Massage Guns – the “How To” guide

Vibration work has been around for a long time, like most things in massage. What we can do with our hands as therapsits we can now do faster and easier with technology. Enter the new toy of sports people, the massage gun.
Quality aside, massage guns all do one thing – deliver vibration to the body and vibration is supposed to be a great recovery tool. But what’s the science behind it and how should you use it in practice? Do massage guns just help muscles relax?
If it were that simple there wouldn’t be any need for an article on it now would there!

To use a massage gun effectively you need to understand a few things about what vibration actually does to receptors in your skin and muscles because they tell your brain and nervous system how to control your muscles – relax or contract. And that’s an important difference! In fact, certain vibration frequencies can cause your muscle to both relax and contract at the same time. Now where will that land your recovery, or will it mess with your performance in your next training session? All will be explained.

Vibration and Muscles.
How a muscle responds to vibration is all about the speed (frequency in Hertz or rpm) and the size of each “punch” (amplitude) delivered by the massage gun. If you watch a slow motion video of a massage gun delivering pulses to the quadriceps muscle (image right) you will see that each punch sends a “wave” through the tissue. That wave is rapid compression and stretching of the tissue. The more powerful the punch the deeper into the tissue the wave penetrates and the more skin and muscle are stretched and compressed.

What happens next? Well that turns out to be more complex than you might want to think about and not (yet) entirely understood. What we do know is that vibration stimulates some of the mechanical and proprioception receptors in tissue more than others and that their response is frequency dependent. The combined response to local vibration is: inhibition and stimulation of the targeted muscle, a change in reflex responses in the targeted muscle and a relaxation of opposing muscles (Reciprocal Inhibition, RI).
Ouch.
What happend to just relaxation? Well our nervous system is amazing if a little comlicated. The good news is you can hack this complex response by changing the applied vibration frequncy of your massage gun to be able to adjust the amount of muscle inhibition or contraction in your favour.

So it matters a lot what setting your massage gun is on and how long you hold it over the same bit of muscle.

The receptors most likely stimulated by a massage gun in the skin and fascia are the Pascinian Corpuscles. They respond to high freqency vibrations. In the muscle it’s the Dynamic Muscle Spindle receptors (DMSr) responding to rate of stretching in the muscle. Like all receptors their job is to send back specific information to the central nervous system (CNS) on what’s happening to our body in time and space. The information received allows us to modify our position, movement or behaviour so we stay safe or stable. Stimulation of Pascinian Corpuscles have been shown to reduce muscle tone in a study by Zimny et al. Skin receptors influencing muscle behaviour makes logical sense because often your skin and fascia are the first to experience a stimulus and they can give good feedback to the central nervous system on what is happening.
Stimulation of the DMSr tells the CNS the muscle is being stretched and the response is to increase muscle tone in order to control or limit the stretch being detected.
All very useful stuff and potentially interesting as an explanation as to how vibration can both reduce tone in muscle and increase it.

How to hack vibration to get what you want:

A simple physiology rule of thumb says that if you apply low frequency local vibraiton to muscle, less than 30-35Hz, the net effect is overall inhibition of muscle tone (relaxing). Possibly because of greater influencet of Pascinian Corpuscles and less from DMSr. If you apply more than 35Hz you stimulate the DMSr with the overall effect of increased muscle tone. To make this a little more complex with > 35Hz vibration there is also a possibility the Tonic Vibration Reflex kicks into action. The motor nerve in the muscle starts to fire at the same frequncy as the applied vibration and creates an induced tone on the muscle. Interestingly the TVR may be a reason high frequency vibration is reported by some studies to enhance force, power and proprioception in people when used before sport.

FUN FACT: The manual equivalent of this is technique calls “spindle stim” by Erik Dalton. You use your hands to rapidly shake or “vibrate” the muscle in all directions for a few minutes. The result, if done well (aka. fast enough), is a stimulation of the muscle and easier activation. It is used in treatment to regain activation in “under used” muscles while “over used” muscles are released or “toned down”. Sounds like DMSr triggering and maybe a bit of TVR!

So let’s take a quick look at the typical frequency settings of massage guns on the market.

Does your massage gun give > or < than 35Hz vibration?

Most high quality massage guns offer a range of vibration or pulse frequencies between 20-60Hz. Having options is important for most sports people as you want to be able to switch between a low frequency setting (<35Hz) for relaxing a muscle in recovery work and high frequency (>35Hz) for pre-sport conditioning and reduced DOMS (see below). Some massage guns (cheaper end of the range) may come with a fixed setting around 2400rpm. Be careful, this is above the 35Hz threshold and cannot be used to relax muscle.

Here are the values of the Pulse Roll Massage Gun ( 12mm amplitude). The Blackroll gun has very similar specs.
Level One 1300 rpm 21.6Hz more “relax”
Level Two 1800 rpm 33Hz more “relax”
Level Three 2500 rpm 41Hz more “stimulate”
Level Four 3300 rpm 55Hz more “stimulate”

By comparrison the Theragun Pro has a range of 1750-2400rpm or 29-40Hz with a 16mm amplitude.

Next, amplitude, what is it?
The amplitude is how many milimeters (mm) the gun head moves back and forth for each “punch”. There are 2 options I can find on massage guns, 12mm or 16mm and in theory the 16mm should feel like it penetrates deeper in the mucle compared to a 12mm amplitude.

Is more Hz better than more mm?
It’s more about personal preference. Some people really like the feeling of more “punch” as it feels like the gun delivers a little deeper into the tissue (but so can pressing harder on the gun while uing it). Maybe it saves you a little bit of manual effort if you have a 16mm amplitude. Not sure. My thought is that as long as you have a good option for low and high frequency settings the punch is your choice.


Using your massage gun effectively, here are some ideas based on scientific studies


1. Preventing exercise induced DOMS (muscle pain & recovery)

Studies have shown that using high frequncy vibration (HFV) helps reduce DOMS caused by heavy exercise BUT, the most effective time to use the gun is BEFORE sport, rather than after. (Sahebazamani et al 2012, Hakami et al 2010, Kim et al 2017).
The measured outcomes in the study were a reduction in swelling, reduction of lost ROM (joint range of motion), and reduction of percevied pain, decreased levels of biomarkers for pain; Creatine Kinase (CK), Lactate Dehydrogenase (LDH)*, Interleukin 6 (IL6), histamine, lymphocytes and an increase in neutrophils. [*LDH was reduced for both pre and post-exercise vibration where other markers were reduced in the pre-exercise time only.]
Using the massage gun AFTER sport was also reported to help reduce DOMS but only to the same level as regular stretching or sports massage does and not as effectively as pre-sport use (Fuller et al 2015).

  • How to use your massage gun to reduce DOMS
  • Pre-sport is better
  • High setting, > 35Hz, 2min/muscle, absolute max of 5 min/muscle

    !! Prolonged vibration of 10-30min/muscle causes inhibition of performance and decreased MVIC. To be avoided before sport !!

2. Performance enhancement in sports

There is evidence from studies that using high frequency vibration can transiently enhance sports performance in terms of muscle power, force, flexibility, proprioception and balance but how is not yet clear. (Cochrane 2011, Bakhtiary et al 2007, Souron 2019). Some previous work suggested it was via the TVR (tonic vibration reflex) which “tones up” the muscle, maybe a bit like pre-loading, but further research is needed to clarify how it happens and under which specific conditions. Some theories also suggest performance enhancement might also be explained by vibration induced change in H-reflex and T-reflex in the muscle. The H-reflex is a mechanically induced stretch reflex (e.g. with a massage gun) and the T-reflex is a deep tendon reflex. (A classic example of the T-reflex is your knee jerk response to someone tapping your patella tendon. The rapid stretch to the tendon triggers a protective reflex contraction of your quad muscle which prevents further lengthening of the tendon). During the application of vibration both reflexes are inhibited in the muscle but as soon as vibration is removed the H-reflex remains temporarily inhibited while the T-reflex is potentiated. In practice, that might suggest that vibration pre-sport is capable of reducing muscle over-activity (via H-reflex inhibition), without negatively affecting the reactive (protective) component of tendon stretch reflex (T-reflex). This is good news for performance and power activities such as running and jumping.
The summary is

  • Use of HFV before exercise could improve training capabilities and performance in subsequent workouts
  • MVIC (Max Voluntary Isometric Contraction) strength was shown to improve over subsequent days (running and endurance sport, but possibly not power activities), if workouts are frequent
  • Likely mode of effect is by reducing the biomarkers for pain pre-exercise and limiting the severity of DOMS post exercise, thereby allowing faster recovery and better performance at the next training session
  • HFV could also reduce excessive muscle tone without compromising muscle reaction to change (H- & T-reflex)

    How to use your massage gun for performance gains
  • Pre-sport
  • High setting, >35Hz: 2min/muscle, absolute max of 5 min/muscle

    !! Prolonged vibration of 10-30min/muscle causes inhibition of performance and decreased MVIC. To be avoided before sport !!

3. Pain reduction

Local vibration is likely effective for reducing some types of acute muscle pain based on studies by (Weerakkody et al, 2003). The study looked at inflammation induced pain (increase in pressure in the muscle that caused pain) and compared standard compression treatment to vibration or combining the two. Compression alone was not great at pain reduction, but vibration definitely helped. One theory of how that works is the GAIT mechanism of pain control where non painful stimuli (gentle vibration) applied at the same time as pain, blocks the signal of pain and prevents it reaching the brain (which compression alone can’t do). However, I’m not convinved you can rule out that vibration will also be impacting the skin and fascia as well as fluid movement in the area (the inflammation) potentially helping to disperse inflammation more effectively than compression does.
Note: Vibration or friction is what we would naturally do anyway when we bang our arm or stub our toe. We instinctively rub the painful area to stop it hurting. We don’t push on it or compress it. The rubbing stops us feeling so much pain.

How to use your massage gun for pain reduction

  • Under advice from a medical professional based on the injury type and severity
  • Low to medium setting, < 35Hz with no defined time that I am aware of yet!

4. Rehab of deconditioned muscles

If you have been out injured or had surgery you will know that muscles start to decondition after a few weeks. If it is not possible for you to do weight baring exercise to build the muscle back up, you might be able to use the massage gun to help recondition the muscle. Studies have shown local high frequency vibration may be sufficient to increase strength in deconditioned muscles. (Iodice et al 2011) by causing increased tone via the DMSr and or the TVR. But remember, increasing tone in the target muscle will inhibit (relax) the opposing muscles by recipricol inhibition. So take care , be aware.

How to use your massage gun for muscle rehab

  • Under the advice of rehab professional
  • High setting, >35Hz: 2min/muscle, absolute max of 5 min/muscle
    !! Prolonged vibration of 10-30min/muscle causes inhibition of performance and decreased MVIC. Probably counter productive for rehab !!

5. Getting a Vibration Foam Roller

If massage guns are a bit much for you then you might be considering a vibration foam roller. But are they any better than just regular foam rollers?
Research implies that vibration added to foam rolling has a significant positive effect on reduction of DOMS, pain pressure sensitivity, improved proprioception, (Lee et al 2018, Cheatham et al 2019, Romero-Moraleda et al 2019) as well as improved fascia gliding and mobility (Griefahn A, 2021 ). So that’s a bonus.
What is not known from studies is whether vibration foam rolling can positively impact range of motion (ROM) and power performance when used as a warm-up tool.

My opinion, and its without any study of this personally, is probably to use the vibration roller on high frequncy before sport in a warm up for mobility capacity and switch to lower frequency after sport for relaxation. But the caveat here is the unknown impact on power performance, so be careful using it immediately before power based sports and check which side of the 35Hz threshold it is set to.


Summary

I use my Pulseroll massage gun very often on clients as part of an integrated treatment. I use it to relax tissue, improve movement in fascia, to change the tone on muscle (stimulate muscle) and I do focussed trigger point release work with it. Basically all the things I can also do with my hands in pre-sport massage, post-sport massage and injry management.
It’s a nice addition to the massage therapy tool kit and something everyone can use at themeselves effectively with a little scientific insight! Just be smart about the setting, about the 35Hz threshold and the total time spent applying vibration to each muscle.

  • Pre-exercise vibration is more effective than post-exercise for reduced DOMS, improved subsequent performace and faster recovery
  • Vibration can be used to reduce acute muscle pain (inflammation type)
  • Vibration can be used to stimulate deconditioned muscle (rehab)
  • Vibration + foam rolling is effective for pain reduction, DOMS and performace (no evidence yet for power performance and ROM)
  • Below 35Hz should be used for relaxation of muscle, above 35Hz for performance, enhanced recovery from DOMS and muscle rehabilitation.
  • 30sec – 2min is optimal for performance benefits, pre-exercise use
  • 10min or longer will inhibit performance and power and should not be used before exercise or when trying to rehab muscles.




A big acknowledgement goes to Brookbush Institute for Human Movement. The very solid foundation of this post and recommendations for application of HFV was taken directly from the Brookbush Institute Integrated Therapist Course (I have completed). I then got lost down a rabbit hole of science and research and my own twist on things which is why it took way longer than I planned to write!

References:
Fuller JT, Thomson RL, Howe PR, Buckley JD. Vibration Therapy Is No More Effective Than the Standard Practice of Massage and Stretching for Promoting Recovery From Muscle Damage After Eccentric Exercise. Clin J Sport Med. 2015 Jul;25(4):332-7. doi: 10.1097/JSM.0000000000000149. PMID: 25290104.

Cochrane DJ. The potential neural mechanisms of acute indirect vibration. J Sports Sci Med. 2011 Mar 1;10(1):19-30. PMID: 24149291; PMCID: PMC3737901.

Zimny, M. L., & Wink, C. S. (1991). Neuroreceptors in the tissues of the knee joint. Journal of Electromyography and Kinesiology, 1(3), 148-157.

Sahebazamani, M., & Mohammadi, H. (2012). Influence of vibration on some of functional markers of delayed onset muscle soreness. International Journal of Applied Exercise Physiology, 1(2).

Hakami, M., Taghian, F., & Karimi, A. (2010). The effect of vibration on preventing the delayed onset muscle soreness in active girls. Journal of Research in Rehabilitation Sciences, 5(2), 75-85.

Kim, J. Y., Kang, D. H., Lee, J. H., Se, M., & Jeon, J. K. (2017). The effects of pre-exercise vibration stimulation on the exercise-induced muscle damage. Journal of physical therapy science, 29(1), 119-122.

Weerakkody, N. S., Percival, P., Hickey, M. W., Morgan, D. L., Gregory, J. E., Canny, B. J., & Proske, U. (2003). Effects of local pressure and vibration on muscle pain from eccentric exercise and hypertonic saline. Pain, 105(3), 425-435

Iodice, P., Bellomo, R. G., Gialluca, G., Fanò, G., & Saggini, R. (2011). Acute and cumulative effects of focused high-frequency vibrations on the endocrine system and muscle strength. European journal of applied physiology, 111(6), 897-904.

Jackson, S. W., & Turner, D. L. (2003). Prolonged muscle vibration reduces maximal voluntary knee extension performance in both the ipsilateral and the contralateral limb in man. European journal of applied physiology, 88(4-5), 380-386.

Bakhtiary, A. H., Safavi-Farokhi, Z., & Aminian-Far, A. (2007). Influence of vibration on delayed onset of muscle soreness following eccentric exercise. British journal of sports medicine, 41(3), 145-148.

Mottram, C. J., Maluf, K. S., Stephenson, J. L., Anderson, M. K., & Enoka, R. M. (2006). Prolonged vibration of the biceps brachii tendon reduces time to failure when maintaining arm position with a submaximal load. Journal of neurophysiology, 95(2), 1185-1193.

Souron, R., Zambelli, A., Espeit, L., Besson, T., Cochrane, D. J., & Lapole, T. (2019). Active versus local vibration warm-up effects on knee extensors stiffness and neuromuscular performance of healthy young males. Journal of science and medicine in sport, 22(2), 206-211.

Cheatham, S. W., Stull, K. R., & Kolber, M. J. (2019). Comparison of a vibration roller and a nonvibration roller intervention on knee range of motion and pressure pain threshold: a randomized control trial. Journal of sport rehabilitation, 28(1), 39-45.

Romero-Moraleda, B., González-García, J., Cuéllar-Rayo, Á., Balsalobre-Fernández, C., Muñoz-García, D., & Morencos, E. (2019). Effects of Vibration and Non-Vibration Foam Rolling on Recovery after Exercise with Induced Muscle Damage. Journal of sports science & medicine, 18(1), 172.

Lee, C. L., Chu, I. H., Lyu, B. J., Chang, W. D., & Chang, N. J. (2018). Comparison of vibration rolling, nonvibration rolling, and static stretching as a warm-up exercise on flexibility, joint proprioception, muscle strength, and balance in young adults. Journal of sports sciences, 36(22), 2575-2582.

Griefahn A, Knicker A, Piekartz H. (2021). Efficacy of foam rolling with additional vibration stimulation on the mobility of the thoracolumbar fascia. An observational study,
Journal of Bodywork and Movement Therapies, Volume 26