Massage Department, Southern Institute of Technology, Invercargill, New Zealand

Transcription

1 1 The effect of massage on flexibility, comfort, efficiency and aerodynamic performance in time trial cycling: a single case study. Derek N. Tan, BTSM, 1 and Joanna M. Smith, BSc, BHSc, MEd(Hons), Dip Mass, 1 1 Massage Department, Southern Institute of Technology, Invercargill, New Zealand Derek is a recent graduate of the Bachelor of Therapeutic and Sports Massage programme at the Southern Institute of Technology and a massage therapist in an Invercargill Massage Clinic. Derek is a keen competitive cyclist and has competed at National level in track cycling in the Masters Category 1 division. Jo lectures in the Bachelor of Therapeutic and Sports Massage programme at the Southern Institute of Technology. Jo has a background in physiotherapy, massage therapy and education and is currently completing a PhD at the University of Otago. Correspondence to be addressed to: Jo Smith, Massage Dept., Southern Institute of Technology, Private Bag 90114, Invercargill 9840, New Zealand. Phone ( ext 8803) Fax ( ) jo.smith@sit.ac.nz

2 2 Abstract The purpose of this study was to investigate the effect of a six week massage on an athlete s flexibility, comfort and performance in time trial cycling. A single case study design was used. Pre and post- measures were obtained in a high and low time trial riding position over a 3000 meter distance. Flexibility was measured with a sit and reach test. The athlete was massaged twice a week using a hamstring and calf protocol over a period of six weeks. The athlete did not engage in hamstring, calf or low back stretching and trained in a normal road riding position for the duration of the. Quicker times were reported in the post massage time trial tests of both high and low riding positions. The lower position with its improved aerodynamics was the fastest position in both pre and post massage. The sit and reach testing showed an overall increase in reach of 77 mm. Massage improved flexibility and this allowed the athlete to be both comfortable and efficient in the lower time trial position and improved cycling performance with no post exercise muscle soreness. Key words: case study, aerodynamics, cycling, flexibility, massage therapy Introduction Competitive time trial cycling is a sport where cyclists ride individually over a set course; it can range from track events such as the 4000 meters individual pursuit to the hour record, as well as competition on the road. It is a discipline that all levels of cycling abilities can participate in and enjoy at club level competition and is often referred to as the race of truth as riders race individually against the clock and their worst enemy is air resistance (Handslip, 2007). The principal resistive force is usually aerodynamic drag (Martin & Cobb, 2002, p.105). The most significant factor influencing aerodynamics on the bike is the rider s body, accounting for about 70 percent of total drag (Burke, 2002). Therefore, optimising riding position is the key to improvement in speed. Optimal aerodynamics is a vital component for success in this sport as racing is often separated by seconds or fractions of seconds. However, whilst an aerodynamic position is recommended, this is not to be at the expense of power output. Handslip (2007) cautions that a low body position is good but not to the point that power is lost. Obtaining better aerodynamics on the bike requires the rider to position their torso as low as possible to reduce frontal area and drag (Burke, 2002). The eventual aim is to get the torso parallel to the ground. As such, the rider will have to learn to rotate the pelvis anteriorly to flatten the back for greater aerodynamics. Figure 1 and Figure 2 illustrate different riding positions. The combination of anterior pelvic rotation with a low handlebar position to achieve a horizontal torso with a flat back is illustrated in Figure 3. Fotheringham (2004) recommends gradually moving the handlebars down in five millimeter increments over a period of months to develop an aerodynamic position. He further suggests the addition of stretching exercises for the lower back and hamstrings to assist this process. Figure 1: This example is a typical position for a cyclist with limited flexibility of the hamstrings. As a result of this, the rider will naturally ride with a more flexed spine as they are unable to anteriorly tilt the pelvis. The bars will have to be set higher to be comfortable and aerodynamics will be compromised.

3 3 Figure 2: This picture illustrates the same bike position as figure 1 but this rider demonstrates a position with an anteriorly rotated pelvis to flatten the back. This position not only facilitates better breathing mechanics by allowing the diaphragm to be unrestricted by the rib cage but also puts less stress on vertebrae by keeping them in better alignment as well as aiding aerodynamics. Figure 3: This photo illustrates the combination of anterior pelvic rotation with a low handlebar position to achieve a horizontal torso with a flat back. This can only be achieved with excellent flexibility of the hip joint with the hamstrings. The rider can be comfortable and powerful in an optimal aerodynamic position. As suggested above, one of the keys to being aerodynamic on the bike is good flexibility - without it you will never reach your potential (Colson, 2003, p.74). Flexibility allows for a fuller range of motion... [allowing] our bodies to conform to the most aerodynamic posture and hence to improve the efficiency of our power output via a reduction in front on surface area (Colson, 2003, p.74). Van Diemen and Bastiaans (2002) emphasise that more flexibility is required when cycling in an aerodynamic position for flat time trials, and suggest that a good aerodynamic position requires a high range of hip motion. Pruitt and Mathery (2006) further point out that hamstring and lower back flexibility plays a role in determining the height of the bars in relation to the saddle. Flexibility of the hamstrings translates to a decreased risk of low back pain in cyclists and may allow a lower, more aerodynamic torso angle (Pruitt & Mathery, 2006, p.168). Success in time trial cycling requires good aerodynamic positioning. Having good flexibility is necessary if the cyclist is to obtain an optimal body position. Massage therapy, particularly dynamic soft tissue mobilization (STM), has been shown to improve hamstring flexibility (Hopper, Deacon, Das, Jain, Riddell, Hall & Briffa, 2005). Dynamic STM is a specific structured technique in which the therapist identifies a

4 4 target area of muscle tightness and focuses the treatment on that specific area whilst moving it longitudinally under different muscle contraction parameters (Hopper et al., 2005, p.597). This single case study explored the concept of flexibility as the key element that will enable the athlete to comfortably assume an aerodynamic low torso position and be able to pedal efficiently without restriction from tight muscles. It was thought that regular massage using lengthening techniques on the posterior legs (hamstrings and calves) would improve an athlete s flexibility and allow them to be comfortable and powerful in a low, aerodynamic torso position, thereby resulting in improved time trial performance over a 3000 meter individual pursuit. The purpose of this study was to investigate the effectiveness of a 6-week massage therapy on flexibility to see if this translated to improved comfort, economy of motion and performance in time trial cycling. Methods Profile of Client: Using purposive sampling, a 28 year old, male, competitive cyclist at national level, experienced in time trial events on both the road and track, with no injuries or health concerns was recruited from the local cycling club for the study. Being relatively new to the sport, having only been involved for three years, his position on his road bike was quite upright with the position of the handlebars. The athlete was enthusiastic about the idea of improving flexibility as he felt he needed more to improve his riding position. Morphologically this athlete was ideally suited for developing a low time trial position due to being tall (1.85m) with a slim build. Ethical approval for the study procedures was granted by the Massage Division of the School of Health Exercise and Recreation Ethics Committee at the Southern Institute of Technology. The athlete was given an information form (which gave a detailed description of what the research involved) and a consent form prior to his agreement to participate. These were read, signed and dated by the athlete before the start of the research. The athlete was permitted to stop treatment at any time, for any reason without consequence. Study Overview: The 6-week study consisted of baseline measures of flexibility using the sit and reach test (Barlow, Clarke, Johnson, Seaborne, Thomas & Gal, 2004), as well as a 3000 meter individual pursuit time trial in two different time trial positions. Flexibility was also monitored by the sit and reach test prior, during and after the massage. Once the base measures were obtained the 6-week massage was employed consisting of two massages a week, each of one hour duration. A final sit and reach test was performed and the same two time trials were repeated following completion of the 6-week massage following the procedures used in pre- testing. The post- time trial test (high position) was undertaken three days after the last massage and the post- time trial test (low position) was undertaken five days after the last massage allowing for a recovery day between time trials. During the six week massage the athlete did no stretching (including no hamstring, calf or low back stretching) or training in the time trial position. He did train as usual with a standard road set up with drop handlebars. Measures: Sit and Reach Test The first base measure was a sit and reach test to establish an accurate assessment of flexibility. This test was chosen for its simplicity and its relevance to the cycling position of forward flexion on a bicycle. The athlete was measured at the Southern Institute of Technology performance lab at 12 noon using the sit and reach device (Figure Finder Flex - Tester manufactured by Novel Products, Inc.). The test was performed after a five minute warm up on a stationary bicycle. The athlete was given three practice reaches on the sit and reach device. The test was performed three times, and for each of the three tests the athletes knees were held down to prevent flexion of the knees. The athlete was instructed to make a smooth and controlled movement as he reached forward with his finger tips on the sliding measurement device. Once maximal reach was obtained the athlete held this for three seconds. The athlete would then relax and the measurement was recorded in millimeters. The three measurements were then averaged Meter Time Trial Tests The next base measure was a 3000 meter time trial test conducted at the Invercargill Licensing Trust (ILT) Velodrome. For the first time trial position, the aero handlebars were set to a comfortable height where the athlete could ride with his legs unrestricted and was the usual position he would use in a time trial.

5 5 The test was performed at 9.30 am. Prior to start time, the athlete warmed up for 20 minutes on a set of rollers and then did an additional 10 minutes of cycling on the track. Track temperature at the start and completion of time trial test were recorded. The tyre pressure was pumped to 130 pounds per square inch (psi). Three people assisted with the time trial test: (1) an operator of the lap counter and bell, (2) a holder and (3) a stopwatch operator. A multi lap memory stopwatch was used by the operator to relay split times to the athlete; it also recorded individual lap times and total time. The holder supported the athlete for the start and also managed the backup stopwatch. The lap counter changed the numbers on the lap board and also rang the bell for the final lap. The athlete was instructed to give his best effort. After the 3000 meter test the individual lap times and overall time were recorded. The athlete then cooled down for 15 minutes on a set of rollers to aid recovery. The following day was a rest day to allow for sufficient recovery and the athlete was instructed to do a recovery ride for an hour on his road bike. On the day following the rest day the same procedures, described above, were used to repeat the test for the second time trial position. The same bike was used with the handlebars lowered by 69 mm to a position where the athlete felt uncomfortable in the back and leg muscles. This change in position was a new unaccustomed set up for the athlete. Periodic testing of flexibility Flexibility testing was performed during the massage by the same sit and reach device and procedures. This test was completed after two weeks (four massages), after four weeks (eight massages) and at the completion of the massage therapy (after twelve massages). Massage : The athlete received a total of twelve, one hour massage sessions during the sixweek treatment period. Two sessions were administered each week and were separated by at least 3 days. The massage was conducted by a massage therapy student with 2400 hours of classroom experience and 280 hours of clinical massage experience. A standardized 60-minute massage treatment protocol was designed and consisted of three phases within the 60-minute timeframe; descriptions of each phase follow. More flexibility was sought in the hamstrings and the calves. Accordingly, the specific muscles massaged included semitendinosus, semimembranosus, biceps femoris, gastrocnemius and the soleus. One leg was massaged completely followed by the other leg. The following protocol was utilised in all 12 massages received by the athlete. Phase 1 Calf in prone position. Treatment of the calves in prone position involved warming up with gentle stripping (longitudinal strokes), which was also used to palpate for any tight areas. This was continued and gradually was worked up to a level six on the pressure scale (1 being light pressure with no discomfort and 10 being intense pressure/pain). Next the knee was bent to approximately 60 to 70 degrees and a strip and stretch technique was used. This involved stripping strokes while the foot was moved into dorsiflexion. In this same position, any tight areas were also treated with pin and stretch (involving compression while the calf muscle was lengthened via dorsiflexion). The final process for the calf involved the legs being placed flat on the massage table with the feet hanging over the end so plantar- and dorsiflexion could be performed by the athlete. On the leg being treated, the calf was slowly stripped in a proximal to distal direction as the athlete plantar- and dorsiflexed his foot. This was performed three times. Phase 2 Hamstring in prone position. Warm up with gentle stripping while palpating for tightness and gradually work up to a six on the pressure scale. Pin and stretch was used for the hamstring. This was performed with the lower leg bent to 90 degrees at the knee joint. Compression with knuckles was performed up to a level six on the pressure scale and then the leg was lowered slowly by the therapist. The bellies of semitendinosus and semimembranosus were targeted as these were tight. Next, an eccentric movement of the leg was performed in three different ways - passive (performed by therapist), active (by athlete) and resisted by actively contracting the quadriceps and resistance provided by the therapist. The same eccentric movements were then used again but this time in conjunction with a continuous gliding stroke along the length of muscle with a pressure of six to seven out of ten. The direction of strokes were initially proximal to distal as the leg was slowly lowered but was modified to a distal to proximal direction from session five onwards. This continuous gliding stroke was performed passively, actively and also with resistance. This was performed with up to three strokes with each technique.

6 6 Phase 3 Hamstring in supine. The treated leg was raised so that the thigh was in flexion and the knee was slightly bent; the non-treated leg was lying flat on the massage table. The treated leg was supported by the therapist at the heel of the athlete s foot and this put a comfortable stretch on the hamstrings. While in this stretched position stripping glides were performed from distal to proximal (downward glide) with pressure ranging from six to seven on the pressure scale. The glide encompassed the entire length of the muscle starting at the tendons at the distal end and finishing at the ischial tuberosity. This was performed with a gentle stretch and after several glides the stretch was gradually increased. The final glides were performed with the athlete contracting the quadriceps to enhance a releasing effect on the hamstrings by reciprocal inhibition. Summary of visits The massage consisted of 12 massages; taking place on Monday and Friday after the subject finished work. The athlete reported no ill effects or post massage soreness from any of the massage sessions. In general the application of the massage protocol was very consistent. During the second massage, a extra focus was given to the distal end of the hamstring region due to noted muscle tension. During the fifth massage, while treating the hamstrings in the prone position, it was noted that stripping from a distal to proximal direction with an eccentric lowering of the leg was easier and more effective than the proximal to distal direction for pressure and athlete comfort. As a consequence, this modification to the protocol was used throughout the remainder of the massage treatments. During the sixth treatment the athlete could withstand a notable amount of increased pressure, especially during the method of stripping and stretching the hamstrings in the supine position. During the seventh massage the athlete reported tenderness in his hamstrings, but thought this was due to the hard riding he had performed two days earlier in the local road race. Pressure of the massage was adjusted accordingly to suit client comfort levels. By the eleventh massage, it was noticeable that the athlete had increased hamstring flexibility as his range of motion was greater during the supine treatment of hamstrings where the stretch and stripping technique was utilised. In all of the treatments the athlete displayed good morale and a positive outlook regarding the benefit of the treatments. Results The sit and reach test showed an increase in length of 77 mm over the duration of the study (Table 1). The greatest improvement was seen after two weeks of the (four massages) where there was a 50 mm increase compared with week four and week six showing significantly smaller increments at 13 mm and 14 mm respectively. Environmental and equipment factors were monitored for the time trial testing and are reported in Table 2. The time trial results show an improvement in time, speed and rider comfort for the post massage time trials compared with the pre- base tests (Table 3). For the high position, there was an improvement in speed of 1.7 seconds in the post trial. For the low position, the post massage trial was 0.65 seconds quicker than the pre massage low position. Table 1. Sit and Reach test Measurements Base measure After 2 weeks After 4 weeks Final measure Mean length - sit and reach test (mm) Progress made between time frames (mm) Accumulated progress (mm)

7 7 Table 2. Environmental and equipment factors High position Low Position Pre (Test 1) Post (Test 3) Pre (Test 2) Post (Test 4) Date 19/06/08 04/08/08 21/06/08 06/08/08 Start time 9.30 am 9.30 am 9.30 am 9.30 am Track temperature (º C) start / finish 13.0 / / / / 14.2 Gear ratio 53 x x x x 16 (89.4 inches) (89.4 inches) (89.4 inches) (89.4 inches) Table 3. Performance measures - pre and post massage therapy Pre (Test 1) High Position Post (Test 3) Post - Pre Gain / (Loss) Pre (Test 2) Low position Post (Test 4) Date 19/06/08 04/08/08 21/06/08 06/08/08 Post - Pre Gain / (Loss) Time (min:sec) Average speed (km/h) Flexibility* (mm) 3: (1.7) (0.65) Rider comments comfortable very comfortable uncomfortable very comfortable * Measured using Sit and Reach Test Participant feedback was also collected. Pre feedback on the higher time trial position was reported as being comfortable. This position was without any restrictions of the legs or back, economy of motion was good as cadence was easy to maintain and the position felt good for the entire effort. In contrast the lower position felt awkward and uncomfortable with economy of pedaling motion feeling restricted. The athlete could feel restriction in the hamstrings, calves and lower back muscles as he pedaled. The main area was the hamstrings and this made the first six laps of the time trial challenging as the athlete s pedaling efficiency felt reduced requiring more muscular effort. For the remaining six laps this feeling subsided as his body settled into this new position. The athlete also reported feeling over flexed in the thoracic spine region and therefore felt restricted in his diaphragm as this lower position forced him into greater spinal flexion. His low back muscles had some post exercise soreness immediately after this time trial with an awareness that his back muscles had been stressed. It was the next day that his low back

8 8 felt the worst with discomfort levels of about four to five on the pain scale (one being low pain and 10 representing high pain). The following day these symptoms had considerably diminished to a level of one to two on the pain scale and by the next day was fine. Post massage comparisons were very different to the pre results. The athlete felt very comfortable in both time trial positions. With the low position he felt none of the restrictions he had previously experienced in the base tests. Economy of motion was not affected as the legs were free of restriction and pedaling felt efficient and was easy to perform. The lower position felt no different in comfort and power compared to the higher position. The athlete believed the bars could be lowered even more as it felt so comfortable and easy to ride. Most importantly he did not experience the post exercise muscle soreness of his low back muscles. Discussion Originally it was thought that the low torso position performed prior to the massage would be detrimental to the athlete s performance and result in a slower time. It was interesting to see that the athlete actually went 2.12 seconds quicker although it was reported to be uncomfortable and resulted in post exercise soreness. It appears that the position in test 2 was not low enough to cause a loss in power output. The time trial results show that there was an improvement with better times for the post massage time trials compared with the pre- base tests. The fastest time was performed in the low position after the massage, demonstrating an improvement in performance and indicates that flexibility may have been a contributing factor. The improvement in flexibility also indicated that the various massage techniques used (i.e. pin and stretch combined with strip and stretch) were effective. This finding is consistent with the study by Hopper et. al. (2005) which found flexibility to improve after using dynamic soft tissue mobilisation techniques on a single treatment. This study was also able to show accumulative improvements over the course of a six week period. Rider feedback comparing the two riding positions pre and post massage show that adaptation may have been facilitated by the increase in flexibility. Also of importance was the lack of post exercise low back muscles muscle soreness post. Comfort in a low position requires the necessary amount of flexibility for this to occur, otherwise it could result in discomfort and even cause injury. These comments by the athlete are consistent with the literature on the topic of flexibility and aerodynamic bike positioning. By being more flexible, a cyclist can adopt a more aerodynamic torso position and given that power output remains the same then this should lead to an increase in speed due to reduced drag (Colson, 2003). Improved flexibility allows the cyclist to maintain economy of pedaling efficiency by allowing the legs to be unimpeded by tight muscles (Handslip, 2007). This exploratory research aimed to investigate whether improved flexibility would allow the rider to adopt a lower and more aerodynamic torso position without a loss in power output and, therefore, improve performance. The results of this study do show that the lower position was faster for both pre and post massage time trials. Environmental and equipment factors were consistent. This improvement in time is very likely due to the improved aerodynamics of the lower position. However, without the use of wind tunnel testing it can only be assumed that the low position was aerodynamically better to the higher position based on the timed results. The massage did increase the flexibility of the hamstrings and calf muscles and the rider more easily adopted a lower riding position. Limitations As a case study with only one participant it is impossible to make generalisations about the pattern of change in flexibility. This would require further study with a greater sample size. There was also a limit as to how far the athlete could be lowered on the bike due to limited access to specialist bike equipment. In addition, access to a power meter measuring device would also have been of great value in setting the riding positions as well as quantifying power output and aerodynamics during the trials. There is also the question of the role that fitness played in this improved performance. However, to improve performance for a 3000 meter pursuit requires specific speed work performed on the track such as motor pacing and interval work. The athlete s training during the six week massage was focused on endurance work performed on the road and not speed. In addition, at the pre- phase, the athlete had some good form as he had just returned from successful competition in the United Kingdom with road races and

9 9 road time trials. So given these factors it is thought that fitness was not a likely variable that could have affected these results. The track temperature was another variable that may have affected results. For the post- time trials there was a slight difference in temperature between the high position (14.1 ºC) and the low position (12.2 ºC) time trials. A warmer track environment means quicker conditions, due to warmer air being less dense, and therefore is easier to push through (Knapp, 2004). However, the rider did not think that the temperature had an effect on the time trial results. As seen above, time trial tests have many contributing variables which may affect results and are hard to control. These variables also include how the athlete feels on the day of the trials, the amount of recovery from regular training or between the time trial efforts, nutritional requirements, the daily routine of life and work. All of these factors can play a role in performance and are definite limitations to the study. Future recommendations It would be interesting to compare the difference in performance between the high and low positions given that the pre massage low position was dramatic enough to reduce performance. To quantify such an experiment it would be necessary to have the equipment at disposal with various handlebar and stem combinations as well as a power meter to quantify power output and aerodynamics. A larger sample size, using an experimental design approach, would give more validity to results and generalisations could be made regarding the information. Variables such as stretching, massage and time trial training in the low position could be investigated in this manner. Conclusion Time trial cycling is a sport that can be separated by fractions of seconds. The enemy is wind resistance and optimal aerodynamics can be the difference between winning and placing. The key to good aerodynamic positioning on the bike comes from having ample flexibility in order to be both comfortable and efficient. Stretching is the standard method for increasing flexibility. This research investigated the effect of massage therapy on flexibility and its application to time trial cycling position. This single case study successfully used a six week massage to improve an athlete s flexibility. This improved flexibility of the hamstrings and calf muscles allowed the athlete to ride comfortably and efficiently in a lower time trial position while maintaining optimal power therefore improving cycling performance. Furthermore, the massage protocol used was effective in increasing hamstring and calf length and could be used in future studies. Acknowledgments We would like to thank our research athlete who gave his time and commitment to making this project possible. We wish you all the best in achieving your cycling goals! Thank you to Dayle Cheatly (BikeNZ coaching manager), Glen Thompson and Nick Harris for their expert advice and assistance. Thanks also to Todd Blair, Damian Tippen and Brett Harris for their much needed help. And lastly a special thank you to Cycling Southland for the use of the ILT Velodrome. References Barlow, A., Clarke, R., Johnson, N., Seabourne, B., Thomas, D., & Gal, J. (2004). Effect of massage of the hamstring muscle group on performance of the sit and reach test. British Journal of Sports Medicine, 38 (3), Burke, E.R. (2002). Serious Cycling (2nd ed.). Champaign, IL: Human Kinetics. Colson, E. (2003). Stretch your abilities. Bicycling Australia, 121, Fotheringham, W. (2004). Cycle Racing How to Train, Race and Win. Oakleigh, South Victoria: Funtastic. Handslip, M. (2007). The science of speed. Bicycling Australia, 147,

10 10 Hopper, D., Deacon, S., Das, S., Jain, A., Riddell, D., Hall, T., & Briffa, K. (2005). Dynamic Soft Tissue Mobilisation Increases Hamstring Flexibility in Healthy Male Athletes. British Journal of Sports Medicine, 39 (9), Knapp, G. (2004). Why track records are falling at Athens. Retrieved October 7, 2008 from humidity Martin, J. & Cobb, J. (2002). Body position and aerodynamics. In: A.E. Jeukendrup (Ed.), High Performance Cycling (pp ). Champaign, IL: Human Kinetics. Pruitt, A.L. & Mathery, F. (2006). Andy Pruitt s Complete Medical Guide for Cyclists. Boulder, CO: VeloPress. Van Diemen, A. & Bastiaans, J.J. (2002). Strength and flexibility. In: A.E. Jeukendrup (Ed.), High Performance Cycling (pp ). Champaign, IL: Human Kinetics.