Once play begins, the massages start. Players can sign up for 30, 60 or 90 minutes of specific massage. If not scheduled for a massage session, massage therapists work in the training room doing spot treatments, warm ups or flushes, and even paperwork. It is not uncommon in the middle of the week to have a few days that go until 12:00 am or later. It is intense, but the days fly by and it is tremendously exciting.
Massage is hindered from reaching the gold standard of scientific research, which includes placebo-controlled and double blind clinical trials. Developing a "sham" manual therapy for massage would be difficult since even light touch massage could not be assumed to be completely devoid of effects on the subject. It would also be difficult to find a subject that would not notice that they were getting less of a massage, and it would be impossible to blind the therapist. Massage can employ randomized controlled trials, which are published in peer reviewed medical journals. This type of study could increase the credibility of the profession because it displays that purported therapeutic effects are reproducible.
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The therapist may utilize some Swedish techniques to warm up the tissues (kneading, friction, percussion), softening the superficial layers so that he or she can access the deeper ones more easily. Then, with little or no lotion, the therapist utilizes the hard surfaces of their hands and arms — surfaces such as fingers, knuckles, forearms, and elbows — and employs a very slow, sustained type of stroke.
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Massage has been shown to reduce neuromuscular excitability by measuring changes in the Hoffman's reflex (H-reflex) amplitude. A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability. Others explain, "H-reflex is considered to be the electrical analogue of the stretch reflex...and the reduction" is due to a decrease in spinal reflex excitability. Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage. It has been noted that "the receptors activated during massage are specific to the muscle being massaged", as other muscles did not produce a decrease in H-reflex amplitude.