Dr. Michael Daignault | Opinion contributor
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This Egyptian spa offers snake massages to brave clients
Snake massages are now being offered at one Egyptian spa.
Buzz60, Buzz60
The #gymtok hashtag on TikTok is ripe with videos extolling the many benefits of using a handheld percussion massage gun after a workout. For those of us who are frequent gym-goers, we are always on the lookout for new hacks to facilitate a faster recovery between training sessions. Some of the purported benefits of percussion therapy include reduction of post-workout muscle soreness, treatment of acute pain and increased flexibility and range of motion. Percussion massage guns have emerged in popularity due to their less expensive, DIY mechanism.
From a personal standpoint, I noticed a reduction in my post-workout muscle soreness when I use my percussion massage gun as part of my nightly wind-down regime. But as an ER doctor, I wanted to know what the science has to say about percussion therapy and what studies exist regarding massage guns and similar treatments. Do they actually work?
What is percussion therapy?
It seems like percussion guns exploded onto the market fairly recently, but the idea of vibration therapy has been around since the 1960s. There are hundreds of articles attesting to the benefits of local vibration, including foam rollers and vibrating plates. Percussions massage guns take vibration to the next level by employing a rhythmic massage at a high-frequency.
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Massage guns and delayed onset muscle soreness (DOMS)?
The benefit of percussion massage with the strongest evidence is for reducing delayed onset muscle soreness (DOMS). DOMS is a fancy way of referring to post-workout or post-exercise muscle soreness. We can all agree that weโd like to minimize this effect after a strenuous workout.
A 2018 meta-analysis did a systematic review of multiple previously done research studies on the benefits of local vibration for reducing DOMS. The analysis included 10 studies across 258 total participants. It found that pre-workout vibration reduced muscle pain at 24, 48 and 72 hours after exercise. DOMS was measured using a visual analog scale (VAS). VAS is a subjective pain rating scale, which can be subject to bias and raise eyebrows from critics, but the results were consistent across multiple studies.
More: Which supplements are most likely to land you in the ER?
However, the studies to date were not randomized-control trials, nor was there double-blinding. Both study organizers and participants were aware of who received the intervention being studied and who didnโt; this reduces the quality of evidence collected.
What about your range of motion?
The data on the benefit of handheld percussion for improving range of motion is also limited. A small 2020 study was the first to look at whether a 5-minute handheld percussive massage treatment of the calf muscles increased the range of motion (ROM) of the plantar flexor muscles. It found the ROM was increased by 18.4% relative to the control group.
Another small study of only 24 healthy active participants showed that in those receiving either foam roller or vibration foam roller treatment after strenuous exercise, there was a greater ankle range of motion and greater reach distances compared to those who received no treatment. But again, both studies were small and more research into whether percussion guns improve flexibility and ROM is needed.
More: 13 things that will help you stick to your New Year's resolutions in 2022
Treatment of acute pain
The evidence that direct application of percussion can reduce acute muscle pain is mixed. Proponents of handheld massagers say that vibration increases blood flow to the painful area, flushing out lactic acid and calcium โ metabolites thought to contribute to muscle contractions and pain after exercise. This sounds wonderful, and anecdotally, we likely all feel better after a deep tissue massage by a professional masseuse or physical therapist. But is there evidence to support this mechanism?
Proponents point to two small studies on whole-body vibration for proof. These studies demonstrated improved blood flow in their subjects but to make the jump that improved blood flow leads to enhanced elimination of pain-causing metabolites is a bit of a stretch.
Are massage guns worth trying?
The bottom line is that you should take the multiple manufacture-promoted benefits of handheld percussion massage guns with a grain of salt until we have more definitive research. Iโm not saying they donโt work โ personally Iโm a fan and Iโve recommended them to friends and family alike.
I also think there might be an interesting neuro biofeedback mechanism at play; thereโs a theory that high-frequency percussive therapy sends signals to the brain faster than pain signals can travel, possibly overriding and decreasing the muscle pain experienced. Thereโs no doubt among elite athletes and trainers of the incredible role the mind plays in recovery, response to pain and performance.
Given that handheld massage guns have come down considerably in price due to competition among manufactures, Iโd recommend incorporating one in your pre-workout warmup and/or for post-workout muscle soreness to see if it helps.
If you want to try it: Focus on a particular soft tissue or muscle for one to two minutes at a time. Donโt use over a bruise, sprain, open wounds or acutely injured areas with swelling. Donโt use over bony areas like your spine or joints either.
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Michael Daignault, MD, is a board-certified ER doctor in Los Angeles. He studied Global Health at Georgetown University and has a Medical Degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps Volunteer. Find him on Instagram @dr.daignault
Show Caption
Hide Caption
This Egyptian spa offers snake massages to brave clients
Snake massages are now being offered at one Egyptian spa.
Buzz60, Buzz60
The #gymtok hashtag on TikTok is ripe with videos extolling the many benefits of using a handheld percussion massage gun after a workout. For those of us who are frequent gym-goers, we are always on the lookout for new hacks to facilitate a faster recovery between training sessions. Some of the purported benefits of percussion therapy include reduction of post-workout muscle soreness, treatment of acute pain and increased flexibility and range of motion. Percussion massage guns have emerged in popularity due to their less expensive, DIY mechanism.
From a personal standpoint, I noticed a reduction in my post-workout muscle soreness when I use my percussion massage gun as part of my nightly wind-down regime. But as an ER doctor, I wanted to know what the science has to say about percussion therapy and what studies exist regarding massage guns and similar treatments. Do they actually work?
What is percussion therapy?
It seems like percussion guns exploded onto the market fairly recently, but the idea of vibration therapy has been around since the 1960s. There are hundreds of articles attesting to the benefits of local vibration, including foam rollers and vibrating plates. Percussions massage guns take vibration to the next level by employing a rhythmic massage at a high-frequency.
On social media, people are drinking a gallon a day: How much water do you really need?
From Reviewed.com: 15 must-have products if you're training for a race in 2022
Massage guns and delayed onset muscle soreness (DOMS)?
The benefit of percussion massage with the strongest evidence is for reducing delayed onset muscle soreness (DOMS). DOMS is a fancy way of referring to post-workout or post-exercise muscle soreness. We can all agree that weโd like to minimize this effect after a strenuous workout.
A 2018 meta-analysis did a systematic review of multiple previously done research studies on the benefits of local vibration for reducing DOMS. The analysis included 10 studies across 258 total participants. It found that pre-workout vibration reduced muscle pain at 24, 48 and 72 hours after exercise. DOMS was measured using a visual analog scale (VAS). VAS is a subjective pain rating scale, which can be subject to bias and raise eyebrows from critics, but the results were consistent across multiple studies.
More: Which supplements are most likely to land you in the ER?
However, the studies to date were not randomized-control trials, nor was there double-blinding. Both study organizers and participants were aware of who received the intervention being studied and who didnโt; this reduces the quality of evidence collected.
What about your range of motion?
The data on the benefit of handheld percussion for improving range of motion is also limited. A small 2020 study was the first to look at whether a 5-minute handheld percussive massage treatment of the calf muscles increased the range of motion (ROM) of the plantar flexor muscles. It found the ROM was increased by 18.4% relative to the control group.
Another small study of only 24 healthy active participants showed that in those receiving either foam roller or vibration foam roller treatment after strenuous exercise, there was a greater ankle range of motion and greater reach distances compared to those who received no treatment. But again, both studies were small and more research into whether percussion guns improve flexibility and ROM is needed.
More: 13 things that will help you stick to your New Year's resolutions in 2022
Treatment of acute pain
The evidence that direct application of percussion can reduce acute muscle pain is mixed. Proponents of handheld massagers say that vibration increases blood flow to the painful area, flushing out lactic acid and calcium โ metabolites thought to contribute to muscle contractions and pain after exercise. This sounds wonderful, and anecdotally, we likely all feel better after a deep tissue massage by a professional masseuse or physical therapist. But is there evidence to support this mechanism?
Proponents point to two small studies on whole-body vibration for proof. These studies demonstrated improved blood flow in their subjects but to make the jump that improved blood flow leads to enhanced elimination of pain-causing metabolites is a bit of a stretch.
Are massage guns worth trying?
The bottom line is that you should take the multiple manufacture-promoted benefits of handheld percussion massage guns with a grain of salt until we have more definitive research. Iโm not saying they donโt work โ personally Iโm a fan and Iโve recommended them to friends and family alike.
I also think there might be an interesting neuro biofeedback mechanism at play; thereโs a theory that high-frequency percussive therapy sends signals to the brain faster than pain signals can travel, possibly overriding and decreasing the muscle pain experienced. Thereโs no doubt among elite athletes and trainers of the incredible role the mind plays in recovery, response to pain and performance.
Given that handheld massage guns have come down considerably in price due to competition among manufactures, Iโd recommend incorporating one in your pre-workout warmup and/or for post-workout muscle soreness to see if it helps.
If you want to try it: Focus on a particular soft tissue or muscle for one to two minutes at a time. Donโt use over a bruise, sprain, open wounds or acutely injured areas with swelling. Donโt use over bony areas like your spine or joints either.
Did you know...? Why Epsom salt should be a staple in your home medicine cabinet
Do you suffer from lower back pain?: It may be time to think outside the medicine cabinet.
Everyone puts hydrogen peroxide on their wounds: They really shouldn't.
Michael Daignault, MD, is a board-certified ER doctor in Los Angeles. He studied Global Health at Georgetown University and has a Medical Degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps Volunteer. Find him on Instagram @dr.daignault