Promising a reduction in muscle soreness and stiffness, quicker recovery times, improvements in range of motion and stretching ability, the rising popularity of massage guns is hard to ignore. But with most mid-range massage guns — percussive therapy devices, to some — tipping into triple-figure price brackets, they can be a hard purchase to justify. Here, Third Space Medical physiotherapist Jonathan Codling shares his take on the tech.
As a physiotherapist, I’m regularly asked by patients whether they should invest in a massage gun. After all, it’s a tool that benefits your training, reduces injuries and increases your performance and recovery. But, we need to look at the science first. Is there ample evidence to back up the claims made by leading brands?
In short, yes, there is evidence out there to support their use. Although the extent of the benefits is limited to particular scenarios and settings. For example, there has been some cherry-picking of the evidence and wide over-estimation of the findings, but if you look for it, evidence can be found.
Range of Movement
Studies have shown that using percussive therapy for five minutes prior to testing a subject’s range of movement (ROM) at a joint has led to significant improvements. The research was based on five minutes of isolated use on one muscle group including the hip, knee and ankle in comparison to a control group of massaging only. The increase in ROM at the ankle was an increase of five degrees — similar to that of static stretching.
There are positives to be found — there was no reduction in the maximal force output of the muscle. Conversely, static stretching could have negative effects on maximal force output when used prior to explosive movements. Before your next workout, use a massage gun on each muscle group for five minutes.
Muscle Activation / Performance / Force Output
Theoretically, massage guns are built to stimulate more receptors, which leads to increased motor recruitment. The studies varied in their results with no conclusive data showing an increase in maximal voluntary contraction. Although there were no significant improvements in muscle output, the studies also highlighted that there was no reduction in the force output.
When massage guns were compared to traditional massage for repeated one rep max (1RM) testing over a 72-hour period, it was found that massage was more beneficial for the reproduction of 1RM tests. Despite no reduction in 1RM force after the use of a percussive therapy, a massage may be more beneficial for repeated 1RM testing over massage guns. Instead, massage guns may replace static stretching before exercise.
Recovery / Delayed Onset Muscle Soreness
This is the nitty-gritty area surrounding massage guns. Companies largely claim that the use of massage guns both pre and post-exercise reduce muscle damage and delayed onset muscle soreness (DOMS). The research identifies muscle damage using two blood markers, Creatine Kinase (CK) and Lactate Dehydrogenase (LDH), which are both used to determine damage to our muscle membrane or other soft tissue structures.
Across the board, the studies are generally very positive and support the claims of the companies. Use of a massage gun before, immediately after exercise and over the next 72 hours reduce both CK and LDH markers at 72 hours when compared to massage or no intervention. Unfortunately, the robustness of the studies is questionable.
When looking at CK and LDH levels following exercise, we know that the type of exercise such as aerobic versus resistance training and bi-set versus multi-set resistance training produces very different markers for muscle damage. The studies for massage guns generally used isolated muscle groups, for example, an eccentric bicep curl. It is therefore questionable whether you can apply these claims to multi-set resistance exercises or aerobic work with the same certainty in comparison to massage or rest. Another caveat to the research is the control groups. Many of the studies used no intervention as their control. With a plethora of evidence surrounding recovery strategies for training, it seems relevant to question why a more evidenced based intervention was not used as the control group.
Limitations of the studies
Many of the studies used one isolated resistance exercise such as an eccentric bicep curl rather than multiple exercises and different contraction types, which many gym users tend to incorporate into their workouts. The control groups of the studies varied, consisting of groups with no treatment, static stretching or massage. For studies where percussive therapy showed significant benefits, it remains unclear on whether these benefits cross over.
Across all of the studies that range from 2014 to the present, each focuses on resistance exercises rather than aerobic training. Of course, we can theorise the perceived benefits although the evidence is currently lacking when you consider aerobic training such as running.
There is limited consistency across studies for the type of massage gun used as well as the method of application, power, frequency and duration used. Where there is evidence for the use of percussion therapy, it is unlikely that the type of massage gun alters the outcome.
Effectively, there is no evidence to support that the expensive massage guns outperform the cheaper or homemade options you can use. Studies were generally conducted over a 72-hour period investigating acute changes. Similarly, there are no long-term studies looking at repetitive use of percussive therapy with multiple sets of training over consecutive weeks. Therefore, long term adaptations for performance and injury reduction are unsubstantiated.
So, when should I use my massage gun?
Before your workout — your massage gun can help with range of movement at a particular join joint and reduction in DOMs following your workout. This is based on five minutes of massage use on each muscle group. After your workout, use a massage gun for recovery and reduction in muscle soreness.
Looking at the evidence, when should I use it?
Pre-workout to help with range of movement at a joint and reduction in DOMs following your workout. Remember this is based on 5-minutes of massage on each muscle group.
Post-workout for recovery and reduction in muscle soreness with reduction in muscle damage markers following resistance training at 72hours.
Should I invest?
I find this a very difficult question to answer. Currently, there are no reasons to not buy or use a massage gun. There are no reported negative effects in their use on performance or output of a muscle contraction. In the clinic, anecdotally, I have seen a couple of nerve related injuries where the massage guns have been used incorrectly or by users not following the manufacturer’s advice. Whether the outcome outweighs the cost is where I struggle to ask my patients to commit.
The evidence is building for the use of massage guns. At present, there are no negative effects of their use and, yes, they reduce the effects of DOMS, but not all of the wider claims are supported with evidence. More research is required, particularly with aerobic exercise and the long term use of massage guns on repeated multi-set training over consecutive training weeks.