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

Effects of Self-Myofascial Release on Athletes' Physical Performance: A Systematic Review

Therapists and strength and conditioning specialists use self-myofascial release (SMR) as an intervention tool through foam rollers or massage rollers for soft tissue massage, with the purpose of improving mobility in the muscular fascia. Moreover, the use of SMR by professional and amateur athletes during warm-ups, cool downs, and workouts can have significant effects on their physical performance attributes, such as range of motion (ROM) and strength. The purpose of this study was to analyse the literature pertaining to these types of interventions and their effects found in different physical performance attributes for athletes. A systematic search was carried out using the following databases: PUBMED, ISI Web of Science, ScienceDirect, and Cochrane, including articles up to September 2023. A total of 25 articles with 517 athletes were studied in depth. SMR seems to have acute positive effects on flexibility and range of motion, without affecting muscle performance during maximal strength and power actions, but favouring recovery perception and decreasing delayed-onset muscle soreness. Some positive effects on agility and very short-range high-speed actions were identified, as well. In conclusion, although there is little evidence of its method of application due to the heterogeneity in that regard, according to our findings, SMR could be used as an intervention to improve athletes' perceptual recovery parameters, in addition to flexibility and range of motion, without negatively affecting muscle performance.

Differential Effects of Classical vs. Sports Massage on Erector Spinae and Upper Trapezius Muscle Stiffness: A Shear-Wave Elastography Study in Young Women

Classical and sports massages are commonly used interventions, but their comparative effects on muscle stiffness remain unclear. Classical massage is more general and uses light to moderate pressure, and its main purpose is relaxation. Sports massage, on the other hand, is more specialized and targets the unique needs of massaged individuals using moderate to firm pressure. This study aimed to evaluate the impacts of classical and sports massages on the stiffness of the erector spinae (ES) and upper trapezius (UT) muscles. Fifteen recreationally active young women, aged 22.9 ± 1.2 years, underwent a randomized cross-over study (with three conditions). Participants received either a five-minute classical or sports massage or a passive rest as a control on distinct days. Muscle stiffness was assessed using shear-wave elastography. The ES shear modulus displayed a significant time effect (p < 0.001; η2 = 0.515) without noticeable differences between the conditions, and the time × massage-type interactions approached statistical significance (F = 2.014; p = 0.073). There was also a large and statistically significant effect of the time on the UT (F = 11.127; p < 0.001; η2 = 0.443). We could not prove that classical and sports massages reduced muscle stiffness. The absence of significant differences might be attributed to the specific intervention parameters (massage duration of 5 min) and the small, only young women sample size. Given some tendencies towards significant effects, larger sample sizes are needed to further investigate this research question.

Effects of wearable low-intensity continuous ultrasound on muscle biomechanical properties during delayed onset muscle soreness

BACKGROUND

Delayed onset muscle soreness (DOMS) is one of the most prevalent musculoskeletal symptoms in individuals engaged in strenuous exercise programs.

OBJECTIVE

This study investigated the effects of wearable low-intensity continuous ultrasound on muscle biomechanical properties during DOMS.

METHODS

Twenty volunteers were distributed into a wearable ultrasound stimulation group (WUG) (n= 10) and medical ultrasound stimulation group (MUG) (n= 10). All subjects performed wrist extensor muscle strength exercises to induce DOMS. At the site of pain, ultrasound of frequency 3 MHz was applied for 1 h or 5 min in each subject of the WUG or MUG, respectively. Before and after ultrasound stimulation, muscle biomechanical properties (tone, stiffness, elasticity, stress relaxation time, and creep) and body temperature were measured, and pain was evaluated.

RESULTS

A significant decrease was found in the tone, stiffness, stress relaxation time, and creep in both groups after ultrasound stimulation (all p< 0.05). A significant decrease in the pain and increases in temperature were observed in both groups (all p< 0.05). No significant differences were observed between the groups in most evaluations.

CONCLUSION

The stiffness and pain caused by DOMS were alleviated using a wearable ultrasound stimulator. Furthermore, the effects of the wearable ultrasound stimulator were like those of a medical ultrasound stimulator.

Recovery Methods in Basketball: A Systematic Review

Although different strategies have been implemented to manage recovery-fatigue status in athletes, there is still a lack of consensus on which recovery protocols have the greatest impact and effectiveness when implemented with basketball players, including both physiological and psychological recovery methods. Thus, the purpose of this systematic review is to: (a) determine which recovery methods attain the greatest benefit in restoring the process of attenuating fatigue and (b) provide sports practitioners with guidelines on how some of the most effective recovery strategies can be used to optimize athletes' recovery and ultimately enhance their performance. Using the PRISMA guidelines, a total of 3931 research reports were obtained through four database searches (i.e., PubMed, Scopus, Cochrane, and Web of Science), from which only 25 met the inclusion and exclusion criteria. The recovery protocols analyzed in this systematic review were: sleep, nutrition, hydration, ergogenic aids, cold-water immersion, compression garments, massage, acupuncture, tapering, mindfulness, and red-light irradiation. The results revealed that all recovery strategies are capable of attenuating fatigue and enhancing recovery in basketball players to a certain degree. However, an individualized approach should be promoted, where a combination of proactive recovery modalities appears to result in the most rapid rates of recovery and athletes' ability to maintain high-level performance. Recovery should be programmed as an integral component of training regimens. Also, cooperation and communication between coaches, players, and the rest of the team staff members are essential in minimizing the risk of non-functional overreaching or injury and optimizing basketball players' on-court performance.

Self-Massage Techniques for the Management of Pain and Mobility With Application to Resistance Training: A Brief Review

ABSTRACT

MacLennan, M, Ramirez-Campillo, R, and Byrne, PJ. Self-massage techniques for the management of pain and mobility with application to resistance training: a brief review. J Strength Cond Res 37(11): 2314-2323, 2023-Fascial restrictions that occur in response to myofascial trigger points (MTrP), exercise-induced muscle damage (EIMD), and delayed onset of muscle soreness (DOMS) cause soft tissue to lose extensibility, which contributes to abnormal muscle mechanics, reduced muscle length, and decrements in joint range of motion (ROM) and actively contributes to musculoskeletal pain. Resistance training and in particular, weightlifting movements have unique mobility requirements imperative for movement efficacy and safety with ROM restrictions resulting in ineffective volume and intensity tolerance and dampened force output and power, which may lead to a failed lift or injury. Self-massage (SM) provides an expedient method to promote movement efficiency and reduce injury risk by improving ROM, muscular function, and reducing pain and allows athletes to continue to train at their desired frequency with minimal disruption from MTrPs-associated adverse effects. Thus, the aim of this review was to determine the efficacy of various self-massage tools in managing pain and mobility and to explore the potential benefits of SM on resistance training performance. Many SM devices are available for athletes to manage ROM restrictions and pain, including differing densities of foam rollers, roller massagers, tennis balls, and vibrating devices. To attenuate adverse training effects, a 10-to-20-minute bout consisting of 2-minute bouts of SM on the affected area may be beneficial. When selecting a SM device, athletes should note that foam rollers appear to be more effective than roller massagers, with vibrating foam rollers eliciting an increased reduction to pain perception, and tennis balls and soft massage balls were shown to be efficacious in targeting smaller affected areas.

Effects of foam rolling on vastus intermedius and lateralis microvascular blood flow

INTRODUCTION

Foam Rolling (FR) as a technique of self-massage has become a widely used intervention in clinical and sports practice. It is assumed that FR leads to an increased intramuscular microvascular blood flow (MBF), and therefore is commonly recommended as a warm-up or regeneration method. However, no data validate the effects of FR on MBF. This study aimed to assess whether FR increases intramuscular MBF using contrast-enhanced ultrasound (CEUS).

METHODS

Ten healthy athletes performed a standardized FR intervention applied to the lateral thigh (3 sets: 45 s FR, 20 s rest). Intramuscular perfusion was determined by CEUS under resting conditions (t0), immediately (t1), and 30 min (t2) after the intervention. Peak enhancement (PE), wash-in rate (WiR), and wash-in perfusion index (WiPI) were evaluated as quantitative perfusion parameters in vastus lateralis (VL) and intermedius (VI) muscle separately via regions of interest mapping.

RESULTS

Immediately after the intervention (t1), perfusion parameters showed a non-significant decrease in VL (p = 0.3; PE: -32.1%, WiPI: -29.6%, WiR: -50.4%) and VI (p = 0.4; PE: -10.3%, WiPI: -6.4%, WiR: -35.6%). A non-significant decrease was found at t2 in VL (p = 0.2; PE: -34%, WiPI -33.9%, WiR -61.2%) and VI (p = 0.2; PE -17.6%, WiPI -13.8%, WiR -43.2%).

CONCLUSIONS

The common assumption of intramuscular MBF improvement due to FR could not be confirmed for up to 30 min after the intervention. If an increase in intramuscular metabolism or MBF is intended, we recommend that alternative methods (i.e., traditional warm-up) should be preferred.

Monitoring Muscle Oxygen Asymmetry as a Strategy to Prevent Injuries in Footballers

Purpose: It has been hypothesized that sports injury risk is explained by muscle metabolism. The objective was to evaluate the muscle oxygen saturation slopes (ΔSmO2 slopes) and muscle oxygenation asymmetry (MO2Asy) at rest and to study their associations with injuries during the pre-season. Methods: A total of 16 male and 10 female footballers participated in this study. Injuries were diagnosed and classified by level of severity during the pre-season. The workload was also evaluated using the rate of perceived exertion × training time, from which the accumulated loads. The SmO2 was measured at rest in the gastrocnemius muscle using the arterial occlusion method in the dominant and non-dominant legs. The repeated measures ANOVA, relative risk, and binary logistic regression were applied to assess the probability of injury with SmO2 and workload. Results: Higher MO2Asy and ΔSmO2 Slope 2 were found among footballer who suffered high-severity injuries and those who presented no injuries. In addition, an MO2Asy greater than 15% and an increase in accumulated load were variables that explained a greater probability of injury. Conclusion: This study presents the new concept of muscle oxygenation asymmetry in sports science and its possible application in injury prevention through the measurement of SmO2 at rest.

Effect of Self-Myofascial Release of the Lower Back on Myofascial Gliding, Lumbar Flexibility, and Abdominal Trunk Muscle Strength: A Crossover Study

Roller massage has been recognized as an effective intervention for managing various conditions. However, data on the effects of roller massage on the dynamic mechanisms of the myofascial and soft tissues of the lower back are limited. This study aimed to examine the effect of the self-myofascial release of the lower back on myofascial gliding, lumbar flexibility, and abdominal trunk muscle strength using a roller massager. This crossover study included 24 college athletes who underwent three interventions-roller massage, static stretching, and control (rest). Before and after the intervention, lumbar and fascial gliding were evaluated using ultrasonography. Long-seat anteflexion (lumbar flexibility) and abdominal trunk muscle strength were assessed. The movement velocities of the subcutaneous tissue and the multifidus muscle over time were calculated using echo video analysis software, and gliding was estimated using the cross-correlation coefficient between the velocities. Gliding, lumbar flexibility, and abdominal trunk muscle strength showed significant intervention-by-time interactions. Roller massage significantly improved gliding, lumbar flexibility, and abdominal trunk muscle strength. The self-myofascial release of the lower back using a roller massager improved the lumbar/fascia gliding, lumbar flexibility, and abdominal trunk muscle strength compared to static stretching.

Massage therapy significantly improves cancer-related fatigue in cancer patients: a meta-analysis of randomized controlled trials

PURPOSE

This study was designed to investigate the effectiveness and safety of massage therapy in cancer-related fatigue (CRF) and to provide a reference for the future management of CRF.

METHODS

Eight databases (PubMed, Embase, Cochrane Library, CINAHL, Sinomed, Chinese Scientific Journal database (VIP), Wanfang, and China National Knowledge Infrastructure (CNKI)) were systematically reviewed from inception to May 2022 for randomized controlled trials. Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed form. The meta-analysis was performed using RevMan 5.3 to calculate the pooled effect sizes and 95% confidence intervals (CIs). Sensitivity analysis was performed to find the source of the heterogeneity. Publication bias was assessed via funnel plot analysis and the Egger test.

RESULT

A total of 11 qualified studies that included 789 patients (massage therapy group: 389; control group: 400) were included in the meta-analysis. Massage therapy had a marked effect on fatigue in cancer patients [standardized mean difference (SMD) =  - 1.69, 95% CI (- 2.46, - 0.93), P < 0.01], especially in breast cancer [SMD =  - 1.62, 95% CI (- 2.18, - 1.05), P < 0.01]. Reflexology [SMD =  - 2.71, 95% CI (- 4.65, - 0.77), P < 0.01] and Chinese massage [SMD =  - 1.14, 95% CI (- 1.95, - 0.33), P < 0.01] can have a more significant effect on fatigue. Massage time is 20 to 40 min [SMD =  - 2.39, 95% CI (- 4.13, - 0.66), P < 0.01], twice a week [SMD =  - 3.46, 95% CI (- 5.47, - 1.45), P < 0.01] for 3-5 weeks [SMD =  - 2.36, 95% CI (- 3.53, - 1.19), P < 0.01], which is more effective in relieving fatigue in cancer patients. Five studies described the occurrence of adverse events and only two studies had adverse events.

CONCLUSION

Massage therapy can be effective in relieving fatigue in cancer patients. Current evidence suggests that reflexology is the most effective approach to relieve fatigue, particularly in the breast cancer patients. The optimal intervention frequency and cycle for massage therapy is twice a week for 3-5 weeks, and the optimal duration is 20-40 min.

The Effects of Massage Therapy on Sport and Exercise Performance: A Systematic Review

BACKGROUND

A massage is a tool that is frequently used in sports and exercise in general for recovery and increased performance. In this review paper, we aimed to search and systemize current literature findings relating to massages' effects on sports and exercise performance concerning its effects on motor abilities and neurophysiological and psychological mechanisms.

METHODS

The review has been written following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. One hundred and fourteen articles were included in this review.

RESULTS

The data revealed that massages, in general, do not affect motor abilities, except flexibility. However, several studies demonstrated that positive muscle force and strength changed 48 h after the massage was given. Concerning neurophysiological parameters, the massage did not change blood lactate clearance, muscle blood flow, muscle temperature, or activation. However, many studies indicate pain reduction and delayed onset muscle soreness, which are probably correlated with the reduction of the level of creatine kinase enzyme and psychological mechanisms. In addition, the massage treatment led to a decrease in depression, stress, anxiety, and the perception of fatigue and an increase in mood, relaxation, and the perception of recovery.

CONCLUSION

The direct usage of massages just for gaining results in sport and exercise performance seems questionable. However, it is indirectly connected to performance as an important tool when an athlete should stay focused and relaxed during competition or training and recover after them.

Analysis of biomechanical characterization of the thumb rubbing method

BACKGROUND

Thumb rubbing is one of the widely accepted massage techniques, owing to its simple and effective operation. Exploring the biomechanical characteristics of the thumb rubbing method can assist the understanding of the operating characteristics of manipulation, thereby improvising the therapeutic role of manipulation.

OBJECTIVE

To study the kinematic and kinetic characteristics of the thumb kneading method from the biomechanical point of view, and to quantitatively analyze the key points of thumb kneading operation.

METHODS

We explored the biomechanical characteristics of the thumb kneading operation by an analysis of the parameters scored by the experts and students using the "thumb kneading data glove and data collection system".

RESULTS

(1) Force trajectory: The expert group showed a regular force trajectory compared to the student group, with a stable thumb suction position, small drift and concentrated force. (2) Force value: The average force value of the expert group was concentrated in the range 0.614 ± 0.041 kg, while the average force value of the student group was concentrated in the range 0.650 ± 0.146 kg and the difference was not statistically significant. (3) Frequency: The frequency of the expert group was mainly concentrated in the range 134.280 ± 39.106 times/min, while that of the student group was 66.04 ± 23.651 times/min, (P< 0.05). (4) Period: The operation cycle during the thumb kneading of the expert and student groups was mainly concentrated in the range of 0.476 ± 0.117 s and (0.990 ± 0.259) s, respectively, and the difference was statistically significant (P< 0.05).

CONCLUSION

The present study revealed that the technical operation of the expert group was more stable and standardized than that of the student group. It was found that the force value was inversely proportional to the frequency of the operation. In the "circular rotation" operation of the thumb rubbing method, the force value conversion degree of different parts of the thumb reflected the motion trajectory. Furthermore, the "circular rotation" operation performed by the expert group was better than the student group. The study of the parameters, including the angle of frequency, period and force value can reflect the biomechanical characteristics of thumb rubbing method to a significant extent.

Clinical studies on the electric automatic massage therapy for recovery of acute sports fatigue

BACKGROUND

Acute sports fatigue impairs athletes' performance and causes other health issues; therefore, an effective method of relieving acute sports fatigue is being researched.

OBJECTIVE

The present study was envisaged to evaluate the effect of electric auto-massage therapy and proprioceptive neuromuscular facilitated (PNF) stretching method on the recovery of acute exercise fatigue using the heart rate variability-based multi-physiological index and RPE scale, and to explore the underlying principle and mechanism.

METHOD

Sixty volunteers were divided into the stretching group, massage group and control group (20 subjects each) using the complete randomization method. The massage group chose the kneading, pressing, tapping and patting techniques using the intelligent massage chair to intervene on the volunteers, the stretching group chose the PNF stretching method to intervene on the volunteers, while the control group did not adopt any of these techniques. The Rating Of Perceived Exertion (RPE) score, heart rate (HR), grip strength, skin electrical activity, heart rate variability (HRV) and blood oxygen saturation (SpO2) of the three groups were recorded before and after the intervention.

RESULTS

Before the intervention, there was no statistically significant difference between the values of heart rate variability (HRV) in the three groups (P> 0.05), while after the intervention, there was a statistically significant difference between the values of heart rate variability - low frequency/high frequency (HRV (LF/HF)) and HRV (HF) in the three groups as: HRV (HF): ηH2= 0.10; P= 0.022; HRV (LF/HF): ηH2= 0.44; P= 0.001. The results indicated that the different intervention methods presented substantial effects on the values of HRV (HF) and HRV (LF/HF) in the volunteers. The HRV (HF) values of massage group, stretching group and control group were compared, and the difference between the massage group and control group was statistically significant (P= 0.019). Further, the HRV (HF) values of massage group rose more significantly than control group after the intervention, and the difference between HRV (HF) values of massage group and stretching group was not statistically significant. When comparing the HRV (LF/HF) values of massage group, stretching group and control group, the differences between the massage group and stretching group and control group were statistically significant (P= 0.001, P< 0.05), and it was observed that the HRV (LF/HF) values of massage group decreased more significantly than those of stretching group and control group after the intervention. The difference in HRV (LF) values between the three groups after the intervention was not statistically significant (P> 0.05).

CONCLUSION

1. It was observed that the electric automatic massage therapy played a vital role in the rapid relief of exercise fatigue by soothing and regulating the human phototropic system, reducing vagal tone, and accelerating the excretion of metabolites; while PNF stretching relieved the exercise fatigue by providing physical and verbal communication to transfer the perception of fatigue, and by promoting the excretion of metabolites through muscle isometric contraction. 2. The effect of electric auto-massage therapy was marginally stronger than the commonly used PNF stretching exercise method.

Reabsorption of intervertebral disc prolapse after conservative treatment with traditional Chinese medicine: A case report

BACKGROUND

Conservative treatments have been reported to diminish or resolve clinical symptoms of lumbar intervertebral disc herniation (LIDH) within a few weeks.

CASE SUMMARY

Computed tomography and magnetic resonance imaging (MRI) of the lumbar region of a 25-year-old male diagnosed with LIDH showed prolapse of the L5/S2 disc. The disc extended 1.0 cm beyond the vertebral edge and hung along the posterior vertebral edge. The patient elected a conservative treatment regimen that included traditional Chinese medicine (TCM), acupuncture, and massage. During a follow-up period of more than 12 mo, good improvement in pain was reported without complications. MRI of the lumbar region after 12 mo showed obvious reabsorption of the herniation.

CONCLUSION

A conservative treatment regimen of TCM, acupuncture, and massage promoted reabsorption of a prolapsed disc.

Effect of Localized Vibration Massage on Popliteal Blood Flow

There is a broad scope of literature investigating whole-body vibration (WBV) effects on blood flow (BF). However, it is unclear how therapeutic localized vibrations alter BF. Low-frequency massage guns are advertised to enhance muscle recovery, which may be through BF changes; however, studies using these devices are lacking. Thus, the purpose of this study was to determine if popliteal artery BF increases from localized vibration to the calf. Twenty-six healthy, recreationally active university students (fourteen males, twelve females, mean age 22.3 years) participated. Each subject received eight therapeutic conditions randomized on different days with ultrasound blood flow measurements. The eight conditions combined either control, 30 Hz, 38 Hz, or 47 Hz for a duration of 5 or 10 min. BF measurements of mean blood velocity, arterial diameter, volume flow, and heart rate were measured. Using a cell means mixed model, we found that both control conditions resulted in decreased BF and that both 38 Hz and 47 Hz resulted in significant increases in volume flow and mean blood velocity, which remained elevated longer than the BF induced by 30 Hz. This study demonstrates localized vibrations at 38 Hz and 47 Hz significantly increase BF without affecting the heart rate and may support muscle recovery.

Effects of Therapeutic Calf Massage on Cardiac Autonomic Function in Healthy Volunteers-a Pilot Study

Background

Calf massage is a therapeutic intervention that improves circulation and relieves us from pain & tightness. The calf massage also improves autonomic performance by modulating the vagal tone of the cardiovascular system. Therefore, the current study was intended to determine therapeutic calf massage on cardio autonomic activity in healthy subjects.

Objective

To assess the immediate effect of a single 20-min session of calf massage on cardiac autonomic modulation through heart rate variability (HRV) measurement.

Materials & Methods

In this study, 26 apparent healthy female participants aged between 18 and 25 years participated. Massage over the calf muscles on both legs for 20 min was performed, and resting cardiovascular parameters and HRV parameters were measured at baseline, immediately after the massage, and during the recovery periods (10 and 30 min after the massage). Data were analyzed using one-way ANOVA followed with post hoc analysis.

Results

Immediately after the massage intervention, heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure were decreased (p < .01), and the reduction was persisted at 10 min and 30 min of the recovery period (p < .01). In HRV parameters, the root mean square of successive differences (RMSSD) and high-frequency normalized unit (HF n.u.) increased, and low frequency (LF n.u.) decreased after the massage, and at the 10 and 30 min of the recovery period.

Conclusion

The present study reports suggest a significant reduction in heart rate and blood pressure after the massage therapy. A drop in sympathetic tone and raise in parasympathetic tone can also attribute to the therapeutic effect.

Effects of Cold-Water Immersion Compared with Other Recovery Modalities on Athletic Performance Following Acute Strenuous Exercise in Physically Active Participants: A Systematic Review, Meta-Analysis, and Meta-Regression

BACKGROUND

Studies investigating the effects of common recovery modalities following acute strenuous exercise have reported mixed results.

OBJECTIVES

This systematic review with meta-analysis and meta-regression compared the effects of cold-water immersion (CWI) against other common recovery modalities on recovery of athletic performance, perceptual outcomes, and creatine kinase (CK) following acute strenuous exercise in physically active populations.

STUDY DESIGN

Systematic review, meta-analysis, and meta-regression.

METHODS

The MEDLINE, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare, and Embase databases were searched up until September 2022. Studies were included if they were peer reviewed, published in English, included participants who were involved in sport or deemed physically active, compared CWI with other recovery modalities following an acute bout of strenuous exercise, and included measures of performance, perceptual measures of recovery, or CK.

RESULTS

Twenty-eight studies were meta-analysed. CWI was superior to other recovery methods for recovering from muscle soreness, and similar to other methods for recovery of muscular power and flexibility. CWI was more effective than active recovery, contrast water therapy and warm-water immersion for most recovery outcomes. Air cryotherapy was significantly more effective than CWI for the promotion of recovery of muscular strength and the immediate recovery of muscular power (1-h post-exercise). Meta-regression revealed that water temperature and exposure duration were rarely exposure moderators.

CONCLUSION

CWI is effective for promoting recovery from acute strenuous exercise in physically active populations compared with other common recovery methods.

PROTOCOL REGISTRATION

Open Science Framework: https://doi.org/10.17605/OSF.IO/NGP7C.

A 1-Week Comprehensive Foam Rolling Intervention Program Can Improve Knee Pain but Not Muscle Function and Range of Motion in Patients with Total Knee Arthroplasty

We investigate the effect of a 1-week comprehensive foam rolling (FR) intervention program on knee pain, range of motion (ROM), and muscle function in patients with TKA.Thirty patients with TKA were randomly allocated to FR (n = 15) or control (n = 15) groups. The control group received only regular physical therapy. Patients in the FR group performed the FR intervention in addition to their regular physical therapy twice daily from postoperative weeks two to three (60 s × 3 repetitions × 2 times/day × 6 days: total = 2160 s). Pain score, knee flexion and extension ROM, muscle strength, walking function, and balance function were measured before and after the FR intervention. From the second to third postoperative weeks, there were significant improvements in all variables, and the reduction in pain score at stretching was significantly greater in the FR group (-26.0 ± 1.4; p < 0.05) than in the control group (-12.5 ± 1.9). However, there was no significant difference in changes in the other variables except for the pain score at stretching between FR and control groups. A 1-week comprehensive FR intervention program in patients with TKA could reduce pain scores at stretching without a synergistic effect on physical function, i.e., walking speed, balance function, and muscle strength of the knee extensors muscles.

Effects of two-week machine massage on muscle properties in adolescent wrestlers

Objective: This study aimed to investigate the effect of a two-week machine massage on the physical properties of the erector spinae and serum biochemical indexes of adolescent athletes after training. Methods: Sixteen male adolescent wrestlers were recruited (age: 15 ± 1 year; height: 166 ± 7 cm; weight: 56 ± 7 kg) and randomly assigned to machine massage (MA, 8) and control (CO, 8) groups. Participants in the MA group received machine massage for 20 min after each wrestling training from Monday to Saturday (except on Thursday) for two weeks, while the participants in the CO group recovered naturally. Over the course of two weeks, all the participants underwent similar wrestling training program under the guidance of a professional coach. Before and after the intervention, serum urea and creatine kinase (CK) levels were measured in a fasting state. A Myoton Pro digital muscle evaluation system was used to measure the physical properties of the erector spinae, including the oscillation frequency, logarithmic decrement of a muscle's natural oscillation, and dynamic stiffness. Results: After two weeks of machine massage treatment, the dynamic stiffness of the erector spinae in the MA group decreased by 12.90% and that in the CO group increased by 2.34%, indicating a significant difference between the two groups (p = 0.04, ƞ ² = 0.286). The decrease in the logarithmic decrement of a muscle's natural oscillation value in the MA was significantly greater than that in the CO (p = 0.003, ƞ ² = 0.286). Moreover, the serum CK values decreased by 33.84% in the MA group and by 1.49% in the CO group, despite a trend of change between the groups (p = 0.062, ƞ2 = 0.084). No significant difference was found in the improvement in serum urea levels between the two groups after two weeks of treatment. Conclusion: Results of the present study indicated that a two-week machine massage had a positive effect on the improvement of the physical properties of the erector spinae of wrestlers during training.

Acute Effect of Short Intensive Self-Myofascial Release on Jump Performance in Amateur Athletes: A Randomized Cross-Over Study

Searching for effective methods to maximize physical performance that can be utilized during warm-ups is challenging in modern sports. This study aimed to investigate the effect of a short and intensive self-myofascial release (SI-SMR) on jumps in amateur, collegiate athletes. The study sample consists of 30 subjects with an average age of 21.8 years. The tests conducted included a squat jump (SJ), countermovement jump (CMJ), and drop jump (DJ). In the first week, half of the participants performed a standardized warm-up with additional short (15 s per lower limb muscle group) and intensive (20 reps/15 s) SMR and then performed jump tests. The other half performed a standard warm-up. The following week the groups switched interventions. The results revealed a tendency for all jump test parameters (height, force, and power), the reactive strength index, and stiffness to improve with SI-SMR, but the differences were small and insignificant. A dependent t-test for paired samples revealed that only SJ height improvement (+0.96 ± 2.63 cm) reached statistical significance (p = 0.04), but the small ES (ES = 0.14) could have attenuated this result. When a two-way mixed ANOVA was applied, the differences were insignificant. SI-SMR was ineffective in the direct improvement of jump performance. Although SI-SMR had no adverse effects, athletes should focus on specific preparations for sports competitions instead of using an SI-SMR protocol.

Acute Effects of a Single-Session of Full-Body Foam Rolling on Heart Rate Variability

Background

Self-myofascial release has been demonstrated to increase relaxation and improve blood flow, yet it is unknown if it can elicit an acute effect on heart rate variability (HRV).

Purpose

This study aimed to determine if a single-bout of foam rolling could increase parasympathetic activity as measured by HRV.

Methods

Twenty (20) participants volunteered and their baseline HRV was assessed using a finger sensor while lying supine, and then a second measure was recorded with them sitting upright with feet on the ground. This study utilized a practical HRV collection method designed for use in the field settings, and the data is recorded in arbitrary units (A.U.). Participants then oscillated on a closed-cell cylindrical foam roller using their body weight on the triceps surae, hamstrings, quadriceps, lumbar spine, and pectoral muscles each for 60 sec. Participants first massaged the right limb and then repeated on the matching muscle group on the left before continuing to the next region. Follow-up HRV measurements were recorded using the same procedures.

Results

Paired samples t tests assessing pre- and post-foam–rolling HRV measures in supine and seated positions revealed no difference between supine measures (p = .05, d = 0.21), nor the seated measures (p = .27, d = 0.17) among all participants. When sexes were analyzed separately, males showed a significant decrease in HRV in supine positions (p = .03, d = 0.33), but females did not (p = .55, d = 0.09).

Conclusions

The single bout of foam rolling on large muscle groups did not increase parasympathetic activity as hypothesized. Males and females responded differently in supine positions, but no difference was present in seated positions across sexes. The task of self-massage may have prevented the anticipated response from the massage. Further research should investigate if passive massage is more effective on HRV response.

Comparison of the Prolonged Effects of Foam Rolling and Vibration Foam Rolling Interventions on Passive Properties of Knee Extensors

Foam rolling (FR) and vibration foam rolling (VFR) interventions have received attention as pre-exercise warm-ups because they maintain performance and increase range of motion (ROM). However, the immediate and prolonged effects and the comparisons between FR and VFR interventions are unknown. Therefore, this study was designed to compare the effects of FR and VFR interventions on passive properties of knee extensors over time (up to 30 min after interventions). A crossover, random allocation design was used with 14 male college students (22.1 ± 1.0 years old) in the control, FR, and VFR conditions. The knee flexion ROM, pain pressure threshold (PPT), and tissue hardness were measured before and immediately after, 10, 20, and 30 minutes after the intervention. The results showed that knee flexion ROM increased significantly immediately after the intervention in both the FR and VFR conditions and maintained up to 30 minutes after both conditions. PPT increased significantly (p < 0.01) immediately after the FR intervention. In the VFR condition, there was a significant increase in PPT immediately after the intervention (p < 0.01) and 10 minutes after the intervention (p < 0.05). Tissue hardness was significantly decreased (p < 0.01) immediately after and 10 minutes after the FR intervention. However, tissue hardness in the VFR condition was significantly decreased (p < 0.01) up to 30 minutes after the intervention. The results suggest that FR and VFR interventions increase knee flexion ROM, and the effect lasts at least 30 minutes, but the effects on PPT and tissue hardness are maintained a longer time in the VFR condition compared to the FR condition. Therefore, VFR can be recommended as a warm-up before exercise to change the passive properties of knee extensors.

Effect of Acute Self-Myofascial Release on Pain and Exercise Performance for Cycling Club Members with Iliotibial Band Friction Syndrome

Cycling is a popular sport, and the cycling population and prevalence of related injuries and diseases increase simultaneously. Iliotibial band friction syndrome is a common chronic overuse injury caused by repetitive knee use in cycling. Self-myofascial release using foam rollers is an effective intervention for this syndrome; however, studies reporting positive results on self-myofascial release in cycling are limited. Therefore, this study investigated the effect of self-myofascial release on pain and iliotibial band flexibility, heart rate, and exercise performance (cadence, power, and record) in adult male cyclists with iliotibial band friction syndrome. We evaluated the pain and exercise ability of the control (n = 11) and self-myofascial release (n = 11) groups before and after cycling twice. Significant differences were observed in the pain scale, the iliotibial band flexibility, and cycling pain and power. The posterior cadence of the self-myofascial release group was 3.2% higher than that of the control group. The control group's record time increased by 74.64 s in the second cycling session compared to the first cycling session, while that of the self-myofascial release group decreased by 30.91 s in the second cycling session compared to the first cycling session. Self-myofascial release is effective in relieving pain and may improve cycling performance by increasing the iliotibial band flexibility.

Effects of different intermittent pneumatic compression stimuli on ankle dorsiflexion range of motion

Despite substantial evidence of the effectiveness of intermittent pneumatic compression (IPC) treatments for range of motion (ROM) improvement, little evidence is available regarding how different IPC stimuli affect ankle dorsiflexion (DF) ROM. This study aimed to investigate the effects of different IPC stimuli on the ankle DF ROM. Fourteen, university intermittent team sport male athletes (age: 21 ± 1 year, height: 1.74 ± 0.05 m, body mass: 70.9 ± 7.7 kg, body fat percentage: 14.2 ± 3.6%, body mass index: 23.5 ± 2.5 kg/m²; mean ± standard deviation) completed four experimental trials in a random order: 1) no compression with wearing IPC devices (SHAM), 2) the sequential compression at approximately 80 mmHg (SQUEE80), 3) the uniform compression at approximately 80 mmHg (BOOST80), and 4) the uniform compression at approximately 135 mmHg (BOOST135). For the experimental trials, the participants were initially at rest for 10 min and then assigned to either a 30-min SHAM, SQUEE80, BOOST80, or BOOST135. Participants rested for 20 min after IPC treatment. The Weight-Bearing Lunge Test (WBLT), popliteal artery blood flow, pressure-to-pain threshold (PPT), muscle hardness, heart rate variability, and perceived relaxation were measured before (Pre) and immediately after IPC treatment (Post-0) and 20 min after IPC treatment (Post-20), and the changes in all variables from Pre (Δ) were calculated. ΔWBLT performance, ΔPPT, and Δperceived relaxation in all IPC treatments were significantly higher than those in SHAM at Post-0 and Post-20 (p < 0.05). ΔPopliteal artery blood flow in BOOST80 and BOOST135 was significantly higher than that in SHAM and SQUEE80 at Post-0 (p < 0.05). ΔMuscle hardness and Δheart rate variability did not differ significantly between trials. In conclusion, IPC treatments, irrespective of applied pressure and mode of compression, increased ankle DF ROM. This resulted from decreased pain sensitivity (i.e., increased PPT). In addition, high inflation pressure and frequency did not provide additional benefits in increasing ankle DF ROM.

A short-term hindlimb massage programme can improve gait symmetry in riding school horses

Musculoskeletal injuries have been reported to be the main contributor to the interruption or dismissal of a horse’s athletic career. The muscles are responsible for the production of forces involved in movement, yet the muscles are often overlooked with regards to pre/rehabilitation. The use of massage therapy as part of a training programme is becoming increasingly popular. The beneficial effects of massage have been widely researched, though much of the research is on the immediate effects, and consistency between studies is lacking. This study was a preliminary investigation into the effects of a short-term massage programme on the gait parameters of riding school horses. 15 clinically sound riding school horses of different breed, age and height were used in a controlled, blind study. The horses were divided in to three groups of five ensuring a mixture of height, breed and age. Group Massage received a 10 min massage at each side on the proximal hindlimb, once a week for three weeks. Group Sham received 10 min groom at each side on the proximal hindlimb, once a week for three weeks; and the Control Group has received no treatment. Gait analysis was conducted on days 1 and 28. In walk, a significant improvement in stride length symmetry index (SI) (P=0.043) and protraction SI (P=0.0043) was found for the Massage Group, with hock flexion SI significantly better for the Massage Group at day 28 (P=0.03). At trot and canter, hock flexion SI was improved in Group Massage (P=0.003 and P=0.024, respectively). A short-term massage programme to the proximal hindlimb improved gait symmetry, particularly hock flexion SI, within riding school horses. An appropriate dosage level for particular results needs to be determined in order to effectively utilise massage within a training programme. Further studies analysing kinetic parameters alongside kinematic parameters will enable further conclusions to be drawn.

The Effectiveness of a Multi-Sensory Sleep-Promotion Program on Sleep Quality among Hospitalized Older Adults of Thailand: A Quasi-Experimental Study

BACKGROUND/OBJECTIVE

Older adults suffer from sleep disturbances, especially during hospitalization, affecting their health condition, recovery, and in-hospital mortality. Therefore, we aimed to explore the effectiveness of a multi-sensory sleep-promotion program on sleep quality among hospitalized Thai older adults.

METHODS

In a quasi-experimental study, the 52 eligible older adults in a private medical ward were equally assigned into two groups. The experimental group received a sleep quality assessment after the first night of admission, the 60-minute multi-sensory sleep-promotion program for three nights, and an outcome evaluation on the last night after the intervention. In contrast, the control group received routine care for the same period. Sleep quality was measured by the Verran and Snyder-Halpern Sleep Scale (Thai version). In addition, independent and paired samples t-tests compared the sleep quality between and within the two groups.

RESULTS

The older adults in the experimental group had better sleep quality than those who did not (p < .001). Those who participated in the multi-sensory sleep-promotion program markedly improved their sleep quality over five days (p < .001).

CONCLUSION

A multi-sensory sleep-promotion program can promote the sleep quality of older adults. The five alternative methods to promote sleep are effective without the deleterious effects of hypnotics and sedatives often experienced among older adults. Therefore, nurses and other healthcare professionals can implement this program as standard practice. In addition, they may adjust it to fit the acuity level and care dependencies of older adults in other cultures to promote sleep quality.

The importance of setting and therapeutic relationships when delivering chiropractic care to those living with disadvantage

BACKGROUND

Chiropractic is a mostly privatised health profession within Australia, with people experiencing disadvantage typically having limited access due to financial barriers. However, some universities within Australia offer community outreach clinics where students provide chiropractic care to people living with disadvantage. This demographic experiences higher rates of chronic conditions including musculoskeletal complaints and requires subsidisation to access privatised care. This need also offers opportunity for the chiropractic profession to work within community healthcare teams. A mixed-methods observational study was used to investigate how the unique setting of a student chiropractic community clinic may influence the experience and outcomes of those who attend.

METHODS

Three patient-reported outcome measures (PROMs) investigated client outcomes: Measure Yourself Medical Outcome Profile (MYMOP); European Five Domain Five Level Quality of Life Questionnaire (EQ-5D-5L); and the Patient Enablement Instrument. The PROMs data were analysed descriptively and inferentially. Interviews were conducted with clients who had received chiropractic care, chiropractic students, clinical supervisors and staff of the centre. Interview data were coded using thematic analysis, and themes were formed using Bronfenbrenner's socio-ecological systems framework and non-participant observations.

RESULTS

Thirty-seven participants completed baseline PROMs and 17 completed follow-ups after four treatments. Seventy-two percent of participants nominated their primary complaint as chronic. Significant change was noted in general health and wellbeing for the MYMOP, pain and disability for the EQ-5D-5L and index scores for the EQ-5D-5L suggested improved health and wellbeing. Most clients experienced higher levels of enablement post treatment. Twelve participants were interviewed (four were clients), with five themes emerging from the interview data. Clients reported their lived experiences impacted their health problems and attending the clinic offered benefits beyond improvement of pain and disability.

CONCLUSIONS

Interview data suggested that these benefits were due to a combination of therapy, the setting and the relationships formed within that setting. Complementing this, PROM data suggested clients experienced better levels of health and wellbeing and decreased levels of pain and disability. Findings indicated that people who experienced disadvantage may receive broader benefits from attending community centres offering chiropractic care. Services such as chiropractic may be complementary in meeting the healthcare needs of those experiencing disadvantage.

The Effect of Massage Force on Relieving Nonspecific Low Back Pain: A Randomized Controlled Trial

OBJECTIVE

To investigate the effect of force applied during massage on relieving nonspecific low back pain (LBP).

METHODS

This single-blinded, randomized controlled trial enrolled 56 female patients with nonspecific LBP at a single medical center. For each participant, the therapist performed a 30 min massage session (20 min general massage and 10 min focal massage) using a special instrument with a force sensor inserted, for a total of six sessions in 3 weeks. During the 10 min focal massage, HF and LF groups received high force (HF, ≥2 kg) and low force (LF, ≤1 kg) massage, respectively. The primary outcome was pain intensity (i.e., visual analog scale (VAS), 0-10), and secondary outcomes comprised pain pressure threshold, trunk mobility, LBP-associated disability, and quality of life.

RESULTS

No significant between-group differences were observed in baseline characteristics. The HF group exhibited significantly lower VAS than did the LF group, with a mean difference of -1.33 points (95% CI: -2.17 to -0.5) at the end of the intervention, but no significant difference was noted at the end of the follow-up. A significant time effect (p < 0.05) was detected in all secondary outcomes except the pain pressure threshold and trunk mobility. A significant time × group interaction (p < 0.05) was found only for the VAS and pain pressure threshold.

CONCLUSIONS

Compared with LF massage, HF massage exerted superior effects on pain relief in female patients with nonspecific LBP at the end of intervention. Applying different levels of force showed no effects on LBP-associated disabilities and quality of life.

Effect of osteopathic techniques on human resting muscle tone in healthy subjects using myotonometry: a factorial randomized trial

Musculoskeletal disorders (MSDs) are highly prevalent, burdensome, and putatively associated with an altered human resting muscle tone (HRMT). Osteopathic manipulative treatment (OMT) is commonly and effectively applied to treat MSDs and reputedly influences the HRMT. Arguably, OMT may modulate alterations in HRMT underlying MSDs. However, there is sparse evidence even for the effect of OMT on HRMT in healthy subjects. A 3 × 3 factorial randomised trial was performed to investigate the effect of myofascial release (MRT), muscle energy (MET), and soft tissue techniques (STT) on the HRMT of the corrugator supercilii (CS), superficial masseter (SM), and upper trapezius muscles (UT) in healthy subjects in Hamburg, Germany. Participants were randomised into three groups (1:1:1 allocation ratio) receiving treatment, according to different muscle-technique pairings, over the course of three sessions with one-week washout periods. We assessed the effect of osteopathic techniques on muscle tone (F), biomechanical (S, D), and viscoelastic properties (R, C) from baseline to follow-up (primary objective) and tested if specific muscle-technique pairs modulate the effect pre- to post-intervention (secondary objective) using the MyotonPRO (at rest). Ancillary, we investigate if these putative effects may differ between the sexes. Data were analysed using descriptive (mean, standard deviation, and quantiles) and inductive statistics (Bayesian ANOVA). 59 healthy participants were randomised into three groups and two subjects dropped out from one group (n = 20; n = 20; n = 19-2). The CS produced frequent measurement errors and was excluded from analysis. OMT significantly changed F (-0.163 [0.060]; p = 0.008), S (-3.060 [1.563]; p = 0.048), R (0.594 [0.141]; p < 0.001), and C (0.038 [0.017]; p = 0.028) but not D (0.011 [0.017]; p = 0.527). The effect was not significantly modulated by muscle-technique pairings (p > 0.05). Subgroup analysis revealed a significant sex-specific difference for F from baseline to follow-up. No adverse events were reported. OMT modified the HRMT in healthy subjects which may inform future research on MSDs. In detail, MRT, MET, and STT reduced the muscle tone (F), decreased biomechanical (S not D), and increased viscoelastic properties (R and C) of the SM and UT (CS was not measurable). However, the effect on HRMT was not modulated by muscle-technique interaction and showed sex-specific differences only for F.Trial registration German Clinical Trial Register (DRKS00020393).

Compression-induced improvements in post-exercise recovery are associated with enhanced blood flow, and are not due to the placebo effect

The aim of this study was to investigate the physiological effects of compression tights on blood flow following exercise and to assess if the placebo effect is responsible for any acute performance or psychological benefits. Twenty-two resistance-trained participants completed a lower-body resistance exercise session followed by a 4 h recovery period. Participants were assigned a post-exercise recovery intervention of either compression tights applied for 4 h (COMP), placebo tablet consumed every hour for 4 h (PLA) or control (CON). Physiological (markers of venous return, muscle blood flow, blood metabolites, thigh girth), performance (countermovement jump, isometric mid-thigh pull), and psychological measures (perceived muscle soreness, total quality of recovery) were collected pre-exercise, immediately post-exercise, at 30 (markers of venous return and muscle blood flow) and 60 min (blood metabolites, thigh girth and psychological measures) intervals during 4 h of recovery, and at 4 h, 24 h and 48 h post-exercise. No significant (P > 0.05) differences were observed between interventions. However, effect size analysis revealed COMP enhanced markers of venous return, muscle blood flow, recovery of performance measures, psychological measures and reduced thigh girth compared to PLA and CON. There were no group differences in blood metabolites. These findings suggest compression tights worn after resistance exercise enhance blood flow and indices of exercise recovery, and that these benefits were not due to a placebo effect.

The Efficacy and Safety of Manual Therapy for Symptoms Associated with Multiple Sclerosis: A Systematic Review and Meta-Analysis

Background:

Multiple sclerosis (MS) is a chronic neurological autoimmune disease, affecting the psychological and physical health of patients. Manual therapies have been proven to relieve pain, strengthen muscles, and improve bladder and bowel problems with a high safety and low adverse event profile. Previous studies have reported the results of manual therapy in alleviating symptoms associated with MS, but the conclusions were controversial.

Objective:

The purpose of this meta-analysis is to comprehensively analyze and determine the efficacy and safety of manual therapy in relieving symptoms associated with MS.

Methods:

Eight electronic databases were searched from inception of the database to April 30, 2021. Randomized controlled trials (RCTs) using manual therapy in patients to relieve symptoms associated with MS were considered eligible for this study. Two reviewers independently extracted data using pre-established standards.

Results:

Finally, 10 eligible RCTs with 631 subjects were included in this meta-analysis. These data establish that massage therapy can significantly ameliorate fatigue, pain, and spasms, while reflexology was only effective in relieving pain in MS patients. No adverse events were reported in eligible RCTs.

Conclusions:

The present study provides strong evidence that massage therapy could alleviate fatigue, pain, and spasms in MS patients, while reflexology plays a positive role in relieving pain. Physicians could consider massage therapy or reflexology as a safe and effective complementary and alternative treatment. Larger RCTs with higher methodological quality are needed in the future, which aim to provide more meaningful evidence for further proof of efficacy.

Frailty Status Improvement after 5-Month Multicomponent Program PROMUFRA in Community-Dwelling Older People: A Randomized Controlled Trial

A study was made of the effect of the PROMUFRA multicomponent frailty program upon physical frailty, kinanthropometry, pain and muscle function parameters in frail and pre-frail community-dwelling older people. Eighty-one participants were randomly allocated to the intervention group (IG) or control group (CG). The IG performed PROMUFRA for 20 weeks, using six strength exercises with three series of 8–12 repetitions until muscular failure, and seven myofascial exercises, with one set of 10 repetitions. The CG continued their routine. The frailty criteria number (FCN), kinanthropometric parameters and muscle function were measured at baseline and after the program. Between-group differences were found in the interaction for FCN, muscle mass, fat mass, skeletal muscle mass index, knee flexion range of motion (ROM), hip flexion with knee straight ROM, maximum isometric knee extension, maximum isotonic knee extension, maximum leg press and hand grip strength., and also on post-intervention frailty status. The IG showed a statistical trend towards decreased pain. In conclusion, the PROMUFRA program is a potential training approach that can bring benefits in physical frailty status, body composition, ROM and muscle function among frail or pre-frail community-dwelling older people.

Investigating the Use of an Intermittent Sequential Pneumatic Compression Arm Sleeve for Recovery After Upper-Body Exercise

ABSTRACT

Cranston, AW and Driller, MW. Investigating the use of an intermittent sequential pneumatic compression arm sleeve for recovery after upper-body exercise. J Strength Cond Res 36(6): 1548-1553, 2022-The current study aimed to investigate the efficacy of an intermittent sequential pneumatic compression (ISPC) device placed on the arm after a fatiguing upper-body exercise circuit. Fifty resistance-trained athletes (37 males/13 females, mean ± SD; age = 27 ± 4 years) performed 3 physical performance tests (grip strength dynamometer, single-arm medicine ball throw, and preacher bench bicep curls to failure) before and after exercise, following a 30-minute recovery period. During the recovery period, subjects were randomly assigned an experimental arm, which was placed in the ISPC device, and a control arm (no device). Subjects completed a perceptual muscle soreness rating through palpation of 4 muscle groups in the upper body at the same time points and also 24 hours after recovery. There was a statistically significant interaction between conditions for the single-arm medicine ball throw (p < 0.01) in favor of the ISPC after the recovery period; however, the effect size was deemed trivial. There was a small but not statistically significant effect (d = 0.22, p > 0.05) for the bicep curls in favor of the ISPC and no significant difference for the grip strength (d = 0.09, p > 0.05). The perceptual muscle soreness scales resulted in significant differences between conditions immediately after and 24 hours after exercise across all muscle groups (p < 0.05), all in favor of the ISPC condition. This study supports the use of an upper-body ISPC device to reduce perceived muscle soreness for up to 24 hours after exercise, with negligible effects on physical performance when compared with a control trial.

Effects of an external pneumatic compression device vs static compression garment on peripheral circulation and markers of sports performance and recovery

PURPOSE

To identify the effects of a single 30 min partial lower leg external pneumatic compression (EPC) treatment compared to a static compression (SC) garment or a no treatment control (CTL) on markers of recovery and performance following a muscle damaging protocol.

METHODS

Thirty healthy, active males (23 ± 3 years; 180.2 ± 9.0 cm; 81.6 ± 11.3 kg) performed 100 drop jumps from a 0.6 m box followed by a randomized, single 30 min treatment of either a partial lower leg EPC device worn below the knee and above the ankle (110 mmHg), SC garment (20-30 mmHg) covering the foot and calf just below the knee, or no treatment CTL, and then returned 24 and 48 h later. Participants were assessed for measures of muscle soreness, fatigue, hemodynamics, blood lactate, muscle thickness, circumferences, and performance assessments.

RESULTS

The drop jump protocol significantly increased muscle soreness (p < 0.001), fatigue (p < 0.001), blood flow (p < 0.001), hemoglobin (p < 0.001), and muscle oxygen saturation (SMO₂; p < 0.001). Countermovement jump and squat jump testing completed after treatment with either EPC, SC, or CTL revealed no differences for jump height between any condition. However, EPC treatment maintained consistent braking force and propulsive power measures across all timepoints for countermovement jump testing. EPC and SC treatment also led to better maintenance of squat jump performance for average relative propulsive force and power variables at 24 and 48 h compared to CTL.

CONCLUSIONS

A single 30 min partial leg EPC treatment may lead to more consistent jump performance following a damaging bout of exercise.

Evidence‐Based Recovery in Soccer – Low‐Effort Approaches for Practitioners

Strategies to improve recovery are widely used among soccer players at both amateur and professional levels. Sometimes, however, recovery strategies are ineffective, improperly timed or even harmful to players. This highlights the need to educate practitioners and athletes about the scientific evidence of recovery strategies as well as to provide practical approaches to address this issue. Therefore, recent surveys among soccer athletes and practitioners were reviewed to identify the recovery modalities currently in use. Each strategy was then outlined with its rationale, its physiological mechanisms and the scientific evidence followed by practical approaches to implement the modality. For each intervention, practical and particularly low-effort strategies are provided to ensure that practitioners at all levels are able to implement them. We identified numerous interventions regularly used in soccer, i.e., sleep, rehydration, nutrition, psychological recovery, active recovery, foam-rolling/massage, stretching, cold-water immersion, and compression garments. Nutrition and rehydration were classified with the best evidence, while cold-water immersion, compression garments, foam-rolling/massage and sleep were rated with moderate evidence to enhance recovery. The remaining strategies (active recovery, psychological recovery, stretching) should be applied on an individual basis due to weak evidence observed. Finally, a guide is provided, helping practitioners to decide which intervention to implement. Here, practitioners should rely on the evidence, but also on their own experience and preference of the players.

Why Percussive Massage Therapy Does Not Improve Recovery after a Water Rescue? A Preliminary Study with Lifeguards

The aim of this study was to analyze the effects of percussive massage therapy (PMT) on lifeguards’ recovery after a water rescue, in comparison with passive recovery. Methods: A quasi-experimental crossover design was conducted to compare passive recovery (PR) and a PMT protocol. A total of 14 volunteer lifeguards performed a simulated 100 m water rescue and perceived fatigue and blood lactate were measured as recovery variables after the rescue and after the 8-min recovery process. Results: There were no differences between PMT and PR in lactate clearance (p > 0.05), finding in both modalities a small but not significant decrease in blood lactate. In perceived fatigue, both methods decreased this variable significantly (p < 0.001), with no significant differences between them (p > 0.05). Conclusions: PMT does not enhance recovery after a water rescue, in comparison with staying passive. Despite PMT appearing to be adequate for recovery in other efforts, it is not recommended for lifeguards’ recovery after a water rescue.

Chronic Effects of Foam Rolling on Flexibility and Performance: A Systematic Review of Randomized Controlled Trials

The purpose of this study is to review the existing literature on chronic effects of foam rolling (FR) on flexibility and performance. Electronic databases were searched during January 2022 for topics related to FR. Included studies met the following criteria: (a) peer-reviewed articles written in English; (b) FR intervention of at least four weeks; (c) non-motorized FR device during intervention; (d) randomized controlled trial with existence of a control group; and (e) any lower body parameter related to flexibility, recovery, and performance. Nine studies met that criteria. Results revealed that chronic FR demonstrated conflicting results for improvement of flexibility. On the other hand, a majority of the articles in this review showed no beneficial effects of FR on performance. Lastly, the effect of FR on recovery is unclear. These findings suggest the need for further studies to establish the consensus about the long-term application of FR in flexibility, recovery, and performance.

Effects of Foam Rolling vs. Manual Therapy in Patients with Tension-Type Headache: A Randomized Pilot Study

Background: This study compares the effect of foam rolling (FR) vs. manual therapy (MT) on pain, pressure pain threshold (PPT), headache disability (HDI) and impact of headache (HIT-6) in patients with tension-type headache (TTH). Methods: A total of 38 participants with TTH were randomly assigned to an FR group (FRG, n = 13), an MT group (MTG, n = 13) or a control group (CG, n = 12). FRG received FR treatment; MTG received MT techniques; CG received a placebo treatment. The treatment lasted one month. Outcome measures were assessed at baseline, post-intervention and follow-up. Results: Both FRG and MTG showed significant improvements in all variables after the treatment, but the intervention effect was maintained only for functional disability (p = 0.002 and p = 0.005, respectively), overall disability (p = 0.007; p = 0.030) and HIT-6 (p = 0.002; p = 0.001) at follow-up. After treatment, FRG and MTG presented a significantly higher PPT in right (p = 0.044; p = 0.009) and left suboccipital (p = 0.004; p = 0.021). MTG showed a significantly lower HIT-6 than CG (p = 0.008). No differences between FRG and MTG were found in any variable. Conclusions: Both FR and MT are effective treatments for the improvement of clinical symptoms in TTH. Further studies are needed to confirm our findings in a larger population.

A Comparison of Effectiveness of Thai Traditional Massage and Tamsulosin in Lower Urinary Tract Symptoms: A Randomized Controlled Trial

The prospective clinical, non-inferiority study aimed to investigate the effectiveness of Thai traditional massage on lower urinary tract symptoms (LUTS) compared with Tamsulosin in Thai men. It was conducted on men aged 50 to 75 years old with LUTS (N = 45). Participants were blocked four randomly assigned into 2 groups. The control group (n = 25) was received 0.4 mg Tamsulosin daily and the study group (n = 20) was given Thai traditional massage for 4 weeks. The efficacy evaluation was performed by the International Prostate Symptoms Score (IPSS), a Thai version of the World Health Organization Quality of Life Questionnaire (WHO-QoL Brief), Uroflowmetry, and Post-void residual urine (PVR) at baseline and end of study. The background characteristics of participants were not significantly different between groups. Both interventions relieved LUTS in the total IPSS and the quality of life score associated with urination were decreased, described as symptoms and quality of life due to urination improvement after 4 weeks of intervention. Interestingly, the Thai traditional massage has significant improvement in total IPSS and voiding score (p < .05). Additionally, the time to peak flow rate, peak flow rate (Qmax), average flow rate (Qave) and voided volume of both interventions were improved with no statistical significance. PVR was decreased in both interventions. The WHO-QoL brief score was improved the total score. There was no significant difference in terms of uroflowmetry, PVR, and WHO-QoL brief scores compared between groups. The result suggests that Thai traditional massage has the potential to be an alternative treatment for LUTS.

Effects of Massage and Cold Water Immersion After an Exhaustive Run on Running Economy and Biomechanics: A Randomized Controlled Trial

ABSTRACT

Duñabeitia, I, Arrieta, H, Rodriguez-Larrad, A, Gil, J, Esain, I, Gil, SM, Irazusta, J, and Bidaurrazaga-Letona, I. Effects of massage and cold water immersion after an exhaustive run on running economy and biomechanics: A randomized controlled trial. J Strength Cond Res 36(1): 149-155, 2022-This study compares the effects of 2 common recovery interventions performed shortly after an exhausting interval running session on running economy (RE) and biomechanics. Forty-eight well-trained male runners performed an exhaustive interval running protocol and an incremental treadmill test 24 hours later at 3 speeds: 12, 14, and 16 km·h-1. Subjects randomly received either massage, cold water immersion (CWI), or passive rest (control). Runners repeated the treadmill test 48 hours after the first test. A two-way mixed analysis of variance was performed comparing groups and testing times. The massage group had significantly better recovery than the control group at 14 km·h-1 in RE (p < 0.05; η2 = 0.176) and greater stride height and angle changes at 16 km·h-1 (p < 0.05; η2 = 0.166 and p < 0.05; η2 = 0.208, respectively). No differences were observed between the CWI and control groups. The massage group had greater stride height and angle changes at 16 km·h-1 than the CWI group (p < 0.05; η2 = 0.139 and p < 0.05; η2 = 0.168, respectively). Moreover, differences in magnitude suggested moderate effects on RE (η2 = 0.076) and swing time (η2 = 0.110). These results suggest that massage intervention promotes faster recovery of RE and running biomechanics than CWI or passive rest.

The Influence of Self-Myofascial Release on Muscle Flexibility in Long-Distance Runners

During long-distance running, athletes are exposed to repetitive loads. Myofascial structures are liable to long-term work, which may cause cumulating tension within them. The aim of this study was to evaluate the acute effect of self-myofascial release on muscle flexibility in long-distance runners. The study comprised 62 long-distance, recreationally running participants between the age of 20 and 45 years. The runners were randomly divided into two groups: Group 1 (n = 32), in which subjects applied the self-myofascial release technique between baseline and the second measurement of muscle flexibility, and Group 2 (n = 30), without any intervention. The self-myofascial release technique was performed according to standardized foam rolling. Assessment of muscle flexibility was conducted according to Chaitow's proposal. After application of the self-myofascial release technique, higher values were noted for the measurements of the following muscles: piriformis, tensor fasciae latae muscles and adductor muscles. Within the iliopsoas and rectus femoris muscles, lower values were observed in the second measurement. These changes were statistically significant (p < 0.05) within the majority of muscles. All these outcomes indicate improvement related to larger muscle flexibility and also, an increase in range of motion. In the control group (Group 2), significant improvement was observed only in measurements for the iliopsoas muscles. The single application of self-myofascial release techniques with foam rollers may significantly improve muscle flexibility in long-distance runners. Based on these results, the authors recommend the self-myofascial release technique with foam rollers be incorporated in the daily training routine of long-distance runners, as well as athletes of other sport disciplines.

Efficacy of massage therapy in improving outcomes in knee osteoarthritis: A systematic review and meta-analysis

BACKGROUND

and purpose: Massage therapy is being used for knee osteoarthritis. However, level-1 evidence is lacking. This systematic review and meta-analysis aimed to synthesize evidence on the effect of massage therapy on knee osteoarthritis.

METHODS

PubMed, Embase, Ovid, Springer, and Google Scholar databases were searched up to May 8, 2021 for randomized controlled trials comparing massage with controls for knee osteoarthritis. Review manager was used for a random-effect meta-analysis. Risk of bias was assessed using the Cochrane collaboration risk assessment tool and certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

RESULTS

Twelve studies with 737 participants were included. After 1-4 weeks of therapy, there was a significant reduction in pain and stiffness scores in the massage group and after 6-8 weeks of therapy, there was a significant reduction in stiffness and functionality scores. There was no significant difference in outcomes with long-term therapy. A statistically significant reduction in stiffness scores was seen with aromatherapy massage. Aromatherapy massage was not superior to standard massage. The overall quality of evidence according to GRADE was low to moderate for standard massage therapy and very low for aromatherapy.

CONCLUSION

Massage therapy may lead to some improvement in pain, stiffness, and functionality scores in the short term but not in long term. Aromatherapy massage was not found to be any better than standard massage therapy. Current evidence is limited by methodological heterogeneity amongst trials and small sample size of the studies.