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Massage post-exercise: aiding or imparing muscle recovery?

Monday, July 20, 2009 Posted by Peter Janiszewski, PhD
Well, it turns out that Travis and I aren’t the only ones around here debunking myths in the health field. Queen’s University's own Dr. Michael Tschakovsky and graduate student, Vicky Wiltshire, have recently completed a study which seriously brings to question one popular claim made by massage therapists: that post exercise massage increases blood flow to the muscle, thereby aiding with recovery. The results of the study have yet to be published but have been presented at this year’s American College of Sports Medicine Conference, and since then Dr. Tschakovsky has been gracing the pages of various papers and magazines.

Dr. Tschakovsky is professor in the School of Kinesiology and Health Studies at Queen’s University who’s research aims to “understand the nature of mechanisms controlling blood vessels involved in adjusting exercising muscle blood flow and how disturbances and disease affect this control.” Both Travis and I have had the pleasure of taking Dr. T’s graduate course in cardiovascular control during exercise. As is evidenced by this study, as with much of his work, Dr. Tschakovsky craves to dispel myths in science and has fought against prevailing scientific dogma for most of his career. He is a true outside-the-box thinker, and is thus an inspiration to his students and others in the faculty (check his web page here). We are very pleased that he offered to answer a few questions regarding his recent research findings on the effects of massage on post-exercise muscle blood flow.

PJ: What is the origin of the popular misconception that massage increases blood flow?

Dr. T: Its difficult to say exactly. However, there was a study in the early 1950's that purported to observe large increases in blood flow in a massaged limb. There is some evidence also that skin blood flow may be elevated by massage. In speaking with massage therapists who believe it does increase blood flow, their comments are that it is obvious because the skin gets red after you push down on it. I think that for a long time the lack of evidence based practice perpetuated this misconception, and it is only recently that in some circles in the world of massage therapy it is being acknowledged that recent evidence does not support that misconception.

PJ: What parties were mostly perpetuating the popular notion that massage therapy is beneficial for exercise recovery? Do you have any examples of websites, companies, etc.?

Dr. T: You can visit the Canadian Sports Massage Therapy Association website for comments that it increases the circulation and helps flush out lactic acid. I think that it is just a case of this "common sense" explanation becoming dogma and not enough critical attention paid to data supporting or refuting it. I will be speaking at the CSMTA annual general meeting and conference in October in Toronto to report our findings and hopefully officially clear up the misconception so that information regarding massage and its possible mechanisms for beneficial effects is updated.

PJ: Your study suggests that massage may actually reduce blood flow to the area being massaged. What is the mechanism behind this effect?

Dr. T: This is quite simple. I think that when people originally thought about the "common sense" effect of increasing circulation, they were thinking of a mechanical "pumping" effect of massage strokes, and some kind of stimulation of blood vessels. However, in order to do the "pumping" and "stimulating" you have to use compressive force. During compression of tissue, you actually squeeze shut the tiny blood vessels in the tissue through which the blood is flowing. You can imagine that if you add this to the normal resting condition, you are adding intermittent impairment to flow. If there is an enhancement effect of massage it would occur between massage strokes. The net effect (increase or decrease or no difference) on blood flow depends on whether the magnitude of impairment or enhancement effects dominates.

PJ: Would the reduced blood flow be expected to aid or hinder recovery from exercise? Why?

Dr. T: A reduction in blood flow per se will reduce the rate at which phosphocreatine stores are replenished. However, this all becomes a moot point by 10 minutes following exercise as the degree of flow reduction with massage that we measured only occurred during the first 4.5 minutes post exercise. There may be other beneficial effects not related to flow, such that I would hesitate to say it is detrimental to recovery.

PJ: Icing and cold baths are other treatments which limit blood flow and are thought to promote recovery by limiting tissue inflammation. Could the reduction in blood flow following massage be beneficial in some circumstances?

Dr. T: I would suggest that in the conditions we studied, the "reduced" flow was still a very high flow, as the blood vessels in the muscle after strenuous exercise remain very open and do so for many minutes. So, in icing we are talking about a much different scale of flow. However, it is a good question and one to which, while there is no apparent reason to suspect a beneficial effect, there may yet be some merit.

PJ: As with many popularized misconceptions, there is often a grain of truth to the matter. Was there ever any actual scientific reason to think that massage would increase blood flow, and thereby aid in recovery or was it purely just an urban legend.

Dr. T: Sure. First, there was an early study that reported substantial measured increases in flow in the early 1950's. Second, there are two mechanisms that increase blood flow in a muscle when it exercises that could be triggered by the compressive strokes of massage. They are the muscle pump, in which emptying of the veins by mechanical compression results in an increased pressure gradient from arteries to veins when you remove compression, thereby increasing flow. Second, resistance vessels in muscle tissue dilate in response to compression. Both of these effects have considerable scientific evidence to support them. The reality is however that these enhancement effects can only manifest themselves during the removal of compression, and the compression itself actually shuts of blood flow, so the net effect depends on which of enhancement or impairment dominates.

PJ: Instead of massage, what would you recommend to aid in recovering from the latest exercise bout?

Dr. T: I don't think I would recommend not to get a massage. We have to remember two things: first, our study did not assess recovery performance, so we are not commenting on whether massage is detrimental to recovery. Further to that, no studies that do assess recovery have found a detrimental effect of massage (some find no effect and others find a positive effect on things like force recovery and inflammation recovery). Second, there may be other benefits of massage (it makes you feel better, and in the world of performance that counts for a psychological effect I would imagine).

PJ: And lastly, we have found that there is something so cathartic about setting the record straight on the nonsense that is out there. Are you planning on investigating any other possible myths in the near future?

Dr. T: Hmmmmm, I've always been skeptical about the existence of Sasquatch....

Although Dr. Tshakovsky’s research has been getting quite the media attention, and is thus surely ruffling a few feathers – particularly among massage therapists, there have been some studies in the past with very similar conclusions.

For example, a literature review by Wilfrid Laurier University’s Dr. Peter Tiidus published back in 1997 in the Journal of Orthopaedic and Sports Physical Therapy, stated the following:

“There is currently little scientific evidence that manual massage has any significant impact on the short- or long-term recovery of muscle function following exercise or on the physiological factors associated with the recovery process. In addition, delayed onset muscle soreness may not be affected by massage.”

Instead, in that paper, Tiidus recommends light exercise as the best method of recovering from strenuous exercise by elevating muscle blood flow and potentially reducing delayed onset muscle soreness (DOMS).

Apparently, some myths are tough to debunk…

Peter

Tiidus PM. (1997). Manual massage and recovery of muscle function following exercise: a literature review. Journal of Orthopaedic and Sports Physical Therapy, 107-112

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3 Response to "Massage post-exercise: aiding or imparing muscle recovery?"

  1. TJ Said,

    wow! what a great blog you have started here!

    We are just starting our own blog that will be about everything Kingston Ontario.. www.kingstonON.blogspot.com

    Your two have very informative posts. We are hoping your bloggers will deliver half as good as you are! Come visit sometime!

    Posted on July 20, 2009 at 6:07 PM

     
  2. Peter Janiszewski, PhD (Cand.), MSc Said,

    Thanks for the positive comments TJ.

    Your new blog looks great - best of luck!

    PJ

    Posted on July 20, 2009 at 11:22 PM

     
  3. Corporate massage Said,

    I'd agree with you. There is no way that massage does prevent recovery in muscles. Perharps a heavy massage won't leave you feel as good as it should. I think quick massages are the best for athletes. 10 minutes tops ! Thanks for the article.

    Posted on November 23, 2009 at 4:55 PM

     

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We are PhD students in the School of Kinesiology and Health Studies at Queen's University in Kingston, Ontario. Our research focuses on the relationships between obesity, physical activity, and health risk. This blog is our attempt to consider the many "cures" for obesity that we read about on a daily basis. Enjoy.

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The opinions expressed here belong only to Peter and Travis and do not reflect the views of any organization. Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.

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