Massage & Bodywork

MAY | JUNE 2019

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is yet another massage example that debunks the notion of "no pain, no gain." There are many situations in which improved or optimized ROM would be beneficial for nonathletic or non-exercise populations. In many of these cases, the added benefit of not requiring the elicitation of discomfort is a bonus. For example, relationships exist between decreased function and activity in older adults with diminished ROM and muscle strength. This research found that even a low force RM intervention significantly improved ROM after three 60-second bouts. This provides a theoretical foundation that a simple and gentle RM approach could support ROM optimization in elders. This approach could be taught to someone with even limited strength to apply on themselves or with the help of a care ally. While I didn't have the literature support at the time, when my private massage practice consisted of mostly adults 75 and older (early and mid- 2000s), I used to give my older adult clients trim paint rollers to rub on their legs, arms, shoulders, and pec areas through their clothes between our appointments. While at the time I used this approach as a way to keep them engaged in our treatment plan and give them meaningful "homework," I feel confident that this self- care also helped support massage treatment effects between the times we saw each other. Now as a researcher, I (or others) could/should develop a study design that tests such treatment theories and related hypotheses. A final point related to this article is one that applies to much of the massage therapy research conducted in athletic populations: ceiling effects. Ceiling effects occur when the level of (potential) change is above the level that an independent variable can be measured. Athletes perform at peak levels, which leaves little room for improvement. In these situations, it is easy for ceiling effects to occur, making it difficult for potentially subtle massage therapy effects to be apparent or register via measurement. Research is often conducted in these populations for one or more of these reasons: because they are convenient test subjects, because the research is performance- or exercise-science–based to begin with, or because there are fewer ethical concerns when studying healthy populations. When massage effects are found in these healthy and high-functioning populations, however, it is only logical to expect that similar and magnified effects are possible in less robust populations. When extrapolating study results found in robust populations to those who are fragile or in nonoptimal health, practitioners need to be mindful of adaptation needs and safety considerations. With regard to this study's methods and application SOMATIC RESE ARCH to practice, I would never consider applying an RM intervention with the weighted plates apparatus used in this study on a frail older adult—or really, anyone. For research purposes, the apparatus was used to standardize and control for human application variances. In real- world practice and application, such standardization is not required or even desired. Indeed, human application variance is one of the great things about massage therapy. CONCLUSION Foam rolling, roller massage, and/or self-massage techniques have great potential for application in massage therapy practice, whether as a way to support treatment effects between sessions or as a way for people without access to massage to receive massage benefits. Whether at low, moderate, or high levels of pressure relative to individualized perceived pain rates, these approaches are inexpensive and have supporting evidence to suggest benefit to function without detriment to strength and performance for those who are young and healthy at the very least. Clinical application of these approaches in nonathletic populations are theoretically sound and should be considered by therapists with clients interested in optimizing or supporting ROM-related function. Notes 1. Niki Munk, "Massage Therapy's Potential for Muscle Regrowth and Remodeling," Massage & Bodywork 33, no. 4 (July/August, 2018): 46. 2. Lena Grabow et al., "Higher Quadriceps Roller Massage Forces Do Not Amplify Range-of-Motion Increases nor Impair Strength and Jump Performance," Journal of Strength & Conditioning Research 32, no. 11 (2018): 3,059–69. Niki Munk, PhD, LMT, is an associate professor of health sciences at Indiana University Indianapolis, a Kentucky-licensed massage therapist, a visiting fellow with the Australian Research Centre in Complementary and Integrative Medicine, and mother of two young daughter-scientists. Munk's research explores real-world massage therapy for chronic pain, trigger point self-care, massage for amputation-related sequelae, and the reporting and impact of massage-related case reports. Contact her at Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 45

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