Top 10 Muscle Groups to get Sports Massaged

From the viewpoint of a Sports Massage Therapist, there's no one "best" area to get massaged - it fully depends on your individual scenario; based on your routine, the sports you do and love, as well as your anatomy and history of injury.

But, over the last 8 years of being a Sports Massage Therapist, I have wondered, how much of my time is spent focusing on the various regions of the body... So, I went through my notes of all the massages I have done over the last several years to give you a comprehensive TOP 10 MOST POPULAR BODY PARTS TO GET MASSAGED.

10. TRICEPS (1.77%; 74.5 hours)

    
    

The Triceps are a muscle group that resides on the posterior side of the upper arm. As the name suggests, the Triceps consist of three muscles that work in unison to help extend the shoulder and the elbow. This routine often includes the posterior and intermediate Deltoids, with some work done to the insertions of the rotator cuff (teres) and latissimus dorsi as well as the origins of the muscles in the forearm (extensor carpi radialis longus & brachioradialis).

It pairs particularly well with the upper back routine as the client is often face down in a prone position, lending itself to an easy and productive routine to help supplement the Upper Back focus. The Triceps are also a powerful group of muscles that can get tight and fatigued, and hence a lot of benefit can be had from getting some TLC. The Triceps also pair well when someone is looking for maintenance with the rotator cuff or irritation around the elbow.

Why aren’t they more popular? They’re out of sight, out of mind and pretty resilient and, as a result, it’s often just not a priority. Clients often have one hour of hands on massage time, and there are usually more pressing areas to address. Therefore, it’s often massaged as a result of my suggestion rather than the specific request of the client. Triceps can be underutilised when it comes to clients training and hence not in need of maintenance compared to other muscle groups. This, plus the Triceps can be surprisingly tender, especially when I begin to dig the thumbs into the muscle tissue. This can put clients off requesting it, even when I do adjust my pressure after all, whilst I want to keep up the intensity, I also need to be compassionate to the client’s pain threshold. But even then, it might make people think twice.

9. SHINS (1.90%; 80 hours)

   
   

A somewhat unusual entry - the Shins! Or, more specifically, the anterior portion of the lower leg. It’s such an underrated area that even after 8 years, a lot of clients are surprised that I can do anything for this region at all. And, yes, whilst there is limited musculature compared to other areas, there it still plenty to address, whether it be the tibialis anterior, the peroneals (brevis/longus) and/or the extensors of the hallux (big toe) and digitorium (toes).

I often utilize this routine when a client is complaining about ankle irritation and/or limitation, most commonly with runners who have just started or those who have increased their mileage. It's also an area to keep in mind when a client believes they might be suffering with shin splints - albeit cautiously as it can be very tender.

It's not the most popular routine because it is quite niche, and it's not the first region that comes to mind when getting a sports massage. And, as said, depending on the person and their choice of activity, it can be quite a tender routine. But despite all this, once people have been introduced to the Shins and had them massaged, the improvements they observe are enough to keep requesting it - and hence securing the Shins a place in the Top 10 areas treated.

8. ITB (3.69%; 155 hours)

   
   

In eighth place - with a big jump up in hours massaged - we have the ITB's, having massaged them almost twice the time I spent on 9th placed Shins! The ITB routine tackles the general lateral thigh region, mostly addressing the biceps femoris and vastus lateralis of the Hamstrings and Quadriceps respectively, in addition to the TFL (tensor fascia latae) and a bit of the lateral glutes too. The ITB itself does also receive treatment, but due to the ITB being connective tissue rather than muscle, it behaves and responds differently to massage techniques and hence requires a more nuanced approach.

It's popular as it's often a very achy area, and niggles in the quads/hams were regularly seen in the lateral thigh. In these cases, the client and I opt for an ITB routine to allow extra exploration to address potentially knotted areas in these muscles. This is a particularly good routine for assessing the TFL’s condition e.g. tenderness could imply fatigue and hence misfiring of the gluteus medius. The ITB is a bit of a buzz word that seems to rise and fall depending on various influences, including social media, and I see a correlation with this exposure with client requests, regardless of actual issues that clients seem to face. The ITB was a common choice during 2018-2021 but the ITB routine has seen much less action in more recent years.

It's less popular mainly due to the discomfort. Pressure on the ITB itself can be very uncomfortable. Combine this with the soreness of the vastus lateralis - and the sometimes burnt out TFL - it can make for one of the more unpleasant routines, especially if I'm doing a thorough session rather than maintenance. Despite this, it’s still proven to be popular enough to earn it 8th place on my list. 

7. GLUTES (6.46%; 272 hours)

   
   

Another big jump up from 8th place going up 100+ hours to #7 - the Glutes! If someone had told me how many buttocks I'd have ended up massaging at the start of my sports massage therapist journey, I'd have been a fair bit bashful! The glute routine focuses on the main three gluteal muscles, the gluteus maximus, gluteus medius and gluteus minimus, in addition to a regular trouble maker, the piriformis. Plus, due its proximity and relationship with the glute medius, emphasis can also be given to the TFL too.

To a non-massage goer, this might seem an unusual and oddly intimate area to see in the Top 10. But with the glutes being the biggest muscle group in the body and its proclivity to be problematic, whether it be misfiring in the medius, overuse of the maximus or even sciatic irritation as a result of tightness in the piriformis, it’s far more common than one might give it credit for. Even for just maintenance, massaging the glutes has a lot of benefits, as the glutes are the major muscles that help us stand up right and a big contributor to squats, running and almost anything incline/step up related. So keeping these muscles well maintained, mobile and functional is in most people’s best interest.

It is not as popular as it could be, and this is almost entirely down to it being an intimate and private area for a lot of people, and a lot of clients simply aren't comfortable having their glutes on show - let alone touched - by another person. Whilst I do try my best to retain their modesty throughout using towels, there's always got to be a sizable portion of one of the glutes shown at any time. But my efforts do put a good few clients at ease, and they understand and see the benefit once they’ve had a glute massage. Overall though, there's few excuses why one should avoid what is otherwise a very productive area to be treated.

6. CALVES (8.84%; 372 hours)

   
   

With another 100 hours more than 7th place, we see Calves take the 6th spot, just missing out on a Top 5 finish. The calves are one of my favourite routines, with it being a fairly simple area to work on, but offers a lot of variety from person to person, and it's one of the regions I see the biggest improvement with, post massage! The key muscles here are the gastrocnemius and soleus, with a lesser focus on the tibialis posterior and the flexors of the digitorium and the hallux also residing in this region.

The calves are often picked by clients, usually without much input or suggestion from me... unless someone is clearly avoiding them because they know it needs to be done but anxious about how sore they might be! I’ll often compromise and suggest we pursue at least some maintenance work to break us in. For the majority, calves are picked for maintenance, but often deeper techniques are required to purge this region of tension more thoroughly. Calves are often recommended when the clients are suffering with cramps, achilles issues or even plantar fasciitis as tight calves can increase the risk of all of these.

Whilst the calves are a popular choice, and often one of the most rewarding, it's not the most enjoyable. The gastrocnemius is very exposed and at my mercy, often manipulating it from the medial, lateral and posterior sides, leaving the aches and niggles very few places to hide from my thumbs, palms, knuckles, and, if I'm feeling particularly cruel, forearms. This does mean there are a few clients who can be hesitant to return to this region, but for the majority, it's worth the discomfort.

5. QUADS (10.42%; 438 hours)

   
   

We break into the Top 5 with a powerhouse - the Quadriceps! As the name suggests, this region consists of four muscles, the vastus lateralis, vastus medialis, vastus intermedius and the rectus femoris. The former three all do the same job, namely extension of the knee joint, with their names reflecting where they are positioned on the femur. Meanwhile, the rectus femoris has a secondary function, being a hip flexor, supporting the psoas. The four quads come together towards the knee to form the quadriceps tendon before inserting on the patella. In addition to the quads, there are other muscles like the psoas insertion, sartorius, the TFL and the lower portion/distal ends of the adductors who all get some work done during the Quad routine.

The quads are a regular choice for many clients, simply due to how involved the quads are in most activities. This means they often need a fair amount of maintenance. Achy knees are often improved from releasing tension from the quads, by alleviating pressure from the quadriceps tendon, giving some freedom for the knee to flex. A good MET or PNF stretch for knee flexion and/or hip extension works a charm here too. 

Despite being a highly productive area to massage and treat, like the calves, they can be a very sore muscle group to work with, most notably the vastus lateralis and the psoas isolations when doing a thorough routine. This can put people off wanting regular deep tissue love, despite how good regular maintenance can be for them, and hence Quads misses out on a Top 3 position.

4. HAMSTRINGS (10.58%; 445 hours)

   
   

In a tight race to fourth place, the Hamstrings just pip the Quadriceps to the line with only several hours worth of massage between them. The Hamstrings, like the quads, are a powerhouse of their own. Working with the glutes to keep us up right, as well as big movements like squatting. The muscles focused here include the biceps femoris, semitendinosus and semimembranosus - in addition to the lower gluteus maximus, and the posterior adductors (e.g. adductor magnus).

Even when healthy, the hamstrings are often pretty tight muscles. But despite this, they aren't particularly painful to be massaged (most of the time!) compared to their anterior counterparts. Like many others on this list, they are very productive to have massaged for day-to-day life, and as a result, they have become a client favourite. A huge range of people are susceptible to tight hamstrings, from those who are more sedentary to the more active ones - just sitting, especially for prolonged periods of time, can allow the hamstrings to shorten. All this, plus with tight hamstrings being a potential contributor to lower back issues, the Hamstring massage is very popular. It's a great routine to have some MET and/or PNF stretch work for hip flexion to really make the most of the massage and improve a key range of movement.

If it's so good, why are Hamstrings not in the Top 3? It comes down to client priorities, and often the hamstrings are out of sight, out of mind and hence aren't the first area a client may have in mind to spend time on. Moreover, the hamstrings are very resilient, so some clients don't appreciate how in need of some TLC their hamstrings are until they are significantly tight. Moreover, the upper legs can be difficult for clients who struggle with body confidence, as it requires a client to remove shorts/trousers etc.. But once a client sees how productive yet relatively pain-free a hamstring session can be, they quickly put hamstrings into their treatment rotation.

3. NECK (527 hours; 12.53%)

   
   

Starting our journey into what may be a fairly predictable Top 3, we begin with… the Neck. Whilst the neck is maybe not the first area when you think about muscular development, the trapezius - one of the larger muscles in the body - makes up a sizable portion of the neck's musculature and hence gathers a lot of mechanical tension. In addition to the traps, the other key muscles dealt with during the massage are the levator scapulae, multifidus and the erector spinae whilst the scalenes, platysma and the sternocleidomastoid (SCM) are addressed when working on the lateral and anterior portions of the neck when a more thorough maintenance is needed.

Away from exercise and activity, the neck is working hard to keep our rather heavy heads upright, so with screen time, from phones to laptops, soaring to new heights in recent years, the neck has suffered greatly. People also hold stress in the upper shoulders and neck, and when coupled with the fact that the stress is often the result of the time spent on said laptops and screens, clients are desperate for a neck massage and pick it time and time again. This means there are often good knots to work with, especially in the upper fibers of the traps, and is hence a greatly rewarding place to utilize Triggerpoint Therapy (TPT). The neck is regularly paired with the Upper Back to give the trapezius a full seeing to. But even if the neck is just feeling a bit stiff, it can bring a lot of relaxation and relief. Therefore, I opt to leave the neck routine until last as it often allows the client to unwind - especially if I've been mean to other muscle groups prior! 

Saying that, if the back is fatigued or showing signs of burnout, and/or the client is acutely stressed, this area can become a hot bed for soreness and tenderness, so a more cautious approach is needed. Too much pressure from my thumbs, knuckles etc., and I may end up contributing to the issue rather than helping. Because of the multitude of factors that impact the neck, the condition of a client's neck can vary drastically. One week, a client's neck may present as tender, and then totally fine and relaxed during another. This inconsistency can make people think twice about a neck routine. But for the vast majority, the neck is a highly valued and very regular session and is considered an essential.

2. LOWER BACK (628 hours, 14.95%)

   
   

With over 100 hours ahead of the Neck, we arrive at second pace - the Lower Back. Another greatly popular option for maintenance, driven by the Lower Back’s tendency to house aches and pains regularly. Some significant muscles reside here, including the latissimus dorsi, multifidus, serratus posterior inferior, erector spinae, quadratus lumborum, top of the gluteus medius and the lower fibers of the trapezius. Other muscles who benefit, but aren’t necessarily targeted, are the transverse, external and internal obliques.

It's a very safe option and it is often chosen when there's not an issue at play as it feels nice to have massaged, hence raking up a lot of hours from just maintenance alone. But it's not all fun and games. Some clients suffer with chronic back pain, whilst others have more short-term, subacute pain. When the Lower Back is in pain, it's often not the cause of its own demise. Dysfunctions and tightness in the hip flexors (psoas major/minor), sacroiliac, the glutes and/or the hamstrings can all be contributors to Lower Back problems. As a result, the Lower Back is often paired with one of these other regions to really tackle the potential causes for the clients pain, given their specific situation. Otherwise, like the Neck, it pairs really well with a general back maintenance in the absence of any specific issues.

So why not number 1? It’s just not quite as troublesome for most of my clients as the #1 region is, and hence not requested as much. But with the Lower Back occupying 15% of all my massage time, it has breezed its way to #2 from being a key trouble area and, in the absence of pain, an otherwise inoffensive and rather relaxing routine.

1. UPPER BACK (964 hours; 22.93%)

   
   

The undisputed champion of regions to be massaged… we bow to the Upper Back. A centre for stress based tension as well as a variety of mechanical issues for a wide range of muscles. It's a hugely busy area, from strong, activity-orientated muscles, to many postural focused ones. The biggest muscles home here are the trapezius (covering almost the entirety of the area), plus the upper lats, rhomboids, serratus posterior superior, rotator cuff muscles (including infraspinatus, supraspinatus and teres minor), erector spinae, multifidus and the muscles at the base of the neck, notably the levator scapulae. The huge variety of muscles makes for a minefield of knots. There's so much I look out for, with so many muscles prone to be problematic, or at least somewhat irritable or tight.

In the modern world, there is a lot of demand to be sat at a desk and/or in a car for prolonged periods of time. This results with the shoulders rounding forwards, weakening the back muscles. In addition to this, as said, the Upper Back is a centre for holding stress. Stress can reduce the threshold for muscular tolerance, making the muscles feel more tired and hence less able to cope with the demands of the workday, let alone exercise. This makes it often a primary choice to assess, isolate and manipulate. And if it's not selected for deep tissue work to really dig into the muscles, it's picked for maintenance to take the edge off the tension and free up some mobility.

Among the sheer variety of issues and dysfunctions the upper back can face, some are very painful, especially when a strain is involved or if a 'knot' has developed in a high traffic muscle tissue - the latter requiring more oomph and multiple rounds of TPT to really get in there. But despite this, it doesn't put clients off picking this region to be massaged, whether it be some nice TLC or more heavy duty tension busting. The Upper Back clearly dominates the body when it comes to choice of massage routines; clocking nearly 300 hours more than second place. Quite the formidable victory!

Thank you for reading! Want to see what the least common massage routines are? Watch this space! I'm still writing that one!