Massage Therapy for muscle Strains

What the research says...

Massage therapy has emerged as a promising intervention for the treatment of muscle strains, offering a non-invasive and holistic approach to managing muscle injuries. Muscle strains, characterized by damage to muscle fibers due to overstretching or overuse, can lead to pain, inflammation, and reduced function. Current research has delved into the mechanisms and effects of massage therapy on muscle strains, shedding light on its potential benefits in alleviating symptoms and promoting recovery.

One key aspect of massage therapy in the context of muscle strains is its ability to reduce muscle soreness and pain. A systematic review and meta-analysis by Guo et al. (2017) highlighted the effectiveness of massage therapy in alleviating delayed onset muscle soreness (DOMS) following strenuous exercise. This review synthesized data from randomized controlled trials (RCTs) and demonstrated that massage intervention can significantly reduce muscle soreness and improve muscle performance indicators such as maximal isometric force and peak torque.

Moreover, massage therapy has been shown to modulate inflammatory signaling pathways associated with exercise-induced muscle damage. Crane et al. (2012) conducted a study that revealed how massage therapy attenuates inflammatory signaling after exercise-induced muscle trauma. The researchers found that massage therapy activated mechanotransduction signaling pathways, potentiated mitochondrial biogenesis signaling, and mitigated the rise in nuclear factor κB (NFκB) nuclear accumulation, thereby reducing inflammation and promoting muscle recovery.

In addition to its effects on pain and inflammation, massage therapy has been linked to enhanced muscle recovery and remodeling. Studies have indicated that massage therapy can promote skeletal muscle regrowth and remodeling, which are essential processes for repairing damaged muscle tissue. This aspect of massage therapy is crucial for individuals recovering from muscle strains as it can aid in restoring muscle function and strength.

Furthermore, massage therapy has been associated with psychological benefits that can complement the physical healing process. Weerapong et al. (2005) discussed the psychological effects of massage therapy, highlighting its positive impact on recovery and psychological well-being. The relaxation and stress-relieving effects of massage therapy can contribute to overall recovery from muscle strains by promoting a sense of well-being and reducing anxiety associated with injury.

Research by Rapaport et al. (2010) explored the effects of a single session of Swedish massage on hypothalamic-pituitary-adrenal and immune function in normal individuals. The study found that massage therapy influenced various physiological markers such as cortisol levels and cytokine production, indicating its potential to modulate stress responses and immune function.

Moreover, the combination of massage therapy with other modalities has shown promise in enhancing its therapeutic effects. Zhao et al. (2021) investigated the combination of electroacupuncture and massage therapy in alleviating myofibroblast transdifferentiation and extracellular matrix production in skeletal muscle fibrosis. The findings suggested that this combined approach could regulate fibrotic processes and promote muscle healing.

In conclusion, the current research on massage therapy and muscle strains underscores its potential as a valuable treatment modality. From reducing muscle soreness and inflammation to promoting muscle recovery and psychological well-being, massage therapy offers a comprehensive approach to managing muscle strains. By understanding the mechanisms and effects of massage therapy on muscle strains, healthcare professionals can optimize its use in rehabilitation programs and enhance the recovery outcomes of individuals with muscle injuries.

Reviewed by Predrag Jancic, MD

References

Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review & 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.

Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage

“…Massage therapy is commonly used during physical rehabilitation of skeletal muscle to ameliorate pain and promote recovery from injury. Although there is evidence that massage may relieve pain in injured muscle, how massage affects cellular function remains unknown. To assess the effects of massage, we administered either massage therapy or no treatment to separate quadriceps of 11 young male participants after exercise-induced muscle damage. Muscle biopsies were acquired from the quadriceps (vastus lateralis) at baseline, immediately after 10 min of massage treatment, and after a 2.5-hour period of recovery. We found that massage activated the mechanotransduction signaling pathways focal adhesion kinase (FAK) and extracellular signal-regulated kinase 1/2 (ERK1/2), potentiated mitochondrial biogenesis signaling [nuclear peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α)], and mitigated the rise in nuclear factor κB (NFκB) (p65) nuclear accumulation caused by exercise-induced muscle trauma. Moreover, despite having no effect on muscle metabolites (glycogen, lactate), massage attenuated the production of the inflammatory cytokines tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and reduced heat shock protein 27 (HSP27) phosphorylation, thereby mitigating cellular stress resulting from myofiber injury. In summary, when administered to skeletal muscle that has been acutely damaged through exercise, massage therapy appears to be clinically beneficial by reducing inflammation and promoting mitochondrial biogenesis.…”

Justin D. Crane, Daniel I. Ogborn, Cynthia Cupido et al. 2012

Sci. Transl. Med

The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention

“…Many coaches, athletes and sports medicine personnel hold the belief, based on observations and experiences, that massage can provide several benefits to the body such as increased blood flow, reduced muscle tension and neurological excitability, and an increased sense of well-being. Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms). Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing. Depending on the massage technique, mechanical pressure on the muscle is expected to increase or decrease neural excitability as measured by the Hoffman reflex (neurological mechanisms). Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response (physiological mechanisms). A reduction in anxiety and an improvement in mood state also cause relaxation (psychological mechanisms) after massage. Therefore, these benefits of massage are expected to help athletes by enhancing performance and reducing injury risk. However, limited research has investigated the effects of pre-exercise massage on performance and injury prevention. Massage between events is widely investigated because it is believed that massage might help to enhance recovery and prepare athletes for the next event. Unfortunately, very little scientific data has supported this claim. The majority of research on psychological effects of massage has concluded that massage produces positive effects on recovery (psychological mechanisms). Post-exercise massage has been shown to reduce the severity of muscle soreness but massage has no effects on muscle functional loss. Notwithstanding the belief that massage has benefits for athletes, the effects of different types of massage (e.g. petrissage, effleurage, friction) or the appropriate timing of massage (pre-exercise vs post-exercise) on performance, recovery from injury, or as an injury prevention method are not clear. Explanations are lacking, as the mechanisms of each massage technique have not been widely investigated. Therefore, this article discusses the possible mechanisms of massage and provides a discussion of the limited evidence of massage on performance, recovery and muscle injury prevention. The limitations of previous research are described and further research is recommended.…”

Pornratshanee Weerapong, Patria A. Hume, Gregory S. Kolt 2005

Sports Medicine

A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic–Pituitary–

“…Objectives Massage therapy is a multi–billion dollar industry in the United States with 8.7% of adults receiving at least one massage within the last year; yet, little is known about the physiologic effects of a single session of massage in healthy individuals. The purpose of this study was to determine effects of a single session of Swedish massage on neuroendocrine and immune function. It was hypothesized that Swedish Massage Therapy would increase oxytocin (OT) levels, which would lead to a decrease in hypothalamic–pituitary–adrenal (HPA) activity and enhanced immune function. Design The study design was a head-to-head, single-session comparison of Swedish Massage Therapy with a light touch control condition. Serial measurements were performed to determine OT, arginine-vasopressin (AVP), adrenal corticotropin hormone (ACTH), cortisol (CORT), circulating phenotypic lymphocytes markers, and mitogen-stimulated cytokine production. Setting This research was conducted in an outpatient research unit in an academic medical center. Subjects Medically and psychiatrically healthy adults, 18–45 years old, participated in this study. Intervention The intervention tested was 45 minutes of Swedish Massage Therapy versus a light touch control condition, using highly specified and identical protocols. Outcome measures The standardized mean difference was calculated between Swedish Massage Therapy versus light touch on pre- to postintervention change in levels of OT, AVP, ACTH, CORT, lymphocyte markers, and cytokine levels. Results Compared to light touch, Swedish Massage Therapy caused a large effect size decrease in AVP, and a small effect size decrease in CORT, but these findings were not mediated by OT. Massage increased the number of circulating lymphocytes, CD 25+ lymphocytes, CD 56+ lymphocytes, CD4 + lymphocytes, and CD8+ lymphocytes (effect sizes from 0.14 to 0.43). Mitogen-stimulated levels of interleukin (IL)–1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-13, and IFN-γ decreased for subjects receiving Swedish Massage Therapy versus light touch (effect sizes from −0.22 to −0.63). Swedish Massage Therapy decreased IL-4, IL-5, IL-10, and IL-13 levels relative to baseline measures. Conclusions Preliminary data suggest that a single session of Swedish Massage Therapy produces measurable biologic effects. If replicated, these findings may have implications for managing inflammatory and autoimmune conditions.…”

Mark Hyman Rapaport, Pamela J. Schettler, Catherine Bresee 2010

The Journal of Alternative and Complementary Medicine

The Combination of Electroacupuncture and Massage Therapy Alleviates Myofibroblast Transdifferentiat

“…Complementary therapies, such as acupuncture and massage, had been previously reported to have therapeutic effects on skeletal muscle contusions. However, the recovery mechanisms on skeletal muscles after blunt trauma via the combination of electroacupuncture (EA) and massage therapy remain unclear. In the present study, a rat model of the skeletal muscle fibrosis following blunt trauma to rat skeletal muscle was established, and the potential molecular mechanisms of EA + massage therapy on the skeletal muscle fibrosis were investigated. The results suggested that EA + massage therapy could significantly decrease inflammatory cells infiltration and collagenous fiber content and ameliorate the disarrangement of sarcomeres within myofibrils compared to the model group. Further analysis revealed that EA + massage therapy could reduce the degree of fibrosis and increase the degree of myofibroblast apoptosis by downregulating the mRNA and protein expression of transforming growth factor- (TGF-) β1 and connective tissue growth factor (CTGF). Furthermore, the fibrosis of injured skeletal muscle was inhibited after treatment through the normalization of balance between matrix metalloproteinase- (MMP-) 1 and tissue inhibitor of matrix metalloproteinase (TIMP). These findings suggested that the combination of electroacupuncture and massage therapy could alleviate the fibrotic process by regulating TGF β1-CTGF-induced myofibroblast transdifferentiation and MMP-1/TIMP-1 balance for extracellular matrix production. …”

Na Zhao, Bo Liu, Liu Siwen et al. 2021

Evidence-Based Complementary and Alternative Medicine