Publications

Objectives: The purpose of this study is to quantitatively evaluate the combined effects of sports massage, blood flow restriction (BFR), and cold therapy on quadriceps recovery in mixed martial arts (MMA) athletes following eccentric exercise, focusing on muscle biomechanical properties, pain, and strength.

Methods: This randomized, single-blind clinical trial involved 36 men and women MMA-trained participants, divided into three groups: massage (n = 12) received massage, BFR/cool (n = 12) received combined BFR and cooling, and control (n = 12) received passive rest as a control. The fatigue protocol involved MMA fighters performing five sets of plyometric jumps on a 50 cm box until exhaustion, with 1-min breaks between sets. After that, the massage group received a 20-min massage overall using standardized techniques; BFR/cool underwent a 20-min alternating blood flow restriction (200 mmHg) and cooling treatment with ice bags on the quadriceps; and the final group served as the control group with passive rest and no intervention. Participants were assessed four times – before exercise, immediately after exercise, 24 h post-exercise (after two recovery sessions), and 48 h post-exercise (after four recovery sessions) – for perfusion unit (PU), muscle elasticity, pressure pain threshold (PPT), reactive strength index (RSI), and total quality recovery (TQR).

Results: The statistical analysis revealed significant effects of both massage and BFR/cooling interventions across key recovery outcomes, with large effect sizes for time-related changes in RSI (p < 0.0001; η2 = 0.87), elasticity (p < 0.0001; η2 = 0.84), and PPT (p < 0.0001; η2 = 0.66). Notably, post-exercise 48 h values for RSI, elasticity, PU, and TQR were significantly improved in both the massage and BFR/cool groups compared to control (p < 0.05)), while no significant group differences were observed for PPT.

Conclusions: The study concludes that both massage and combined blood flow restriction with cooling interventions significantly enhance post-exercise recovery – improving muscle perfusion, elasticity, reactive strength, and perceived recovery – compared to passive rest.

Keywords: combat sports, MMA, regeneration, occlusion, manual therapy, sports medicine, ice bags

The study highlighted the contribution of acute recovery interventions, specifically sports massage combined with blood flow restriction and ice, to muscle recovery following eccentric exercise in mixed martial arts athletes. By focusing on these combined modalities, the study sought to address everyday performance and injury issues faced by athletes participating in high-intensity sports. Results revealed reduced muscle soreness and improved strength loss due to acute fatigue in participants who received the integrated treatment compared to the control group, thus providing a solid approach to accelerated recovery. This study thus effectively addressed the initial research question by establishing a clear association between combined recovery techniques and improved muscle recovery outcomes, offering empirical support for integrating these interventions into sports training programs. The practical implications emphasize the need to incorporate multimodal recovery strategies to optimize athletic performance and enhance recovery protocols, which may be particularly important when designing training programs that prioritize athlete health and sustainability.