Massage, Stress and HRV
Over the last few articles we have talked about stress, quantifying stress, and Heart Rate Variability (HRV). In the HRV article I hinted at massage and the potential effect is can have on HRV and helping the athlete/client get into a more parasympathetic state. While science continues to exam what is happening under the skin when soft tissue therapy is being applied, one thing is for certain, people tend to feel better after getting some bodywork. Athletes report less delayed onset of muscle soreness (DOMS) and tend to feel more relaxed and rested following massage therapy.
As I stated in previous articles, as coaches we have become very good at applying the stress. We can take the athlete out and run them, make them lift heavy, throw medicine balls, do circuits, do intervals, etc., however, we often overlook the restorative aspect in our training programs. No program is a good program if you cannot recover from it. One of the ways that I have found soft tissue therapy to be of extreme value is its use in restoration and recovery. It is one way in which we can help the athlete relax and calm down following intense bouts of work and stress (training, competition, etc).
Some athletes will require more recovery between intense periods of training/competition than others, making it important to understand your athletes and how they respond to these situations so that you can adjust training accordingly. Using some form of soft tissue therapy/bodywork is one method that can be helpful in bringing the athlete back to a parasympathetic state. A number of papers have looked at changes in HRV following a few different types of massage techniques – trigger point therapy, rolfing, joint manipulation, and thai massage. In all instances, massage helped to increase HRV, indicating a move towards a parasympathetic state.
While the changes in HRV, enhanced parasypathetic state, and overall psychological well-being are impressive, many of these studies are not conducted in conjunction with exercise. However, one study conducted by Arroyo-Morales et al, looked at the effects of 40min. of myofascial release work compared to placebo (sham ultrasound) following three 30-second Wingate tests (high intensity exercise). Interestingly enough, those in the massage/myofascial release group actually had better recovery in HRV and blood pressure compared to the placebo group. Those in the massage group recovered their HRV and blood pressure back to baseline/pre-exercise levels.
As noted above, knowing your athletes and when they need a “recovery day” is important for enhancing their development and avoiding overtraining. One thing that I have noticed in athletes that are in a more sympathetic or under-recovered state is that their skin is a little more tight/taught when I try and move it, compress it, or roll it. Additionally, there are other changes in the skin and muscle that may be interpreted as an increased sympathetic state:
- Goosebumps when skin rolling techniques or pressure is applied
- Inability to relax when pressure is applied (often times going into an upper chest breathing pattern or being very guarded)
- Some have suggested that being ticklish is a sign of an overly sympathetic state (especially if it happens on one side of the body and not the other)
- Extreme soreness or tenderness with light pressure
From a practical standpoint, when athletes are in this sort of sympathetic state, it is necessary to be patient with your soft tissue therapy and be aware of how the athlete is responding to the treatment. Being to aggressive in times like this or trying to ”work deep” to quickly (not patiently waiting for their body to make the changes that allow you to work into deeper layers) may lead to a less than desirable result, as it is important to keep in mind that soft tissue therapy can also be thought of as a stress that ones needs to recover from.
Trying to get the athlete to relax and get comfortable is an important goal to have in these times, as these circumstances differ slightly from doing soft tissue therapy for a specific injury or painful movement pattern. I often think of it as successful if I can get the athlete to nod-off a little bit on the table and get “sleepy”. Because the parasympathetic nervous system is thought of as the “rest and digest” portion of our autonomic nervous system, eliciting a more rest-full/sleepy state is a good goal to have. My colleague, physiotherapist Willem Kramer, has stated before that “a little bit of pain can be a gateway into the parasypathetic nervous system”. What Willem means by this is a little bit of the good pain – you know, the “it hurts so good” stuff – can help to fatigue the athlete or make them a little bit tired (sort of like what happens when you sit in the sun all day and get sleepy). Willem states that a goal is to try and get the athlete to fall asleep on your table, as he interprets this as helping push them into a parasypathetic state and increasing healing (Willem, is talking about more “treatment” based soft tissue/manual therapy here, where you are dealing with a specific injury).
Acknowledging the recovery aspect of your training program and being aware of your athlete’s physical and mental state is an important part of a well-rounded training program. Massage therapy is one type of modality that can be used to help improve recovery and increase heart rate variability.