Under the gun: the effect of percussive massage therapy on physical and perceptual recovery in active adults

Key Points

1. Despite their popularity, little is known about the efficacy of massage guns for recovery.
2. The purpose of this repeated-measures, single-group study was to determine the effect of massage gun therapy on perceptual and physical recovery after intense calf exercise.
3. There were no statistically significant differences in perceptual or physical recovery between the experimental and controls legs at any time point.

BACKGROUND & OBJECTIVE

Massage guns, which are thought to reduce soreness and increase flexibility, have become an increasingly popular recovery strategy from intense exercise (1). However, little is known about their efficacy for these metrics or for performance recovery.

This study aimed todetermine the effect of a 5-minute bout of massage gun therapy on both perceptual and physical recovery after intense calf exercise.

Massage guns have become an increasingly popular recovery strategy from intense exercise.

Post-exercise massage gun therapy may not provide any benefits over passive recovery for the calves – even though the majority of the participants believed it would.

METHODS

• 65 physically active undergraduate students (34 females, 31 males) participated in a repeated-measures, single-group study.

• Each participant served as their own control, with one leg randomly allocated to the experimental condition (massage gun recovery) and the other to the control condition (passive recovery).

• Participants were first asked to rate their belief that “massage guns will improve recovery following exercise” on a visual analog scale (VAS).Then they were measured on five lower-limb variables bilaterally at five time points (Table 1)surroundinga five minutewarm-up, an exercise intervention (3 x 20 double-leg calf raises), and recovery. For the experimental leg,recovery consisted of five minutes of massage gun therapy (using a Hydragun) and 15 minutes of passive sitting. The control leg sat passively for all 20 minutes.

RESULTS

• About seven in 10 participants believed massage guns would improve recovery (>5 out 10 on the VAS).

• Compared to perceived calf muscle soreness at baseline (1±1 out of 10), soreness was significantly higher at every subsequent timepoint for both the experimental and control legs (between 3 and 5 ± 2 out of 10) (Figure 1).

• There were no statistically significant differences in perceived soreness between the experimental and controls legs at any time point. However, after the recovery intervention and at the 4-hour follow-up, there was a small effect size for increased soreness in the experimental leg.

• Calf circumference increased on both legs (by an average 0.4 cm) post-exercise intervention; however, this difference may not exceed the measurement error of the test (2), and there was no difference between legs. Similarly, calf raise to exhaustion decreased on both legs (by an average of 5 repetitions) post-exercise intervention, but there was no between-leg difference. None of the measures of isometric calf raise strength differed over time or between legs; nor did the weight-bearing lunge test.

LIMITATIONS

This study had several limitations in terms of sample size, interventions, and reporting:

• The study was underpowered to detect statistical significance for small effect sizes.

• The exercise intervention was intended to be intense, yet peak isometric strength was no different post-exercise.Perhaps an even more intense intervention than 3 x 20 double-leg calf raises would have affected the outcomes.

• The duration and settings (speed and amplitude) for the massage gun intervention were based on manufacturer recommendations. A longer application, different settings, or a different brand of massage gun could have a different effect.

• Although participants’ beliefs about massage guns were reported, their previous experience with massage guns was not. Acclimatization to massage guns may also affect outcomes.

CLINICAL IMPLICATIONS

Despite limited empirical evidence, massage guns have become increasingly popular in recent years, including among professional athletes. This study was one of the first on the topic. It compared perceptual and physical recovery from intense exercise before and after 5 minutes of massage gun therapy on one legwith passive recovery on the other leg.

Contrary to the authors’ hypotheses, there were no statistically significant differences between legs at any time point on any physical or perceptual measure of recovery. Perceived muscle soreness was slightly, though non-significantly, higher after the recovery intervention and at the 4-hour follow-up in the calf that received the massage gun therapy.

These findings suggest post-exercise massage gun therapy may not provide any benefits over passive recovery for the calves – even though the majority of the participants believed it would. In fact, it may be slightly counterproductive in terms of perceived soreness in the short term (the first several hours after application).Additional research is needed to explore the effects of a separate massage gun session (e.g. 24 hours post-exercise) on both perceptual and physical recovery.

+STUDY REFERENCE

LeabeaterA, Clarke A, James L, Huynh M, Driller M (2023) Under the Gun: The effect of percussive massage therapy on physical and perceptual recovery in active adults. Journal of Athletic Training,Published online first.

SUPPORTING REFERENCE

1. Leabeater, A. J., James, L. P., Huynh, M., Vleck, V., Plews, D. J., & Driller, M. W. (2022). All the gear: The prevalence and perceived effectiveness of recovery strategies used by triathletes. Performance Enhancement & Health, 10(4), 100235.
2. Carmont, M. R., Silbernagel, K. G., Mathy, A., Mulji, Y., Karlsson, J., &Maffulli, N. (2013). Reliability of achilles tendon resting angle and calf circumference measurement techniques. Foot and Ankle Surgery, 19(4), 245–249.