and it helps unlock my joints and loosen the muscles.

lnomalley
09-19-2005, 12:23 PM
Inomalley,

You could take a cue from Kane. No offense but you come on awfully strong when others disagree with your views.


and your point is?

andy mac
09-19-2005, 12:27 PM
totally agree spider, emma is the closest thing i've found in my world travels to the hand of god. i just wish i could find her equivalent on the northeast coast of the usa. someone with a physio background that understands bike fitting.

http://www.topbike.com.au/physio.htm

it seems you either get one or the other.

anyone have any leads in the USA, pref east coast???

sirroada
09-19-2005, 08:52 PM
sirroada,

I did have a series of ultrasound treatments last year shortly after the mri confirmed the problem. Probably need to continue treatment.

My chiro did use the Graston technique on the patellar tendon once but it just did not feel right for a few days after the "manipulation". I don't know if this odd discomfort is normal and more treatment is needed to get things back to on track.

Graston is an excelllent technique but just like all other forms of conservative treatment the prognosis is better when you stick with it. I always tell patients that after their first treatment one of three things will happen and they are:
1.) Nothing-no change in symptoms
2.) They will get better
3.) They will experience increased pain
The latter comprises 30% of the patients so hang with it for at least 10 treatments before deciding to change. Anyway...good luck to you.