Comparative Effectiveness of Massage Gun and Myofascial Release Technique for Releasing Latent Trigger Points of Calf Muscle: A Randomized Clinical Trial

ABSTRACT Background and Aims Latent trigger points (LTrPs) in the calf muscle contribute to localized pain, increased pain sensitivity, and impaired movement. Massage gun (MG) and myofascial release (MFR) are used to manage LTrPs, but there's limited direct evidence comparing their effects. Therefore, we aimed to compare the effects of MG and therapist‐applied MFR on pain and ankle movement in individuals with calf muscle LTrPs. Methods This assessor‐blinded, single‐center randomized clinical trial included 60 participants with calf muscle LTrPs. Participants were randomly assigned to MG ( n = 30) or MFR ( n = 30). Both groups received 10 treatment sessions over 5 consecutive days (twice daily) with MG or MFR, followed by a standardized 20‐min ice application. Primary outcomes: Pain intensity was assessed using the visual analog scale (VAS), and pain sensitivity or pressure pain threshold (PPT) was measured with a digital algometer. Secondary outcome: active ankle dorsiflexion ROM (AADF‐ROM) was measured with an inclinometer. Outcomes were measured at baseline and post‐intervention. Results Both groups demonstrated significant within‐group improvements in pain intensity, pain sensitivity tolerance, and AADF‐ROM (all p = 0.001), with moderate‐to‐large within‐group effect sizes (r = 0.68–0.72). However, between‐group analysis showed significantly greater improvements in the MFR group compared with the MG group across all outcomes, including pain reduction (median change: −2.89 vs −1.69; Z = 6.05, p < 0.001, d = 0.92, 95% CI: 0.72–1.14), increased PPT (+1.64 vs +0.62 kg/cm 2 ; Z = 5.51, p < 0.001, d = 0.85, 95% CI: 0.63–1.03), and greater improvement in AADF‐ROM (+3.01° vs +1.02°; Z = 5.49, p < 0.001, d = 0.78, 95% CI: 0.54–0.96), indicating large between‐group effect sizes favoring MFR. Conclusion Both interventions effectively improved pain and ankle mobility in individuals with calf muscle LTrPs. However, therapist‐applied MFR yielded superior outcomes and may be the preferred intervention for this musculoskeletal condition. Trial Registration Clinical Trials Registry of India (CTRI/2023/08/056794).