Muscle Soreness, Delayed Onset Muscle Soreness, Athletic Injuries
Conditions
Keywords
muscle recovery, SmO2, tecartherapy, shockwave therapy, massage
Brief summary
The goal of this clinical trial is to evaluate the impact of various passive post-exercise recovery techniques on professional athletes. The main questions it aims to answer are: Do passive recovery modalities significantly improve muscle oxygenation and tissue temperature immediately following high-intensity effort? Which specific technique is most effective in reducing perceived pain, measured by the pressure pain threshold, and restoring muscle strength? Researchers will compare six different therapeutic interventions-Transfer of Energy Capacitive and Resistive therapy, manual massage, intermittent negative pressure therapy, extracorporeal shockwave therapy, percussion therapy, and pneumatic pressotherapy-to determine which provides a superior immediate physiological and functional recovery effect. Participants will: Perform a high-intensity physical effort designed to induce peripheral fatigue. Be randomly assigned to receive one of the six recovery protocols. Undergo objective measurements immediately after the intervention, including near-infrared spectroscopy to assess muscle oxygen saturation, tissue thermography, algometry, and dynamometry.
Detailed description
This project is designed as a randomized, double-blind (outcome assessor and statistician), crossover clinical trial. The study aims to address the critical need for evidence-based recovery strategies in high-demand sports such as basketball, where muscle overload is a primary risk factor for injury.The investigation will focus on the immediate physiological and functional effects of six widely utilized physiotherapy modalities:Capacitive and Resistive Energy Transfer (TECAR) Therapy: Utilized to improve tissue perfusion and modulate inflammatory responses through deep endogenous thermotherapy.Percussive Massage Therapy: Applied via mechanical vibration to reduce muscular stiffness and enhance explosive force restoration.Extracorporeal Shockwave Therapy (ESWT): Evaluated for its capacity to enhance muscular microcirculation and accelerate immediate tissue metabolic activity.Intermittent Pneumatic Compression (Pressotherapy): Targeted at reducing perceived pain and the sensation of limb heaviness through mechanical fluid drainage.Intermittent Negative Pressure Therapy (Vacuum Therapy): Investigated for its role in localized blood flow enhancement and pain modulation.Manual Sports Massage: Defined as the traditional manual intervention for reducing perceived muscle soreness and improving soft tissue flexibility.Physiological monitoring will be conducted using Near-Infrared Spectroscopy (NIRS) to measure muscle oxygen saturation ($SmO\_2$) and total hemoglobin, providing direct data on muscle oxidative metabolism. Functional outcomes will be assessed through pressure pain thresholds (PPT) via algometry and maximal isometric strength via dynamometry to determine the effectiveness of each technique in restoring neuromuscular homeostasis.The study will be conducted at the Sierra Varona Physiotherapy Clinic (Toledo, Spain) between February and March 2026..
Interventions
Application of acoustic pulses to the gastrocnemius muscle to modulate tissue mechanotransduction and improve local microcirculation.
DEVICEMassage Gun
Mechanical vibration applied to the calf muscles to promote myofascial release and neuromuscular recovery through high-frequency percussion.
DEVICETECAR Therapy
Application of high-frequency electromagnetic energy (diathermy) to the lower limb to induce deep endogenous heat and accelerate metabolic waste removal.
OTHERManual Massage
Systematic manipulation of soft tissues using manual techniques (effleurage and petrissage) focused on reducing muscle tension and perceived soreness.
DEVICEcupping
Controlled suction therapy applied to the gastrocnemius to create space between fascial layers and stimulate lymphatic and venous drainage.
DEVICEPressotherapy
External pneumatic compression through a sequential inflation system to facilitate venous return and reduce lower limb edema post-effort.
Sponsors
Sierra Varona SL
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
Due to the nature of the physical interventions-such as manual massage, extracorporeal shockwave therapy, and intermittent negative pressure-participants and therapists cannot be blinded to the treatment assignment. To mitigate potential bias, a double-blind approach will be implemented for data collection and statistical analysis. The Outcome Assessor, responsible for recording measurements from near-infrared spectroscopy, algometry, and dynamometry, will remain blinded to the specific recovery modality administered to the athlete during each period. To maintain this blinding, the assessment will take place in a separate area from the intervention site. Furthermore, the statistical analysis will be conducted by an independent investigator using a coded dataset, ensuring that group allocation remains concealed until the final results are processed.
Intervention model description
This is a randomized, 6-period, 6-sequence crossover clinical trial. Each participant will undergo six different recovery interventions-extracorporeal shockwave therapy, percussive massage therapy, manual sports massage, capacitive and resistive energy transfer therapy, intermittent negative pressure therapy, and pneumatic pressotherapy-in a randomized sequence. To prevent carry-over effects, a minimum wash-out period of one week will be established between intervention sessions. Prior to each recovery modality, all participants will perform a standardized high-intensity exercise protocol designed to induce peripheral muscle fatigue. Physiological and functional measurements, including near-infrared spectroscopy, infrared thermography, pressure algometry, and isokinetic dynamometry, will be recorded at baseline and immediately following the intervention in each period to assess acute recovery effects.
Eligibility
Sex/Gender
MALE
Age
18 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
Professional or Semi-professional athletes (specifically basketball players or endurance athletes) with a minimum of 2 years of competitive experience. Aged between 18 and 35 years. Healthy individuals with no current musculoskeletal injuries in the lower limbs. Regular training frequency of at least 4-5 sessions per week. Signed informed consent to participate in the study and follow the 6-week crossover protocol. Commitment to maintain similar nutritional and sleep habits throughout the duration of the study.
Exclusion criteria
Presence of any acute or chronic injury in the gastrocnemius or Achilles tendon in the last 6 months. Contraindications for specific therapies: For Shockwave Therapy: Blood clotting disorders or use of anticoagulants. For TECAR/Diathermy: Metal implants in the lower limbs or pacemakers. For Cupping: Acute skin infections or dermatological hypersensitivity. Consumption of performance-enhancing drugs, anti-inflammatory medication (NSAIDs), or stimulants that could affect muscle oxygenation (SmO2) or pain perception. Recent surgery in the lower extremities (within the last year). Inability to complete the standardized fatigue protocol or attend all 6 intervention sessions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Oxygen Saturation (SmO2) | immediately post-effort (fatigue), and immediately post-intervention (recovery). | Measured using Moxy Monitor (Near-Infrared Spectroscopy - NIRS). It evaluates the percentage of hemoglobin/myoglobin oxygenated in the gastrocnemius muscle. |
| Pressure Pain Threshold (PPT) | immediately post-effort (fatigue), and immediately post-intervention (recovery). | Measured using a digital pressure algometer. It quantifies the minimum pressure (in kg/cm²) at which a participant perceives the stimulus as painful in the gastrocnemius. |
| Maximum Isometric Muscle Strength | immediately post-effort (fatigue), and immediately post-intervention (recovery). | Measured using a handheld dynamometer. It evaluates the peak force (in Newtons) during a maximum voluntary isometric contraction of the calf muscles. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Surface Temperature | immediately post-effort (fatigue), and immediately post-intervention (recovery). | Measured using a digital infrared thermography camera. It assesses the changes in skin surface temperature over the gastrocnemius muscle area, reflecting changes in local blood flow. |
| Participant Satisfaction and Perceived Recovery | 5 minutes after each recovery intervention. | Measured using a Visual Analog Scale (VAS) and a customized survey (Likert scale 1-5). Participants rate which recovery modality felt better and their perceived level of muscle readiness for a new effort. |
Contacts
CONTACTALBERTO SANCHEZ SIERRA
Outcome results
None listed