Acute Effect of Percussive Massage on Cross-Section Area, Muscle Strength, and Late Muscle Pain of the Quadriceps Muscle Following a Fatigue Protocol in Physically Active Men: Randomized Clinical Trial.
Aline da Rosa Castilho, Andreo Fernando Aguiar, Alex Silva Ribeiro and 4 others
A 5-minute massage-gun session on the quadriceps after a fatiguing leg press kept muscle area stable while the rest-only group's swelled.
Strength was unchanged in both groups. Treated-group pain fell 53% by 48 hours, but the between-group difference was not significant. Small, unblinded, young men.
Key findings
1Percussive massage prevented the increase in rectus femoris cross-sectional area (edema) that developed in the control group at 24 and 48 hours after a fatiguing leg press; the treated group's area remained stable over the same period.
2No significant difference in peak isometric knee-extension strength between groups or across time points, despite very large effect sizes (d = 2.42 at 24 h, d = 2.01 at 48 h) that the authors attribute to the small sample and high variability.
3The treated group's pain during a sit-to-stand test fell by 53% between 24 and 48 hours (p < 0.001), while the control group's pain did not change significantly over the same interval; however, the between-group interaction was not significant (p = 0.209).
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What it does not show
Participants could not be blinded because the vibration was obvious, and the data-collection team was also not blinded, so expectation effects are possible. Only 37 young, healthy, physically active men were included; findings may not generalise to women, older adults, or clinical populations. Convenience sampling from a single university limits representativeness. No biochemical markers (e.g., CK, CRP) were measured, so the claim that percussive massage modulates inflammation is speculative; the authors themselves note this. Only one device, one frequency, and one duration were tested; it is unclear whether other parameters would produce different results. The 53% pain reduction is a within-group change in the treated arm; the between-group interaction did not reach significance, so it cannot be concluded that percussive massage reduced pain more than rest. The large effect sizes for strength (d = 2.42, d = 2.01) did not reach statistical significance, likely due to the small sample and high variability; the strength result should be read as null, not as a positive finding.
Declared interests
The authors declare no conflicts of interest and report no funding source.
The easy way to misread this
Do not read the very large effect sizes for strength (d = 2.42 at 24 h, d = 2.01 at 48 h) as evidence that percussive massage improves strength recovery. The between-group p-value was 0.177 and the interaction was 0.652, both non-significant, and the authors themselves attribute the discrepancy to the small sample and high variability. Likewise, the 53% pain reduction at 48 hours is a within-group change in the treated arm; the between-group interaction was not significant (p = 0.209), so it cannot be concluded that the massage gun reduced pain more than rest.
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