Can Deep Massage Help Muscle Soreness?
Deep massage provides modest, temporary relief of muscle soreness after physical activity, reducing pain by approximately 30% without improving actual muscle function or recovery. 1
Evidence for Massage in Muscle Soreness
The American College of Physicians guidelines on low back pain found low-quality evidence showing no serious adverse events with massage, though 2 RCTs reported soreness during or after massage therapy. 2 This establishes massage as safe but highlights that it can paradoxically cause temporary discomfort.
For cancer-related pain, meta-analytic results revealed a significant reduction in pain with massage (standardized mean difference -1.25) when pooled data were analyzed, though this was in a different population than healthy adults with exercise-induced soreness. 2
Specific Effects on Delayed-Onset Muscle Soreness (DOMS)
The highest quality evidence shows massage applied 3 hours after eccentric exercise reduced peak muscle soreness by approximately 30% and decreased swelling, but had no effects on recovery of muscle strength or range of motion. 1 This study used 10 minutes of massage and measured outcomes over 14 days post-exercise.
A head-to-head comparison found that both active exercise (shoulder shrugs with elastic resistance) and massage provided similar acute relief of muscle soreness, with the greatest effect occurring immediately after treatment and diminishing within one hour. 3 The effect on perceived soreness peaked immediately, while pressure pain threshold improvements peaked at 20 minutes post-treatment. 3
Mechanisms and Limitations
Massage likely works through multiple pathways: mechanical pressure increasing blood flow and muscle compliance, neurological effects on excitability, and psychological relaxation responses. 4 However, massage reduces the symptom of soreness without addressing the underlying muscle damage or functional impairment. 1
A systematic review concluded that while massage may be promising for DOMS, most trials were burdened with serious methodological flaws and results were not uniform. 5
Clinical Implications and Pitfalls
The relief provided by massage is temporary—lasting approximately 20-60 minutes—making it most useful for immediate preparation before competition or strenuous work rather than as a recovery strategy. 3
Common pitfalls to avoid:
- Do not expect massage to accelerate functional recovery or return to full strength. 1 The pain reduction does not reflect improved muscle healing.
- Be aware that massage itself can cause transient soreness during or immediately after treatment. 2
- Recognize that active warm-up exercises provide equivalent acute benefits and may be more practical and cost-effective than massage. 3
For healthy adults experiencing normal exercise-induced muscle soreness, the American Heart Association notes that slight muscle soreness when beginning exercise is expected, but if symptoms persist or worsen, the intensity should be decreased. 2 The American Geriatrics Society guidelines on osteoarthritis pain similarly note that muscle soreness from exercise is common and not necessarily harmful. 2
In practical terms: massage can make sore muscles feel better temporarily, but it won't make them work better or heal faster.