Muscle biopsies show massage fights inflammation


As of September 2017, new Sweat Science columns are being published at Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)


Very cool new study on massage, from Mark Tarnopolsky’s group at McMaster (abstract here, press release here). Massage is one of those interventions that’s very difficult to study objectively — people like the feel of massage, you can’t blind them, and the outcomes you’re interested in are usually very subjective. But this study does a very good job.

The details: 11 volunteers exercised to exhaustion (about an hour or more on an exercise bike with gradually increasing pace) to induce muscle damage. Then, after a 10-minute break, one of their legs was massaged as follows:

(i) 2 min of effleurage, a light stroking technique delivered with a moderate pressure; (ii) 3 min of petrissage, a firm motion involving compression and subsequent pressure release from the muscle; (iii) 3 min of slow muscle stripping, consisting of repeated longitudinal strokes of ~40 s; and (iv) an additional 2 min of effleurage.

The leg to be massaged was randomly selected, and no one except the massage therapist knew which leg had been massaged until after the results were analyzed.

So how to figure out what the massage did? They took three muscle biopsies from each leg: one at rest, one immediately after the massage, and one 2.5 hours after the massage. Then, because they didn’t know exactly what to expect, they did an untargeted whole-genome analysis to figure out which genes reacted differently between the massaged and non-massaged leg. The result:

[W]hen administered to skeletal muscle that has been acutely damaged through exercise, massage therapy appears to be clinically beneficial by reducing inflammation and promoting mitochondrial biogenesis.

How and why does this happen? The researchers suggest that “mechanical stretch or strain during massage treatment” activates the relevant signalling pathways. In fact, they suggest, the mechanism may be essentially the same as conventional anti-inflammatory drugs. Which is very cool. They also checked the rate of glycogen restoring and lactate clearance in the muscles; neither were improved by massage (which, in the case of lactate, we already knew).

So what does this tell us? Massage does something. Do these acute signalling changes translate to a clinically significant difference in muscle recovery a day later? Impossible to say for now. Is effleurage or petrissage more effective than one of those self-massage devices you can buy from late-night informercials, or than a foam roller? Who knows. But it’s a very good start.

11 Replies to “Muscle biopsies show massage fights inflammation”

  1. Thanks for this Alex, I love how you revisit topics from your book and provide updates on interesting studies, as well as an assessment of their validity. It’s encouraging to see more information being gleaned on the mystery of massage – maybe this will someday help feed more effective approaches.

  2. Do you think foam rollers do the same or does this apply only to massage? Also, do you think this is beneficial? Reducing inflammation sounds like a good thing, but this reminds me of your post on ice baths (9/24/11). If we reduce the stress from training, will our bodies adapt and get stronger? Reducing the stress makes us feel good, but are we robbing ourselves of some of the benefits of our training by getting massages and taking ice baths? I’m all for speeding up recovery, but I don’t want to reduce the adaptations to a training load. And to muddy the waters a little more, you also have to factor in the potential for increasing the overall training load over the course of a training block by using techniques like ice baths and massages, even if they reduce the adaptations from a a single workout by a little bit (that would be a tough one to quantify). By reducing the inflammation and stress from a single workout, can we increase the overall training load through a training block?

    Interesting topic.

  3. Inflammation is nessesairy for recovery. Therefor reducing it would not seem beneficial for muscle growth/!adaptation. It might be nice for rheamatic disease patients.

  4. @Mike and @Wouter: Yes, there has been much discussion about whether too much recovery (e.g. ice baths, anti-inflammatories, and now massage) might actually take away the signal that tells the body to adapt and get stronger. So far there’s been only been one actual training study that found that effect (a Japanese study in 2006 that measured handgrip strength). The idea certainly makes sense in theory, but as Mike points out, it’s possible that the reduced adaptive signalling after each workout is more than compensated for by the ability to work out harder or more often. We simply don’t know at this point.

    As a result, it would be a mistake to flip to the opposite extreme and decide that all recovery modalities are therefore bad. One approach is to periodize your recovery: don’t put too much emphasis on recovery during heavy base training, when your primary goal is to get fitter. But during competition phases, where the goal is to feel good, use whatever tools you’ve got!

    (And of course, we still don’t really know how clinically effective most recovery protocols — e.g. massage, ice baths, etc. — actually are. So the first priority should be studies like this that tells us whether and how they work. Then the next step is to worry about whether they work TOO well!)

  5. As Wouter suggested, do you believe that this reduction in inflammation would stifle the adaptation process? Inflammation does some key to signaling process for adaptation, but there are (possibly?) many kinds of inflammation, so maybe different inflammatory mechanisms are being mediated. In school, they tell us that the body over-inflames in response to injury and training; but that makes absolutely no sense to me.

    I feel the science behind that question might be lacking, but if you have any suggested resources, that would be greatly appreciated!


  6. This is fantastic!

    I train intensely 2-3 times per week and had no idea massage could be so valuable! I’m going to begin scheduling weekly massages and practicing self massage after every workout.


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