An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized and controlled trials
PubMed 29755363 · doi:10.3389/fphys.2018.00403
What was done
A systematic review and meta-analysis of 99 studies (randomized controlled trials, crossover trials, and repeated-measures studies) identified from PubMed, Embase, and Web of Science. The review evaluated the effects of post-exercise recovery modalities (active recovery, massage, compression garments, electrostimulation, stretching, immersion, and cryotherapy) on delayed-onset muscle soreness (DOMS), perceived fatigue, and markers of muscle damage and inflammation (creatine kinase [CK], interleukin-6 [IL-6], and C-reactive protein [CRP]).
What was found
Active recovery, massage, compression garments, immersion, contrast water therapy, and cryotherapy reduced DOMS magnitude (Hedges' g between -2.26 and -0.40), with massage being the most effective technique for DOMS and perceived fatigue. Pooled analysis across techniques showed decreases in CK (SMD = -0.37, 95% CI: -0.58 to -0.16; I2 = 40.15%), IL-6 (SMD = -0.36, 95% CI: -0.60 to -0.12; I2 = 0%), and CRP (SMD = -0.38, 95% CI: -0.59 to -0.14; I2 = 39%). Massage and cold exposure were the most effective for reducing inflammatory markers.
Why it matters
This review pools evidence across nearly 100 recovery trials, providing quantitative comparisons demonstrating that massage, cold modalities, and compression are superior to stretching or passive control for accelerating recovery from muscle damage and soreness.
Limits
The total number of participants, sex breakdown, and athletic training levels are not reported in the abstract. Subjective outcomes (DOMS, fatigue) are susceptible to participant expectation bias due to lack of blinding in physical interventions.
Cited by
- supports Performing soft tissue work after heavy training decreases delayed-onset muscle soreness (DOMS).