A massage therapist with a Massachusetts minor-league hockey franchise shares her insights.

We met on a frigid New England morning, just after the holidays, when everyone is acutely aware that the worst of winter looms ahead. But for Joana Brown, this is her time of year. That's because she has a rewarding career working with some of the toughest guys around--professional hockey players.

For the past three years, Brown has been working with the American Hockey League's (AHL) Lowell Lock Monsters in Lowell, Massachusetts, a minor-league team in the Eastern Conference Atlantic Division.

The AHL is the premier professional developmental league in the world, with nearly 75 percent of its players advancing to the National Hockey League (NHL). More than 100 graduates have been inducted into the Hockey Hall of Fame. The Lowell Lock Monsters are a minor-league affiliate of the Carolina Hurricanes.

This photo (and others to follow) shows Joana Brown with hockey player Eric Veilleux.  In this shot, sht is using a strain/counterstrain technique to releae the iliacus and psoas muscles

Brown is the first massage therapist to work with these outstanding athletes, and it is here that she has found her true calling. It has been so gratifying, in fact, that she is compelled to inspire her colleagues and those still in training to choose sports massage as a specialty.

Brown herself is an inspiration. Born on the Portuguese island of Madeira with severe bilateral clubfeet, she endured more than a dozen surgical procedures before she was a teenager. The challenges were enormous, but they helped set the foundation at an early age for her to gain the ability to transcend obstacles, both physically and professionally.

One of her earliest triumphs involved learning to swim. With keen powers of observation and a sense of resolve honed by intently watching her parents and other avid swimmers day after day, Brown, in one try, walked into a pool and swam the whole length. Shortly after this, at nine years of age, her family moved to a second island--Isle of Jersey, England. In this situation, she had to get used to another country and language, and make new friends while dealing with ongoing surgery to reconstruct her feet. Here, she learned to release her pain through meditation. At times her feet were so sensitive that even the touch of a bed sheet was excruciating. By sitting completely still, focusing on the pain and accepting it, she taught herself to relax until she could feel the pain dissipate. At this key point in her development, she realized that she wanted to help other people relieve their pain.

The therapeutic benefits of massage were inbred in Brown at an early age. "Massage was second nature in our home," she says. "Whenever we had a pain my mother would massage us or call a local woman to do home remedies. It was a comforting and natural part of what we did to stay healthy."

It was not until many years later, however, that she would take her instinctive knowledge of massage's benefits and translate it to her life's work: a career in sports massage. After moving to the United States, she was faced with new challenges. However, this time they were not physical, but professional and financial. Now a wife and mother of two young boys, Brown was laid off from her job at a major hospital in Boston. She had become well known as a specialist in launching and managing mammography services, a career path that developed after she graduated from college as a radiology technologist.

A single-leg, pelvic tilt stretch helps attain maximum flexibiility of the sacrospinalis (low back), proximal hamstring tissue and gluteus maximus.

After months of little income and much soul-searching to find her passion, Brown decided to go back to school to study massage therapy. "I had always taken it for granted that massage was a major component in staying healthy, but I had never thought of it as a career," she says. "It occurred to me that since I knew about bones, learning about muscles would be the next step and a natural complement to my clinical training."

She graduated from the Muscle Therapy Institute in Cambridge, Massachusetts (founded by MTJ Contributing Editor Ben Benjamin). Later, Brown went on to study for a year with Grace Chan and James Waslaski. It is Waslaski's techniques that have had the greatest impact on her work with professional athletes because of the immediate results she saw. Brown follows his systematic approach to soft tissue work, and supplements it with the Proprioceptive Neuromuscular Facilitation (PNF) techniques of Reciprocal Innervation and Inhibition for relief of cramps and Tense-Relax to increase muscle pliability.

To read: How To Connect With A Sports Team, click here.

Because Brown works with the Lowell Lock Monsters throughout the season, as well as during training, she sees the players pregame, postgame, during competition and between games. The key points that differentiate sports massage from other specialties are timing of treatment, and the specific physical challenges of the sport.

Brown's pregame techniques are fast-paced to stimulate blood flow, flush the system and reduce resistance. Overall, she facilitates the players' warm-up, and helps them maintain focus and remain upbeat. During competition, she works primarily as an adviser, answering questions, helping to diagnose injuries and suggesting follow-up treatment. Her postgame techniques are geared toward relaxation and getting the circulation back to homeostasis. She tries to be sensitive to the emotions associated with a win or a loss, and to always convey a positive message.

For maintenance between games, Brown tends to use Swedish massage with deep transverse friction. It is a maintenance massage program, according to Waslaski's teaching, that can best provide the structural changes needed to prevent injuries and enhance athletic performance. Optimally, a maintenance program of sports massage can work with the athletes' schedules to delay or accelerate their periods of peak performance to correspond to the team's schedule of competition.

With hockey players, the majority of requests concern the lower back, hips and shoulder blades. Brown's focal points are usually the rhomboids, levators, trapezius and cervical area, along with the psoas, iliacus, quadratus lumborum (QL), piriformis and glutes. For "homework," she has the athletes stretch the muscles that are short and tight, and strengthen those that are overstretched and tight. With shoulder tightness, for example, she would have them stretch the subscapularis and pectoralis muscles, and strengthen the rhomboids, infraspinatus and teres minor muscles.

Brown is using broadening strokes to warm the fascia of the  iliotibial band, alleviating tension to get into the vastus lateralis of the quadriceps femoris.

In the case of injuries, which often occur in the knees with hockey players, Brown's treatment protocol proceeds as follows in keeping with the approach that she learned from Waslaski: After assessing the active, passive and resisted range of motion, she prepares the area with some general sports massage strokes such as effleurage, kneading and compression. This is followed by strain/counterstrain techniques and myofascial work to release the fibers from their guarded state and access the deeper fibers. She then does some trigger point work, followed by cross-fiber friction and multidirectional frictioning. Brown winds down the treatment by increasing the range of motion, stretching through the use of specific isolated flexibility techniques and PNF.

Brown does not think it is beneficial to work at the level of pain, and will only do so on rare occasions and with clearance from a medical doctor. She thoroughly investigates the cause of recurring pain, and strives to make her clients aware of its cause. Homework frequently involves stretching and the use of a special 2-inch rubber ball for pressure point work; larger athletes may need something the size of a softball. "It's important to give a client one tool at a time, so you can track the progress of that particular approach; otherwise, it's hard to determine cause and effect," she says.

"Jim Waslaski also taught me to observe subtleties of movement and muscle strain in a client's gait," Brown continues. "I watch the players closely, especially as they enter and exit the ring, and I've learned to detect when someone is compensating." Her keen powers of observation enable her to provide valuable feedback to players between games. She'll let them know if she detected any signs of strain that might not have been obvious to them during competition, such as favoring one side, skating that is not as smooth as it usually is, or "sucking wind" from overwork and pain.

When Brown can treat a player soon after an injury or severe strain, she can be invaluable in helping return the player to peak performance quickly so the team is minimally affected. According to Theory and Practice of Therapeutic Massage, Second Edition, by Mark F. Beck (Milady Publishing Company, a division of Delmar Publishers Inc., Albany, New York, 1994), athletic massage can reduce the recuperation time by as much as 50 percent. It is also three to five times more effective in combating fatigue than simply resting, because it encourages lymph drainage to quickly flush out the metabolic wastes of exertion.

Brown recalls working with a sprinter at the University of Massachusetts--Lowell when she volunteered as a massage therapist in the school's Athletic Health Care Department. "The athlete was doing weight-bearing stretching that taxed her lower leg. I switched her to PNF stretching, which allowed her to use her hands to stretch her leg on a daily basis. Head Athletic Trainer Artie Poitras remembers it well: "Joana treated a wide variety of musculoskeletal injuries with profound results," he says. "Her expertise decreased our athletes' recovery time from both injury and intense workouts, which in turn helped to improve their level of performance and workout intensity as never before. The female sprinter went on to finish second in the nation in the long jump."

Another example involved a male 400-meter runner who had chronic hamstring problems for two years. After working with Joana for a month he was symptom-free, and had his best track season in two years.

The rewards of working with professional athletes are immediate. Their bodies are in top condition, so recovery time is dramatically reduced. Because of this higher fitness baseline, results seem almost immediate compared to the weeks it often takes with nonathletes. They do their homework because their bodies and careers depend on it. And when they show up for treatment, because their level of visceral awareness is so high, they can be more specific in "telling you where it hurts."

"Coming from a clinical background, I was accustomed to seeing results," Brown says. "It's gratifying to get that immediate feedback, to see the player you've worked on performing at peak level back on the ice."

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