Chapter 19 After completing this chapter, the student will be able to perform the following: 1 Apply appropriate massage interventions for clients with infections, inflammation, cardiovascular/respiratory disease, thermoregulating disorders and heat-related illnesses, and breathing pattern disorder. Athletes resist reducing training workloads. Improper nutrition and psychological stress can compound the negative influence that heavy exertion has on the immune system. Indicators of overtraining include immunosuppression, loss of motivation for training and competition, depression, poor performance, and muscle soreness. Parasympathetic dominance is a very important area of therapeutic massage intervention for stress management and immune system function. In addition, several lifestyle practices may be beneficial. The athlete needs to eat a well-balanced diet, keep other life stresses to a minimum, avoid overtraining and chronic fatigue, obtain adequate sleep, and space vigorous workouts and competitive events as far apart as possible (Box 19-1). Chronic inflammation is a perpetuating factor in many chronic conditions. Chronic inflammation is a factor in disorders such as asthma, lupus, and rheumatoid arthritis, as well as in tendinopathies caused by microdamage in the collagen fibers, followed by an acute inflammation, which can evolve to chronic inflammation if healing processes are disrupted (Solomonow, 2012). Overuse tendinopathies are a common cause of pain and disability in athletes. These conditions occur as failed healing responses to overuse tendon injury (Battery and Maffulli, 2011; Del Buono et al., 2011). Substance P (SP) is a neurotransmitter involved in the transmission of pain impulses from peripheral receptors to the central nervous system. Substance P may be produced by primary fibroblastic tendon cells called tenocytes (Backman et al., 2011). When tendons are submitted to mechanical loading, substance P production is increased. Massage may suppress substance P levels (Field et al., 2002). If this is the case, then massage might be beneficial in the reduction of pain perception. Having a massage after strenuous exercise appears to reduce inflammation in muscles at the cellular level. Massage may reduce the activity of inflammation-inducing proteins called cytokines in muscle cells. Massage may alter genes, thus reducing inflammation and supporting muscle adaptation to exercise (Crane et al., 2012).
Systemic Illness and Disorders
Immune Function
Immunity in Athletes
Inflammation
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