Massage therapy actually IMPAIRS muscle recovery? Say what now?
Five articles on PainSci cite Wiltshire 2010: 1. Does Massage Therapy Work? 2. The Complete Guide to Trigger Points & Myofascial Pain 3. Does Epsom Salt Work? 4. Why Drink Water After Massage? 5. Massage Does Not Reduce Inflammation
PainSci commentary on 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 wherever possible.
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 showed that just the opposite may be the case, and probably is 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,” Crane et al, Science Translational Medicine, 2012.
- “Massage therapy restores peripheral vascular function after exertion,” Franklin et al, Archives of Physical Medicine & Rehabilitation, 2014.
- “Nothing ‘evil' and no ‘conundrum' about muscle lactate production,” 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.
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- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.