Effect of Manual Lymphatic Drainage on Muscle Fatigue in Female 11-a-side Football Players (EDLMF11)

This clinical trial investigates the effectiveness of manual lymphatic drainage (MLD) in accelerating recovery following induced fatigue in female football players. The study integrates objective performance measurements using linear encoders with anthropometric assessments and psychophysiological evaluations. It aims to quantify the impact of MLD on neuromuscular recovery, muscle edema, and perceived fatigue, considering sex-specific physiological factors and the influence of sleep and psychological stress. The findings will contribute to developing non-invasive, individualized recovery strategies to enhance performance and reduce injury risk in women's football.

Study Overview

• Status: Recruiting
• Conditions: Women
• Intervention / Treatment: Other: Manual lymphatic draige

Detailed Description

This study aims to assess the effectiveness of manual lymphatic drainage (MLD) as a recovery strategy following induced fatigue in female football players. The intervention is applied immediately after a standardized fatigue protocol using a linear encoder to objectively measure performance decline. The study adopts a multidimensional approach, integrating biomechanical, physiological, and psychometric variables to evaluate recovery.

Participants will undergo three experimental sessions involving a fatigue protocol followed by either MLD or control conditions. Performance will be assessed through guided machine squats, measuring the number of repetitions and time until a 20% velocity loss. Thigh circumference will be measured pre- and post-intervention to monitor fluid shifts and potential edema. Subjective recovery perception will be recorded, and emotional state will be evaluated using the Hospital Anxiety and Depression Scale (HADS). Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI) to explore its influence on fatigue and recovery response.

This trial addresses the need for non-invasive, efficient recovery strategies tailored to female athletes, considering sex-specific physiological and psychological factors. The findings may contribute to optimizing post-exercise recovery protocols and reducing injury risk in women's football.

• Study Type: Interventional
• Enrollment (Estimated): 11
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Edurne Úbeda D'Ocasar, Doctor; Phone Number: 19217 +34 8153131; Email: eubeda@ucjc.edu

Study Locations

• Spain
  • Madrid, Spain, 28691
    • Recruiting
    • University of Camilo José Cela
    • Contact: Edurne Úbeda Docasar; Email: eubeda@ucjc.edu

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Female athletes actively participating in 11-a-side football, either federated or official team members.
• Age ≥ 16 years to 20 years old.
• Regular training (≥ 3 sessions per week) or active competition
• No food intake within 3 hours prior to evaluation (to standardize the influence of digestion on performance).
• No acute lower limb injury in the past 3 months.
• Availability to attend all three study visits.
• Signed informed consent; for participants under 18, parental consent is also required.

Exclusion Criteria:

• History of deep vein thrombosis
• Decompensated heart failure
• Active lower limb infection
• Pregnancy
• Recent lower limb surgery (< 3 months), or any medical contraindication to receiving manual lymphatic drainage (MLD).
• Failure to comply with the fasting requirement prior to performance testing.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Manual Lymphatic Drainage Group; The study consists of three visits. During the first visit, participants are informed about the study, eligibility criteria are verified, informed consent is obtained, and baseline assessments are conducted using psychophysiological questionnaires and thigh circumference measurements. In the second visit, assessments are repeated and fatigue is induced through guided squats at 50-60% of estimated 1RM, monitored via a linear encoder. Fatigue is defined as a 20% loss in execution velocity. Immediately after fatigue induction, manual lymphatic drainage (MLD) is applied for 10 minutes (5 minutes per quadriceps), following Emil Vodder's standardized technique. Post-intervention, performance testing and measurements are repeated. The third visit, conducted 15 days later, serves as a follow-up to evaluate sustained effects without further intervention, repeating the fatigue protocol and all assessments.

Other: Manual lymphatic draige; This method, part of complex decongestive physiotherapy, involves gentle massage techniques that stimulate lymphatic circulation and venous return. MLD promotes lymph fluid mobilization, increases lymphangiomotor activity, and has positive effects on the immune system. Its application has shown to reduce limb edema, decrease muscle fatigue, and raise pain thresholds. Moreover, the gentle touch during MLD activates cutaneous receptors that influence the parasympathetic nervous system, producing physiological changes such as reduced heart rate, blood pressure modulation, and increased muscle strength.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of repetitions	Number of repetitions until 20% velocity loss: recorded via linear encoder during guided squat test.	baseline; 5 minutes before and 5 minutes after the first procedure, 5 minutes before and 5 minutes after the second procedure, and 15 days after the procedure was completed.
Time to fatigue	Time to fatigue (seconds): total time from first repetition until velocity drops by 20%.	baseline; 5 minutes before and 5 minutes after the first procedure, 5 minutes before and 5 minutes after the second procedure, and 15 days after the procedure was completed.
Velocity profile	average velocity per repetition, expressed in m/s.	baseline; 5 minutes before and 5 minutes after the first procedure, 5 minutes before and 5 minutes after the second procedure, and 15 days after the procedure was completed.
Thigh circumference (cm)	measured with a non-elastic tape at the midpoint between the anterior superior iliac spine and the upper border of the patella, in both legs, pre- and post-intervention.	baseline; 5 minutes before and 5 minutes after the first procedure, 5 minutes before and 5 minutes after the second procedure, and 15 days after the procedure was completed.
Perceived fatigue	assessed using Borg CR-10 scale (0 = no fatigue, 10 = maximum fatigue).	baseline; 5 minutes before and 5 moinutes after the first procedure, 5 minutes before and 5 minutes after the second procedure, and 15 days after the procedure was completed.
Perceived pain (VAS)	assessed using Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (maximum pain).	baseline; 5 minutes before and 5 minutes after the first procedure, 5 minutes before and 5 minutes after the second procedure, and 15 days after the procedure was completed.
Perceived recovery (PRS)	assessed using the Perceived Recovery Status Scale (PRS), ranging from 0 (no recovery) to 10 (full recovery).	baseline; 5 minutes before and 5 minutes after the first procedure, 5 minutes before and 5 minutes after the second procedure, and 15 days after the procedure was completed.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sleep quality (PSQI)	assessed using the Pittsburgh Sleep Quality Index (PSQI), a 19-item questionnaire with scores ranging from 0 to 21 (higher scores indicate poorer sleep quality).	baseline, after the second procedure and 15 days after the procedure was completed
Emotional state	assessed using the Hospital Anxiety and Depression Scale (HADS), comprising 14 items across anxiety and depression subscales (scores range from 0 to 21 per subscale).	baseline, after the second procedure and 15 days after the procedure was completed
Sociodemographic Variables	Age, Height, Body weight, Body mass Index	Baseline
Dominant leg	self-reported (leg used to kick the ball).	Baseline
Sports experience (years)	total years of systematic football practice.	baseline
Training frequency (sessions/week)	average number of sessions during the season.	baseline
Menstrual cycle phase	self-reported, to control for physiological variations in fatigue and recovery.	baseline, after the second procedure and 15 days after the procedure was completed

Collaborators and Investigators

• Sponsor: Camilo Jose Cela University
• Investigators: Principal Investigator: Edurne Úbeda Docasar, Doctor, University Camilo José Cela

Study record dates

Study Major Dates

• Study Start (Actual): November 17, 2025
• Primary Completion (Estimated): February 28, 2026
• Study Completion (Estimated): July 30, 2026

Study Registration Dates

• First Submitted: November 27, 2025
• First Submitted That Met QC Criteria: December 9, 2025
• First Posted (Actual): December 10, 2025

Study Record Updates

• Last Update Posted (Actual): December 10, 2025
• Last Update Submitted That Met QC Criteria: December 9, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Women; Football; Manual Lymphatic Drainage
• Other Study ID Numbers: UCJCDLMF

Plan for Individual participant data (IPD)

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

IPD Plan Description

What IPD Will Be Shared:

De-identified individual participant data (IPD) related to primary and secondary outcome measures, including performance metrics (e.g., number of repetitions, velocity profiles), anthropometric data (e.g., thigh circumference), and questionnaire responses (e.g., Borg scale, VAS, PRS, PSQI, HADS).

When Will IPD Be Available:

IPD will be made available upon publication of the main results or within 12 months after study completion.

How Will IPD Be Shared:

Data will be shared upon reasonable request to the principal investigator. Access will be granted for academic and non-commercial research purposes, following approval by the ethics committee and under a data-sharing agreement to ensure confidentiality and compliance with GDPR.

With Whom:

Qualified researchers affiliated with academic institutions or research organizations.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No