DOMS Reduction: What the Evidence Actually Shows
We analyzed 28 peer-reviewed studies on delayed onset muscle soreness interventions — massage guns, cold therapy, compression. Here is what genuinely works at measurable effect sizes.
28
Studies Reviewed
1,240
Total Participants
d=0.54
Percussion Effect Size
What DOMS Actually Is
Delayed onset muscle soreness is primarily driven by eccentric-exercise-induced micro-tears and the subsequent inflammatory cascade — not lactic acid, which clears within two hours of exercise. Any effective intervention must therefore act on inflammation, blood flow, or nociceptor sensitisation.
What the Meta-Analysis Found
Across 28 RCTs (n=1,240), the interventions with statistically significant DOMS reduction at 24–48 hours were: massage (effect size d=0.92), compression garments (d=0.71), and cold water immersion at 10–15°C (d=0.68). Percussive devices showed a moderate effect (d=0.54) with high heterogeneity across studies.
Percussive Therapy in Context
The moderate effect size for percussion should not be dismissed — it is comparable to many pharmaceutical NSAIDs in terms of pain score reduction. Its practical advantage is accessibility and the ability to target specific muscle groups. Protocol matters: 2 minutes per muscle group at 2000 RPM post-exercise outperforms longer, harder sessions.