Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: Systematic review and meta-analysis

Abstract

Introduction: Exhaustive and/or unaccustomed exercise, mainly involving eccentric muscle actions, induces temporary muscle damage, evidenced by delayed onset muscle soreness (DOMS) and decreased muscle function. Different strategies to recover from its signs and symptoms have been studied and, as a result, a significant number of articles on this issue have been published.Objective: To assess whether some modalities currently used in physiotherapy such as massage, cryotherapy, stretching and low-intensity exercise are effective for treating the signs and symptoms of exercise-induced muscle damage.Methods: Randomized controlled trials (RCTs), written in English or Portuguese, that included physiotherapeutic interventions [i.e., massage, cryotherapy, stretching and low-intensity exercise, on adult human subjects (18-60 years old) of both gender] were searched on electronic databases including MEDLINE, CINHAL, EMBASE, PEDro and SPORTDiscus.Main outcome measures: "Muscle soreness" and "muscle strength" were the outcome measures included in the meta-analysis.Results: Thirty-five studies were included; nine analysed the effects of massage, 10 examined the effects of cryotherapy, nine the effects of stretching and 17 focused on low-intensity exercise intervention.Massage was the only intervention with positive effects, reducing soreness at 24 hours, on average, 0.33 on 10 cm on VAS (95 percent CI: -0.59, -0.07) and increasing muscle recovery by 1.87 percent (95 percent CI: 0.30, 3.44). Additionally, there is inconclusive evidence to support the use of cryotherapy, while there is little evidence to prove the efficacy of stretching and low-intensity exercise.Conclusion: Massage proved slightly effective in the relief of symptoms and signs of exercise-induced muscle damage. Therefore, its mean effect was too small to be of clinical relevance. There is a lack of evidence to support the use of cryotherapy, stretching and low-intensity exercise.

The Use of Recovery Strategies Among Participants of the BUPA Great North Run: A Cross-Sectional Survey

“…Correspondingly stretching was reported as the most commonly used recovery strategy in the present study; however stretching was not most frequently reported as the most beneficial recovery strategy. This belief that stretching is not the 18 most beneficial recovery strategy available is consistent with a recent systematic review and meta-analysis, which reported that there is no robust scientific evidence to support the use of stretching in reducing muscle soreness or improving muscle recovery after exercise-induced muscle damage [4]. The reasons why runners continue to use stretching, despite an awareness that its benefits may be limited, were not investigated in the present study.…”

“…The effectiveness of such recovery strategies does however appear to vary widely. For example recent meta-analyses investigating post-exercise recovery strategies have concluded that the use of compression garments [2] and cold water immersion [3] are beneficial, but that there is insufficient evidence to support the use of stretching [4] or contrast immersion [3].…”

The efficacy of manual versus local vibratory massage in promoting recovery from post-exercise muscle damage – A systematic review

“…Torres et al (2012) reported that massage applied after exercise is effective on muscle soreness only after 24h post exercise. This confirms the recommendation of Tiidus (1997) who showed that massage also had an effect on inflammatory response and may be able to affect the later development of muscle soreness.…”

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“…By the way, these results have been inconsistency effect on muscle soreness sensation and muscle performance yet (Sellwood et al, 2007;Jakeman, Macrae & Eston, 2009;Howatson, Goodall & Someren, 2009;Goodall & Howatson, 2008;Torres et al, 2012).…”