Massage Therapy for Delayed onset muscle sorenes

What the research says...

Massage therapy has gained significant attention in the realm of treating delayed onset muscle soreness (DOMS) among athletes and individuals engaging in strenuous physical activities. Research has highlighted the potential benefits of massage in alleviating DOMS and improving muscle performance post-exercise. A systematic review and meta-analysis by Guo et al. (2017) emphasized the positive effects of massage on reducing DOMS and enhancing muscle performance after intense physical exertion. Similarly, Heiß et al. (2019) concluded that post-exercise massage can effectively reduce DOMS following strenuous workouts, leading to improvements in muscle soreness, muscle performance, and serum creatine kinase levels.

Moreover, studies such as those by Hilbert (2003) and White et al. (2020) have delved into the mechanisms through which massage therapy influences muscle soreness and performance. Hilbert (2003) demonstrated that massage administered after muscle injury decreased soreness and neutrophil count, indicating a reduction in inflammation. White et al. (2020) explored the impact of post-exercise massage on inflammatory signaling and subsequent muscle performance, showing promising results in reducing soreness and enhancing recovery after intense exercise.

While massage therapy has shown promise in managing DOMS, other interventions like cryotherapy, stretching, and electrical modalities have not demonstrated significant effects on alleviating muscle soreness (Cheung et al., 2003). This underscores the potential of massage as a viable treatment option for individuals experiencing DOMS. Additionally, Tiidus & Shoemaker (1995) highlighted that unaccustomed muscular exercise, especially involving eccentric muscle contractions, can lead to muscle damage and DOMS, further emphasizing the relevance of effective interventions like massage in managing post-exercise soreness.

In conclusion, the current body of research supports the efficacy of massage therapy in reducing delayed onset muscle soreness and improving muscle performance following strenuous physical activity. Massage therapists can leverage these findings to enhance their practice and provide effective treatments for individuals experiencing DOMS, ultimately aiding in quicker recovery and improved athletic performance.

Reviewed by Predrag Jancic, MD

References

Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and M

“…Purpose: The purpose of this systematic review and meta-analysis was to evaluate the effects of massage on alleviating delayed onset of muscle soreness (DOMS) and muscle performance after strenuous exercise.Method: Seven databases consisting of PubMed, Embase, EBSCO, Cochrane Library, Web of Science, CNKI and Wanfang were searched up to December 2016. Randomized controlled trials (RCTs) were eligible and the outcomes of muscle soreness, performance (including muscle maximal isometric force (MIF) and peak torque) and creatine kinase (CK) were used to assess the effectiveness of massage intervention on DOMS.Results: Eleven articles with a total of 23 data points (involving 504 participants) satisfied the inclusion criteria and were pooled in the meta-analysis. The findings demonstrated that muscle soreness rating decreased significantly when the participants received massage intervention compared with no intervention at 24 h (SMD: –0.61, 95% CI: –1.17 to –0.05, P = 0.03), 48 h (SMD: –1.51, 95% CI: –2.24 to –0.77, P < 0.001), 72 h (SMD: –1.46, 95% CI: –2.59 to –0.33, P = 0.01) and in total (SMD: –1.16, 95% CI: –1.60 to –0.72, P < 0.001) after intense exercise. Additionally, massage therapy improved MIF (SMD: 0.56, 95% CI: 0.21–0.90, P = 0.002) and peak torque (SMD: 0.38, 95% CI: 0.04–0.71, P = 0.03) as total effects. Furthermore, the serum CK level was reduced when participants received massage intervention (SMD: –0.64, 95% CI: –1.04 to –0.25, P = 0.001).Conclusion: The current evidence suggests that massage therapy after strenuous exercise could be effective for alleviating DOMS and improving muscle performance.…”

Jianmin Guo, Linjin Li, Yingyun Gong et al. 2017

Front. Physiol

Advances in Delayed-Onset Muscle Soreness (DOMS) – Part II: Treatment and Prevention

“…Poppendieck et al concluded that post-exercise massage therapy can be relevant particularly for short-term recovery after intensive training [51]. A systematic review concluded that post-exercise massage can be effective for reducing DOMS after strenuous exercises with positive effects on muscle soreness, muscle performance (i. e., maximal isometric force and peak torque) and serum CK levels [52].

Rafael Heiß, Christoph Lutter, Jürgen Freiwald et al. 2019

Sportverletz Sportschaden

The effects of massage on delayed onset muscle soreness

“…14 15 Muscle massage may be an alternative therapy, one that is popular and possibly effective. 16 If massage is rendered during the early stages of inflammation, the mechanical pressure applied with the massage might decrease neutrophil margination, thereby reducing inflammation and DOMS. [16][17][18] Indeed, massage rendered 2 h after muscle injury decreased muscle soreness and increased the circulating neutrophil count, which suggests the treatment reduced neutrophil margination. …”<<

“…16 If massage is rendered during the early stages of inflammation, the mechanical pressure applied with the massage might decrease neutrophil margination, thereby reducing inflammation and DOMS. [16][17][18] Indeed, massage rendered 2 h after muscle injury decreased muscle soreness and increased the circulating neutrophil count, which suggests the treatment reduced neutrophil margination. 17 Theoretically, decreased margination should have attenuated muscle damage induced by inflammation, a variable not measured in the aforementioned study.…”

James E. Hilbert 2003

British Journal of Sports Medicine

Massage Therapy Modulates Inflammatory Mediators Following Sprint Exercise in Healthy Male Athletes

“…Massage therapy is a common postexercise recovery modality aimed to reduce DOMS and performance decrements by attenuating the inflammatory response to exercise [8,11,12,21]. Although this mechanism has been suggested by several authors [8,11,12,21], inflammatory processes are not commonly evaluated in tandem with performance and soreness metrics. The present study is the first to examine the effects of postexercise massage therapy using effleurage and neurolymphatic activation techniques on postexercise inflammatory signaling and subsequent muscle performance and soreness resulting from an intense bout of exercise. …”

Gillian White, Sarah West, Jessica E. Caterini et al. 2020

JFMK

Delayed Onset Muscle Soreness

“…Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted.A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of muscle soreness or other DOMS symptoms. Exercise is the most effective means of alleviating pain during DOMS, however the analgesic effect is also temporary. Athletes who must train on a daily basis should be encouraged to reduce the intensity and duration of exercise for 1-2 days following intense DOMS-inducing exercise. Alternatively, exercises targeting less affected body parts should be encouraged in order to allow the most affected muscle groups to recover. Eccentric exercises or novel activities should be introduced progressively over a period of 1 or 2 weeks at the beginning of, or during, the sporting season in order to reduce the level of physical impairment and/or training disruption. There are still many unanswered questions relating to DOMS, and many potential areas for future research.…”

Karoline Cheung, Patria A. Hume, Linda Maxwell 2003

Sports Medicine

Effleurage Massage, Muscle Blood Flow and Long-Term Post-Exercise Strength Recovery

“…It is well documented that intense, unaccustomed muscular exercise, particularly that which involves eccentric muscle contraction, will induce muscle damage and delayed onset muscle soreness (DOMS) (1, 25). A loss of muscle isometriccontractile strength of -40% lasting from several days to over one week is also characteristic of post-eccentric muscularwork (18.…”

Peter M. Tiidus, J. Kevin Shoemaker 1995

Int J Sports Med