Mechanisms and Efficacy of Massage Therapy for Post-Exercise Muscle Repair: A Narrative Review.

Although widely used, massage has not been reported to be effective in enhancing recovery from exercise-induced muscle damage in humans. Studies using massage-like interventions in animal models have, in contrast, consistently demonstrated a significant enhancement of muscle repair, reduction in muscle inflammation and enhanced return of muscle force following muscle damage. The physiology of muscle damage and repair and the putative physiological mechanisms of potential massage-induced muscle repair and post-damage recovery, including soreness sensation, edema, inflammation, protein synthesis and other related mechanisms, are reviewed in this context. Animal models have demonstrated that massage effectiveness in enhancing post-damage muscle repair is dictated by the timing, duration, force and technique of its application and may also be modified by age and sex effects. The potentially very narrow "window of effectiveness" of massage application for the enhancement of post-damage muscle repair in humans has yet to be defined. And the lack of demonstrated effectiveness for massage on post-damage muscle recovery may be due to the wide range and inconsistency of massage techniques, timing and methodologies applied in human studies. Until a specific massage application protocol is defined for massage efficacy in post-damage human muscle recovery, therapists will continue to work blind, using a variety of techniques which lack empirical validity and have an undemonstrated effectiveness for enhancing muscle repair.