Massage impairs post exercise muscle blood flow and lactic acid removal
PainSci summary of Wiltshire 2010?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
One of the classic claims of massage therapy is that it “aids muscle recovery from exercise … by increasing muscle blood flow to improve ‘lactic acid’ removal.” But this 2009 evidence shows that just the opposite may be the case, in at least some circumstances. It was a straightforward experiment: the researchers subjected twelve people to intense hand-gripping exercises and then measured their blood acidity with and without basic sports massage. Their measurements showed that massage significantly “impairs lactic acid and hydrogen ion removal from muscle following strenuous exercise by mechanically impeding blood flow.” Yes, you read that right: massage impairs.
That’s quite a surprising result that applies a firm push to the side of a classic sacred cow of massage lore. (Note that good corroborating evidence was published again in 2012: see Crane 2012. Or see Franklin 2014 for some contrary evidence.)
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
PURPOSE: This study tested the hypothesis that one of the ways sports massage aids muscle recovery from exercise is by increasing muscle blood flow to improve "lactic acid" removal.
METHODS: Twelve subjects performed 2 min of strenuous isometric handgrip exercise (IHG) at 40% maximal voluntary contraction (MVC) to elevate forearm muscle lactic acid. Forearm blood flow (FBF; Doppler and Echo ultrasound of the brachial artery), and deep venous forearm blood lactate and H concentration ([La-], [H]) were measured every minute for 10 min post-IHG under three conditions: Passive (passive rest), Active (rhythmic exercise at 10% MVC), and Massage (effleurage and petrissage). Arterialized [La] and [H] from a superficial heated hand vein was measured at baseline.
RESULTS: Data are mean +/-SE. Veno-arterial [La] difference ([La]v-a) at 30 s post-IHG was the same across conditions (mmol/L; Passive 6.1 +/-0.6, Active 5.7 +/-0.6 mmol/L, Massage 5.5 +/-0.6, NS), while FBF (ml/min) was greater in Passive (766 +/-101) vs. Active 614 +/-62 (P=0.003) and vs. Massage 540 +/-60 (P<0.0001). Total FBF area under the curve (AUC; ml) for 10 min post handgrip was significantly higher in Passive vs. Massage (4203 +/-531 vs. 3178 +/-304, P=0.024) but not vs. Active (3584 +/-284, P=0.217). La- efflux (mmol; FBF x [La]v-a) AUC mirrored FBF AUC (Passive 20.5 +/-2.8 vs. Massage 14.7 +/-1.6, P=0.03 vs. Active 15.4 +/-1.9, P=0.064). H+ efflux (mmol; FBF x [H]v-a) was greater in Passive vs. Massage at 30 s (2.2 +/-0.4 e-5 vs. 1.3 +/-0.2 e-5, P<'0.001) and 1.5 min ( 1.0 +/-0.2 e-5 vs. 0.6 +/-0.09 e-5, P=0.003) post-IHG.
CONCLUSION: Massage impairs La- and H+ removal from muscle following strenuous exercise by mechanically impeding blood flow.
related content
- “Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage,” Justin D Crane, Daniel I Ogborn, Colleen Cupido, Simon Melov, Alan Hubbard, Jacqueline M Bourgeois, and Mark A Tarnopolsky, Science Translational Medicine, 2012.
- “Massage therapy restores peripheral vascular function after exertion,” Nina C Franklin, Mohamed M Ali, Austin T Robinson, Edita Norkeviciute, and Shane A Phillips, Archives of Physical Medicine & Rehabilitation, 2014.
- “Nothing ‘evil' and no ‘conundrum' about muscle lactate production,” Robert Robergs, Experimental Physiology, 2012.
- “Lactic Acid Is Not Muscles' Foe, It's Fuel,” Gina Kolata, NYTimes.com.
Specifically regarding Wiltshire 2010:
- “Response to Queen’s Study,” Burchat, Paula and {Canadian Sport Massage Therapists Association}, CSMTA.ca.
These five articles on PainScience.com cite Wiltshire 2010 as a source:
- Does Massage Therapy Work? — A review of the science of massage therapy … such as it is
- Trigger Points & Myofascial Pain Syndrome — A guide to the unfinished science of muscle pain, with reviews of every theory and self-treatment and therapy option
- Does Epsom Salt Work? — The science of Epsom salt bathing for recovery from muscle pain, soreness, or injury
- Why Drink Water After Massage? — Massage therapy does not flush toxins into the bloodstream, and water wouldn’t help if it did
- Massage Does Not Reduce Inflammation — The making of a new massage myth from a high-tech study of muscle samples after intense exercise
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.