"Recovery Techniques on Pain, Force and Muscle Oxygenation in Athletes: A Crossover Trial"

"Effects of Multiple Muscle Recovery Techniques on Pain, Force, Temperature, and Muscle Oxygenation in Professional Athletes: A Randomized Crossover Trial"

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.

Study Overview

• Status: Not yet recruiting
• Conditions: Athletic Injuries; Muscle Soreness; Delayed Onset Muscle Soreness
• Intervention / Treatment: Device: Extracorporeal Shockwave Therapy (ESWT); Device: Massage Gun; Device: TECAR Therapy; Other: Manual Massage; Device: cupping; Device: Pressotherapy

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..

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: ALBERTO SANCHEZ SIERRA; Phone Number: 608801238; Email: alberto.sanchez@uclm.es

Participation Criteria

Eligibility Criteria

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

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Double

Number of Arms

6

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Extracorporeal Shockwave Therapy (ESWT); Application of radial shockwave therapy using the Longest LGT-2500S device. A total of 2,000 pulses will be delivered to the gastrocnemius muscle (medial and lateral heads) at a pressure of 2.5 bar and a frequency of 10-15 Hz. The intervention aims to improve local microcirculation and reduce myofascial stiffness.	Device: Extracorporeal Shockwave Therapy (ESWT); Application of acoustic pulses to the gastrocnemius muscle to modulate tissue mechanotransduction and improve local microcirculation.
Experimental: Percussive Therapy - Massage Gun; Application of percussive massage using the Hyperice Hypervolt 2 Pro device. The intervention will last 5-10 minutes and will be applied to the gastrocnemius muscle at a frequency of 50 Hz (Level 3), focusing on the muscle-tendon junction to enhance neuromuscular recovery.	Device: Massage Gun; Mechanical vibration applied to the calf muscles to promote myofascial release and neuromuscular recovery through high-frequency percussion.
Experimental: TECAR Therapy -; Application of diathermy using the Fisiowarm 300 system (Golden Star, Italy). The treatment will be administered for 15 minutes using a combination of capacitive and resistive modes at a frequency of 500 kHz. Intensity will be set at a thermal level (Type III) to promote deep vasodilation and metabolic clearance in the calf muscles.	Device: TECAR Therapy; Application of high-frequency electromagnetic energy (diathermy) to the lower limb to induce deep endogenous heat and accelerate metabolic waste removal.
Experimental: Expert Manual Sports Massage; A standardized sports massage session lasting 15-20 minutes will be performed by a senior physiotherapist with more than 20 years of experience in elite sports. The protocol will include deep effleurage, petrissage, and transverse friction techniques to alleviate muscle tension and improve blood flow in the gastrocnemius muscle.	Other: Manual Massage; Systematic manipulation of soft tissues using manual techniques (effleurage and petrissage) focused on reducing muscle tension and perceived soreness.
Experimental: Intermittent Negative Pressure; Application of intermittent negative pressure using the Physium System (multimodal vacuum therapy). The protocol consists of a 10-minute session applied to the gastrocnemius area to decompress tissue layers, enhance lymphatic drainage, and modulate mechanoreceptors to reduce pain.	Device: cupping; Controlled suction therapy applied to the gastrocnemius to create space between fascial layers and stimulate lymphatic and venous drainage.
Experimental: Pressotherapy; Application of pressotherapy using the Hermes Professional system. The treatment will last 20 minutes with a sequential six-chamber inflation cycle at a pressure of 70-80 mmHg, aiming to accelerate venous return and reduce post-exercise edema.	Device: Pressotherapy; External pneumatic compression through a sequential inflation system to facilitate venous return and reduce lower limb edema post-effort.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Oxygen Saturation (SmO2)	Measured using Moxy Monitor (Near-Infrared Spectroscopy - NIRS). It evaluates the percentage of hemoglobin/myoglobin oxygenated in the gastrocnemius muscle.	immediately post-effort (fatigue), and immediately post-intervention (recovery).
Pressure Pain Threshold (PPT)	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.	immediately post-effort (fatigue), and immediately post-intervention (recovery).
Maximum Isometric Muscle Strength	Measured using a handheld dynamometer. It evaluates the peak force (in Newtons) during a maximum voluntary isometric contraction of the calf muscles.	immediately post-effort (fatigue), and immediately post-intervention (recovery).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Surface Temperature	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.	immediately post-effort (fatigue), and immediately post-intervention (recovery).
Participant Satisfaction and Perceived Recovery	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.	5 minutes after each recovery intervention.

Collaborators and Investigators

• Sponsor: Sierra Varona SL

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): June 15, 2026
• Study Completion (Estimated): August 16, 2026

Study Registration Dates

• First Submitted: January 27, 2026
• First Submitted That Met QC Criteria: January 27, 2026
• First Posted (Actual): February 4, 2026

Study Record Updates

• Last Update Posted (Actual): April 24, 2026
• Last Update Submitted That Met QC Criteria: April 23, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: massage; muscle recovery; shockwave therapy; SmO2; tecartherapy
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Musculoskeletal Diseases; Nervous System Diseases; Muscular Diseases; Wounds and Injuries; Neuromuscular Diseases; Musculoskeletal Pain; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Athletic Injuries; Myalgia; Therapeutics; Complementary Therapies; Physical Therapy Modalities; Rehabilitation; Ultrasonic Therapy; Diathermy; Hyperthermia, Induced; Therapy, Soft Tissue; Musculoskeletal Manipulations; Massage; Drainage; Extracorporeal Shockwave Therapy; Manual Lymphatic Drainage; Cupping Therapy
• Other Study ID Numbers: 22

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: "De-identified individual participant data (including muscle oxygenation variables, pressure pain thresholds, and isometric strength values) will be made available upon reasonable request to the principal investigator. Data will be shared to facilitate meta-analyses or to verify the findings of this study, provided that the requesting researcher provides a methodologically sound proposal and signs a data use agreement to ensure athlete confidentiality."

Drug and device information, study documents

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