Massage, Compression and Foam Rolling: Reliable for Perception, Modest for Function
Massage, compression, foam rolling and contrast therapy reliably reduce soreness and perceived fatigue, with modest cuts in damage markers, while their effects on maximal performance are small; emerging modalities show promising but lower-certainty signals.
- Pain that is sharp, localized or worsening: see a clinician
What the evidence says
The sources are meta-analyses, systematic reviews and one crossover trial of manual and mechanical recovery modalities. Dupuy 2018 (meta-analysis) reports small-to-large reductions in delayed-onset soreness with active recovery, massage, compression, immersion, contrast water therapy and cryotherapy, and reductions in creatine kinase, IL-6 and C-reactive protein, and concludes that massage seems to be the most effective method for soreness and perceived fatigue. Araujo 2018 (systematic review) reports 7 of 9 studies associating compression garments with reduced soreness and improved performance, at intermediate methodological quality; Leabeater 2022 (systematic review) reports compression garments consistently lowering soreness and benefiting subsequent endurance and resistance bouts; Rey 2017 (crossover) reports large effects of foam rolling on agility, perceived recovery and soreness at 24 hours; Wiewelhove 2019 (meta-analysis) reports small effects of foam rolling on performance, flexibility and pain; Zhu 2026 (meta-analysis) reports that percussive therapy may improve jump recovery and reduce creatine kinase, at low and very low certainty, without clear effects on maximal strength or soreness; Bieuzen 2013 (meta-analysis) reports contrast water therapy better than passive recovery for soreness and strength loss, with little difference from other interventions; Choi 2024 (meta-analysis) reports an effect of contrast therapy on sprint performance; Leal-Junior 2015 (meta-analysis) concludes that phototherapy, especially applied before exercise with red or infrared wavelengths, improves muscle performance; Babel 2026 (meta-analysis) reports that hyperbaric oxygen may lower blood lactate with limited effect on power; Liu 2026 (meta-analysis) reports cold-water immersion more effective than whole-body cryotherapy for soreness within 24 hours.
- Misconception: 'These speed up recovery of strength.' Effects concentrate on soreness and perception.
- Does not treat injury
- Does not break down scar tissue or adhesions
- Agreement
- Direction recorded for 0 of 11 sources; not yet recorded for the rest.
- The claim's outcome
- Outcome not yet recorded
- Certainty
- No source states a certainty rating.
What each source measured and concluded (11)
- What it measured
- Impact of recovery techniques on DOMS, perceived fatigue, muscle damage, and inflammatory markers
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review with meta-analysis
- Studies and participants, as stated
- 99 studies
- What it measured
- Muscle recovery and delayed onset muscle soreness
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review
- Studies and participants, as stated
- 9 studies
- What it measured
- Physiological, physical, neuromuscular, biomechanical, and perceptual outcomes
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review (PRISMA-P)
- Studies and participants, as stated
- 160 articles, 2530 participants
- What it measured
- Total Quality Recovery, perceived muscle soreness, jump, agility, sprint, flexibility at 24h post-training
- How it was read
- screened only, not extracted
- What it measured
- Sprint, jump, and strength performance; flexibility; muscle pain
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis
- Studies and participants, as stated
- 21 studies (14 pre-rolling, 7 post-rolling)
- What it measured
- Neuromuscular performance (CMJ, MVC), muscle soreness (DOMS), and biochemical markers (CK) after percussive therapy
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis of RCTs (PRISMA; RoB2, PEDro, GRADE)
- Studies and participants, as stated
- 12 RCTs
- What it measured
- Recovery following exercise-induced muscle damage (muscle soreness, strength loss)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 18 trials (13 pooled); all high risk of bias
- What it measured
- Exercise performance and physiological recovery variables
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis (PRISMA)
- Studies and participants, as stated
- 15 articles
- What it measured
- Muscle performance (repetitions, time to exhaustion) and creatine kinase (muscle damage risk)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review with meta-analysis of RCTs
- Studies and participants, as stated
- 16 RCTs (13 of acceptable quality analyzed)
- What it measured
- Athletic performance, metabolic recovery, physiological responses (post-recovery blood lactate)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis
- Studies and participants, as stated
- 11 studies eligible; 6 in meta-analysis
- What it measured
- Comparison of cold-water immersion (CWI) vs body cryotherapy (BC) on DOMS and jump performance
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and meta-analysis (RCTs)
- Studies and participants, as stated
- 13 RCTs, 214 participants
Every source below is shown with its study design and links to the original study. This is the audit trail.