From the Guidelines
Massage should be avoided during the acute phase of a muscle strain, typically the first 24-48 hours after injury, as there is insufficient evidence to determine its efficacy in this context 1. Instead, follow the RICE protocol:
- Rest the injured area
- Apply Ice for 15-20 minutes every 2-3 hours
- Use Compression with an elastic bandage
- Elevate the injured area above heart level when possible. Taking over-the-counter pain relievers like ibuprofen (400-600mg every 6-8 hours with food) or acetaminophen (500-1000mg every 4-6 hours, not exceeding 4000mg daily) can help manage pain and inflammation. After the acute phase, gentle massage around (not directly on) the injured area may be introduced to improve circulation and reduce muscle tension, as conditionally recommended by the 2022 American College of Rheumatology guideline for exercise, rehabilitation, diet, and additional integrative interventions for rheumatoid arthritis 1. When massage is appropriate, it should be light and performed by a trained professional who understands muscle injuries. Premature or aggressive massage can worsen the injury by causing additional bleeding and inflammation in the damaged tissue, potentially extending recovery time. As healing progresses, typically after 3-7 days, deeper massage techniques may be gradually introduced as tolerated to help break down scar tissue and restore normal muscle function. It is essential to note that the evidence for massage in acute muscle strain is limited, and more research is needed to fully understand its effects 1.
From the Research
Massage in Acute Muscle Strain
- There is no direct evidence in the provided studies that discusses the use of massage in acute muscle strain.
- However, the studies do discuss various treatments for acute muscle injuries, such as rest, ice, compression, and nonsteroidal anti-inflammatory drug therapy 2, 3.
- Some studies also discuss the use of muscle relaxants and other medications for treating acute and chronic pain 4, 5.
- Additionally, one study discusses the use of neuromuscular electrical stimulation for treating muscle impairment, but does not specifically address massage therapy 6.
- The studies do emphasize the importance of early rehabilitation and physical therapy in treating acute muscle injuries, which may include various modalities such as massage, but this is not explicitly stated 2, 3.