Sports Massage to Improve the Immunoglobulin A (Iga) and the

Hormon Beta Endorphin

Bambang Priyonoadi

, Panggung Sutapa

, Ali Satia Graha

Sport Science Department, Universitas Negeri Yogyakarta, Jl. Colombo No.1 Yogyakarta, Indonesia

Keywords: Sports massage, high intensity, weight training, IgA, beta-endorphin

Abstract: Background: Massage may decrease muscle tension, accelerate blood circulation, increase nerve

conductivity and hormonal changes, and increase immunity. Sports massage may also increase the level of

beta endorphin (BE) hormone and immunoglobulin A (IgA) to accelerate the recovery of athletes.

Objective: The aim of this study was to evaluate evidence of the effect of exercise massage on changes in

IgA and BE hormone levels. Method: This research was an experimental research with the pre-test – post-

test design. Research subjects were taken by inclusion: 1). 3rd year student of Sport Science Department,

Yogyakarta State University, Indonesia, 2). Male students, 3). Healthy, and 4). Willing to be the subject of

research. There were 18 students divided into 2 groups namely: treatment group I (K1), which was given

sports massage, and group II (K2) as a control group, treated with placebo massage. The blood samples

were taken through in vena cubiti of both control and experiment groups before and after treatment, and

examined for the level of beta endorphin (BE) hormone and immunoglobulin A (IgA), by using instruments.

The treatment for all the groups were physical exercises in the form of circuit weight training with 12

sessions and 10 repetitions/sets of 3 sets at high intensity for 60 minutes. After completion of circuit weight

training, all samples were rested for 60 minutes. After the breaks, then all of the samples in each group were

given 45 minutes massage treatment in the form of sports massage and placebo massage treatment for the

group I and group II, respectively followed by resting for 60 minutes. Results: The exercise significantly

increased the average IgA immune level by 36.22 mg/dl and beta-endorphin hormone levels by 1.65 ng/ml

(F> 0.05). Conclusion: Sports massage to athletes performed heavy work and or exercise at high intensity

could increase IgA and BE hormone.

1 INTRODUCTION

The massage is often undertaken to reduce the

movement errors due to daily or exercise activities.

The massage, including sports massage, is a massage

that is specifically used or given to healthy people,

especially sportsmen. The objects of sports massage

are certain body parts of a healthy person.

Manipulation is a method of gripping, which is a

way of using the hands to adjust to certain areas of

the body and also to give certain influences (Findley,

2010). The manipulation techniques that are often

used in massage according to Paine (Paine, 2015)

are effleurage (rubbing), petrissage (squeezing and

pressing), shaking, friction (grinding), tapotemen

(beating, hacking, clapping), walken (variations of

rubbing), vibration, stroking, skin-rolling (folding

the skin), chiropractice (tapping). Those

manipulation techniques are often used in sports

activities. There are 9 types of manipulation taught

in FIK UNY (Priyonoadi, 2011) namely effleurage

(rubbing), petrissage (squeezing and pressing),

shaking, friction (grinding), tapotemen (beating,

hacking, clapping), walken (variations of rubbing),

and vibration. In this study, the manipulation

technique used only 9 kinds of manipulation, namely

(rubbing), petrissage (squeezing and pressing),

shaking, friction (grinding), tapotemen (beating,

hacking, clapping), walken (variations of rubbing),

and vibration.

Sports massage is known as a manual and

manipulative therapy. This is a physical treatment

mainly used in the neuromusculoskeletal system to

treat pain and disability. The type and method of

massage are preferred to make muscles relaxed and

to improve the blood circulation for recovery

704

Priyonoadi, B., Sutapa, P. and Graha, A.

Sports Massage to Improve the Immunoglobulin A (Iga) and the Hormon Beta Endorphin.

DOI: 10.5220/0009801807040709

In Proceedings of the 3rd Yogyakarta International Seminar on Health, Physical Education, and Sport Science in conjunction with the 2nd Conference on Interdisciplinary Approach in Sports

(YISHPESS and CoIS 2019), pages 704-709

ISBN: 978-989-758-457-2

between training or high intensity competition

sessions, reducing the possibility of tissue damage

(Arroyo-Morales et al, 2009), decreasing heart rate,

improving the blood circulation and pressure,

reducing muscle tension, increasing joint motion,

and reducing pain (Callaghan, 1993), as well as

multidirectional changing in the metabolism of

important biological compounds, improving the

functional state of neuromuscular devices and

activating energy production (Bykov et al, 2011).

Therefore, the massage can help the athletes achieve

the effective recovery.

Massage after an intense exercise may increase

the IgA level (Saman et al, 2011). Similarly,

(NCCAM, 2012) concluded that a Swedish massage

session indicates a measurable biological effect and

could have an effect on the immune system. As

expressed by Major et al (Major et al, 2015), the

provision of massage effleurage in mouse showed a

trend of increasing the number of thymocytes in T

cells in lymphoid organs increasing the IgA immune

production. Similarly, massage affecting BE

hormonal changes was seen in Fraser's and Cooper

(Fraser & Cooper, 2009) and (Rokade, 2011)

massage studies. BE hormone interferes the pain

transmission by increasing the circulation of

naturally-produced neurotransmitters in neural

synapses in central nervous system pathways.

Endorphins bind to the pre-synaptic membrane,

inhibiting the release of substance P which may

inhibit the transmission of pain, resulting in less

pain.

It is possible that IgA immune and hormone

levels BE levels can be used as a parameter to

predict the health level of the body after

experiencing high-intensity exercise, such as a

circuit weight training. Therefore, the research about

the benefit of sports massage to immunoglobulin A

(IgA) and beta endorphin (BE) hormone levels need

to be conducted.

2 METHODS

2.1 Research Instruments

The IgA immune level was examinaned by ELISA

(Enzyme-Linked Immunosorbent Assay) method

carried out by indirect sandwich using Siemen

Healthcare Diagnostics Inc., (SIEMENS, 2008).

Data were interpreted using Elisa Reader with 95%

sensitivity.

The BE hormone level was examined by ELISA

(Enzyme-Linked Immunosorbent Assay) method

carried out by the indirect sandwich using

Peptide Enzyme Immunoassay (IEA, 2014). Data

were interpreted using Elisa Reader with 95%

sensitivity.

2.2 Research Subject

This experimental research was conducted using a

pre-test post-test design (Sugiyono, 2013),

(Sugiyono, 2014). The research subjects were 23

males and during the research process there were 5

subjects who could not continue the research, so that

the entire subject was 18 males and healthy sport

science students of Yogyakarta State University,

Indonesia. Prior to the research, the subjects signed

consent letters stating the willing to be the subject of

research. During the research, the subjects divided

into 2 groups, namely treatment (K1) and control

(K2) groups. The K1 and K2 groups were treated

with sport and the placebo massages respectively.

2.3 Procedure

All the groups (K1 and K2) took a preliminary test

(pre-test). 7 mL of blood sampling of the subjects

were taken from the cubital vein. The

immunoglobulin A (IgA) and beta endorphin (BE)

hormone levels of the blood were examined in the

lab using instruments. The blood tests (post-test)

were again undertaken after the subject finished

activities including physical activity training that

was a circuit weight training of 12 sessions and

repetition 10 times / set as many as 3 sets at high

intensity for 60 minutes. Workout load of each

muscle was 30% from 1 RM, each session took 30

seconds, and the breaking interval between training

sessions to another session was 60 seconds. The

breaking interval between sets was 3-5 minutes. The

breaking interval was used as a substitute for

exhausting activities before being treated using

massage. After resting for 60 minutes, 45 minutes

sports massage was given to the group K1 and the

placebo for group K2, and another 60 minutes rest.

Measurements 1 and 2 were performed with the

sample in the position of sitting. In the research

process, there were 2 people who resigned because

they were unable to continue the research and 4

participants with the extreme data results so that the

total sample that could be analysed was 18. Data

takers were experts of Prodia Laboratory located at

Jl. Bintaran Kulon No. 28 Yogyakarta, and expert

therapists (masseurs) were professional therapists

from the FIK UNY Therapy Clinic.

Sports Massage to Improve the Immunoglobulin A (Iga) and the Hormon Beta Endorphin

705

2.4 Data analysis technique

Normality (Shapiro-Wilks), homogeneity (Levene

test), and T-test of data were undertaken by using

SPSS V.19.0 suit of program.

3 RESULT AND DISCUSSION

3.1 Description of Research Data

Immunoglobulin A (IgA) and beta endorphin (BE)

hormone levels of pre-test and post-test were

obtained and calculated to determine the gain scores

(GS). The positive value (+) indicates the increasing

Immunoglobulin A (IgA) and beta endorphin (BE)

hormone levels after treatments. Statistic parameters

of the data are given in Table.

Table 1: The Increase of IgA Immune Levels (mg / dl) in Experimental and Control Groups.

VARIABLE EXPERIMENTAL GROUP CONTROL GROUP

Independent

Variable

GS (Post-Pre)

POST PRE POST PRE

SPORT MASSAGE

337 302 35 192 194 -2

307 258 49 388 361 27

320 284 36 197 187 10

237 208 29 307 298 9

250 205 45 220 211 9

242 214 28 178 174 4

220 183 37 229 228 1

304 259 45 209 213 -4

276 254 22 316 325 -9

Σ= 326 Σ= 45

Mean 36.22 Mean 5.00

Std. Dev 8.955 Std. Dev 10.512

Min22Min-9

Max 49 Max 27

Table 1 describes the results of research on the

Gain Score (GS) for the experimental group of

sports massage on the IgA immune level with the

total amount (Σ) of 326 mg/dl, the mean value (

) of

36.22 mg/dl, standard deviation 8.955 mg/dl, the

minimum value of 22 mg/dl, and the maximum

value of 49 mg/dl. On the other hand, the GS on the

IgA immune level in the control group was the total

amount (Σ) of 45 mg/dl, the average value (

) of 5

mg/dl, the average value (

) 5.00, and standard

deviation of 10.512 mg/dl, with the minimum value

of -9 mg/dl and the maximum value of 27 mg/dl.

Table 2: The Increase in BE Levels (ng/ml) in the Experimental and Control Groups.

VARIABLE EXPERIMENTAL GROUP CONTROL GROUP

Independent Variable BE HORMONE

GS (Post-Pre)

BE HORMONE

GS (Post-Pre)

POST PRE POST PRE

SPORTS MASSAGE

9.52 8.53 0.99 14.83 14.98 -0.15

11.15 9.37 1.78 7.97 7.41 0.56

10.13 8.99 1.14 14.53 15.38 -0.85

13.83 12.14 1.69 9.65 9.37 0.28

14.03 11.5 2.53 13.63 13.07 0.56

13.44 11.88 1.56 16.16 16.53 -0.37

15.72 13.07 2.65 12.61 12.56 0.05

11.1 9.46 1.64 13.5 13.76 -0.26

11.32 10.42 0.9 8.64 9.1 -0.46

Σ= 14,88 Σ= -0.64

Mean 1.6533 Mean -.0711

Std. Dev .61838 Std. Dev .47745

Min .90 Min -.85

Max 2.65 Max .56

YISHPESS and CoIS 2019 - The 3rd Yogyakarta International Seminar on Health, Physical Education, and Sport Science (YISHPESS

2019) in conjunction with The 2nd Conference on Interdisciplinary Approach in Sports (CoIS 2019)

706

Table 2 describes the results of research on the

Gain Score (GS) for the experimental group of

sports massage on the value of the BE hormone level

with the total level (Σ) of 14.88 ng/ml and the

average value (

) of 1.6533 ng/ml, standard

deviation .61838 ng/ml, minimum value of .90

mg/dl, and maximum value of 2.65 ng/ml. Whereas

the GS level of BE hormone in the control group

was gained the total score (Σ) of -0.64 ng/ml and the

average value (

) of -.0711 ng/ml, standard

deviation of .47745 ng/ml with the minimum value

of -.85 ng/ml, and the maximum value of .56 ng/ml.

3.2 Presentation of Test Results Test

Requirements.

The normality test of immunoglobulin A (IgA) and

beta endorphin (BE) hormone levels data indicates

that data is normally distributed with p ˃ α 0.05.

The homogeneity test of immunoglobulin A

(IgA) and beta endorphin (BE) hormone levels data

is analysed by using the Levene's technique. It is

obtained that F> α 0.05, meaning the working

hypothesis is rejected and the null hypothesis is

accepted. Thus it can be concluded that the final

Gain Score (GS) data of the population variants in

the treatment group is homogeny.

Table 3: T-test

t-test for E

ualit

of Means

t df Sig.

(2-

tailed)

Mean

Diff

Std.

E. D

95% Confidence

Interval of the

Difference

Lowe

Uppe

GAIN SCORE IgA

Equal variances assume

6.783 16 .000 31.22 4.603 21.46 40.980

Equal variances not assume

6.783 15.606 .000 31.22 4.603 21.44 41.000

GAIN SCORE BE

ual variances assume

6.622 16 .000 1.724 .2604 1.172 2.27651

ual variances not assume

6.622 15.03 .000 1.724 .2604 1.169 2.27939

Based on the results of data analysis through the

Simultaneous Confidence Interval presented in table

5, the confidence level was 95%. It can be argued

that with a 95% confidence level there was an

increase in the Iga and BE variables. The degree of

changes in the increase of IgA was at the lowest

level of 21.464 mmHg with the coefficient of 31.222

mg/dl, whereas the increase of BE hormone was at

the lowest level of 1.17238 ng/ml with the

coefficient of 1,72444 ng/ml.

Based on the presentation of the results of T-test

data analysis in Table 5., the Gain Score (GS) data

of the whole group of sports massage treatment and

in the control group on the immune measurement

test of IgA and BE hormone levels have been found

significance F> α 0.05, meaning the working

hypothesis is rejected and the null hypothesis is

accepted. So it can be concluded that the final Gain

Score (GS) data: 1) Sports massage has a significant

effect on elevated IgA immune levels; 2) Sports

massage may have a significant effect on elevated

levels of the hormone BE.

The results showed that: 1) Sports massages may

increase the average IgA immune level by 36.22

mg/dl and have a significant effect of F> 0.05; 2)

Sports massage may increase hormone levels to 1.65

ng/ml and have a significant effect due to F> 0.05.

3.3 Discussion

Agreeing with Tejero's statement (Tejero-Fernandez,

Membrilla-Mesa, at al 2014), the best

way to describe the practice of massage to

mechanically manipulate body tissue was by

applying rhythmic pressure. Furthermore, Field et al.

(Field, Diego, Hernandez, 2010) stated that one of

the mechanisms giving to massage impacts is by

stimulating mechanoreceptors nervous system found

in the skin (eg. Meissner and Pacinian corpuscles,

Merkel disc tip, Ruffini and free nerve endings). The

pressure applied to the receptors activated pathways

that send signals along nerve fibres and myelin to

limbic regions of the brain (Sliz, Smith, Wiebking,

Northoff, Hayley, 2012) or affected the release of

such substances P or serotonin considered

responsible for mediating 'relax' (Listing, et

al. 2010).

These suggested that emotion and

neuronal modulation were key elements for the

effectiveness of massage therapy. Major et al

believed catecholamine released in lymphoid organs

under central nervous system control was known as

regulators of the immune repertoire.

The mediation of massage increases

catecholamine. Banker (Banker, Christine, Waters.,

2013) stated that the effleurage massage to rats may

Sports Massage to Improve the Immunoglobulin A (Iga) and the Hormon Beta Endorphin

707

significantly decrease fluorescence intensity in both

the cortical and cortico-medullary intersections. This

is in line with the opinion of Herman et al (Herman,

Poindexter at al 2012) that the large noradrenergic

nerve plexus predominates in the subcapsular cortex

and the corticomedullary junction, where reside

thymocytes are more mature. Reinforced

by Major's research previous studies conducted on

human’s show that the effleurage massage enhances

vagal activity through stimulation of pressure

receptors which in turn signals the limbic system

reduces norepinephrine release in the bloodstream

causing regulation of overall sympathetic activity.

Interestingly, Major's research and other research

groups have shown sympathetic nerves that

lymphoid innervate tissue as one of the major

pathways of the nervous and immune systems

communicate to maintain body homeostasis (Diego

at al, 2009), (Field, 2008), (Pilipovic et al, 2012),

(Leposavic at al, 2011), (Leposavic & Perisic, 2008)

The results of the above analyses indicate that

sports massage can increase the immune IgA levels

physiologically due to the result of treatment of

manipulation in sports massage as much as 9 (nine)

repetitions beginning with effleurage manipulation,

petrissage (squeezing and pressing), shaking,

friction, beating, hacking, clapping, walking,

vibration and closing with effleurage manipulation

leads to smoothening of the circulatory system that

delivers the build-up of lactic acid and carbon

dioxide and increases oxygen levels to help the

process of energy formation in muscle cells within

the mitochondria. This smooth blood circulation will

stimulate the endocrine system in the thymus gland

to produce the thymocytes and in the liver and bone

marrow produced lymphocytes consisting of B cells

and T cells circulated through blood and lymph

nodes to the mucosal epithelial tissue of mucous

membranes, including mucus, saliva, and tears and

mucosal tissue in the respiratory and digestive tracts

that trigger to produce IgA immunity (Barrett at al,

2010), (Wiarto, 2012). So sports massage is highly

recommended to be given to athletes in order to

increase the levels of IgA is very high useful as

immune in the body. Meanwhile sports massage can

increase levels of hormones BE physiologically due

to the impact of treatment on sports massage as

much as 9 (nine) repetition that resulted in the

influence on a good in nerve system, it turns out that

this repetitive manipulation stimulus is responded to

by larger A-beta fibres, so this stimulus reaches the

brain first, thereby closing the pain gate so that pain

perception does not arise. In addition, the

stimulation provided to stimulate the body's natural

morphine expenditure is the hormone endorphin by

stimulating the sensory nerve receptors to be

delivered to the central nervous system. If the

impulse reaches the nucleus of the raphe Magnus

resulting in secreting the encephalin proceeding in

both directions downward to the end of the dorsal

nucleus root of the spinal cord (aiming at the

secretion of serotonin to affect the spinal cord

neurons to secrete encephalin) in order to inhibit the

carrying nerve the pain that enters through the

lamina I and IV of the dorsal roots, while the

upwardly transmitted signals of the midbrain of the

midbrain (periaqueductal), the stimuli received by

the periaqueductal are conveyed to the

hypothalamus, from this hypothalamus via the

descending nerve pathway of the endorphin

hormone secreted to the vessels blood, so it can be

said that the pain and fatigue is reduced because the

release of encephalin (inside the endorphin beta

molecule) released by centring on the brain and

spinal cord as a result of the gate control theory also

resulted in a sense of euphoria due to the release of

the BE hormone that circulates throughout the body

(Guyton, 1994). So sports massage is recommended

to the athlete in order to increase the levels of the BE

hormone that is used in an effort to reduce muscle

fatigue and pain, although the rate of increase is not

greatly increased compared to IgA.

4 CONCLUSIONS

Sports massage may affect and significantly increase

IgA immune and BE hormone levels.

ACKNOWLEDGEMENT

I am grateful to all the sport science students of

Yogyakarta State University who have been pleased

to be the samples, and the masseurs who generously

assisted the treatments.

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