Crane JD, Ogborn DI, Cupido C, Melov S, Hubbard A, Bourgeois JM, & Tarnopolsky MA (2012). Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Science Translational Medicine, 4 (119) PMID: 22301554
Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage.
Crane JD, Ogborn DI, Cupido C, Melov S, Hubbard A, Bourgeois JM, and Tarnopolsky MA. Sci Trans Med. 2012 February; 119(4).
Massage therapy is a complementary and alternative medicine therapy that is often used to manage pain, relieve stress, and prevent injury following exercise. This treatment, the fifth most widely used complementary and alternative medicine therapy, usually consists of a physical manipulation of the muscle and connective tissue. While massage therapy is reported to be widely used, it has not been objectively evaluated. Therefore, Crane and colleagues completed a study to evaluate the influence of massage within muscles that had performed a bout of intense exercise. The aim was to better understand whether massage is appropriate for managing exercise-induced inflammation. Eleven, recreationally active, males volunteered to participate in the study. Each volunteer was seen on two occasions separated by 2 weeks. All subjects were instructed to abstain from moderate to intense physical activity for 72 hours before each appointment. All subjects were given a 355 kcal defined formula diet 2 hours prior to each trial. Visit one consisted of a baseline biopsy of the vastus lateralis muscle (rest), followed by testing for peak aerobic capacity (VO2peak) using an upright cycle ergometer. During visit 2 each volunteer cycled at a workload of 60% VO2peak (30 min, 70-90 rpm), followed by 65% VO2peak (5 min), 60% VO2peak (5 min), increased to 70% VO2peak (5 min), dropped to 60% VO2peak (5 min), and then to a maximum of 85% VO2peak. The test then continued until the subject was unable to maintain 70 rpm. Following the exhaustive protocol, all subjects rested for 10 min, and then a single leg was randomly chosen to receive massage treatment for 10 minutes from a registered massage therapist. Follow-up biopsies were then taken 10 minutes after the massage was completed and again 3 hours after the exhaustion protocol was completed. Analysis of the biopsied tissues found that immediately after treatment there were activated pathways that are related to mechanical stimulation. These activated pathways may help explain how the muscle reacts to massage (via mechanical stimulation). Massage was also beneficial in reducing the concentration of a pro-inflammatory protein (tumor necrosis factor-a) and a protein that regulates inflammation (interleukin-6). This suggests that massage therapy may reduce muscle inflammation following acute muscle damage due to exercise.
This study presents a very objective look at whether massage therapy is beneficial in reducing muscle inflammation. Clinically, this can be extremely useful as this could perhaps be a method of preventing exercise-induced muscle inflammation. Although this study looked exclusively at biomarkers in muscle, it would have been very interesting to see a subjective measurement of muscle pain and soreness. Due to the study using the adjacent limb as a control, this would be an excellent opportunity to eliminate the bias of one patient receiving massage while the other did not. This would add to the clinical relevance of the information, if biomarkers suggest that inflammation is attenuated but patient-reported soreness outcomes are unchanged in both limbs, it can be argued that massage therapy is not as effective as other therapeutic pain treatments. Do you use massage therapy often, and if so, how do you feel your patients have responded? This study focused one of the quadriceps muscles, but have you found massage therapy to be more or less useful at other site?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban