Diving and Massage: Understanding Risks and Safe Practices

Can you go to massage after diving?

While the allure of a relaxing massage after an invigorating dive is strong, it is generally advised to wait a significant period before receiving a massage due to the physiological changes your body undergoes during diving, particularly concerning decompression sickness risk.

Understanding the Physiological Impact of Diving

Scuba diving subjects the body to increased ambient pressure. As you descend, inert gases from your breathing gas (primarily nitrogen) dissolve into your body's tissues and blood in accordance with Henry's Law. This is a normal and necessary part of diving. The challenge arises during ascent, when the pressure decreases, and these dissolved gases must safely come out of solution and be exhaled. If ascent is too rapid or dive profiles are aggressive, the gases can form bubbles in the tissues or bloodstream, leading to Decompression Sickness (DCS), commonly known as "the bends." Symptoms of DCS can range from mild joint pain and skin rash to severe neurological impairment, paralysis, or even death.

How Massage Affects the Body

Massage therapy involves the manipulation of soft tissues—muscles, connective tissue, tendons, and ligaments—using various techniques. Its physiological effects include:

• Increased Blood Circulation: Massage can enhance blood flow to the massaged areas, delivering more oxygen and nutrients while aiding in waste product removal.
• Enhanced Lymphatic Drainage: It can stimulate the lymphatic system, which is crucial for fluid balance and immune function.
• Changes in Tissue Pressure: Applied pressure can affect local tissue perfusion and interstitial fluid dynamics.
• Muscle Relaxation and Reduced Spasm: By reducing muscle tension and promoting relaxation, massage can alleviate soreness and improve flexibility.
• Nervous System Modulation: Massage often induces a parasympathetic (rest and digest) response, leading to overall relaxation.

The Intersection: Massage and Post-Dive Physiology

The primary concern regarding massage after diving centers on its potential interaction with the inert gas off-gassing process and the risk of DCS.

• The Primary Concern: Decompression Sickness (DCS) Risk: The theory is that increased blood flow and lymphatic circulation, or direct tissue manipulation, could potentially:

  • Promote Bubble Formation: If dissolved gases are still supersaturated in tissues, increased blood flow could theoretically facilitate the formation of new bubbles by rapidly transporting gas to nucleation sites.
  • Mobilize Dormant Bubbles: Existing, asymptomatic "silent" bubbles (which often form after dives but are safely reabsorbed) could be mobilized by massage, potentially growing in size or traveling to more critical areas, thus precipitating symptomatic DCS.
  • Alter Gas Kinetics: Rapid changes in local blood flow or tissue pressure might interfere with the controlled, gradual off-gassing process the body relies on to prevent DCS.

• Divers Alert Network (DAN) Guidelines: DAN, a leading authority on dive safety, advises caution regarding activities that significantly alter circulation or metabolic rate immediately after diving. While not explicitly prohibiting all forms of massage, their general guidance leans towards avoiding activities that could theoretically increase DCS risk. The consensus among dive medicine experts is that it's prudent to allow sufficient time for inert gas elimination before engaging in activities that might significantly alter circulation or tissue dynamics.

• Type of Massage Matters: The intensity and type of massage are relevant. A very light, superficial relaxation massage might pose less risk than a deep tissue, vigorous, or percussive massage that significantly alters blood flow and tissue pressure.

Recommended Waiting Periods

While there's no universally agreed-upon definitive waiting period for all types of dives and all types of massage, conservative recommendations are paramount for diver safety.

• General Guideline: Many dive professionals recommend waiting at least 12-24 hours after your last dive before undergoing any significant massage, especially deep tissue or vigorous techniques.
• For Repetitive, Deeper, or Decompression Dives: A longer waiting period, potentially 24-48 hours, is advisable due to higher inert gas loads and potentially longer off-gassing times.
• For Very Shallow, Short Dives (e.g., single no-decompression dive): While the risk is lower, a conservative approach still suggests waiting several hours, ideally overnight.

Benefits of Post-Dive Massage (When Safe)

Once a safe waiting period has passed and the body has adequately off-gassed inert gases, massage can offer several benefits for divers:

• Muscle Soreness Relief: Diving, especially with heavy gear or in strong currents, can lead to muscle fatigue and delayed onset muscle soreness (DOMS). Massage can help alleviate this.
• Relaxation and Stress Reduction: The physical and mental demands of diving can be significant. A massage, once safe, can provide welcome relaxation and promote recovery.
• Improved Circulation (Later Stage): After the risk of DCS is mitigated, improved circulation can aid general recovery and nutrient delivery to tissues.

When to Absolutely Avoid Massage After Diving

• Any Signs or Symptoms of DCS: If you experience any symptoms of decompression sickness (joint pain, numbness, tingling, rash, unusual fatigue, dizziness, visual disturbances, etc.) after diving, do not get a massage. Seek immediate medical attention and inform them of your dive history.
• Feeling Unwell: If you feel unusually tired, nauseous, or generally unwell after a dive, postpone the massage.
• Immediately After a Challenging or Deep Dive: The higher the inert gas load, the greater the caution should be.

General Recommendations and Best Practices

• Hydration is Key: Ensure you are well-hydrated before, during, and after diving. This aids in overall physiological function and potentially inert gas elimination.
• Listen to Your Body: Pay close attention to how you feel after a dive. If something feels off, err on the side of caution.
• Consult Dive Tables/Computer: Understand your dive profile and residual nitrogen levels indicated by your dive computer.
• Communicate with Your Massage Therapist: Inform your massage therapist that you have been diving and when your last dive was. This allows them to adjust their techniques or advise against the session if necessary.
• When in Doubt, Wait: It is always safer to wait longer than to risk a potential DCS incident.

Conclusion

While the desire for post-dive relaxation through massage is understandable, prioritizing safety is paramount. The potential for massage to influence inert gas kinetics and increase the risk of decompression sickness warrants a cautious approach. Adhering to recommended waiting periods, particularly for deep or repetitive dives, and listening to your body's signals are crucial steps to ensure that your post-dive recovery is both relaxing and safe.