RESPONSE

Dear Editor-in-Chief: With regard to Dr. Moraska's contention that our work (3) does not have external validity: we are in complete agreement that massage applied 15 min after a 10-km race is irrelevant for lactate clearance. This is why we state in the introduction that the only situation where massage might be relevant in terms of "lactic acid" removal is "in athletic events that involve intermittent bursts at a high power output where substantial lactic acid production would occur and rapid recovery is required." This is the context in which our study has external validity. We would categorically disagree with Dr. Moraska if his view was that massage could not be implemented in certain important muscle groups "between shifts" in basketball or football, for example, if the goal was to enhance "lactic acid" removal. Whether massage is not applied as such is not because it cannot be but because it has not been considered. This is where our issue with the "myth" of massage efficacy for "lactic acid" removal comes in; namely, the contention that it elevates muscle blood flow. Under resting conditions, it has already been established that massage does not enhance limb blood flow (2), but nothing is known about after exercise where blood flow is still elevated. With regard to Dr. Moraska's contention that the reported group differences are due to incorrect application of statistics: he is in error when he states the 30-s postischemic handgrip (IHG) data are "before intervention" and therefore the "values should be equal between groups" such that "not accounting for baseline differences misrepresents the intervention effect." The 30-s postexercise data are not before intervention. In the Methods sections, "Post-IHG active recovery and massage (p. 1063)," we state "After 2 min of IHG, the subject lay quietly with the forearm at rest for 30 s, at which time active recovery/forearm massage began." In the Methods section, "Post-IHG data acquisition (p. 1064)," we state "…(data) were obtained over an approximately 20-s period every minute starting at 30 s post-IHG..." The reduced blood flow in the massage and active recovery at 30 s after IHG is therefore due to the well-documented impairment effect of mechanical compression and muscle contraction. Indeed, the groups were identical at this time point in terms of arteriovenous [lactate] difference and in terms of blood pressure for massage and passive recovery. (Of course, active recovery would have a higher blood pressure at this time since contractions have begun and there is an immediate effect on arterial blood pressure with forearm contractions (1).) In conclusion, no study has investigated the efficacy of massage in removing "lactic acid" from exercised muscle, and our study examined the immediate postexercise condition because this is the only time that such efficacy might be relevant. Our statistical analysis and data interpretation was appropriately based on intervention differences from control at 30 s after exercise and beyond. Dr. Moraska's inference of "questionable results interpretation" is unfortunate, as it is based on his error regarding the experimental conditions at the 30-s postexercise time point. Michael E. Tschakovsky, PhD E. Victoria Wiltshire, MSc School of Kinesiology and Health Studies Queen's University Kingston, Ontario, Canada

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