When it comes to massage, keep in mind the old adage that “absence of evidence is not evidence of absence.” No one has conclusively proven a benefit, but that doesn’t mean you’re wasting your time. (And they do feel nice.)
Here are some tips for getting the most out of your sessions.
Time it right
“When I’m really training hard, I’ll add a massage because I want to make sure I’m recovering as fast as I can,” Eric Young (Optum-Kelly Benefit Strategies) says. And Tiidus agrees that heavy training may push us beyond that inflammatory threshold, where massage might be of the most help. So if you’re going to get a rub down, the best time to do it is after hard workouts.
See the therapist who’s on top of the research
You’re not looking for incense and mood lighting. If a massage is going to help you, it will be in large part because it was delivered by someone who specialises in sport science and stays abreast of the literature on things like mechanotransduction (the process by which soft-tissue pressure and stretching promotes immune and biochemical responses).
Ask for recommendations and interview different therapists. You’re after something more akin to a medical treatment than a spa day.
Find a middle ground
Clearly you want more than gentle caressing. But, as Young points out, “if you’re grabbing onto the table and crying, that’s probably doing damage.” One study on massage found that overly vigorous sessions increased muscle damage. It has also been shown that the degree of pressure has an impact on the balance between inflammation-promoting and repair-promoting macrophages.
Work your way up
Our veins have one-way valves that prevent blood from flowing in the wrong direction. Massaging against blood flow can damage these valves and cause varicose veins. Make sure the therapist works your arms and legs in the direction toward your heart.
Don’t wait too long
The immunological benefits of massage appear to be greatest when treatment takes place within two hours of damaging exercise. If you can’t fit one into that window, plan for no later than the next day. Macrophages shift from inflammatory to repair mode 48 hours after muscle damage occurs. Inhibiting them with massage when they’re in this mode could be counterproductive.
Mind the pills
The same rules apply to painkillers. NSAIDs like acetaminophen and ibuprofen block inflammation, which can be good or bad, depending on where your balance is at. While researchers still debate their effects on training, there is growing evidence.
This includes a well-cited study from Denmark in the Journal of Applied Physiology, showing that NSAIDs taken post-exercise by male endurance athletes inhibit satellite cell activity, which is critical to muscle repair and super-compensation.
Don’t ignore the other stuff
Massage doesn’t replace things like cool downs, recovery rides, and stretching — all of which are backed by extensive research. In fact, a 1983 study out of Sweden published in the American Journal of Sports Medicine found that stretching was more effective for recovery and range of motion than massage in healthy male volunteers.
But don’t exercise after massage
No study has found benefits to pre-workout massage. Hard exercise does further damage and would undo any potential immunological gains from massage.
Yes, use your foam roller
The rabbit study that found benefits to muscle repair used a mechanical massager that was more like a foam roller than a regular massage. (Apologies if you were envisioning lab assistants pampering rabbits on little bunny massage tables.)
Two recent studies showed that foam rolling reduces soreness and allows runners to restore their full sprint speed sooner. Higher density foam with bevels appears to increase the effects.
Physiological benefits or not, there’s no denying a massage can be good for the soul. “Sometimes it’s just nice to sit there and force yourself to think about the race,” Young says. (We also like thinking about nothing at all.)