“It was truly amazing how effective this strategy was,” says Jeff in retrospect. “I was not only better in an hour, but I was up and walking within two hours and had a normal next day.” 

Since this episode, Jeff has had another “chance” to try his combined method of massage, heat and carbohydrates and it worked equally well the second time. “Granted these attacks were only a 6 on a scale of 10, but I wouldn’t hesitate to try it again,” he says. “The longer one goes in an attack—and we are talking minutes here—the more the muscle shrinks and hardens.”

Jeff’s experience raises some interesting questions. Why was this combo so much more effective than carbohydrates alone? What does massage accomplish in muscle? Why do so many athletes, coaches and trainers believe massage aids in muscle recovery? Are there any potential dangers in using massage during an attack of muscle breakdown caused by CPT II deficiency?

For answers, we turned to expert Peter Tiidus, Ph.D., a Canadian researcher who has studied exercise-induced muscle damage. “We do know that massage is unlikely to have any great influence on blood flow in relaxed muscles of healthy individuals, and will probably not increase oxygen or fuel delivery to these muscles,“ says Tiidus. “However, it is certainly possible that massage can decrease spasms, and this would aid in the return of blood flow.”

In addition to damage from low levels of ATP (fuel), the cramps that occur in CPT II deficiency can block blood flow to the muscle and lead to more damage, says Tiidus. Then when blood flow is restored, a third type of damage occurs known as reperfusion injury. Research suggests that this third type of injury is caused by free radical generation. Tiidus notes that the longer the blood flow to muscle is blocked, the greater the injury. Therefore, any technique that could potentially reduce spasms or cramps would have the potential to reduce cumulative muscle injury.

What about potential damage from the massage itself? “If the massage is relatively gentle and is started immediately at the onset of cramping, then it is unlikely to be harmful,” says Tiidus. However, he cautions that high-pressure massage used later in an attack of muscle breakdown could manually damage the muscle.

Jeff DuPonte agrees. “I look at this as a rehab measure, except preemptive,” he says. “But you need to know the difference between a severe case and a lesser attack. It all depends on a good deal of common sense and judgment.” 


Reference:
Tiidus PM. Massage and ultrasound as therapeutic modalities in exercise-induced muscle damage. Can J Appl Physiol 1999 24(3):267-78



MASSAGE
Two massage techniques are commonly used in athletic settings for their potential restorative effects on muscle.

EFFLEURAGE
Includes both light and deep muscle stroking in the direction of blood and lymph flow, i.e. towards the heart. The goal is to relax the muscle and reduce any excess fluid accumulation.

PETRISSAGE
Involves muscle kneading and rolling performed with the palms or heels of the hands, or tips of the fingers. The goal is to decrease muscle spasms.