Massage Q+A: Does it Work?

Last April, a 21-miler left a band of exquisite tenderness along my inner calf. I rested and iced for five days, but the pain lingered until my next sports massage. Agonising as it was, the treatment eliminated the problem completely and I ran a half marathon PB a week later. So it won't surprise you to hear that I'm a keen proponent. And I'm not alone.

Look to the elites and you'll struggle to find anyone who doesn't consider massage crucial. "Massage is an essential part of my training programme," says RW's triple Olympian contributing editor Jo Pavey. "It's important for both performance and recovery." Mo Farah also gets rubbed the right way: "I get massaged by the physio all the time, it's so important when you've put you body through hard work."

But massage has had some – excuse the pun – bad press recently. Last year, a study published in the Journal of Strength and Conditioning Research found that pre-event massage had no effect on running performance, while research from Queens University in Canada found massage actually slowed lactic acid removal from muscles post-exercise. Which leaves a few questions to be answered if you're going to get the results you're after. 

First things first: Does it actually work?

Yes, but...

It depends on many factors: the type, frequency and quality of the massage, if you have a specific problem and what you hope to gain from the treatment. Will a massage knock three minutes off your 10K PB next Sunday? Probably not. But neither will a single set of 800m reps.

"In most cases, sports massage has a cumulative effect," says sports massage therapist Peta McSharry (sportsmassagezone.co.uk). "One treatment may have a short-term benefit, but correcting long-term problems takes longer."

Which explains some of the negative research. A study published in the journal Physical Therapy in Sport found no beneficial effects on hamstring length, but subjects were given just a single eight-minute treatment.

Conflicting research

"There are difficulties studying massage," says Lorraine Western, a sports massage practitioner with a master's degree in sports injury management (stayfitsportsmassage.com).

"Quality research depends on using a repeatable method, but as every massage treatment is unique to the individual at that moment, it's difficult to compare like with like."

Another study, published in Medicine & Science in Sports & Exercise, which used a more 'real life' scenario of three massages a week for 10 weeks on one leg of study subjects and no treatment on the other leg, found that massaged legs gained four degrees of flexibility  and 13 per cent strength.

There's more backing from the boffins, too: research in the Journal of Athletic Training noted a 30 per cent reduction in post-exercise muscle soreness; more in the Clinical Journal of Sport Medicine found improved recovery; and satisfied run-and-rub testers in the British Journal of Sports Medicine enjoyed decreased fatigue.

Elite favourite

These results keep elite athletes - including Haile Gebrselassie, who has daily treatments - coming back. And they're right there at someone else's fingertips for you, too.

Could it all be in the mind?

Probably not - and does it really matter?

Sceptics argue that the benefits are more psychological than physical, and a study published in the British Journal of Sports Medicine found that having a massage in between fights led boxers to feel they'd recovered more, while physiological testing in the second bout didn't support this.

However another study - though admittedly on rabbits - found that massaged muscles regained more strength, had fewer damaged fibres and showed less swelling than non-massaged muscles.

The bunnies were unavailable for comment, but it's unlikely that such benefits existed solely between their floppy ears. You may also consider how much it really matters if the benefits are, in part, mental. "The psychological aspect of running can make a real difference to performance," says Western. 

How can it help my running?

Think of the holy trinity of more efficient running, faster recovery and fewer injuries.

"Sports massage can improve flexibility of tight muscles and correct imbalances," explains Western.

"Some techniques improve circulation, enabling muscles to use oxygen and nutrients more effectively, which can boost performance. Techniques to promote venous return [the rate of blood flow back to the heart] and lymphatic drainage can help you recover by relieving congestion in the muscles and removing waste products."

Pavey cites another benefit: "Massage can identify areas of tightness you weren't aware of, nipping potential problems in the bud and preventing injury." Which, all in all, isn't too bad for a 30-minute lie down.

Is massage more useful at particular times?

Book in if you up your training.

"Muscular tightness can cause discomfort and injury if untreated," says Western. But there's little evidence pre-event massage boosts performance, says Iain Fletcher, senior lecturer in sports biomechanics at the University of Bedfordshire.

"Massage stretches muscles and fasciae, decreasing stiffness, and so making movements slower. Post-exercise, I can see a benefit, though," he says. The best type of massage is also a matter of timing.

"The depth should vary according to your training," says Pavey. "I find light massage helpful straight after a hard session, then stronger the next day."

Maintenance massage shouldn't conflict with performance or recovery, says Michael McGillycuddy, author of Massage for Sport Performance (£23.99, Human Kinetics). "It can be deep, addressing chronic injuries, increasing flexibility and enhancing neurological pathways." Ideal before you tackle the cryptic crossword, then.

Do I really need it as a recreatonal runner?

What goes for the pros, goes for average Joes (and Jos).

Even if you're not training twice a  day and clocking 100-mile weeks, you'll still benefit from laying your parts on the table, so to speak.

"Recreational runners use the same muscles as elite athletes and undergo the same stresses," says sports massage therapist and lecturer Clive Lacey (bodymaintenance.co.uk).

Western agrees: "Many recreational runners push themselves to perform to their potential, so pre- and post-event treatments help them prevent injury, achieve their goals and recover well." And still no mention of panpipes or Nicaraguan volcanic mud, you'll notice.

So I'm going to feel less sore afterwards?

There's the rub indeed.

And yes, you are. Expert opinion now holds that muscle soreness isn't caused by lactic buildup, but by microscopic damage to muscle fibres. But according to Lacey, massage still has the power to soothe by promoting healing through breaking down fibrous tissue and adhesions.

An Ohio State University review of 27 studies backs this, finding evidence that massage therapy can alleviate symptoms of the dreaded delayed onset muscle soreness (DOMS).

"You may find massage best a couple of days after a hard workout or race to allow initial soreness and stiffness to subside," says Pavey. By that point you should just about be able to hobble to the appointment, too.

On the next page: Discover the type of massage you need and how often need it, plus some more extreme remedies.