For as long as I can remember I’ve been passionate about sports and all that encompasses them. From learning new skills on skates with the puck, to seeing how far I can push my body into the red zone on the bike, all the way to the ongoing battle of mastering those first 25 meters out of the starting blocks in the sprints. It’s what fuels my interest in sport and how we put our bodies to the test. It’s been an incredible driving force behind learning not only how my own body functions, but how the bodies of each athlete I’ve worked with over the years and continue to work with today, operates and maintains optimal performance. I consider myself lucky to be working in a profession, where not only do I get to assess and study the biomechanics of the human body and how it manages itself, but I get to see how individuals push it to its’ limits, demanding the very most from it, often day in and day out, time after time again. The really cool part is, I get to be a part in maintaining that optimal performance they seek from it, or in rehabilitating or repairing it when it breaks down on them. Either way, whether it’s maintaining or rehabilitating, as a Massage Therapist, I get to play an integral part of it all coming together, and personally I think it’s the greatest job in the world! I’ve decided to share a few general pieces of information for not just other therapists looking to work within the sport community, but for athletes looking for further gains or tips to help in their goals with training and treatment options. Sports, health and fitness has always been one of my favorite topics to discuss, so I thought I’d share some of my experience and hopefully provide some useful information and insight into a great connection……..that of therapist and athlete.

Either way, whether it’s maintaining or rehabilitating, as a Massage Therapist, I get to play an integral part of it all coming together, and personally I think it’s the greatest job in the world!

From the time we’re born, we begin to learn how our body moves and takes us from point A to point B. In the beginning, as infants, we discover our movement on our own, through exploration and curiosity, but as we grow and develop further, it’s through observations from those around us that teach us more complex movement patterns. It starts with our parents teaching us how to walk, then run, then ride a bike, swing a baseball bat, throw a ball or do our first somersault. From there, we learn even further complex movements related to our growth, strength, interests and capabilities through specific individuals. These individuals could be in the form of a school teacher, a coach, an instructor, a trainer or simply a more experienced individual with a greater understanding of the movements involved in that particular activity. Before we know it, based on our interest, talent and strengths within a particular activity or sport, we’ve got a whole team of expert eyes helping us perfect these movements and progress to the next level with them. And the higher the level of sport or activity, with more complexity involved in our body mechanics, the bigger the support team grows to make sure nothing is missed when it comes to achieving that ‘perfect purposeful movement’. This is where I come in, as one of those experts making sure that nothing is missed for allowing the body to perform at its’ best, day in and day out. At times it might be observing a running pattern or shoulder mobility with a spike in volleyball to determine if a certain structure is restricted or not firing correctly, or other times it might be during treatment on my table with hands on palpation to assess certain soft tissue limitations. Either way, through visual or hands on assessment, it’s my job to make sure that the athlete is functioning to the best of their abilities. As I’ve said in the past, we have to give back to the body what we demand of it, and with athletes demanding more from their bodies than the average person, it’s an even greater need to give back to it, on a more frequent basis.

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As most will attest to, there’s a high level of trust and confidence placed between the client/therapist relationship when it comes to Massage Therapy, and progressing towards the goals set out between the two. There’s no difference when it comes to the therapist/athlete relationship. The trust athletes place in their therapist to provide not only the appropriate hands on treatment, but the competent knowledge in proper assessment, understanding the condition/injury presented, or home care and training modifications, can often be the difference in having a successful season/competition, or missing out on a certain goal they’ve set out to achieve for that particular season/competition. Regardless of the sport or athlete, they all come with unpredictable outcomes at times. It’s our jobs as health care providers or therapists working with athletes to educate, not only on an injury they might be dealing with, but on the prevention of injuries from happening in the first place, therefore decreasing these ‘unpredictable outcomes’. The great thing is, through the ever evolving realm of science, training, coaching, athlete testing, treatment options, etc…, those unpredictable outcomes are becoming far easier to manage, or even occurring less and less with a negative impact. Sports and sport science have evolved immensely over the years, and I’m happy to say, that the profession of Massage Therapy or Manual Therapy, has progressed and evolved right along with it. Those of us working with athletes or working in a clinical setting are treating far beyond the treatment room or treatment table. We’re educated professionals constantly seeking the best possible treatment plan for those athletes, whether it’s in the clinic or out on the field/pitch/track/ice/road or pool. We want the very best treatment options and advice for the athlete, so it requires having a variety of tools and knowledge when it comes to getting the results needed. One could read up on a particular treatment option, or consult with a number of educated and qualified health care providers, and chances are, there has been a study conducted or a study in place to validate its’ results, determining whether or not it’s the right course of action for them or not. The more we understand about how the human body works, the more we understand what it needs to keep operating at optimum levels. The use of Massage Therapy within the athletic community is no different. We’re not just treating a specific symptom that’s presented, we’re looking at why that symptom arose in the first place and what steps need to be taken to ensure it doesn’t re-occur. We’re treating the entire body, since there’s never simply one isolated area that is affected. Pain in our knee or shin didn’t stem from that area alone, we need to seek out the root of the cause to correct a particular pattern that has created this discomfort. Whether it stems from an impairment in the hip or from the foot, we have to establish its’ origin and work to resolve it. Often this leads to therapists learning more and more about what movements are involved with a particular sport or activity and how they can make the most gains for their client/athlete through their treatment plan. It also leads to a collective group of experts, each with their own unique skill set, working together to ensure nothing is missed for that athlete and the gains they seek.

As most will attest to, there’s a high level of trust and confidence placed between the client/therapist relationship when it comes to Massage Therapy, and progressing towards the goals set out between the two.

Every athlete, just like every client, has to be treated with their own, individual treatment plan and treatment approach. As a therapist, this means I have to be prepared to alter my treatment approach or techniques depending on that particular athletes’ needs or goals. This also means I need to have a clear understanding of the time frame I have to work with in order to develop a proper treatment plan that will enable them to either return to play, (post injury, and remain injury free), or maintain their optimal training performance that has been achieved. It’s a challenge at times to find the balance between proper treatment options, length of treatment, timing of treatment, and even activities leading up to and following a treatment, but it’s all part of the process and a pretty exciting challenge in my opinion. I’ve come up with a few, general, key points to cover that I feel are essential in the successful athlete/therapist relationship. I could probably write a novel on each topic and go into far greater detail, but I’ll save that for the Dave Kervin novel and give just a few key points to take away.

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Knowing your athletes sport:

This is certainly a key part of providing appropriate care for any athlete, at any level. As a therapist, if I don’t have an understanding of what mechanics are involved with a particular sport, or what energy systems are required (anaerobic vs aerobic), it becomes pretty difficult to formulate an accurate assessment or gather enough subjective (what the athlete is telling me) information to start to treat correctly. Every sport has it’s variations of mechanics and even within that sport, you’ll find further variations. For example, in soccer, defenders and strikers perform a higher percentage of lateral and backward movements, starts and stops, and vertical jumps, compared to mid-fielders who tend to perform the most amount of time running with PM (purposeful movement) and cover the largest amount of distance out on the field. A track and field sprinter will require a large amount of muscle mass with fast twitch fibres (type 2) for explosive power in order to propel his/her body out of the blocks and down the track as fast as humanly possible. While a distance runner will require far less muscle mass and work to develop a greater amount of slow twitch muscle fibres (type 1) to carry them over greater lengths for longer periods of time with a minimal amount of body weight. Even though both disciplines fall under the running category, one can see that the demands they require of their bodies and cardiovascular systems are vastly different. This information gives me a greater idea of what areas I might need to target in order to either gain mobility/flexibility, or to prevent an injury from occurring based on the movements required and the demands placed on those soft tissue or bony structures. This bit of information can also provide me with feedback for educating a client or athlete on relevant home care or exercises that will not only help my treatment goals, but their performance goals as well. With the amount of technology and instant information available to us these days, it’s easy to take an athlete out onto the field or court, or put them on a treadmill and watch, video or photograph them while they’re going through a certain drill or activity to gain a better understanding of how you can direct your treatment focus. Together you can review it to point out areas that might show some weakness or restriction that could be further addressed. Now don’t get me wrong, there are many different sports in the world, and I don’t claim to have an expert knowledge on every sport out there. I have my strengths with certain sports but quite enjoy the learning process of a variety of sports that I haven’t had the opportunity to participate in or work directly with myself. The great thing about working in a sports related field is that over time, you build up a large number of inter-professional relations with various health care providers within your community or even outside your geographical community and can either refer to one of them if they have a greater knowledge of that sport, or use them for insight. We’re all on the same team, working towards the same goal of allowing people to participate in an activity they love to do, for as long as they choose to do it. Personally, I love the fact that within Peterborough alone there are many excellent therapists working within the sport community that all have their own advanced knowledge in sport, ranging from contact sports (lacrosse, hockey, football, etc…), to non-contact sports (running, cycling – unless you consider contact with the pavement, swimming, rock climbing, etc..). I can call on them at any time to ask advice or send an athlete to them for the best possible results. Like I say, we’re all on the same team.

Getting to know your athlete:

Whether the athlete you’re working with is a member of a National Team that’s training for the Olympics, or a local sports enthusiast training to stay fit and healthy, establishing goals with them will be a common process. Obviously the goals will vary, but the treatment plan will have a familiar look to it. It’s important to have an understanding of, 1; what the athlete is seeking treatment for, 2; how often they are training or competing, 3; what type of training or competition are they involved in, day to day, week to week, and the level of competition they’re at 4; when was their last competition and when is their next competition, 5; have they been receiving ongoing treatment (this determines how they will respond to treatment and how fast they will recover from it) or are they even familiar to your treatment modalities, 6; how long have they been involved in their activity or sport, and 7; what are their current and long term goals related to their sport. All of this information helps a therapist create a treatment plan that will fit the needs of that particular athlete. There are obvious limitations that are to be factored in as well, including scheduling issues for receiving treatment (based on athletes work schedule or family commitments, or the therapists availability with their schedule in the clinic), financial constraints for the number of treatments allotted, the type of injury or condition being addressed (certain injuries will require a longer healing or rehabilitation time than others), as well as accessibility to the therapist (is the therapist only at a training camp for a certain time period, or is the athlete only in the area for a certain time period). These are all topics to sit down and cover between the therapist and athlete prior to the start of any treatment. The key to successful treatment results happens before any actual hands on treatment is provided. It’s the initial consultation and approach between therapist and athlete that will get things started towards a successful, trusting relationship. Once you’ve established what goals the athlete is seeking to achieve, together you can work on formulating what treatment options will best suit their needs.

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Personally, I love the fact that within Peterborough alone there are many excellent therapists working within the sport community that all have their own advanced knowledge in sport, ranging from contact sports (lacrosse, hockey, football, etc…), to non-contact sports (running, cycling – unless you consider contact with the pavement, swimming, rock climbing, etc..).

Training schedules and incorporating types of treatment into them:

As I mentioned before, every athlete is unique and should be assessed and treated this way. How they respond to treatment and how frequent they require treatment will determine the appropriate and agreed upon plan of care from one athlete to the next. Treatment should typically follow a natural flow within an athletes’ training program and not disrupt or alter the goals set in place. Through the CSMTA (Canadian Sport Massage Therapists Association) and their Advanced Sport Massage Course, members within this organization are educated and trained to develop the skills and techniques for safely treating athletes not only within a clinic setting, but during competition or event times. What this means , depending on the type of treatment required, is that an athlete can be treated not only leading up to an event or competition, or following an event/competition for restorative/recovery purposes, but can be treated on the day of competition/event as well. This adds an even greater benefit for an athlete looking to gain any advantage over their competition when they can not only prepare mentally prior to an event, or between events, but they can have a trained therapist physically prepare their bodies as well, prior to, during and after the event. The CSMTA teaches safe and effective techniques that can be used for pre-event massage, inter-event massage (between games within a single day, or between events such as in gymnastics or track and field), as well as post-event massage. In order to formulate a successful treatment plan within the clinic, a therapist should have an outline of the athletes’ weekly training schedule in order to determine when the best possible time to receive treatment would be and what type of treatment should be applied. For example, if an athlete has a competition or game coming up over the weekend, and they aren’t particularly used to having a lot of treatment done on them, I will typically recommend that they come to see me a couple of days prior to the competition/game in order for the body to recover fully from the treatment alone (this will vary from athlete to athlete and will vary depending on the type of treatment they are receiving – deep tissue work versus mobilisations or stretching techniques). The treatment itself can be considered a physical workout or taxing and draining on the body, therefore adequate time should be given following for the body to recover and be fully prepared to perform. On ‘game day’ or often within 24 hours prior to an event, I will often use more mobilisations or certain types of stretching modalities or even Active Release Techniques that will aid to increase circulation to an area, while at the same time providing that release or lengthening within tissues so they can perform without the risk of injury. Over the years and through experience I’ve often altered this approach depending on the results I’m trying to achieve and the athlete I’m working with as there are always exceptions to this general treatment approach. Many sprinters will prefer very deep work often the day before competition or even the day of and in between, as they find the increase in circulation and aggressive work prepares them for that explosive contraction their muscles require. The point is, it’s important to work with the athlete and utilize the knowledge one gains as a therapist from not only working within the athletes’ schedule, but understanding what their body can benefit from as far as treatment goes. At the National level, or Professional level, where it’s a full time commitment to train and compete, athletes will often receive some form of treatment multiple times a week, occasionally multiple times a day in order to keep them functioning 100%, as they approach a major competition. For these athletes it’s a matter of scheduling treatment around the type of workout they have that day and how many workouts they have within that day. Unfortunately the majority of sports enthusiasts aren’t at a level where it’s feasible to receive this amount of treatment, this frequent, so it becomes a matter of working together to establish when treatment will benefit them the most with the number of treatments they are comfortable with receiving. I generally encourage athletes, regardless of how much treatment they’ve had prior to a competition or event, to make an effort to come within 24-48 hours post event for treatment to allow for faster healing and recovery times within structures that were stressed during competition, and work to restore any damaged tissue on those areas from the intensity of competition. This allows decreased time off of training, and helps to maintain an injury free athlete.

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Injuries and setbacks:

At some point, in every athletes’ career, they will run into some form of setback. Whether it’s a physical injury due to inadequate training or improper training that doesn’t allow them progress, or one that is unpredictable, such as rolling an ankle on the court, or from direct hit from an opponent, it’s all going to be discouraging and difficult for an athlete to overcome. Let’s face it, sports can be dangerous, in often dangerous environments…………injuries are bound to happen. I recently read an article with a quote in it that read, “An injury can be a permanent setback or a gift. It’s all in how you look at it and how you respond. It’s your choice. Choose wisely.” As a therapist it’s important to keep a positive outlook when it comes to treating an injury or going through setbacks with an athlete. We have to remind the athlete that in many cases this gives an opportunity for some much needed rest and healing time for one area, while another, potentially weak area can be addressed and even improved. This allows for double the treatment benefit. Working on repairing and restoring one area, while providing treatment or giving exercises to another area keeps a forward progression with treatment which could otherwise keep an athlete focused on the negative outcome of an injury rather than the positive. It’s all about how you choose to approach an injury or setback that will set the tone for the outcome you wish to achieve. The athlete will certainly appreciate the positive outlook you give when it comes to their setback. Having said that, it’s extremely important to provide as much honest and accurate information as possible regarding their injury or condition so they have an understanding of how much time they need to take off or modify their training. Far too many times I’ve seen athletes progress to a certain point with treatment, feel as though they are ready to return, only to get back into training or competition too soon and re-injure themselves once again. As therapists we have to emphasize the importance of ‘long term athlete development’ and ensure they stick to the treatment plan and time frame discussed regarding their injury. This means, as much as they want to be ‘fixed’ for the next big game or competition, we have to educate them on the long term damage that can be created by not allowing an injury to heal completely, and how it may hinder them or prevent them from participating in a sport or activity that they enjoy down the road. For most athletes, this is a hard pill to swallow. And there are varying degrees of injuries, some life-changing, some career ending, and some that can be resolved in a short amount of time. It’s our job to evaluate, assess and educate athletes on the severity of their injury, and either begin a treatment plan or refer out to further specialists if needed. Physical setbacks aren’t the only obstacles that athletes will face in their career, and won’t be the only reason they come to seek treatment either. More and more teams and athletes are using Sport Psychologists as a valuable asset to their progression with performance. These professionals have a wealth of tools and knowledge to assist an athlete in getting through a particular challenge or scenario, enabling them to overcome mental or emotional obstacles. It’s through this great team of expert health care providers that many referrals will come to our clinics seeking treatment. An unforeseen stressor (such as a family emergency, the loss of financial stability, or a newly developed health condition), can all present emotional challenges that can be frustrating for any athlete to work through. Massage Therapy is not only a useful treatment modality for the physiological changes it can have for an athlete, but for the emotional gains it can provide as well. I’ve treated athletes that will use the time on the table to vent about many of the stresses they face, not just in sport, but in general day to day life, and athletes that use the time for complete silence to either mentally re-charge or have some time to reflect for themselves. Either way, while I’m working on their physical well-being, they are able to focus on their mental well-being, and for athletes, it has to all come together. An athlete can be as physically fit as they want, spend hours and hours training their body to withstand the demands of intense competition or training, however if the connection between mind and body isn’t there…………if there’s some mental or emotional blockage, all the training in the world won’t matter, the results or goals just won’t be achieved. The mind and body have to be in sync. You’ll hear it from athletes all the time; my body felt strong but I just couldn’t focus. Many athletes will become very anxious prior to competition, often freezing up or forgetting everything they learned in training or at workouts. It’s a challenge to help an athlete overcome this anxiety, but it’s just one more reason Massage Therapy is so beneficial for them. So, in short, setbacks will occur, injuries will happen, but with a positive attitude between both therapist and athlete, together you’ll come out on the winning side of things. It takes patience and often a good listening ear, but as a therapist, when you can provide that essential part of therapy to get an athlete through a challenging setback, and come out feeling better about their future goals, it’s as good as helping them win a gold medal.

As therapists we have to emphasize the importance of ‘long term athlete development’ and ensure they stick to the treatment plan and time frame discussed regarding their injury.

The life of a therapist working with athletes:

I can honestly say, that over the course of my 17 year career, working with various levels of athletes over those years, I’ve been able to make many of my dreams come true. From working in Florida with our National Swim team, then watching those same athletes go on to win Olympic medals and set National records, to working Pan Am Games in Toronto in the Athletes Village with our Canadian athletes, it’s been an incredible experience. I could sit and talk about sports for hours, and marvel in the incredible progression that athletes have made over the years, and just how much sport medicine and sport science has progressed. It’s never a topic that gets’ old for me. It’s also no secret that I have an undeniable passion for sports and seeing how far humans can push their bodies to reach new heights, new speeds, new records. I’ve been blessed with the opportunity to work with athletes on every level, and they all share the same thing in common, that look in their eye…………..that look of determination, of dedication, of focus when it comes time to test their own limits and push themselves further and further with training or competition. To be a part of it, well, it motivates and inspires me, and allows me to strive further and further towards my own personal goals in life. I’d like to leave with a few words of wisdom through my experiences in this great career. It’s a great feeling to not only watch someone achieve a goal they’ve set out to achieve in their sport, but to be a part of it, knowing that you helped get them there is a feeling that is hard to put into words. And while there are many highs involved with working with athletes, there are also their fair share of lows and difficult times. There are always ups and downs and challenges that come with every job, and some you wouldn’t even think of when it comes to working with athletes and being a Massage Therapist, but nonetheless, you may face them. For example, you may end up being one of the drivers for a rental vehicle to transport athletes to and from a sporting venue, and if it’s in a foreign town or city, you may also have to navigate rather quickly to find your route. Some venues may not have adequate air conditioning or water supply, so you may have to prepare ahead of time or think on the spot to solve the problem. There are times when you might end up improvising in order to have a treatment space or even a treatment table. If you travel with a team or athletes and have to fly to a venue, sometimes your table may not always arrive to the destination when you do, but those athletes need treatment today. Guess what? You’ve still got to find a way to treat those athletes. I’ve learned to treat on a hotel room floor with limited space, on a pool deck, on bleachers, wherever the space permits. The point is you may have to improvise to accommodate the needs of the athletes. Be respectful, honest, flexible, accommodating, and you’ll be just fine in this great profession. You might not always have the solution or answers to a particular injury or condition, but the more networking and resources you can pull from, the more answers and knowledge you can gain. There are a couple of motto’s we stand by within the CSMTA, one is, as an organization of leading health care providers, we are ‘keeping athletes in trusted hands’, and the other is ‘do no harm’. The second I really try to stress to other therapists beginning work with athletes, especially on site, during an event. Sometimes, less is more, and more can end up having the reverse outcome you hoped for in the first place. For the most part, if that athlete comes to see you as a therapist prior to or in between competition, the ground work has already been laid to achieve their goal for that event/game/competition. We’re there to provide safe and effective treatment but not to try and impress them with new techniques or impede any physical gains they’ve made prior to getting on our table. Sometimes this means limiting the time we spend on them, as well as the techniques we may otherwise choose to use within the clinic setting. Athletes love hands on care, so it’s important that they trust our skills and knowledge to provide them with the best possible outcome for treatment. One great benefit to working with athletes is that, for the most part, they accept any home care or home exercises that you send them off with and will usually make sure they’re done with ongoing treatment when they’re not in our presence. This often makes our jobs as therapists that much easier. It’s a win/win situation, both parties are able to progress with the goals set out to achieve. In closing, you may have guessed that I love my job, and love that I frequently get to work with athletes of all levels. I hope this provides a better look into the connection between the therapist/athlete and provides some education on the role of Sport Massage Therapy and how it benefits any athlete. I’m always eager to discuss this topic in greater detail, so feel free to email me if you have questions or would like further advice.

Sports do not build character. They reveal it. – Heywood Brown

Carpe Diem!

Dave Kervin, RMT, SMT(cc), ART Provider