If you’ve watched any professional sporting events within the past few years, you’ll have undoubtedly been exposed to the barrage of advertisements praising the Theragun. However, if by some miracle you haven’t; they’re positioning themselves as an at home do it yourself physio, providing relief for a wide range of maladies, from muscle soreness to insomnia.  But extraordinary claims require extraordinary evidence, and can the Theragun really stack up against the professionals?

The theoretical basis for the Theragun is undoubtedly well founded. The machine is attempting to replicate percussive therapy, a technique employed by physiotherapists the world over. (Please note, this is distinct from the therapy of the same name employed in those with airway disease.) However, can you reduce years of training into what is, some say, an overpriced drill bit, and expect the same results? Well, the answer is obviously no, but that is not to say, it is of no benefit, and whilst there is currently limited high quality evidence available to assess the efficacy of the Theragun, can you incorporate it into your training and expect improvements?

The central claim, and the reason for the Theragun is its ability to promote recovery. However, recovery is a poorly defined term. For us to establish that it improves recovery, we must first agree on its clinical manifestation. Theragun makes the claim that it’s devices can; decrease muscle soreness & stiffness, increase blood flow, decrease lactic acid (the role of lactic acid and its importance is another topic entirely), improve range of motion, hydrate tissue and improve stretching ability. Now, a number of these are physiological consequences of the others, but most will play some part in improving the subjective perception of recovery.

However, perhaps the best way to assess its efficacy is to establish its effect on the presence of delayed onset muscle soreness, which essentially boils down to simply asking the subjects how they feel. Two studies have asked this question. Cochrane in 2017 (1) and Imtiyaz, in 2014 (2). While neither of these studies specifically used a theragun, the medical interventions used are comparable.  Cochrane studied the effect of vibration therapy on 13 healthy males, and assessed for improvements in strength, range of motion, electromyography, subjective muscle soreness, and creatine kinase (CK) levels (a biochemical marker indicating muscle breakdown).  While this is a very small study, with a less than ideal control group, the results are promising. 

The first finding indicates that vibratory therapy decreases pain perception within 24 hours following exercise, when compared to the control group (no intervention).  Whilst it would be nothing more than a guess at a mechanism for this effect, my best idea would be that something known as the gate theory of pain is involved. This theory essentially states that non-painful stimuli, such as that provided by a Theragun, will close and or occupy the ‘gates’ of nociceptors (pain receptors) preventing perception of painful stimuli. Think deep heat.(3)   

The study also documented improvements in range of motion and CK (creatinine kinase) following exercise in the experimental group. The improvement in CK is of questionable significance, as there are a multiplicity of factors that affect a subject's CK level, and there is no documented relationship between CK levels and the magnitude of a post-exertional injury. (4)  However, the improvement in range of motion could have significant impacts on an athlete's perception of recovery.  The study found that vibration therapy increased a subjects ability to flex their elbow by up to as much as 20 degrees. 

The study did not find evidence to support the idea that vibration therapy accelerates recovery of power. 

The second study (Imtiyaz et. al) found similar results, further supporting the idea that percussive therapy plays an important role in athletic recovery. The team documented significantly reduced reporting of DOMS (Delayed onset muscle soreness), increased ROM and reduced CK. This study also reports improvements in rate of return to baseline strength, however the conflicting results indicate that further research is required. 

So how can you incorporate this into your routine?  Well, the data is still being fully published, but the early studies are promising. There does seem to be tangible benefit for use of these devices such as therapy following a workout, especially if you’re working out in rapid succession and don’t have time to allow for a full recovery period! However, be wary of any far fetched claims, and always review the evidence! If you have any questions, let me know in the comments, and I’ll do my best to answer them!

By Dr Tim Davis - Pushys Resident Medical Expert.

Sources:

1. Cochrane, Darryl J. "Effectiveness of using wearable vibration therapy to alleviate muscle soreness." European journal of applied physiology 117.3 (2017): 501-509.
2. Imtiyaz, S., Veqar, Z., & Shareef, M. Y. (2014). To compare the effect of vibration therapy and massage in prevention of delayed onset muscle soreness (DOMS). Journal of clinical and diagnostic research: JCDR, 8(1), 133.
3. Moayedi, M.; Davis, K. D. (3 October 2012). "Theories of pain: from specificity to gate control". Journal of Neurophysiology. 109 (1): 5–12. doi:10.1152/jn.00457.2012. PMID 23034364.
4. Clarkson PM, Byrnes WC, McCormick KM, Turcotte LP, White JS. Muscle soreness and serum creatine kinase activity following isometric, eccentric, and concentric exercise. Int J Sports Med. 1986 Jun;7(3):152-5. doi: 10.1055/s-2008-1025753. PMID: 3733311.