Laurie's Blogs.

 

10
Jul 2021

Handheld Percussive Massage Therapy

By Jen McNutt, BSc., MScPT, CGIMS, Diploma of Canine Rehabilitation, CHT

GUEST BLOG  

It seems there are new massage tools popping up on the market almost daily. It can feel hard to keep up on what is available; however, I can guarantee some of our clients know the latest and greatest and will be asking about them.

 

One of the newer and, it seems, more popular tools available are handheld percussive massage tools. These are those handheld guns that use targeted vibration to massage muscle tissue. I have had several clients from the human and animal side of my practices ask about these tools. In response, I figured it was time to look to the research to be able to give better recommendations around what to look for when purchasing, how to use them, what they are effective for and if there are any precautions.

So, what do we know?

 

We know there is mounds of research to support the beneficial effects of manual massage on both humans and animals. If percussive massage tools (PMT) set out to be as beneficial as massage therapy, they should boast these benefits as well. However, do PMT provide the same benefits? Should animal rehab practitioners be recommending their use? Should we be using them instead of hands-on manual massage? Are they safe for use on smaller muscles in dogs and cats?

 

What did I find in the research?

 

Considering how popular these babies have become, there is surprisingly minimal peer-reviewed research on their efficacy. There are even fewer studies looking at possible side effects or contraindications. 

 

Of the studies I did find, all were on human subjects and most looked at the efficacy of PMT with regards to muscle length, muscle performance and perceived pain. There were no studies looking at PMT and stimulatory effects on muscle activation. Most studies used either the Hyperice Hypervolt (price range $249-$599 CAD) or the Theragun (price range $249-$799). The Hypervolt will oscillate up to 3300 pulses per minute, with 10 – 14mm amplitude.  The Theragun will oscillate at 1750 Hz to 2400 ppm, with a 16mm amplitude.  Most other PMT available are within this same range. My understanding is, the Theragun and Hypervolt are two of the quietest on the market. PMT from other companies can reportedly be quite loud, which may be an important consideration with use on animals.

 

Most studies identified positive effects with use of PMT on increasing muscle length (without decreasing strength) and decreasing perceived pain. One study, (Konrad et al, 2020) looked at ankle dorsiflexion before and after 5-min treatment on the gastrocnemius and found that dorsiflexion improved significantly after treatment.  They also looked at vertical jump performance post treatment and found that PMT treatment did not negatively affect gastroc muscle performance. Another study looked at daily 5-min treatment on low back muscles and hamstrings (Patel and Patel, 2020) and showed improvements in sit and reach outcomes. Guzman, et al (2021) found positive effects on hamstring length after a single 5-minute treatment session as well. It was proposed that PMT could help increase circulation to the muscle groups and increase intra-muscular temperature, thus decreasing stiffness and improving joint range of motion. 

 

An interesting study looked at the effect of PMT versus vibration massage vs. manual massage of knee range of motion and hamstring flexibility. Koumantakis et al. (2020) found that while all improved knee extension, there was no difference in outcomes between the three modalities.

 

There was only one study found that discussed side-effects of PMT. This was a case study describing an incident of rhabdomyolysis following the use of PMT for warm-up on a female athlete by her coach. The case was quite severe, but the article did note the athlete was anemic and that this may have worsened the rhabdomyolysis. Although it has only been reported once in the literature, it does raise a question as to the safety of using these devices on animals. Especially when there have been no studies to date of their safe, effective use on animals.

 

What should we as practitioners consider when recommending use of PMT?

Should we be recommending clients use them at home on their pets? 

 

My thoughts are that if you recommend their use, do so with caution. As with any recommendation you need a clear goal as to what you are trying to achieve in having a client use a PMT to massage their pet. For instance, if the goal is strengthening, you would not recommend one. On the other hand, if you were trying to gain range of motion in a joint (and the restriction was due to decreased muscle length), then recommending their use might be indicated. However, please consider that the human studies out there have looked only at PMT use on large lower body muscles. Human gastrocs and hamstrings and large, thick muscles. These muscles on a dog (depending on breed) can be significantly smaller. As with any massage modality, there is a chance of causing injury to muscle tissue, so I would recommend PMT use for short periods of time only and with the softest, broadest attachment available. I feel, that if you are going to recommend PMT use, you must give clear parameters for time used, location, and pressure to help prevent deleterious effects and/or injury.

 

Should we be using them in clinic?

 

I may be a little biased with knowing how much my hands can pick up, but my thought here is… If there was no difference in efficacy between the PMT and manual massage, why would I choose to use a tool over my hands. I think there is so much extra information one can glean from having their hands over the tissues that are being worked on. In doing so, you can directly feel how tissues are responding to treatment. You completely lose this with a tool between yourself and the patient,

I think though, if I worked on horses, I would consider using a PMT along with manual massage. I can imagine, with the larger patients there is a bit more strain on the hands at times.

 

About the Author:

Jen McNutt is a human physiotherapist and animal rehab practitioner. She has worked in canine rehab since 2012 and operates Kootenay Canine Rehabilitation (www.kootenaycaninerehab.com) in Nelson, BC.

She also owns Thera-Paw Canada (www.therapaw.ca), a company that creates customized soft orthoses for animals, and is the Canadian distributor for TheraPaw Inc. 

References: 

  1. Chen, J., et al. (2021) “Rhabdomylosis After the Use of Percussion Massage: A Case Report”, Physical Therapy. 101(1). https://doi.org/10.1095/ptj/pzaar199. Accessed June 29, 2021.
  2. Guzman, et al. (2020) “The Effects of a Single Percussive Therapy Application on Active Lower Body Range of Motion”, California State Polytechnic University, Pomona dept. Kinesiology and Health Promotion Human Performance Research Lab. https://www.cpp.edu/~honorscollege/documents/convocation/SCI/KIN_Guzman.pdf Accessed June 30, 2021.
  3. Koumantakis, G., et al. (2020 ) “The immediate effect of IASTM versus Vibration versus Light Hand Massage on Knee Angle Repositioning Accuracy and Hamstring Flexion”, Journal of Bodywork and Movement Therapies. (24)3, 96-104.
  4. Konrad, A., Glasbuttner, C., Tilp, M. (2020) “The Acute Effects of a Percussion Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance”, Journal of Sports Science Medicine. 19(4) 690-694.
  5. Kujala, R. Davis, C., Young, L. (2019) “The Effect of Handheld Percussion Treatment on Vertical Jump Height”, International Journal of Exercise Science. 8(7). 
  6. Martin, J. et al. (2021) “A Critical Evalutation of Percussion Massage Gun Therapy as a Rehab Tool Focusing on Lower Limb Mobility. A Literature Review”. The University of Winchester. https://www.researchgate.net/publication/348636056_A_critical_evaluation_of_percussion_massage_gun_devices_as_a_rehabilitation_tool_focusing_on_lower_limb_mobility_A_literature_review. Accessed June 28, 2021.
  7. Mansur, U., Patel, S., "Effectiveness of Theragun and Ergonomic Advice in Patients with Low Back Pain among Bus Drivers - A Randomized Controlled Trial", International Journal of Science and Research (IJSR), https://www.ijsr.net/search_index_results_paperid.php?id=SR21330095433, Volume 10 Issue 4, April 2021, 50 – 53.

 

 

 



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