How Percussive Therapy May Help With Recovery and Pain Relief

Step aside foam rollers, there’s a hot recovery modality that made an appearance a few years ago and has since taken the industry by storm. You’ll see it on football fields, basketball courts, soccer fields, golf courses, locker rooms, and at friends’ houses and you might even own one at home. Percussive therapy devices, also known as massage guns, are now widely used to relieve muscle tension and soreness, improve sleep and recovery, ease pain, and decrease stress.

By applying repetitive and fast-pulsing pressure to target areas of your body, massage guns trigger a multi-faceted response impacting the nervous, circulatory, and musculoskeletal systems.

While there isn’t any long-term, peer-reviewed research on percussive therapy yet, a few smaller studies and its historical applications have shown many benefits.

History of percussive therapy

The mechanism by which these percussive therapy devices work is rooted in a type of massage therapy that was practiced in the 1800s, called tapotement. Coming from the French word “tapoter” meaning “to tap” or “to drum,” massage therapists would apply a rhythmic, alternating tapping motion with their fists loosely held or the edge of their hands.

At the time, it was believed that it would help loosen up muscles and calm the nervous system before activity or a sporting event. For centuries, therapists in both Eastern and Western medicine would utilize this manual technique in sports, physical therapy, muscle relaxation, and recovery.

“Percussive modalities are most helpful when we want downregulation of the neuromuscular system. In other words, when we need the muscles and body to relax in some way,” Cameron Yuen, a physical therapist, told Healthnews. “This could be because we are trying to improve range of motion, reduce muscle soreness or tension, or promote recovery. It can be especially useful after injury when muscles are guarded or in spasm, or after a training session to reduce muscle tone.”

In 2016, percussive therapy in the form of massage guns became widely available to everyone. The inventor behind the new sensation was California-based chiropractor Dr. Jason Wersland. Driven by finding a solution to help with his pain after a motorcycle accident in 2007, Wersland created the first massage gun. After eight years of tweaking and testing, the Theragun was born.

Since then, several other brands have launched their version of massage guns and these devices are now used by people from all walks of life, from athletes and executives to personal trainers and physical therapists.

How does percussive therapy work?

The percussion and vibration work through a mechanism similar to massage by stimulating the sensory nerves in the skin, fascia, and muscles. Through a rhythmic, high-amplitude pulsing motion in conjunction with pressure and vibration, the percussive therapy device creates a non-invasive deep tissue stimulation. While very much a soft-tissue, physical-first approach, it translates over to impacting our psychology and nervous system at large.

Humans have known for millennia that physical touch can impact us both physically and mentally — think hugs, massage therapy, or a mother holding her child. These all create a sense of safety and activate the body’s parasympathetic response, which is the state when the body best heals, rests, and recovers.

“The different sensory receptors in our soft tissues are stimulated by pressure, vibration, heat, and touch and cause changes to our nervous system,” Tim Roberts, Vice President of Science and Innovation at Therabody told Healthnews. “The nervous system can be described as one of the body's methods of communication, and it is through the nervous system’s modulation that percussive therapy can be used to create physical change (decreased tone of the muscle, increased range of motion, reduced pain) or mental change (perceived relaxation, reduced stress, etc).”

Roberts added that the multifactorial response and exact mechanisms of mental and psychological change after percussive therapy is yet to be fully understood, but observations in terms of increased parasympathetic stimulation have been made with measures of brain activity, heart rate variability, and perceptual responses.

Benefits of percussive therapy

Whether you want to speed up recovery, reduce the intensity of delayed onset muscle soreness (DOMS), destress, or downregulate your nervous system, percussive therapy can be beneficial.

By impacting the circulatory system, it increases nutrient and oxygen delivery to the targeted areas, which are essential for improved recovery. Additional peripheral responses of decreased tone, increased muscle relaxation, and decreased pain are also likely to play a role in the overall response.

“Percussive therapy is really designed to be applied to the soft tissues of the body,” Roberts said. “However, in doing so and the effects of treating the muscles and tendinous junctions, means there are indirect benefits to joints. Decreased muscle tension and stiffness can reduce the mechanical strain on joints, and increased circulation in adjacent soft tissues will ultimately have some benefit for the joint.”

Increased range of motion

Range of motion is a mechanism we rely on every day. Reaching up for a plate in the kitchen cabinet, tying our shoelaces, showering, or getting dressed all require a level of range of motion. It is described as the flexibility of one or multiple joints or muscles. However, as we age, the amount of lubricating fluid between our joints decreases, leaving our joints less limber and stiff, decreasing flexibility and range of motion.

While stretching, physical therapy, and various massage techniques have been utilized to improve range of motion, percussive therapy has shown promising effects as well.

A recent study looking at the acute effects of percussive massage treatment on range of motion and performance found it to be efficacious in increasing range of motion without affecting muscle strength and power.

Increased circulation

Increased circulation is one of the most important benefits of percussive therapy that leads to accelerated recovery. As Roberts explained, “This increase in circulation directly increases the delivery of oxygen and nutrient-rich blood to the area and transport of metabolic waste products away from it.”

Beyond delivering nutrient-rich blood across the body through the circulatory system, percussive therapy also helps stimulate your lymphatic system, which plays an important role in preventing fluid build-up in tissues, promoting a healthy immune system, and helping your body get rid of toxins and pathogens.

Decreased muscle tone and soreness

The nervous system controls the muscular system, so when a muscle is restricted, it is more the case that it is the nervous system restricting movement for protection than it is the actual muscle itself that is stiff.

“When this protective tone is too high and is preventing recovery, or it starts interfering with other joints or tissues, then it becomes important to find ways to reduce that tone,” Yuen explained. “This is where percussive modalities work well, as it can help reduce tone through relaxation of the nervous system.”

Delayed onset muscle soreness, which you might experience within 24 to 48 hours post-exercise, is the result of a combination of mechanisms. The buildup of lactic acid, muscle spasms, connective tissue damage, muscle fiber damage, and inflammation are all contributing factors. By impacting both the autonomic and peripheral nervous system, circulatory system, and lymphatic system, massage therapy, and vibration have been found to be efficacious in accelerating recovery after exercise.

Pain relief

After a percussive therapy treatment, you might feel this subtle vibration across your whole body and a sense of awe, which is the result of your nervous system tapping into its parasympathetic (rest-and-digest) activation. When working on a painful area, the repetitive pressure and pulsing vibration stimulate the nerve receptors, desensitize the area, and reduce pain, be it acute or chronic.

Additionally, loosening up the fascia (a tissue barrier designed to protect organs, muscles, bones, nerves, and blood vessels) is one of the key players in reducing pain. After an injury, the fascia surrounding the area contracts to further protect that area, which also triggers the nearby muscles and joints to work even harder, creating even more tension and strain.

By decreasing myofascial restriction, percussive therapy aids in muscle relaxation and helps decrease your perception of pain.

Better sleep

A 2020 study conducted by Therabody and Biostrap Labs showed that after using the Thergun percussive device prior to bedtime, 87% of participants fell asleep faster and 70% had less awakening and sleep disruptions at night.

Both physical pain or mental stress may impact sleep quality and cause sleep disruptions, so by allowing your neurophysiology to relax, falling asleep and getting a good night’s sleep becomes much easier.

When to use a massage gun

Percussive therapy can be used both as part of a warm-up and following a workout. The only difference is the duration spent on each area.

“An ideal practice would be spending one to two minutes with self-selected pressure on the muscle groups that are restricting the range of motion as part of a warm-up routine that also contains dynamic stretching, or as a standalone routine that also includes dynamic stretching,” Yuen explained, adding that this can also be done following a workout, or whenever a muscle feels sore and stiff for one to five minutes to reduce tension.

As the tension persists, feel free to run a percussive therapy session several times a day as needed. Roberts said, “A good rule to follow within those limits is to treat the muscles for shorter times when trying to prepare for activity and longer durations when you are wanting to help relaxation, recovery, or pain.”

How to choose the right percussive therapy device

When buying a massage gun, there are a few factors to keep in mind to ensure you will get the best return on investment. Here are seven tips to consider, as recommended by both Roberts and Yuen:

• Quality. Is it a brand that is investing in science and research to design the best products or just trying to make something cheap? Rotations per minute, amplitude, tissue depth, and percussion angle all matter.
• Education. Does the device come with an app to provide education on how to best use the device for your needs?
• Device design. Is it designed to help you treat your body (such as a triangle grip design) or designed to be as cheap as possible with off-the-shelf components?
• Attachment design. Are there any additional attachments designed with a specific size, shape, or material to treat the body in the best possible way? Or are they hard plastic and painful to use?
• Noise. Some older models can be rather loud and wouldn't be suitable for those who live in apartments.
• Price. There are many affordable options that work extremely well. The most expensive ones aren't necessarily the best.
• Battery life. Some require frequent charges for very short working times.

Is percussive therapy for you?

From Rihanna and Karlie Kloss to LeBron James and Rory McIlroy, long lists of athletes and high-performing professionals have invested in brands selling percussive therapy devices, for a common reason: they believe the technology works.

Research is continuing to unfold investigating the various impacts of percussive therapy, but to this day, no dangers or downsides have been reported. Whether it’s improving performance, decreasing pain, or preventing injury, the human body seems to be benefiting in many ways from repetitive pulsing vibration and pressure.

However, as with many trendy health and wellness devices on the market, there are many that over-promise and underdeliver in their quality. Therefore, it’s important to do your research, and if needed, ask for advice from a healthcare professional before investing in a massage gun.