Effect of Myofascial Release on Post-Exercise Recovery in Water Polo Athletes

Effect of Release of Trigger Points on Functional Capacity, Biomechanical and Physiological Variables in Recovery After Game Simulation in Water Polo Athletes

Objective: To assess the acute effect of a myofascial release protocol applied to the adductor muscles of the thigh on functional, biomechanical, and physiological variables. Methods: This study is a randomized, double-blind, two-arm crossover clinical trial that will analyze male water polo athletes aged 16 to 25 years recruited from a sports training center in the city of Bauru. Data related to the following parameters will be collected for the physical evaluation: functional performance, through the jump test; biomechanical, through maximum isometric torque of hip adductors, electromyography of the hip and gluteus medius muscles; and physiological, through the analysis of serum markers of muscle damage and inflammation, and heart rate variability. After the initial evaluation, the participants will be randomly divided into two groups: intervention group and sham group. Then, all participants will perform a game simulation. After the game, the participants will receive the intervention designated for each group. For the intervention group, a manual therapy protocol will be applied, based on myofascial release in the thigh region that presents trigger points. For the Sham group, a manual technique, called classic massage, will be applied, with superficial pressure, used to reach only subcutaneous tissues, without acting on muscles and fascia. This protocol will be repeated at four different times, always after the games. After a washout week, the participants will change groups and the data collection protocol will be applied again.

Study Overview

• Status: Active, not recruiting
• Conditions: Fatigue
• Intervention / Treatment: Other: Classic Massage; Other: Myofascial Release

• Study Type: Interventional
• Enrollment (Estimated): 16
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Brazil
  • São Paulo
    • Bauru, São Paulo, Brazil, 17011-160
      • Universidade do Sagrado Coração

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Male athletes;
2. Age 16 to 25 years old;
3. Have at least one year of experience in the sport;
4. Perform a training load of at least 10 hours per week in the sport;
5. Participate in at least regional level competitions

Exclusion Criteria:

1. Have no reports of muscle injury in the thigh in the three months prior to the study,
2. Joint injuries in the hip, such as femoroacetabular impingement or tendinopathies of the tendons of the hip muscles or trochanteric, iliopectineal or ischial bursitis diagnosed by a clinician;
3. Do not present a drop in -performance for more than four weeks that could characterize the occurrence of non-functional overreaching or signs of overtraining syndrome

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Myofascial Release	Other: Classic Massage; Massagem clássica, com pressão superficial, utilizada para atingir apenas tecidos subcutâneos, sem que haja ação sobre músculos e fáscias
Placebo Comparator: Classic Massage	Other: Myofascial Release; A myofascial release protocol, applied to the thigh muscles in post-effort recovery in water polo athletes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Maximum Vertical Jump Test		From enrollment to the end of treatment at 2 weeks
Maximum Voluntary Isometric Torque of the Hip Adductors		From enrollment to the end of treatment at 2 weeks
Electromyography of Adductors, Gluteus Medius and Transversus Abdominis		From enrollment to the end of treatment at 2 weeks
Collection of Serum Markers	The markers: creatine kinase (CK; Units of Measure= U/L), lactate dehydrogenase (LDH; Units of Measure= UI/L), myoglobin (Myo; Units of Measure= ng/mL), erythrocyte sedimentation rate (ESR; Units of Measure= mm/h), tumor necrosis factor alpha (TNFA; Units of Measure= Å) will be considered for analysis of muscle damage markers and will be determined through specific kits and following the manufacturer's instructions.	From enrollment to the end of treatment at 2 weeks
Heart Rate Variability	Heart rate variability (HRV) will be collected, at rest, through a non-invasive method used to measure cardiac autonomic control, to assess the autonomic nervous system (ANS), and the RR interval will be recorded by a portable heart rate monitor.	From enrollment to the end of treatment at 2 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Effort Control Variables: Subjective Perception of Exertion and Lactate Threshold	To estimate the intensity of the exercise, the method proposed by Foster (1998) will be used, which suggests multiplying the subjective perception of exertion (RPE) of the session by the total duration of the training session (sRPE), with the results expressed in arbitrary units (u.a.). To quantify performance during the game, lactate will be collected at the end of each quarter of the game, through blood collections from the earlobe (25 μL) to analyze the peak lactate concentration ([La-]peak) of the effort.	From enrollment to the end of treatment at 2 weeks

Collaborators and Investigators

• Sponsor: Luis Gustavo Lizi Jorge
• Investigators: Principal Investigator: Rebeca Gasparoto Carmezin, Acadêmica em Fisioterapia, Universidade do Sagrado Coração

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2024
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026

Study Registration Dates

• First Submitted: March 26, 2025
• First Submitted That Met QC Criteria: April 15, 2025
• First Posted (Actual): April 18, 2025

Study Record Updates

• Last Update Posted (Actual): April 18, 2025
• Last Update Submitted That Met QC Criteria: April 15, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: fatigue; post-exercise recovery; physical exertion
• Additional Relevant MeSH Terms: Fatigue
• Other Study ID Numbers: 6.711.962

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No