In the follow up to Part I, I take a look at the role of the soigneur in professional cycling and consider the science behind the art. For those perhaps unfamiliar with the term, it is French for a caretaker or carer, literally a person who gives massage, and other assistance to a team, during a cycle race. My experience as a soigneur in cycling was short and sweet (I’ll explain why at the end of this blog) with stints on the Tour of Guadeloupe, Rapport Tour in South Africa, and a follow up on the London-Paris Triathlon.
|Tour of Britain|
Nowadays, post-Armstrong, the sport appears to have cleaned up its act. Soigneurs still play a vital part in every team’s preparation, especially in the stage races (races that last more than 1 day) like the Grande Tours of France, Italy and Spain. The role involves everything from, driving to and from airports, shopping for provisions (nutritional needs of the riders), to making up bottles and feed bags, pinning on numbers, pre-race massage, handing up feed bags, through to post-race massage and even in some cases, washing/mending riders clothes … not to mention, acting as the riders confidant … this is no ordinary job.
So what is the role of the massage I hear you ask? Well, riders will make their way to the massage table in dribs and drabs, depending on the day’s events such as stage wins, crashes, visits to doping control, TV/Radio interviews etc. Then they will spend between 30-45 minutes on the table, receiving a full body massage with a bias towards the legs. Those legs of course, will have been pumping at 90-120 revolutions per minute for anything between 4 and 6+ hours (day after day) in the big Tours. Each team will have 3-4 soigneurs who share the volume of work. Most riders avail themselves to the skills of the soigneur, BUT there are a few notable exceptions. It is said that Chris Boardman former yellow jersey holder and Tour de France stage winner, was not a big fan of massage, but would occasionally take to the massage table to appease the GAN soigneur at the time.
|Massage: A social interaction. Photo via https://derotsmedia.com/2012/03/22/5-april-holland-sport-special-parijs-roubaix/|
So what of the science?Much has been written on the topic and massage as a 'therapy' has its fair share of critics and advocates (see here). It is fair to say that the evidence for its use is far from conclusive. In cycling, massage has always been a traditional form of preparation for the big Tours and major events by riders, coaches and team managers alike. So much so, that from a socio-economic perspective, professional teams will happily employ 3 or 4 soigneurs for the duration of the Grand Tours and major events throughout a season. Whilst some riders retain personal soigneurs.
So let’s consider a few questions:
Is massage always the same?
No. There are a plethora of different styles and applications, ranging from Swedish massage’ hands on to mechanical methods using foam rollers and devices/tools. This naturally makes reproducibility and research into massage very challenging. The most commonly used types of massage in cycling are hands on, Swedish style applications, but the exact method and style may be down to an individual’s preference.
Is massage always appropriate?
Short answer ... NO.
Pre-event massage immediately before an event, has been shown to reduce explosive power and speed. Hence most pre-event rubs tend to be more for the superficial application of oils or creams, especially in adverse weather conditions e.g. cold, rain, snow etc.
Why is it difficult to conduct research into massage?
The reasons are many and varied. As mentioned previously, each rider is different, their exercise and race protocols are different, techniques vary and their application is differs from practitioner to practitioner. Not to mention, the difficulties of setting up a sham control group. Most studies into the effect of massage have been small, in both numbers and effect sizes (see here) and compare to other dissimilar interventions.
Emerging research (reported here) into physiological effects, is partially encouraging. Some studies have (apparently) shown support for the contention that 'massage attenuates the inflammatory response to exercise, as well as decreases pain, muscle tone and hyperactivity'. This research suggests that reductions in inflammatory cells and proinflammatory cytokines via massage may 'mitigate secondary injury associated with intense exercise, thereby reducing tissue damage and accelerating recovery'. This all sounds almost too good to be true, and readers should note that this particular small study has been comprehensively pulled apart by various commentators (here & here). Furthermore, a meta analysis in 2016 suggested that the effects on 'performance recovery are rather small and partly unclear'. However, a later systematic review with meta analysis in 2017 stated that 'current evidence suggests that massage therapy after strenuous exercise could be effective for alleviating DOMS and improving muscle performance'.
To summarise, it seems that as things stand ... NO ONE IS QUITE SURE!
It has been quite rightly proposed that ‘future studies should attempt to use standardised protocols so that between-study comparisons in which only varied single variables, such as timing and dose of massage, can be examined’. This of course works perfectly well in Science, but is entirely non-contextual for the sport, or the individual involved in that sport.
So what about the psychological effects of massage?
Massage (mainly in small underpowered studies) has been reported to have significant psychological benefits, including increased relaxation and decreased expression of stress biomarkers (i.e. cortisol). However, the effects of therapeutic touch are a key area for further research and this comes in the light of recent research (here) suggesting that skin is thought to play a key role in the regulation of blood pressure. This may in part, provide a physiological explanation for the commonly reported relaxation and wellbeing commonly reported.
So what is the bottom line?
Well frankly, the jury remains out from a scientific perspective, especially with regard to the physiological effects of massage. The effects of multiple bouts of massage, either daily or at regular intervals over the course of the Grand Tours, has yet to be investigated. Despite this, the suggestion remains that massage, to quote the BMJ 2017, remains 'an area worthy of (further) investigation, as we continue to advance the science for these therapies'.
In the mean time, practitioners may be wise to avoid extravagent claims for what they are doing.
If however, we consider the psycho-social benefits of massage, there is perhaps an argument for its continued use. What is particularly interesting, is that whilst many pro cycling teams, have radically altered training programmes, diet and resting regimes for their athletes in response to emerging science, none have so far considered it prudent to remove or alter massage as an active ingredient of rider preparation.Whether this is down to science, tradition or a fear of rider rebellion, remains another unknown.
Massage, as suggested in Part 1 of this blog, may indeed be the ultimate biopsychosocial intervention, for there are (some) biological, psychological and social reasons for its continuation in the context of professional sport … and that truly is food for thought in an ever changing world. What is clear, is that there remains a demand for massage in sport (and other areas of health provision). Massage will continue to be delivered by those with the necessary skills, and whether ANY therapists believe themselves above and beyond that ... is frankly, entirely up to them ... and their interpretation the science, ethics, psychology and socio-economics of the topic.
That massage as a therapy, has stood the test of time is indeed an interesting sociological observation ... and perhaps nothing more.
|Massage in cycling - perhaps the most biopsychosocial of interventions|
Finally a word of advice.
It is worth reminding yourself that the role of team masseur/soigneur is one of the most demanding of jobs, both physically and psychologically. Having experienced both, first as a pro-cyclist and secondly a team soigneur … I can tell you for sure, personally, I would rather ride the race, and that is why my tenure in the job (as a soigneur) was very short lived. The final straw for me, was actually the 8 hours I spent bobbing up and down in a tiny fishing boat on the English Channel, trailing in the wake of a swimmer in the London-Paris Triathlon. BUT don’t let that put you off, it is also an incredibly rewarding role …but it is no ordinary job AND believe me, you’ll earn every last penny!
Author: Alan J Taylor is a writer and critic who thinks about stuff and works as a Physiotherapist, University Assistant Professor and Medico-Legal expert witness ... The views contained in this blog are his own and are not linked to any organisation or institution. Like Bukowski, he 'writes to stay sane'. He once rode the Tour of Britain and worked as a cycling soigneur.