Alternative treatments for muscle injury: massage, cryotherapy, and hyperbaric oxygen

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Current evidence suggests that popular alternative therapies such as massage, cryotherapy, and hyperbaric oxygen exposure as currently practiced on humans have little effect on recovery from minor muscle damage such as induced by exercise. While further research is still needed, hyperbaric oxygen exposure shows clear promise for potentially being a successful adjunct treatment for enhancing muscle repair and recovery from more severe crush on contusion injury in humans. Cryotherapy or icing, as currently practiced, will not likely be successful in cooling muscle sufficiently to have any significant influence on muscle repair regardless of the degree of injury. However, based on studies in animal models, it may be that if sufficient muscle cooling could be achieved in humans, it could actually delay recovery and increase muscle scarring following significant muscle damage. Conclusions about the effectiveness of massage on influencing muscle recovery from more severe injury cannot yet be made due to a lack of experimental evidence with a more significant muscle damage model.

This is a preview of subscription content, log in to check access.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    Hyldahl RD, Hubal MJ. Lengthening our perspective: morphological, cellular and molecular responses to eccentric exercise. Muscle Nerve. 2013;49:155–70.

    Article  PubMed  Google Scholar 

  2. 2.

    Jarvinen AH, Jarvinen TLN, Kaarianen M, Kalimo H, Jarvinen M. Muscle injuries biology and treatment. Am J Sports Med. 2005;33:745–64.

    Article  PubMed  Google Scholar 

  3. 3.

    Delos D, Maak TG, Rodeo SA. Muscle injury in athletes: enhancing recovery through scientific understanding and novel therapies. Sports Health. 2013;5:346–52.

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Tiidus PM. Skeletal muscle damage and repair. Champaign IL: Human Kinetics Pub; 2007.

    Google Scholar 

  5. 5.

    Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Rep. 2008;12:1–23.

    Google Scholar 

  6. 6.

    Tiidus PM. Massage Therapy in Tiidus PM ed. Skeletal muscle damage and repair. Human Kinetics Pub. Champaign IL. 2007 pp. 195–202

  7. 7.

    Torres R, Riberio F, Duarte JA, Cabri JMH. Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis. Phys Ther Sports. 2011;13:101–14.

    Article  Google Scholar 

  8. 8.

    Weerapong P, Hume PA, Kolt GS. The mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Med. 2005;35:235–56.

    Article  PubMed  Google Scholar 

  9. 9.

    Zainuddin Z, Newton M, Sacco P, Nosaka K. Effects of massage on delayed-onset muscle soreness, swelling and recovery of muscle function. J Athl Train. 2005;40:174–80.

    PubMed  PubMed Central  Google Scholar 

  10. 10.

    Warren GL, Lowe DA, Armstrong RB. Measurement tools used in the study of eccentric contraction-induced muscle injury. Sports Med. 1999;27:43–59.

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Tiidus PM, Shoemaker JK. Effleurage massage, muscle blood flow and long term post-exercise strength recovery. Int J Sports Med. 1995;16:478–83.

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Jonhagen S, Ackermann P, Eriksson T, Saartok T, Renstrom PA. Sports massage after eccentric exercise. Am J Sports Med. 2004;32:1499–503.

    Article  PubMed  Google Scholar 

  13. 13.

    Tiidus PM. Massage and ultrasound as therapeutic modalities in exercise-induced muscle damage. Can J Appl Physiol. 1999;24:267–98.

    Article  CAS  PubMed  Google Scholar 

  14. 14.

    Tiidus PM. Manual massage and recovery of muscle function following exercise: a literature review. J Orthop Sports Phys Ther. 1997;25:107–12.

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Haas C, Butterfield TA, Abshire S, Zhao Y, Zhang X, Jarjoura D, et al. Massage timing affects postexercise muscle recovery and inflammation in a rabbit model. Med Sci Sports Exerc. 2013;45:1105–12.

    Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Haas C, Butterfield TA, Zhao Y, Zhang X, Jarjoura D, Best TM. Dose-dependency of massage-like compressive loading on recovery of active muscle properties following eccentric exercise: rabbit study with clinical relevance. Br J Sports Med. 2013;47:83–8.

    Article  PubMed  Google Scholar 

  17. 17.

    Haas C, Best TM, Wang Q, Butterfield TA, Zhao Y. In vivo passive mechanical properties of skeletal muscle improve with massage-like loading following eccentric exercise. J Biomech. 2012;45:2630–6.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Butterfield TA, Zhao Y, Agarwal S, Haq F, Best TM. Cyclic compressive loading facilitates recovery after eccentric exercise. Med Sci Sports Exerc. 2008;40:1289–96.

    Article  PubMed  Google Scholar 

  19. 19.•

    Crane JD, Ogborn DI, Cupido C, Melov S, Hubbard A, Bourgeois JM, et al. Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Sci Trans Med. 2012;4:119ra13. Interesting study which highlights some of the effects massage may have on inflammatory signaling in human muscle.

    Article  Google Scholar 

  20. 20.

    Wiltshire EV, Poitras V, Pak M, Hong T, Rayner J, Tschakovsky ME. Massage impairs postexercise muscle blood flow and “lactic acid” removal. Med Sci Sports Exerc. 2010;42:1062–71.

    PubMed  Google Scholar 

  21. 21.

    Shoemaker JK, Tiidus PM, Mader R. Failure of manual massage to alter limb blood flow: measures by Doppler ultrasound. Med Sci Sports Exerc. 1999;29:610–4.

    Article  Google Scholar 

  22. 22.

    Bleakley CM, Glasgow P, Webb MJ. Cooling an acute muscle injury: can basic scientific theory translate into the clinical setting? Br J Sports Med. 2012;46:296–8.

    Article  CAS  PubMed  Google Scholar 

  23. 23.

    Schaster KD, Disch AC, Stover JF, Lauffer A, Bail HJ, Mittlmeier T. Prolonged superficial local cryotherapy attenuates microcirculatory impairment, regional inflammation, and muscle necrosis after closed soft tissue injury in rats. Am J Sports Med. 2007;35:93–102.

    Article  Google Scholar 

  24. 24.••

    Takagi R, Fujita N, Arakawa T, Kawada S, Ishii N, Miki A. Influence of icing on muscle regeneration after crush injury to skeletal muscle in rats. J Appl Physiol. 2011;110:382–8. Important study which highlights the potential longer term negative influence of cryotherapy on muscle regeneration following crush injury.

    Article  PubMed  Google Scholar 

  25. 25.

    Howatson G, Gaze D, van Someren KA. Efficacy of ice massage in the treatment of exercise-induced muscle damage. Scan J Med Sci Sports. 2005;15:416–22.

    Article  CAS  Google Scholar 

  26. 26.

    Crystal NJ, Townson DH, Cook SB, LaRoche DP. Effect of cryotherapy on muscle recovery and inflammation following a bout of damaging exercise. Eur J Appl Physiol. 2013;113:2577–86.

    Article  PubMed  Google Scholar 

  27. 27.

    Bennett MH, Best TM, Babul-Wellar S, Taunton JE. Hyperbaric oxygen therapy for delayed muscle soreness and closed soft tissue injury. Cochrane Rev. 2005;4:CD004713.

    Google Scholar 

  28. 28.

    Strauss MB. The effect of hyperbaric oxygen in crush injuries and skeletal muscle-compartment syndromes. Undersea Hyperb Med. 2012;39:847–55.

    PubMed  Google Scholar 

  29. 29.

    Kanhai A, Losito JM. Hyperbaric oxygen therapy for lower-extremity soft-tissue injuries. J Am Podiatr Med Asssoc. 2003;93:298–306.

    Article  Google Scholar 

  30. 30.

    Tiidus PM. Hyperbaric oxygen and drug therapies. In: Tiidus PM, editor. Skeletal muscle damage and repair. Champaign IL: Human Kinetics Pub; 2007. p. 257–61.

    Google Scholar 

  31. 31.

    Gregorevic P, Lynch GS, Williams DA. Hyperbaric oxygen improves contractile function of regenerating rat skeletal muscle after myotoxic injury. J Appl Physiol. 2000;89:1477–82.

    CAS  PubMed  Google Scholar 

  32. 32.

    Babul S, Rhodes EC, Taunton JE, Lepawski M. Effects of intermittent exposure of hyperbaric oxygen for the treatment of an acute soft tissue injury. Clin J Sports Med. 2004;13:138–47.

    Article  Google Scholar 

  33. 33.••

    Horie M, Enomoto M, Shimoda M, Okawa A, Miyakawa S, Yagishita K. Enhancement of satellite cell differentiation and functional recovery in injured skeletal muscle by hyperbaric oxygen treatment. J Appl Physiol. 2014;116:149–55. Important recent study which highlights the potential enhancing effects of hyperbaric oxygen therapy for enhancing muscle satellite cell responses and recovery following injury.

    Article  CAS  PubMed  Google Scholar 

  34. 34.

    Majmundar AJ, Skuli N, Mesquita C, Kim MN, Yodh AG, Nguyen-McCarty M, et al. O2 regulates skeletal muscle progenitor differentiation through phosphatidylinositol 3-kinase/AKT signaling. Mol Cell Biol. 2012;32:36–49.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. 35.

    Yamada N, Toyoda I, Doi T, Kumada K, Kato H, Yoshida S, Shirai K, Kanda N, Ogura S. Hyperbaric oxygenation therapy for crush injuries reduces the risk of complications: research report. 2014;41:283–289

Download references

Compliance with Ethics Guidelines

Conflict of Interest

Peter M. Tiidus declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Peter M. Tiidus.

Additional information

This article is part of the Topical Collection on Muscle Injuries

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tiidus, P.M. Alternative treatments for muscle injury: massage, cryotherapy, and hyperbaric oxygen. Curr Rev Musculoskelet Med 8, 162–167 (2015). https://doi.org/10.1007/s12178-015-9261-3

Download citation

Keywords

  • Muscle damage
  • Massage
  • Cryotherapy
  • Hyperbaric oxygen
  • Muscle repair