Short-term effectiveness of massage techniques on myotendinous structures’ stiffness: a systematic review and meta-analysis

This systematic review (CRD42022307586) investigated the acute effects of massage techniques on myotendinous structures’ stiffness. We searched PubMed, Embase, Web of Science, PEDro, and Cochrane Library databases (to January 2026). Randomized clinical trials examining the acute effects of massage on myotendinous stiffness were included. Studies involving co-interventions or post-exercise were excluded. Risk of bias was evaluated using Cochrane RoB2. Data were synthesized qualitatively and quantitatively through random-effects meta-analysis. From 3,584 records, 25 studies (617 participants) were included. Studies investigated self-massage (n = 17), manual (n = 4) or instrumental massage (n = 4). Meta-analyses revealed no significant effects on overall muscle (SMD: −0.17; 95%CI: −0.35 ~ 0.02) or gastrocnemius medialis stiffness (SMD: −0.15; CI95%: −0.58 ~ 0.29). Qualitative synthesis confirmed no consistent alterations in muscle (n = 16), tendon (n = 2), or muscle-tendon unit (MTU) (n = 9) stiffness. Therefore, evidence suggests that massage techniques do not acutely change muscle, tendon, or MTU stiffness, challenging mechanical tissue-release theories. However, conclusions are limited by methodological heterogeneity.