A massage therapist has to match the appropriate hands on therapy they will provide to the type and stage of injury they may be treating. This requires a strong understanding of musculoskeletal conditions.
They must also differentiate overuse from injury, which has obvious signs of heat, reddened appearance, swelling, pain, and even loss of function.
Some of the most common musculoskeletal injuries people experience are strains to soft tissue like fascia, muscles, and tendons, as well as sprains to ligaments and joint capsules.
Accompanying these types of conditions is damage to the surrounding delicate blood capillaries, and bursae (fluid filled sacks that reduce friction around the body).
Blood and fluid leaking out of damaged capillaries, cells, and tissues in the injured area create initial swelling. The more extensive the damage, the more severe the swelling.
White blood cell activity increases tissue and blood vessel permeability, further flooding the injured area with cellular components necessary to begin the healing and reparative process.
Secondary swelling occurs instantly as the protein rich leak pulls fluid from surrounding healthy tissue, causing painful muscle spasms. Within minutes, blood clotting takes place to control the hemorrhaged fluid.
Surrounding the damaged blood capillaries are lymphatic capillaries, which are the body’s drainage system for inflammation. Untreated excess swelling puts pressure on these lymph vessels, shutting down their ability to drain the area.
It is important to contain any inflammation immediately, as untreated swelling drastically increases the amount of healing and repair that must occur.
Rest is important when addressing soft tissue injuries, especially to the extremities. It immobilizes the area and decreases the likelihood of further injury.
Ice is a pain reliever and anti-inflammatory, constricting the leaky capillaries in the injured area to limit swelling. In addition, the weight of a large ice pack can compress and reduce inflammation anywhere around the body.
Compression wrappings (ace bandages) are especially effective on the extremities when applied immediately following an injury in limiting inflammation.
Elevation of the injured area uses the force of gravity to assist with drainage of excess tissue fluid into the surrounding lymph vessels where it is slowly removed.
The only massage technique recommended on the site of an acute soft tissue injury is manual lymphatic drainage which is perfectly safe for decreasing swelling and pain.
Different treatment protocols are required for different stages of an injury. If in doubt as to how to massage a client with an acute soft tissue injury, simply use the protocol of RICE (Rest, Ice, Compression, Elevation) and continue massaging the rest of the body.
Just avoid working on, around, or below the injury as this will increase swelling, interfere with the healing process, and possibly release a blood clot.