What are the theoretical benefits of percussive massage devices?
Handheld percussive massage devices (i.e., massage “guns”) have become popular in recent years. More and more advertisements are popping up of the popular brands that make these devices (e.g., Hypervolt, Theragun, etc.) in which claims are made of enhanced recovery among athletes at the elite and professional level. Endorsement from elite/professional athletes, however, is not enough grounds to establish whether a device works or not. Although individual testimonial is certainly useful, what is the actual theoretical premise behind which these massage guns are based on?
Well, percussive devices such as massage guns seem to base their logic on the fact that they are combining massage and vibration therapy together. There is a good amount of literature to suggest that massage (either via a massage therapist or via foam rolling of some sorts) can lead to reductions in the intensity of delayed onset muscle soreness (DOMS) following intense exercise as well as lead to improvements in range of motion (3). Vibration therapy (usually applied by having an individual stand on a plate that vibrates at a low magnitude, high-intensity frequency or by having someone use a vibrating foam roller on a specific muscle) also has some evidence to support that it can lead to reductions in the intensity of DOMS as well as lead to improvements in range of motion (1,2).
Therefore, it would seem that if you could combine the two and make a device that does both massage and apply some sort of vibration to the muscles that you could also receive some benefits on athletic performance. However, despite the benefits of massage and vibration therapy individually, research still needs to establish that massage guns actually do work before we claim that they do. Let’s discuss this research next.
What are the actual benefits of percussive massage devices?
Not surprisingly given how new these types of devices are, there is very, very little research published to date investigating the effects of percussive massage devices on athletic performance. The only study that seems to be done thus far is one very recently published by Konrad and colleagues earlier this year (4). In this study, research had 16 individual volunteers come into a laboratory on two separate occasions. On each occasion, they performed a calf (i.e., gastrocnemius) range of motion assessment and a calf maximum voluntary muscle contraction assessment (sort of a proxy test to assess maximum muscle strength in the calf muscle) after a standardized warm-up on a stationary bike. However, on one day, after the standardized warm-up, participants received a 5-min massage with the Hypervolt massage gun on their calf muscles before performing the tests; and on the other day they just sat still after the standardized warm-up for six minutes before performing the tests. When receiving the 5-min massage with the Hypervolt device, participants actually saw a significant increase in their ankle dorsiflexion range of motion (i.e., greater calf flexibility) without a decrease in calf muscle strength. When simply sitting still, participants did not see any sort of improvement in their ankle dorsiflexion range of motion.
This study is interesting as it demonstrates that the massage guns could be a potentially useful tool as part of a warm-up due to the fact that it did not seem to impair muscle performance (i.e., strength) but increased range of motion around a joint. The most likely causes for this are due to the massage device increasing blood flow to the muscle, reduction in pain sensitivity, increased sensation of relaxation, reduced muscle compliance and stiffness, and also greater viscosity (i.e., less resistance to movement) of the muscle itself and the skin and fascia surrounding it.
However, this study did not investigate the effects of the massage gun on DOMS following intense exercise. Therefore, it is not clear yet as to whether or not massage guns, like the Hypervolt, are useful post-exercise as a recovery tool and can lead to reductions in the intensity or length of time that one experiences DOMS after an intense exercise session.
Additionally, this study did not investigate any sort of long-term range of motion/flexibility changes. So, it is also not clear if the acute improvements in range of motion can be made permanent by regular use of a massage gun. In all likelihood, these changes in range of motion are not permanent when the massage gun is used just one time. Similar to massage and foam rolling, there can be transient increases in range of motion or flexibility due to increased relaxation and a reduced sensitivity to pain (among other factors). However, would using a massage gun regularly to target “trigger points” or spots of significant muscle tension and stiffness lead to long-term improvements in mobility and flexibility? There isn’t enough research to answer this question quite yet.
Furthermore, we also don't yet know quite what the optimal "dose" of massage gun usage is needed to elicit any sort of positive responses. This particular study discussed herein had participants exposed to 5-min of massage on both legs, so we know that 5-min of massage gun exposure seems to work for improving range of motion acutely. However, would less time have been just as effective? In the foam rolling literature, which I have discussed in a previous Science Post, just 1 or 2 sets of 60 seconds seem to be effective in improving range of motion acutely. Would 60 seconds of massage gun exposure be just as effective as 5 minutes? This, we do not know yet and much more research will need to be done before we have a more complete picture as to what the optimal "dose" is to see any sort of benefit.
Finally, this study did have a small sample size of healthy volunteers, albeit, it was a randomized controlled trial. Due to such a small sample size and the relatively young, healthy participants included, the takeaways from this study should therefore be in the context of the limitations of study itself and the findings shouldn't be generalized to ALL types of individuals.
So far, with the one study that has been published to date on the topic of massage guns, it seems that there is some evidence to suggest that they can be useful tools during a warm-up routine before an intense exercise session. However, their benefit on recovery or long-term mobility/flexibility changes is unknown. It could be theorized that using massage guns post-exercise can lead to reductions in DOMS and potentially enhance recovery time, but the evidence isn’t there to support these claims officially quite yet.
On another note, some of the more popular brands of massage guns (i.e., Hypervolt, Theragun) can be very expensive (upwards of $350-$400 for the device). In my own personal experience, I have purchased lesser known branded version of massage guns for less than $100 and they seem to do the job just as well as the more expensive branded massage guns. So, it may be worth considering trying a much cheaper brand of massage gun initially if you simply want to try out these types of devices. In my experience so far, the massage guns do feel nice after hard exercise sessions and can be quite useful in helping me warm-up before sessions as well. However, in my own opinion, $350-$400 for one of these devices is absolutely ridiculous and one should consider a cheaper alternative, particularly given the fact that there is so little evidence currently available to justify such high price points.
1. Cerciello S, Rossi S, Visonà E, Corona K, Oliva F. Clinical applications of vibration therapy in orthopaedic practice. Muscles, ligaments and tendons journal. 2016 Jan;6(1):147.
2. Cheatham, S. W., Stull, K. R. and Kolber, M. J. (2019) Comparison of a vibration roller and a nonvibration roller intervention on knee range of motion and pressure pain threshold: A randomized controlled trial. Journal of Sport Rehabilitation 28(1), 39–45.
3. Davis, H. L., Alabed, S. and Chico, T. J. A. (2020) Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine 6(1), e000614.
4. Konrad A, Glashüttner C, Reiner MM, Bernsteiner D, Tilp M. The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance. Journal of Sports Science and Medicine. 2020 Dec 1;19(4):690-4.
Happy training and racing!
-Ryan Eckert, MS, CSCS
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