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Sports massage or active exercise for DOMS relief? A systematic review and meta-analysis among healthy population

Muhammad Syazani Sohaimi, N. F. Ilias, A. B. M. Soberi, Noorfahzarina Amiuliya Abu Bakar, Mazlifah Omar, George Thomas, M. Sajadi, Hosni Hasan et al.

Retos, 2025

1,148 participants · 3 citations

Abstract

Background: Delayed-onset muscle soreness (DOMS) commonly appears 24–72 hours following eccentric exercise and can impair performance, recovery, and functional capacity. Sports massage therapy (SMT) and active exercise therapy (AET) are frequently prescribed interventions to alleviate DOMS symptoms, yet their comparative effectiveness remains unclear.

Objective: This systematic review and meta-analysis aimed to compare the effects of SMT and AET on muscle soreness, range of motion (ROM), and serum creatine kinase (CK) levels among healthy adults experiencing exercise-induced DOMS.

Methods: Four electronic databases (PubMed, Scopus, Web of Science, and Google Scholar) were systematically searched for randomized controlled trials published between November 2004 and October 2020. Eligible participants were healthy adults aged 18–60 years who received either SMT (manual massage techniques) or AET (light-to-moderate activity ≤70% HRmax) following eccentric exercise. Data synthesis was conducted using Review Manager 5.4 and a random-effects model to calculate standardized mean differences (SMD) with 95% confidence intervals (CI). Methodological quality was assessed using the TESTEX tool, and heterogeneity was quantified using I² statistics.

Results: Thirty-nine RCTs (n = 1,148) met the inclusion criteria, comprising 27 SMT and 17 AET interventions. SMT significantly reduced muscle soreness compared to control conditions and demonstrated a stronger directional trend toward improved…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,148 participants or records.

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