A good rubdown is thought to bring a host of benefits – from aiding recovery and reducing stiffness to preventing injury – but how much does it really help? Paul Hobrough looks at the evidence

Massage has been used by athletes since the dawn of time. It’s a practice which has been ingrained into routines the world over yet there are arguments out there to suggest it may not bring all of the performance gains we might think. Let’s take a closer look. 

Getting specific

Sports, deep tissue, trigger point therapy, Swedish, shiatsu, Thai… there are myriad options out there when it comes to massage. However, for the purposes of this article, we’re looking at one particular area.

When athletes talk about massage, they are referring to sports massage, not a gentle rub with essential oils designed to help you relax as part of a spa day. So, when we are looking at the science for “massage” we must be specific about what is actually being researched.

The information discussed here is focusing on deep tissue sports massage, by an experienced and well-trained professional in that specific type and style of treatment.

There are a huge variety of qualifications, so you may get treatments from a sports massage therapist, sports therapist, sports rehabilitator or maybe you see your local physio or other healthcare practitioner who also holds a qualification in sports massage. Most of the time, runners will know who the best person is locally and refer them on to others. A recommendation is worth its weight in gold.

What are the benefits? 

Despite feeling good after a sports massage, are there any lasting effects?  Sports massage has become dogma in the sense that professionals use the service regularly and if it is seen as an important part of their recovery then surely it must be good for you, right?

Davis et al (2021) performed a meta-analysis of 29 scientific studies containing a total of 1012 participants in order to study the effect of manual massage on recovery and sporting performance.

Their findings show no statistical evidence for an improvement in performance, but did find a small but statistically relevant improvement in flexibility and delayed onset of muscle soreness (DOMS).

Tani (2019), a PhD student, compiled a tiny study looking at massage in terms of mental state and stress, measuring saliva and the “Profile of mood states” (POMS) questionnaire (albeit on just two subjects).

The results showed a reduction in stress (cortisol) and mood state (POMS) following massage or the use of compression sleeves. These results are by no means statistically relevant but may form the basis of future study to see if the effect can be seen on a larger set of data.

In 2021 The Harvard Wyss institute for Biologically inspired engineering looked at how mice react to mechanical compressive forces on their legs and found a rapid clearance of immune cells (neutrophils) and inflammatory cytokines from injured muscle tissue. This process can double the speed of the muscle fibre regeneration process.

If you consider the effects on offer here – improved flexibility, reduced muscle soreness, improved muscle tissue regeneration and potentially reduced stress and improved mood state, then might we have reason to continue with our love of sports massage.

The argument against

In contrast Salleh (2021) found no evidence for improved DOMS, Moran (2018) found massage to actually reduce sprint speed compared to a traditional warm-up and Bender (2019) found no effect on perceived fatigue, flexibility, strength or jump performance following massage. We therefore find ourselves in a situation of massage have some plus points but a lack of evidence in others.  

What we do know is that sports massage, whilst sometimes painful, appears to have no negative effects except pre-sprint competition. On that basis, what are the risks of using sports massage if you feel it helps? Literally none it seems. 

There are some thoughts that continued passive treatments can form an unhealthy reliance – where science shows little or no effect, but the patient continues to believe that the treatment is the only thing that “works”. 

This sort of reliance can in fact decrease wellbeing, with a failure to take positive action in terms of strengthening the body to become more resilient.

What will make the greatest difference?

So, where does sports massage fall in this process?  Should we denounce any treatment that we cannot unequivocally “prove” has a long-term effect?  Where no harm is being done, where perceived or actual benefit is being achieved then why not continue with your sports massage, provided there is affordability?  

Athletes have spent decades trying to find the short cut, the magic intervention or the latest technology to advance their performance. New shoe technology offers specific percentage gains these days, while sports science continues to find new ways of providing nutrition support and coaches the world over look to find new techniques to ensure their athletes stand atop the podium.

Science can also tell us that strength training has a marked impact on performance, biomechanics and technique – that these literally provide free speed when correctly mastered.

In a world where there are positive gains to be made in your running journey that have far higher scientific merit than massage, spend your money wisely, get stronger, train harder and eat better.

When all other stones have been lifted, or you have the means, then have as much sports massage as you like, because we are starting to learn that it might just make a small, albeit short-term, difference.

» This article first appeared in the December issue of AW magazine, which you can buy here