Pain reduction following massage after induced fatigue is not mediated by changes in muscle stiffness or intramuscular fluid content: a randomized controlled trial with mediation analysis
Massage therapy is a common intervention for athletic recovery. However, its effects on fatigue, muscle stiffness, and intramuscular fluid content, or the mechanism for pain reduction remain uncertain. To evaluate the immediate and subacute effects (24-72 hours) of massage on pain, fatigue, muscle stiffness, and intramuscular fluid content in university athletes following an induced fatigue protocol. Additionally, we investigated whether changes in muscle stiffness and intramuscular fluid content mediate the effects of massage on pain and fatigue. Randomized controlled clinical trial. Laboratory. Eighty-six university athletes, who completed a quadriceps fatigue protocol involving isokinetic concentric contractions. Participants receive either a 10-minute massage therapy targeting the quadriceps, or a sham control intervention. They were applied immediately after the fatigue protocol and repeated 48 hours later. Pain and fatigue were assessed using numeric rating scales. Muscle stiffness and intramuscular fluid content were evaluated using ultrasound elastography and echo intensity, respectively. Massage therapy reduced pain immediately after the intervention compared to sham group by -1.4 points (95% CI -2.8 to -0.1). No differences were observed for pain at subsequent time points or for fatigue, muscle stiffness, or intramuscular fluid content at any time. Mediation analysis did not reveal indirect effects of changes in muscle stiffness or intramuscular fluid content on changes in pain or fatigue. Massage therapy provides immediate pain relief following induced fatigue but does not produce lasting effects on pain, fatigue, muscle stiffness, or intramuscular fluid content. The observed pain reduction was not mediated by changes in muscle stiffness or intramuscular fluid content.ABSTRACT
Context:
Objective:
Design:
Settings:
Patients or Other Participants:
Interventions:
Main Outcome Measures:
Results:
Conclusions:
Contributor Notes