A Randomized Controlled Trial of Massage and Pneumatic Compression for Ultramarathon Recovery

Abstract

Study Design Randomized controlled trial. Background Postexercise recovery techniques are widely used, but little research has examined their effectiveness. Objectives To examine the effectiveness of massage and pneumatic compression on recovery from a 161-km ultramarathon. Methods Participants in the 2015 161-km Western States Endurance Run were randomized to a 20-minute postrace intervention of massage, intermittent sequential pneumatic compression, or supine rest. Each subject completed two 400-m runs at maximum speed before the race and on days 3 and 5 after the race, and also provided muscle pain and soreness ratings and overall muscular fatigue scores before and for 7 days after the race. Results Among the 72 runners who finished the race and completed the study, comparison among intervention groups revealed no significant group or interaction effect on 400-m run time, but there was a significant (P<.0001) time effect. Immediately posttreatment, massage resulted in lower muscle pain and soreness ratings compared with the supine-rest control condition (P<.0001), while both massage (P<.0001) and pneumatic compression (P<.01) resulted in lower overall muscular fatigue scores compared with the control group. There were no significant differences between groups in any outcome 1 to 7 days after the race. Conclusion Single 20-minute sessions of postrace massage and intermittent sequential pneumatic compression provide some immediate subjective benefit. There is no evidence, however, that such treatments provide extended subjective or functional benefits of clinical importance. The trial was registered at www.clinicaltrials.gov (NCT02530190). Level of Evidence Therapy, level 1b. J Orthop Sports Phys Ther 2016;46(5):320-326. Epub 23 Mar 2016. doi:10.2519/jospt.2016.6455.

A Placebo-Controlled Trial of Riboflavin for Enhancement of Ultramarathon Recovery

“…This approach has been previously used at the WSER [2–7] and elsewhere [39], and the values have been found to correlate with plasma CK concentrations [3–5]. Ratings were provided at race registration, during the race at the 48-, 90-, and 126-km checkpoints, at the finish prior to the blood draw, and each morning of the 10 days following the race after being up and moving around for approximately 30 min.…”

“…A 400-m run at maximal speed was used as a functional measurement, which we have previously used successfully [2, 3]. Those subjects enrolled in advance of race registration were asked to perform this test twice on separate days during the 21 days before the race, and all subjects were asked to perform the test on days 3, 5, and 10 after the race.…”

“…A priori sample size determination was performed based on muscle pain and soreness ratings from previous research at the WSER [2–4]. Using a level of significance of p  < 0.05, an expected common SD of 1.5 points, and 80% power, the predicted minimum sample size to determine a meaningful group difference of 1.5 points was 13 per group.…”

“…Using a level of significance of p  < 0.05, an expected common SD of 1.5 points, and 80% power, the predicted minimum sample size to determine a meaningful group difference of 1.5 points was 13 per group. Recent research at the WSER has shown attrition rate to be roughly 25–30% [2, 3, 40], so we aimed to recruit a minimum of 17 subjects per group.…”

“…The study was performed in association with the 161-km Western States Endurance Run (WSER) since this race is known to induce considerable muscle damage and pain [2, 3, 5–7, 28–32]. Based upon the evidence that riboflavin can protect tissue from oxidative damage and is important in cell repair, we hypothesized that riboflavin would be effective at reducing muscle pain and soreness and improving muscle recovery after this extreme level of exercise.…”