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Massage therapy restores peripheral vascular function after exertion

PainSci » bibliography » Franklin et al 2014
Tags: massage, exercise, movement, DOMS, manual therapy, treatment, self-treatment, inflammation, pain problems, muscle

One article on PainSci cites Franklin 2014: Does Massage Increase Circulation?

PainSci notes on Franklin 2014:

The experiment showed not only that typical Swedish massage increased the “responsiveness” of blood vessels for up to a day, but that it did so throughout the body — in the arms, specifically, when only the legs were massaged. Their conclusion, translated: in some healthy young couch potatoes, when blood vessel function has been impaired by wicked workout soreness, massaging their legs seemed to improve it in their arms.

More functional blood vessels seems like a good thing! But note that it isn’t “increased circulation” per se, just a change in one of many biological factors that affect circulation. It would be a leap of logic to characterize this as evidence that massage “increases circulation,” especially given other evidence showing no significant effects on actual blood flow (the most obvious and direct measure of “circulation”).

If true, it is an interesting and happy result. Unfortunately, I don’t think this is a good study or paper, and I simply don’t trust the authors or their conclusions. First of all, the lack of a true control group here isn’t just a “limitation,” as the authors acknowledged, it’s closer to a deal-breaker. And there are many red flags and a through-the-roof risk of bias shining through in many ways in the text. For a more detailed analysis, see Does Massage Increase Circulation?.

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.

OBJECTIVE: To determine if lower extremity exercise-induced muscle injury reduces vascular endothelial function of the upper extremity and if massage therapy (MT) improves peripheral vascular function after exertion-induced muscle injury.

DESIGN: Randomized, blinded trial with evaluations at 90 minutes, 24 hours, 48 hours, and 72 hours.

SETTING: Clinical research center.

PARTICIPANTS: Sedentary young adults (N=36) were randomly assigned to 1 of 3 groups: (1) exertion-induced muscle injury and MT (n=15; mean age ± SE, 26.6 ± 0.3); (2) exertion-induced muscle injury only (n=10; mean age ± SE, 23.6 ± 0.4), and (3) MT only (n=11; mean age ± SE, 25.5 ± 0.4).

INTERVENTION: Participants were assigned to exertion-induced muscle injury only (a single bout of bilateral, eccentric leg press exercise), MT only (30-min lower extremity massage using Swedish technique), or exertion-induced muscle injury and MT.

MAIN OUTCOME MEASURES: Brachial artery flow-mediated dilation (FMD) was determined by ultrasound at each time point. Nitroglycerin (NTG)-induced dilation was also assessed (0.4 mg).

RESULTS: Brachial FMD increased from baseline in the exertion-induced muscle injury and MT group and the MT only group (7.38%±.18% to 9.02%±.28%, P<.05 and 7.77%±.25% to 10.2%±.22%, P<.05, respectively) at 90 minutes and remained elevated until 72 hours. In the exertion-induced muscle injury only group, FMD was reduced from baseline at 24 and 48 hours (7.78%±.14% to 6.75%±.11%, P<.05 and 6.53%±.11%, P<.05, respectively) and returned to baseline after 72 hours. Dilations of NTG were similar over time.

CONCLUSIONS: Our results suggest that MT attenuates impairment of upper extremity endothelial function resulting from lower extremity exertion-induced muscle injury in sedentary young adults.

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Specifically regarding Franklin 2014:

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