Pre/Post Dive Massage Therapy

[scubastaci]

Email from DAN


Dear Cara,

Thank you for your email to Divers Alert Network regarding massage and diving

Technically for your muscles, deep tissue massage can be very similar to exercise so the same issues apply.

It is best if you are going to have it done to have it a few hours, more than two but it doesn’t have to be more than 5 or 6 hours before you dive. Or, at least four hours after you dive.

If the average half life of nitrogen in your system is 6 hours, so nitrogen is reduced by half, you should be able to have a massage 4 to 6 hours after the dive. The consideration is that by heating up (increased blood flow) the muscles with massage, if in a high concentration or partial pressure, you could provoke bubbles to form which would be feed by nitrogen in the tissues. So while this could happen, there really is a massage study. There have been exercise and diving studies done and those point to not exercising too soon after the dive.

The actual risk is not great for a problem with bubbles but the risk is also not zero. So with a little caution and good judgment you should be able to avoid any bubble trouble.

I hope you will support DAN and diving safety with your membership in DAN.

Sincerely,

Joel Dovenbarger BSN

Medical Services

 

[DocVikingo]

Hi scubastaci,

Thanks for posting DAN's response.

As was anticipated in post #5 of this thread, DAN was not able to assist in citing research studies on massage as it relates to diving, likely because such studies do not seem to exist.

IMHO, their response is rather disappointing as sections of it are hard to follow, e.g., "The consideration is that by heating up (increased blood flow) the muscles with massage, if in a high concentration or partial pressure, you could provoke bubbles to form which would be feed by nitrogen in the tissues. So while this could happen, there really is a massage study" (?).

And other assertions appear to be factually incorrect, e.g., "Technically for your muscles, deep tissue massage can be very similar to exercise so the same issues apply." The studies cited by DrDeco, and his statements, strongly suggest that the passive activiation of muscle by massage is not technically very similar to the active movement of muscle by exercise as regards the circulation of blood.

In any event, good luck with your pursuit.

Regards,

DocVikingo

 

[fisherdvm]

Not posting as a professional... But boy, or boy... could I use a massage after a long day of diving! Where it hurts is the upper shoulder, where the BC strap shut off the circulation, and strain the joints!!

If you did a study between two groups of divers, I am sure you'll find that 100% will say they will love the post dive massage. Now simply getting the word out, so they'll come in and see you is the difficult part.

And it is alot safer than aspirin, motrin, or NSAIDS.

 

[scubastaci]

I was thinking the same thing about the DAN response. It sounded more like he was going off of what he thought would be the correct (safe) answer. Granted, I guess in most instances it is better to not do something if you are unsure, but, if it could help in the long run why not. I am not sure if there are any dive docs in my area. Should look into that.

There are research grants available through the massage therapy foundation that I may have to look into if I can find a local doc to oversee the medical aspects. We have tons of divers in the area that dive Thurmond Dam/Clark's Hill, so I don't think that we will have a shortage of volunteers.
Until then, I will only study my fam and friends. Or at least those that will let me!

 

[DocVikingo]

There are research grants available through the massage therapy foundation that I may have to look into if I can find a local doc to oversee the medical aspects.

Hey scubastaci,

Now that would be exciting and valuable.

Be aware that the at least theoretical possibility massage may precipitate DCS could make the proposal a hard sell to the foundation's Research Ethics Review Committee. And, obviously, any medical oversight would best come from a physician well trained in diving medicine.

Please keep us posted.

DocVikingo

 

[scubastaci]

And, obviously, any medical oversight would best come from a physician well trained in diving medicine.

Please keep us posted.

DocVikingo

Will do. I looked up listings on google and they listed 3 of our local hospitals as either having a chamber or having dive docs. Since it did not specify, I will have to give them a call. If I find a doc willing to participate, then we can apply for the grant. I do know that the doc will have to be willing to perform physicals on the divers prior to the beginning to the study. We will have to "weed" out those that have predisposed risks to DCS.
Will have to contact DAN also if we get this going.
I may be a little bit on the selfish side, since I am a massage therapist, but I can honestly say that if I got out of the water and there was a therapist set up to do a 15-30 minute massage on me, I would jump on it! (provided that it has been proven safe)

 

[merxlin]

Scubastaci,

I for one want to thank you for taking this approach, and doing the research before just "jumping in" and offering a massage service to divers. Too many times I think the lack of contraindicated research creates a false sense of endorsement (nothing that says you can't). Please keep up informed of your findings.

 

[DocVikingo]

And it is alot safer than aspirin, motrin, or NSAIDS.

Hi fisherdvm,

Are aspirin and Motrin (ibuprofen) not considered within the class of NSAIDs?

Thanks,

DocVikingo

 

[fisherdvm]

Funny, I asked the same question too when I took pharmacology. By convention, ASA (aspirin) is not considered to be an NSAID. Eventhough, technically it is. Motrin (ibuprofen) is an NSAID.

I have not kept up with all the new classes of NSAID. But aspirin and tylenol are not considered to be NSAID. But everything else is.

In my practical thinking, ASA thin your blood for about 2 weeks, and NSAIDS for about 2 days. Tylenol has little (to some) effect on coagulation, but not enough for me to stop before surgeries.

 

[fisherdvm]

While some pharmacist are practical minded and categorize aspirin into the NSAID category (correctly), many physicians prefer to separate it out (I think wrongly).

But essentially, aspirin is unique in blocking cyclooxygenase of platelets irreversibly, and it takes up to 14 days for new platelets for form and restore the clotting action of platelets.

NSAIDS is then broken up into 2 other categories (not including aspirin), and I don't know enough about it to go into more details.

Tylenols are non-steroidal analgesic agent, but not lumped with the NSAID.

I guess when it comes to communicating with patients, doctors, and pharmacists - you will have to know who you're talking to. Crazy world we live in.