Acute Effect of Percussive Massage on Cross‐Section Area, Muscle Strength, and Late Muscle Pain of the Quadriceps Muscle Following a Fatigue Protocol in Physically Active Men: Randomized Clinical Trial

BACKGROUND AND PURPOSE: The massage gun is widely used to alleviate delayed-onset muscle soreness (DOMS); however, empirical evidence regarding its physiological effects remains limited. OBJECTIVES: This study aimed to evaluate the acute effects of percussive massage on the quadriceps muscle's cross-sectional area (CSA), strength performance, and pain perception following a fatigue protocol. METHODS: A randomized clinical trial was conducted including 37 physically active men. Participants performed a fatigue protocol on a 45° leg press, at 70% of their one-repetition maximum (1RM). The volunteers were allocated to an intervention group (G0 n = 19, mean ± SD; 25.7 ± 4.5 years, 83.7 ± 10.6 kg, 176.8 ± 6.3 cm) and control group (G1 n = 18, mean ± SD; 27.6 ± 5.0 years, 76.8 ± 15.7 kg, 174 ± 7.3 cm). Assessments were performed at baseline, 24 and 48 h, using ultrasound imaging, isometric dynamometer and VAS questionnaire (visual analog pain scale). RESULTS: Regarding the muscle area, significant increases were observed in the control group p < 0,05 for the rectus femoris at both measurement points compared with the baseline, which suggests that percussive massage may mitigate exercise-induced edema. While no statistically significant differences were observed between groups or across time points for muscle strength, G0 demonstrated a large effect size (d > 2.0) in strength maintenance at 24 and 48 h compared to G1. Both groups showed reduction in pain over time, while G0 demonstrated a significant decrease at 48 h compared to 24 h (53%, p < 0.001). CONCLUSION: Within-group assessments revealed significant reductions in pain perception over time for the intervention group. Regarding muscle strength, despite a large exploratory effect size observed during recovery, no statistically significant between-group superiority over passive rest was established. The findings suggest potential preliminary benefits for symptom relief without acute performance deficits.