Out of scope of practice or just politics Part 3

Part 3

History of the Soviet Medical and Sports Massage.

As explained in Part 1 and Part 2 of this blog the science of Soviet Medical Massage was originally developed by Professor Anatoli Sherbak in the nineteen-thirties as well as my Dr.Serazini, who was internationally recognized as a father of modern sports massage.  In the nineteen fifties, these developments were expanded by German scientists Drs. Glezer and Dalicho.  Later in the sixties and seventies, many scientists of the former Soviet bloc countries contributed to this development.  They were, for instance, Soviet scientists like professor Dembo, professor Popilyansky, Dr.Chernich, professor Kremer, the Bulgarian scientist professor Ivanov, Prof Anichkin, Prof.Belaya, and many, many more.  Yet, little or close to nothing of the Medical and Sports Massage protocols, that was improving sports performances, was known in the West. Although the large research institutions were involved in the Medical and Sports Massage studies, their developments were kept in strict secrecy.  The secrecy was guaranteed by the mighty Soviet secret service organization KGB.

KGB or the Committee of Government Security, to some degree, was similar to the confluence of two American organizations FBI and CIA.  Except for that American citizens rarely get involved with either of these organizations as it's primary goal is to counteract internal and external foes of the United States. In the Soviet Union, one careless word or a risky joke could not only end one's career but also make him or her a foreign spy - the enemy of the Soviet people and thus being tortured, sent to GULAG or killed.  Therefore no one in Russia messed with KGB, which enabled it to keep any information as secret as the Communist Party wanted it to be. In this particular case, the secrecy was overseen by the influential member of the central Communist Committee comrade Suslov personally.

The reason for such secrecy was substantial.  During the “Cold War,” Soviet propaganda always tried to portray the Soviet system and the Soviet way of life as superior to the one adopted by the West.  It even came up with the myth of a special new “Soviet Person”, the carrier of the advanced Soviet mentality, which allegedly was far superior to a mentality of a Western person.

In order to somehow substantiate this myth, the Soviet propaganda utilized any Olympic sports and the dominance of the Soviet bloc athletes, especially of the USSR and Eastern Germany during Olympic Games in the sixties, seventies, and eighties.

It would be essential to point out much greater longevity of the Soviet bloc athletes compared to their Western counterparts.  The vast majority of the Soviet bloc athletes were competitive for ten to fifteen years.  The real secret of such longevity was the elaborate system of pre-event and post-event rehabilitative Sports massage and the proper warm-up procedure; a sequence of special exercises including neuromuscular re-education that ensured that all the muscles of the responsible regions work in assembly and in the neurological sense. Such powerful scientifically based methods made verifies that joints are stable enough to withstand huge competitive loads and to perform to the maximum physiological potential of individual athletes.

All that changed during the time of Gorbachev’s “perestroika” – restructuring of the Soviet economy – and, subsequently, during the time when the Soviet system has fallen apart.  The scientific institutions that for decades were supported financially by the Soviet Government, regardless of their actual profitability, were suddenly left without any funding and, thus, quickly disintegrated.

The impressive body of knowledge accumulated by decades of arduous work by talented scientists was literally abandoned.   That’s why, paradoxically, the only people who could carry the torch of knowledge in the Russian Medical and Sports Massage were those who have emigrated from the Soviet Union at the time and prior to “perestroika.”

In the institution where I worked in 1963, a military faculty was organized, which was preparing military sports instructors, thus making it a military PO. Box. The research was conducted under strict secrecy, and practitioners who were trained were obligated to keep this secrecy and knew that those protocols were a secret product of the Communist party. Perhaps, for those who lived in the free world, the threat of KGB will be difficult to comprehend, but we all knew too well that messing around with KGB was a bad idea. It was too serious.

The Soviet government used to keep secrecy only for massage protocols that substantially improved athletic performances. The other medical massage research papers, including hands-on massage protocols, such as fibromyalgia and many other ones were available (see the link below)

Massage Therapy a Beneficial Tool

Medical massage and Control of Arterial Hypertension

As I know, today post-concussion rehabilitation protocols and some others were published.  I remember very well how our bosses used to gloat regarding the fact that Medical Massage for visceral and skeletal muscular diseases in no case was of interest in America as the US was under complete control of the pharmaceutical industry. What was kept in strict secrecy, were post-event sports massage protocols like the one attempted to develop by the Western Experts below:

The possibility of speeding up the athlete’s recovery by massage captured the attention of Western European and American scientists working in the field of Sports Medicine. However, authors of numerous studies in different centers mostly concluded that massage does not have any significant impact on the process of recovery after maximal exercises (Drews, et al., 1990; Carfarelli, et al., 1990; Rodenberg, et al., 1994; Tiidus, et al., 1995; Gupta, et al., 1996, and more). All these studies were conducted by very responsible scientists and published in respected professional journals.

After studying the above report in detail and many others similar to this one, I realized why there was such a discrepancy in the results. The time of treatment here plays a crucial role.  All Western articles, which reported about the failure of massage therapy to speed up the recovery process, had the same striking similarity. Despite a truly scientific approach to the evaluation of treatment and its duration, these studies neglected to follow the proper protocol: TIME OF THE TREATMENT and DURATION.

Cafarell, et al., 1990 immediately after exercise 4 min

Drews, 1990 immediately after exercise 30 min

Wenos, et. al., 1990 48 hours after exercise N/A

Rodenberg, et al., 1994,15 minutes after exercise 15 min

Tiidus, 1995 48 hours after exercise 10 min

Gupta, 1996 48 hours after exercise 10 min

After numerous experiments, the Soviet scientists concluded that massage has to be initiated no earlier than 2-2.5 hours after vigorous exercises.  Further, in my further discussion, I’ll be referring to this essential consideration.

Only one published article on this subject puts everything in the correct perspective. In this study, a group of North Carolina and Virginia authors (Smith, L.L et al., 1994) formulated a protocol based on that of Russian scientists, proving its value. Prof. Smith, L.L et al., 1994) even wrote, I followed recommendations of Soviet scientists and, evidently, discovered the importance of a rehabilitative massage.

It so happens that I personally know and know very well the Soviet scientist, who in 1993, secretly wrote a research massage protocol for Prof. Smith on a piece of paper. Even at that time, Soviet citizens used to be afraid of disclosure.

According to the Soviet protocol, authors examined the effect of massage on delayed onset of muscle soreness, and creatine kinase (an enzyme indicator of muscle damage) and neutrophil (an inflammatory white blood cell) count.  It is noteworthy, the authors adjusted their experimental protocol according to the practical recommendations of the Russian scientist who was also a massage therapist. These authors considered that vigorous exercises damage muscular tissue with the development of aseptic (noninfectious) inflammation and interstitial edema. The body reacts to these events by mobilizing neutrophils to the affected area. Neutrophils enter tissues and start their cleaning job (i.e., phagocytosis) to remove the waste products produced by the muscular injury and inflammation. Their increased concentration also attracts other types of phagocytic cells, macrophages. In the process of phagocytosis, catabolic enzymes are released from neutrophils, additionally damaging already injured muscular fibers. Dr. Smith and associates, through their research, noticed that two major events indirectly support this theory: temporary reduction of neutrophil count and increased concentration of creatine kinase in local blood vessels, and their following migration into soft tissues as critical elements responsible for the long-lasting muscle soreness after vigorous exercises. This study showed that this process precisely matches the 2-hour time limit after vigorous exercise.

This is what Smith, et al., had to say in their conclusion:

“During acute inflammation, blood flow slows as vessels dilate in an area of injury. When this occurs, the white blood cells, including neutrophils, are displaced from the central, axial zone of blood flow to the peripheral, plasmatic zone and subsequently marginate along the vessel walls. Since sports massage appears to increase blood flow through the vascular bed, we theorized that this increased flow rate in the area of microtrauma could prevent the typical outward displacement of neutrophils. In addition, we speculated that the mechanical action of sports massage could shear marginated cells from vessel walls and thus hinder emigration of cells from the circulation into tissues spaces. …control group exhibiting a more rapid and steeper increase CK (i.e. creatine kinase) values than the massage group. …sports massage rendered hours after termination of unaccustomed eccentric exercise reduces the intensity of delayed onset muscle soreness and reduces serum creatine kinase levels.”

Dear colleagues,

Delayed onset muscle soreness might sound innocent. Yet phagocytosis actually injures healthy muscles, and when it happens repeatedly, it makes muscles weaker disabling them from performing at their maximum potential, as well as preconditions them for injury.  As a part of the Soviet training regime, Olympians practiced until their heart rate would reach 205 to 220 times per minute.  Imagine what kind of physical athletes had to perform if their resting heart rate was 40 to 45 times per minute.

The workouts of such intensity could produce substantial damage to muscles unless two hours later athletes would undergo post-event rehabilitative sports massage. This treatment cannot be viewed as a shock absorber, for additional damages by phagocytosis, but as a preventive effort against additional injuries.  Working with Olympian teams, I, as well as other therapists in our group, used to restore the local blood supply in muscles immediately, preventing the development of fascia tension, as well as restoring normal functions of organs and systems. Briefly, I'm talking about this in my article that, amusingly, was published in Massage Magazine.

Sports Recovery and Performance Enhancement

Below I included the references to this article.

Smith, L.L., Keating, M.N., Holbert, D., Spratt, D.S., McCammon, M.R., Smith, S.S., Israel, R.G.: The Effect of Athletic Massage of Delayed Onset Muscle Soreness. Creatine Kinase and Neutrophil Count: Preliminary report. J. Orthp. Sports Phys. Ther., 19(2): 93-99, 1994.

Luckily for “Sports Recovery and Performance Enhancement” all the references to this work were by the Western Experts.

Another important aspect of the sports recovery paradigm is referred to in the following snippet.

Working in the “Inhibitory Regime” (massaging while gradually increasing pressure), we awaken reflexes to the original stimuli. These are expressed in vasodilation (reduction of peripheral vascular resistance, reduction of left cardiac work, etc.) As a matter of fact, with Post-Event Sports-Massage, we also prevent the enlargement of the heart muscles (hypertrophy), balance the biomechanics that prevents sports-related injuries, as well as improve the performance of the athlete.

The above article uses proper protocols is what makes the difference between proper and improper utilization of Sports Massage.  Scientifically-proven protocols are designed through extensive research and thorough analysis of data on efficacy and safety of any treatment. Post-Event Sports Massage contains important methods used to improve the performance of athletes, rehabilitate from exercise stress, eliminate side effects, and prevent sports-related injuries.

Dear Colleges,

I hope I don’t end up sounding like a boaster.  In reality, I am a very humble man.  I just happen to be in the right place at the right time and, as a result, I was exposed to the amazing source of knowledge, which, by a freak of current, got abandoned and dried up.

All my life, I was trying to popularize this knowledge, make it available to everybody, and especially at the place of my new motherland that was so good for me and my family.  I did what I could, what was within my physical, mental and financial abilities and now I am not a young man.  I made 22 medical massage educational videos describing protocols of Medical Massage.  I hope this contribution of mine would be rightly understood despite my less than perfect English.

In Volume 7 of my Medical and sports Massage medical massage educational video series, I demonstrate specific techniques of sports massage as well as stretching for different groups of muscles.

For a detailed discussion of all the protocols discussed above please follow the link.

I also highly recommend purchasing medical massage texts by Dr.Ross Turchaninov.

This is what I wrote about him and his works.

Dear colleagues, Please find below the descriptions of medical massage books by Dr. Ross Turchanonov. Dr. Turchanonov is a medical doctor with a Ph.D. in studies related to medical-massage. For everyone who desires to learn medical massage, this book is a unique educational source, because it is written by a scientist who himself believes in and practices medical-massage. Dr. Turchanonov is a scientist and educator but is also a clinician. Not only that he shares his knowledge acquired in a medical school and throughout his Ph.D. studies, but also, most importantly, the knowledge gained in the treatment room. Therefore, all scientific data you find in his 3 books, is not for a general education only, but for practical use in the treatment room. I often ask myself a rhetorical question: "If a professor, who teaches surgical procedure, could himself have performed a few surgeries; wouldn't such a professor be able to teach real surgical techniques?" Massage therapy isn't a surgery, but it is an extremely powerful medical methodology of treatment, which can possibly prevent surgeries, rid people of painful orthopedic disorders, treat and manage anxieties, clinical depression, tension headaches, and sleep disorders, help to manage symptoms of fibromyalgia syndrome, allowing patients to come back to normal active life and much, much more. Dr. Turchanonov's books are a great reliable study source; not only from a full-time scientist and a writer, not only from a full-time CE presenter but from a clinician as well. This fusion of expertise could prove to make a crucial difference in the quality of your education.

Best Wishes,
Boris Prilutsky

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