Acute effects of percussion massage therapy on balance, functional performance, and pain in adolescent cyclists: a randomized controlled trial

Percussion massage therapy (PMT) is increasingly used in sport as a warm-up and recovery tool, yet its acute effects on neuromuscular performance in youth athletes are unclear. This study examined whether a single PMT session is associated with short-term changes in dynamic balance, functional performance and pain in adolescent cyclists. In this assessor-blinded randomized controlled trial, 32 licensed cyclists aged 12–15 years were allocated to a PMT group (n = 16) or control group (n = 16). PMT was delivered bilaterally to the gluteus maximus, quadriceps femoris, and gastrocnemius muscles using a handheld percussive device (Compex® Fixx™ 2.0; 41.7 Hz) for a total of 18 min, while controls rested for an equivalent period. Outcomes were assessed pre- and immediately post-intervention and included Y Balance Test (YBT) composite score, Triple Hop Test distance, isometric lower-limb strength (handheld dynamometry), and lower-limb pain (Numeric Rating Scale, NRS). Compared with controls, the PMT group showed significantly greater improvements in YBT composite scores (dominant limb: p = 0.015, d = 0.91; non-dominant: p = 0.016, d = 0.90). Within-group improvements were observed in Triple Hop Test distance in the PMT group; however, post-intervention between-group differences were not consistently observed across all outcomes. Isometric strength of the gastrocnemius, quadriceps femoris, and gluteus maximus did not change significantly in either group (all p > 0.05). NRS scores decreased markedly after PMT (within-group d = − 2.18), with change scores favoring PMT over control (p < 0.001, d = − 1.33). A single PMT session was associated with short-term improvements in dynamic balance, selected aspects of functional performance, and pain perception in adolescent cyclists, without altering maximal isometric strength. These findings should be interpreted as acute and exploratory, suggesting that PMT may serve as a complementary pre-activity modality primarily through short-term neuromuscular and pain-modulating mechanisms rather than definitive performance enhancement. Prospectively registered in the ClinicalTrials.gov registry (NCT07206576) on 26/09/2025.