Massage guns are heavily marketed as a substitute for professional therapists, providing benefits such as sports recovery and pain... Read Article
The best massage for DOMS and sore muscles
The trouble with having a really good workout is the next day your muscles are sore, and it takes a few days until you can work out with full intensity again. Massages are widely used to reduce this soreness speed recovery, but which is the best type, and when is the best time to have them? Also, using professional therapists is expensive so there are many aids marketed towards self help, but do these work and are they safe?
The good news is that scientists have studied this and done a great number of clinical trials, so we can give you a definitive answer. In this article we’ll share with you which massages give great results, plus which of the self help methods work and which are just a waste of money. The way we’ll do this is to:
Why you get sore muscles after a workout
Post exercise soreness is also called DOMS or Delayed Onset Muscle Soreness. Lets look at what happens to your muscles to cause this.
As this diagram shows your muscles are made up of microscopic fibres. Strenuous exercise will damage some of these fibres, and you will also get a build up of metabolic wastes and chemicals that result from the breakdown of damaged tissues.
Tightening your muscles
Also, your muscles tend to tighten after exercise. This causes tension in your muscles plus where they attach to your bones. As this diagram shows it will also put pressure on your blood vessels, restricting blood flow. This reduces the clearance of wastes and break down products, plus the re-supply with fresh nutrient.
Reduced strength and endurance
Your muscles will not be able to perform as well suffering from microscopic damage and restricted blood flow. For example, say you could normally do 10 reps of an exercise. The day after a strenuous workout you might only be able to do 6, and not be able to perform fully again until recovered a few days later.
What your muscles need to do to help recover faster
Understanding why your muscle get sore and won’t perform normally after a workout, the main ways massage can help is by:
- relaxing the muscles (removing tension and removing pressure from the blood vessels)
- increasing blood flow (helping remove wastes and bring in fresh nutrients)
Your massage options
As discussed, you’ve two main types of massage: using professional therapists, and self massage. Lets look at your options for each.
Professional massage therapy
Professional therapists are widely used for post exercise recovery, and are often employed by sports clubs. They often describe their services using terms like those listed below.
- Sports massage
- Remedial massage
- Swedish massage
However, we recommend that you not worry too much about what the massage is called. The reality is that they all use the range of techniques listed below. Different styles may emphasise certain techniques or may be more forceful in their approach, but the massage you receive will depend more the skill and experience of the therapist, and whether he or she is performing a more remedial or relaxation massage.
The type of massage used in clinical trials
Most of the clinical trials we consulted used one of these terms to describe the type of massage used. However, when we read the fine print to see what was actually done the descriptions were very similar, using a mixture of the techniques below.
- Effleurage (stroking along the muscle fibres)
- Petrissage (kneading)
- Friction (rubbing across the muscle fibres)
- Pressure (pressing on spots): eg trigger point therapy or acupressure)
Self massage options
For self massage you have two main types to choose from: manual massage and vibration massage.
There are a wide range of contraptions such as balls and rollers that are designed to help self apply the techniques professional therapists use.
There are two types of massagers that vibrate.
- vibration massagers
- percussion massagers
Looking at the effectiveness of each
Now we’ve seen the options, lets look at what the scientists have found about each.
What science says about massage from professional therapists
A 2020 scientific review called “Effects of sports massage on performance and recovery” reviewed 29 clinical trials (1). In summary, they found that massage gave a 13% reduction in post exercise soreness (DOMS or Delayed onset Muscle Soreness ) and a 7% increase in flexibility. The increased flexibility would be due to reduced tension in the muscles, which as discussed is ideal to help healing.
Massage has also been shown to reduce this loss of strength and endurance, and speed recovery (2,3). Your muscles will still suffer a reduction in strength and endurance, but not as much, and you will be back to full performance sooner.
When should you have a massage
We could not find any studies that compared having a massage before or after exercising. All we found was one study that showed it was better to be massaged immediately after exercise rather than having a considerable delay (4).
What the science says about using balls and rollers
Clinical trial results
Balls and foam rollers are widely used as a way get practically unlimited self massage. Their marketing material often refers to studies showing them to be effective. The reality is though, as we discuss in our article Do foam rollers work we found a total of 11 clinical trials and the actual results were either minimal or none. They were certainly no where near those achieved in the trials where professional therapists were used. Further, as discussed in the same article we believe that the real world results from using balls and rollers would be even worse, and in my experience as a Chiropractor for 27 years a lot of people hurt themselves with these for very little benefit.
Lets look at:
- why clinical trial results for balls and rollers were no where near as good as those achieved by professional therapists, and
- why real world results would be even worse.
The reasons using balls and rollers is much less effective than professional therapy
- Self users rarely have the skill or knowledge of a professional therapist
- It can be difficult to get into the needed positions and apply the correct pressure
- Most importantly, when consulting a professional therapist you are usually lying relaxed on a table. However, when using a foam roller the muscles being massaged are often tightened just to get into the appropriate position. Massage won’t relax muscles if you are trying to tighten them at the same time.
The reason real world results are less than those in clinical trials
Clinical trials are a perfect world scenerio. Patients are excluded if using balls or rollers would not be suitable or be unsafe. They are then given excellent instructions and supervision. On the other hand in the real world people use balls and rollers without instruction or supervision, and sometimes on conditions where this therapy is inappropriate or unsafe.
There are two types of vibrating massagers available for self use. We’ve summarised the differences below, and got full details in our article Percussion Massage vs Vibration massage.
Vibration massage is where vibrations are used to penetrate the muscles and have their therapeutic effects. The way these work is the vibrating head of a massager is placed on a muscle and the vibrations penetrate in a similar way to the way ultrasound does. As discussed in our article The scientifically proven effects of vibration massage- with clinical applications scientists have confirmed that these vibrations have a host of beneficial effects.
Percussion massage (massage guns)
The heads of percussion massagers go up and down to, but they do this to drive the head into the muscle like a jackhammer rather than transmit vibration. Massage gun marketers say that this helps the therapy penetrate better. However, the reality is that this is purely a marketing gimmick. By jack hammering rather than vibrating the therapeutic effect of the vibrations is dramatically reduced, while the risk of causing injury is increased. Unfortunately though massage gun marketers make false claims and misrepresent the effectiveness of their product, and those modifications make it so massage guns are actually very dangerous and can potentially cause serious injury or kill you.
What the science says about vibration massage and post exercise recovery
We found 11 clinical trials of vibration massage for sports and exercise recovery, summarised in the appendix. All but three gave excellent results, which included those below. Please note that these cannot be applied to massage guns or percussion massagers.
- reducing post exercise soreness (DOMS or Delayed Onset Muscle Soreness)
- reducing the amount of unwanted chemicals such as lactic acid,
- reducing the loss of strength and endurance, and speeding recovery.
The speed of vibration massage
Trial results show that vibration massage is much faster than manual massage. Where the two were directly compared (5) five minutes of vibration gave better results than 15 minutes of massage. This means a typical 30 minute pre or post exercise massage would only take about 10 minutes. Later we discuss how we have developed a vibration massager with four powerful application heads that is much faster still, and could do the equivalent of a full hour massage in minutes.
The three that didn’t give good results
Why did three trials produced poor results? In our article How to choose a massager we give the appropriate specifications for a therapeutic vibration massager in order to give effective vibration.
- the vibration frequency should range from 30-55 Hz (cycles per second).
- The vibrating head needs to go up and down from 3-5mm
All the clinical trials where massage was applied massage using these specifications gave excellent results. On the other hand, as shown below the three trials that gave very poor results used massagers that were totally inadequate to deliver effective therapeutic vibrations. I have emailed each or the researchers offering them the use of effective machines should they ever do further studies.
Ineffective vibration massager used in three trials
- Trial one: 73 Hz, 0.5 mm
- Trial two: 120 hz, 1.2 mm
- Trial three: 50 Hz, 0.9 mm
When to use vibration massage: before exercise, after or during recovery
Some trials used the vibration massage before exercising, some used it after, while others used it after exercising then daily during recovery. From these results:
- vibration before and after are both effective, but before is slightly more so, and
- applying vibration massage after then daily during recovery gave excellent results.
The practical reality is that if you have your own massager the optimal solution would be to to use it both before and after, then daily during recovery.
How long to apply the vibration for
We noted that in the trials the researchers used applications ranging for one minute to 30 minutes. From our knowledge of massagers the usage time required would depend on a lot of things including:
- the size of the muscle(s) being massaged,
- the power of the massager and the size of the application head, and
- the condition of the muscles.
However, we can generally say that the trial results were consistent with our clinical experience. The recommendations we advise in our usage guide would be a good start.
Our recommendations: the best massage for DOMS and sore muscles
Which massage is best for DOMS and sore muscles? Based upon the clinical trials and other scientific evidence, we make the following recommendations.
- massage by professional therapists, and
- self applied vibration massage (much faster, less cost)
- Massage guns
- Balls and foam rollers
An overall strategy to reduce DOMS and muscle soreness
In the next section we discuss our recommended massage options, but massage is only part of an effective strategy to reduce post exercise soreness and speed recovery. It is important to get adequate sleep, rest, hydration and nutrition. There are also other therapies that may be useful. For a complete strategy please see our Practical, science based guide to post exercise recovery. Please also note that this is for general information only, to be discussed with a professional familiar with your own specific needs.
Professionally applied massage therapy
From the clinical trial results, having a massage from a professional therapist either before or after sports or a workout will reduce post exercise soreness and speed recovery. We also note that massages are proven to increase flexibility by 7% which could also help athletic performance and reduce the risk of injuries such as muscle tears.
As discussed, the skill and knowledge of the therapist and the type of massage he or she does is more important than what the massage is called. You may need to seek recommendations or trial some in order to find the best for you.
When to massage
When massage is done shortly after exercise (such as often happens at a sports club) is likely better than having it done some time later.
As we’ve seen vibration massagers are highly effective. Also because basically all you need to do is sit the head of the massager on the site to be massaged and allow the machine to do the work vibration massage can easily and effectively be self applied. For how to apply vibration massage please see our article How to use a hand held massager for more details.
When to use vibration massage
Vibration massage was shown to be useful before exercise, after exercise, and during recovery. If you have your own vibration massage unit the optimum might be to use it before exercise, after exercise, and each day during recovery.
You will need a decent vibration massager
This is where there’s been a problem. A few years ago a team of UK researchers studied the commonly available personal use hand held massagers (6). That is the type of massage available for someone like you to use at home (or the gym). They found that they were ineffective. Basically the manufacturers were more concerned about how their machines looked on shop shelves rather than how they worked.
Since then it’s actually become worse, and now we also have heavily marketed massage guns that are really ineffective and dangerous gimmicks.
As a Chiropractor for over 27 years I had patients that needed a decent effective home massage unit so unable to find anything I was happy to recommend I had my own built. Please allow me to share them with you.
The General Purpose Massager
We had our General Purpose Massager built about 10 years and have sold about 100,000 of them. They’re widely used by professionals such as Chiropractors, Osteopaths and Physiotherapists. These professional also recommend them to their patients for self massage. At the business end they have a very strong vibration mechanism, and they’ve got an ergonomically designed handle that makes it extremely easy to massage anywhere on your body.
We have patients use them for a variety of uses including back pain, health and wellness, and of course post exercise recovery and they amazing job. The only issue is that with only a single head you can only massage a limited area at a time. If you wanted to use one before sport or a workout it might take 20-30 minutes to massage all the muscles in your body. For a long time we wanted something that would be just as effective, but work on a much larger area so you could effectively massage your whole body in 5-10 minutes.
Get a General Purpose Massager
The Ultimate Quad Head Massager
So you can effectively massage larger areas we’ve developed our Ultimate Quad Head Massager. It has the same ergonomically designed handle so you can easily massage anywhere on your body, and it can also be easily used as a chair massager or a cushion massager.
New design: smoother more comfortable machine, but better penetration
The problem is that massagers with larger heads of multiple heads have always had a problem with harshness, vibration and the machine not adapting the body well. The good news is we’ve solved that problem and built four headed massager that’s actually smoother and more comfortable. It penetrates amazingly well without feeling like it is pummeling you. This is how we’ve done it.
Get an Ultimate Quad Head Massager
The problem with large flat heads
This pic shows a professional massager that was designed to do larger areas. You can see the vibrating pad on the bottom. This would be perfect, except human bodies aren’t flat.
The problem with large heavy heads
Next we’ll next look at a massager built by one of the most respected makers of professional massagers. It’s a beautifully built machine with four contacts for a larger area, but if you look closely it’s just one head with four balls attached. As you can see in the following diagram massagers follow the laws of physics. If you have great big head each time it pushes down the machine pushes up. That’s going to be quite harsh and vibrate the hell out of the machine you’re trying to hold. Also there’s a lot of inertia in that big plate with the four heads going up and down. If you happen to hit something like a bony bit it’s not going to be very forgiving.
The problem with multi head see-saw mechanisms
There are also a lot of other multi head machines that use a see saw mechanism. As shown in the following diagram they have exactly the same problem, except that they rock from side to side rather than bounce up and down.
How we built a multi head massager that has high penetration, yet is smooth and comfortable
The way we fixed that is by having a mechanisms where two rockers work the opposite to each other. There’s always two heads coming down and two going up, so they balance. It’s the same right to left and front to back. You’ve always got one going down in each side, and you’ve always got a front and back one going down. That’s why these can send vibrations right through you body, yet they’re extraordinarily comfortable.
DrGraeme massagers were originally built by Dr Graeme for use in his clinic, and to prescribe to his patients for additional self use at home. Now these are used by colleagues and other professionals for similar purposes. If you are a professional and wish to know more about this therapy, or possibly get a sample massager to trial please check out our practitioner page.
Appendix: summary of clinical trials of vibration massage used for post exercise recovery
What was done
Applied vibration to relieve post exercise soreness
Used an applicator with only 0.9mm travel
Compared massage vs 50Hz vibration. Patients were assessed 24, 48 and 72 hours post exercise.
Reduced pain, reduced lactic acid
15 minutes massage was used compared with 5 minutes of vibration, yet the vibration produced better results.
30 minutes of vibration after exercise, then at days 1,2,3 & 4
Reduced soreness, faster recovery of range of motion (less stiffness)
50 Hz vibration for one minute before exercising
Prevented DOMS (post exercise soreness)
20 Hz applied for 20 minutes
Reduced pain, increased blood flow
This is outside the optimum 30-55Hz, but still helped
35 Hz applied with a vibrating pad
22-61% reduction in pain
Our Ultimate Quad Head Massager can be used as a super effective pad.
10 minutes of 45 Hz done before exercise than twice a day during recovery
Less loss of strength post exercises and greater oxygen saturation of the tissues
Used an electronic massage device 28-85 Hz
Reduced pain, increased post exercise strength
Comment: self treatment allows greater frequency
30-50 Hz vibration before exercise
Reduced tenderness and DOMS (post exercise soreness)
Used vibration cushion, 73 Hz, 0.5mm
Woefully inadequate vibration device
Used a 120 Hz, 1.2mm device
Woefully inadequate vibration device
- Davis HL, Alabed S, Chico TJA. Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport Exerc Med. 2020;6(1):e000614.
- Mancinelli CA, Davis DS, Aboulhosn L, Brady M, Eisenhofer J, Foutty S. The effects of massage on delayed onset muscle soreness and physical performance in female collegiate athletes. Phys Ther Sport. 2006;7(1):5–13.
- Naderi A, Aminian-Far A, Gholami F, Mousavi SH, Saghari M, Howatson G. Massage enhances recovery following exercise-induced muscle damage in older adults. Scand J Med Sci Sport. 2021;31(3):623–32.
- Haas C, Butterfield TA, Abshire S, Zhao Y, Zhang X, Jarjoura D. Massage timing affects postexercise muscle recovery and inflammation in a rabbit model. Med Sci Sport Exerc. 2013;45(6):1105–12.
- Imtiyaz S, Veqar Z, Shareef MY. To compare the effect of vibration therapy and massage in prevention of delayed onset muscle soreness (DOMS). J Clin Diagnostic Res. 2014;
- McDonagh D, Wilson L, Haslam C, Weightman D. Good vibrations: Do electrical therapeutic massagers work? Ergonomics. 2005;
- Kamandani R, Ghazalian F, Ebrahim K, Ghassembaglou N, Shiri Piraghaj M, Khorram A. The Effect of Acute Vibration Training on Delayed Onset Muscle Soreness in Young Non-Athlete Women. Heal Scope. 2015;
- Fuller JT, Thomson RL, Howe PRC, Buckley JD. Effect of vibration on muscle perfusion: A systematic review. Clin Physiol Funct Imaging. 2013;33(1):1–10.
- Cochrane D. Effectiveness of using wearable vibration therapy to alleviate muscle soreness. Eur J Appl Physiol. 2017;117:501–9.
- Pournot H, Tindel J, Testa R, Mathevon L, Lapole T. The acute effect of local vibration as a recovery modality from exercise-induced increased muscle stiffness. J Sport Sci Med. 2016;15(1):142–7.
- Lau WY, Nosaka K. Effect of vibration treatment on symptoms associated with eccentric exercise-induced muscle damage. Am J Phys Med Rehabil. 2011;
- Bakhtiary AH, Safavi-Farokhi Z, Aminian-Far A. Influence of vibration on delayed onset of muscle soreness following eccentric exercise. Br J Sports Med. 2007;
- Koeda T. A trial to evaluate experimentally induced delayed onset muscle soreness and its modulation by vibration. Environ Med. 2003;47:26–30.
- Rhea MR. Effect of iTonic Whole-Body Vibration on Delayed-Onset Muscle Soreness Among Untrained Individuals. J Strength Cond Res. 2009;23(6):1677–82.
- Percival S et al. Local vibration therapy increases oxygen re-saturation rate and maintains muscle strength following exerciseinduced muscle damage. J Athl Train. 2021;Aug 17.
- von Stengel S, Teschler M, Weissenfels A, Willert S, Kemmler W. Effect of deep oscillation as a recovery method after fatiguing soccer training: A randomized cross-over study. J Exerc Sci Fit. 2018;16(3):112–7.
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About Dr Graeme
Several years ago Dr Graeme, a Chiropractor practicing in Victoria, Australia was looking for a serious hand held massager his patients could use at home to get the extra quality massage they needed. The ones he found in the shops and on-line for home use looked nice but were not serious, and... read more
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