The effects of deep tissue massage on acute muscle health

Deep tissue massage (DTM) is a popular massage modality used in rehabilitation and sports medicine. Despite its widespread use, few studies have validated DTM efficacy, especially using a randomized cross-over design. This study assessed the acute effects of DTM on muscle soreness and range of motion (ROM) over a 24-hour period. It was hypothesized that DTM would induce a delayed-onset muscle soreness (DOMS)-like response, characterized by increased pain, decreased ROM, and heightened point tenderness. Twenty males aged 18-45 years received DTM protocol or control (no massage) in a randomized single cross-over fashion with a 2-week washout. Initial pre- and 24 hours post right upper and lower limb ROM and point tenderness were measured. Pre-, immediate-post, 8-hour, and 24-hour subjective pain surveys were administered. A linear mix model testing a difference in means between DTM and Control groups revealed a significant interaction between group and survey time (p= 0.043). Pain scores were significantly higher (p=0.0008) in the DTM group (1.1904±0.1806) than in the control group (0.23320±0.1884) immediately post-treatment. The DTM group showed a mean decrease in chest tenderness (-0.33±0.05) and upper trapezius tenderness (-0.355±0.6341) compared to the control (means= 0.297 and -0.04, respectively). Interestingly, knee flexion ROM increased in both the DTM group (mean diff= 4.7°) and control group (mean diff= 1.85°). Shoulder horizontal abduction ROM also increased across both groups (DTM mean diff= 3.35° and control mean diff= 6.675°). Based on the Wilcoxon rank-sum test and linear mixed models, no statistically significant differences were noted between DTM and control for chest tenderness (p Wilcoxon =0.348, p linear = 0.266), quad tenderness (p Wilcoxon =0.659, p linear =0.744), trapezius tenderness (p Wilcoxon =0.107, p linear =0.614), knee flexion (p Wilcoxon =0.989, p linear =0.747), and shoulder horizontal abduction (p Wilcoxon =0.829, p linear =0.189). There was insufficient evidence to suggest that the DTM group differed from the Control group in terms of point tenderness and ROM. While not significant, however, fixed effects for Day x Treatment suggested a trend towards greater muscle tenderness the day after receiving DTM (p-value= 0.09). Although neither day nor treatment had significant effects on these variables, there were overall trends of worsening tenderness in the chest and upper trapezius from Day 1 to Day 2 in the DTM group compared to the control. It is perhaps surprising that this is one of the few studies to validate that recipients of DTM experience increased pain post-treatment. Patients, however, seek DTM for long-term pain relief. This study did not evaluate the long-term effects of DTM, and further studies are needed to validate DTM efficacy. Winona State University Foundation PIF grants This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.