The following article is a guide for colleagues (and interested people) on scientifically proven benefits of vibration massage, including:
- the therapeutic benefits
- the best vibration frequencies to use, and
- clinical applications.
Contents
Increasing blood flow
Relaxing muscles
Reduces pain
Inhibits spasm and cramps (trigger points and elite stretching)
"Stretches" muscles
Decreases post exercise soreness and speeds recovery
Increase performance
Speeding and improving healing
Practical advice on using vibration massage
Therapeutic applications of vibration have been shown to significantly increase blood flow (3-5) . In one trial vibrations at both 30 and 50 Hz were shown to substantially increase peripheral blood flow, with 50 Hz giving the superior results, having a more rapid and longer lasting effect. 30 Hz vibration slowly increased blood flow, which lasted for about 7 minutes. 50 Hz increased blood flow more rapidly, and was still increased 15 minutes later.
Special application: cellulite massage
The main cause of cellulite is poor circulation in the affected tissues, resulting in less efficient reabsorption of fats. The repeated application of vibration massage over time has increased circulation, allowing these deposits to be reabsorbed, resulting in a long term reduction in size and improved appearance. For more information please see our article How to massage for cellulite.
Various studies have shown that the application of vibration massage in the range of 20-60 Hz causes muscles to relax, while vibrations from 100-200 Hz have been shown to cause muscles to contract (1)
Clinical applications of increasing blood flow and relaxing muscles
The relaxation of muscles and increasing blood flow are the principle benefits of most types of massage therapy, whether it is for simple relaxation, relieving tight tired muscles after a hard day's work, or as part of a rehabilitation program. Science tells us that vibration massage at around 50 Hz does this very well.
The main way vibration massage helps reduce pain is to help address the causes of pain, such as tight sore muscles and trigger points (tender lumps in muscles- see below). However, the application of stimulation at 100 Hz has been shown to neurologically block pain, which is the same principle used by a TENS machine (8). As an example, a trial showed that repeated applications of 100 Hz massage to the distal quadriceps muscles (just above the knee) produced a considerable reduction of symptoms in those with osteoarthritis of the knees (9). Keep in mind that the main therapeutic benefits of vibration occur at 30-50 hz so most therapeutic massagers do not run at this higher speed, and as stated 100 Hz has potentially undesired affects such as causing muscles to contract (tighten) rather than relax.
Cramps and spasms are caused by neurological reflexes. These reflexes are generally useful. As an example stretch reflexes stimulate your muscles to tighten when rapid or excessive stretching is detected. This is an excellent protective mechanism that prevents muscles from being overstretched and damaged.
However, these can "lock on" abnormally in the case of muscle cramps or spasms. It is also a core problem in (myofascial) trigger points where part of the muscle spasms causing the lump. Vibration in the range of 30-50 Hz has been shown to temporarily suppress this reflex (1, 10). For more information please see our guide Your Complete Guide To (Myofascial) Trigger Points .
Clinical application: trigger points
The main application for suppressing these reflexes is treating trigger points, which are arguably the most common cause of musculoskeletal pain such as back, neck and shoulder pain. They are those tender lumps in muscles that shoot pain when pressed upon. As this diagram shows scientists have found that these are part of the muscle that have gone into spasm, causing a positive feedback loop that involves tightening of the muscle, a reduction in blood flow, and a build up of waste products.
All trigger point therapies help by addressing one or more parts of the loop. Vibration massage is an extremely effective treatment because it is scientifically proven to address all the parts of the feedback loop at once. For more info please see here.
Clinical application: "Elite" stretching
Gymnasts have also used the application of 30 Hz vibration to inhibit the stretch reflex, achieving superior results when stretching (15) . What they did was temporarily shut down the body's protective mechanism against overstretching. This may have merit for elite gymnasts in a controlled setting, but otherwise not something we would recommend.
Stretching exercises are done to lengthen muscles to their proper operational length. This allows full movement and efficient function of the muscles. Clinical trials show that the application of vibration of 40-50 Hz produces a similar lengthening of muscles. This would be extremely useful in situations where stretching cannot be used or if it were difficult to isolate the appropriate muscles.
Example: where stretching cannot be used
An example would be while an injured ankle was healing. Conventional stretches could no be used as they would further damage the joint, however, vibration could be applied to the calf muscles to prevent them shortening.
Example: where it is difficult to stretch
An example would be parts of the spine. Your spine is made of a chain of links. If one link is stiff it is practically impossible to isolate a stretch to that link only, however, a vibration massager can easily apply very localised vibration. An excellent example would be the intrinsic muscles of the spine, as discussed in our article Back pain: massage therapists miss the most important muscles.
Strenuous exercise causes microscopic damage to your muscles. This results in post exercise soreness (also known as DOMS- delayed onset muscle soreness), and your muscles will suffer a loss of performance until recovered. Clinical trials (16-22) have shown that the application of vibration from 30-65 Hz either before or after exercise will result in:
- less soreness
- a reduction in blood chemicals that result from cell membrane damage, tissue necrosis and muscle cell damage
- a reduction in the temporary loss of muscle performance.
Clinical applications
Everyone who works out or plays sports seriously will suffer stiffness and soreness after. Vibration massage does exactly what your muscles need: relaxes them and stimulated blood flow to flush the wastes and bring in nutrients. Various clinical trials have shown that using a massage will help if done before exercise, after exercise, and during recovery . With your own vibration massager you can do them all. It is simple to do and has practically no ongoing cost.
For further information check out our The practical, science based guide to post exercise recovery .
There are several possible ways vibration massage may be used to help increase performance:
- Direct application
- regular massages
- helping eliminate impediments to performance
Direct application
The application of vibration has been shown to enable the nervous system to stimulate more receptors in muscles, both in number and type. The result is higher maximum contraction force and increased muscular effort. (23) This should be of interest to anyone who wishes to achieve greater performance, such as those who play sport or work out in a gym. A research summary (23) found 21 published trials covering this area. The protocols and vibration frequencies used varied widely. However, in general they found that the lower frequencies (5-50 Hz) used short duration applications worked well. They also found that better results were achieved by applying the vibration directly to the muscles rather than via indirect methods,
Regular massages
There have been several trials where regular massage has been shown to increase performance. In one example, during a three week training camp athletes received a 45-52 Hz vibration massage each evening. They suffered reduced fatigue compared with those who received no vibration massage (24)
Helping eliminate impediments to performance
The previously mentioned (myofascial) trigger points can have a profound affect on performance, including reducing strength, causing rapid fatigue, and altering neurological control. For more information please see our article on the effects of (myofascial) trigger points on sports and athletics performance .
In animal experiments (25,26) the application of 45 hz for 30 minutes per day has dramatically sped and improved healing, including:
- speeding wound healing
- speeding the growth of muscle fibres,
- reducing the amount of scar tissue
- increasing the level of growth hormones
- increasing angiogenesis
- increasing the rate of nerve growth
For more details please see our article Does vibration help healing . However, two pictures from the trial reports follow to illustrate how profound these effects are.
Much faster growth of muscle fibres
In these images the oval shapes with the dots are muscle fibres in cross section. In the trial the daily 45hz vibration caused the body to produce increased levels of growth hormones resulting in the healing muscle fibres becoming musch larger.
Healing with reduced scar tissue
In pic "A" the large amount of white/grey material is scar tissue. As you can see when the daily 45hz vibratation was applied the muscle healed with almost no scar tissue.
Practical advice on using vibration massage
Using a massager
Using vibration massage is incredibly easy. We have full details in our article How to use a hand held massager However, basically all you need to do is place the vibrating pad of a massage over where you wish to massage and let the vibrations penetrate.
The common mistake we see colleagues make
The main mistake we see is colleagues make is use the techniques they have learned for conventional massage, such as pushing he head in or moving it a around. As the diagram shows this is a bit like using axe techniques with a chain saw.
Self massage
Vibration massage is very safe and easy to apply, so if patients have the correct equipment and appropriate advice they can do effective therapy at home. Many clinics supply our massagers to their patients for this purpose. The main benefits of this occur where patients need more therapy than the clinic can provide or the patient can afford. Examples include:
- recovery massages after sports or exercise
- performance increasing massage as discussed above
- chronic myofascial issues
- cellulite massage as discussed above
- any other management that requires a large number of applications of massage or soft tissue therapy.
Choosing the right equipment
What you need
To take advantage of the the physiological and neurological effects discussed you will need a vibration massager that:
- has a strong mechanism designed to transmit vibrations, and
- can operate in the 40-50 hz range where most of these benefits occur.
We've got a separate article on how to choose a massager, however you will find that most “vibrating massagers” will not be suitable. The unsuitable equipment includes “consumer massagers” and massage guns or percussion massagers.
“Consumer massagers”
A study conducted a few years ago found that manufacturers of massagers built for the public to use at home were concerned about how their machines looked on shop shelves rather than how they worked: resulting an machines that looked good but had little therapeutic benefit (27). As an example the factory that builds our massagers sent us the machine pictured. Like most of these types of machines it came with a host of cheap gimmick shaped plastic heads, so we glued on a decent one. When we tried it the head only went up and down 1-2mm rather than the 4-5mm needed for effective vibration transfer. Where a proper professional machine will send vibrations right through you this machine just “buzzed” the surface.
Massage guns (percussion massagers)
Massage guns are designed to drive their heads into your muscles rather than deliver vibrations. Because of this they deliver less vibrations and they are at the wrong frequency.
Massage guns deliver less vibrations
The easiest way to explain is to use this diagram.
- The machine on the left is a genuine vibration massager. You can see that it has the large pad to send copious amounts of therapeutic vibrations deep into your muscles.
- The tool on the right is a t-bar that massage therapists use to deliver deep (usually painful) pressure.
- The machine in the middle is a massage gun, or percussion massager. It’s head goes up and down a lot further and is designed to drive into your muscles. Bascially it is a t-bar with a jack-hammer mechanism.
The key differences
As you can see, compared with the vibration massager the massage gun :
- delivers far less therapeutic vibrations, and
- is much more likely to hurt you.
Massage guns cannot be used at the therapeutic frequencies
We have see that for most of the benefits the effective frequency is around 50hz. “Professional” massage guns drive their heads into your muscles 12-16mm. Driving something 12-16mm into your muscles 50 times a second would cause tremendous damage so Theraguns have a maximum of 40hz, but even that is way too fast. A survey of professionals found that most used their massage guns on “slow” or “medium” (28). This means they are operating way outside the effective therapeutic frequency range.
We built our own personal use vibration massagers
You will find most machines on the market to be massage guns or ineffective “consumer machines”. Because of this when we were looking for an effective massager for our own patients we built our own.
The General Purpose Massager
We’ve had this machine for over a decade and it’s proved to be extremely effective, economical and reliable. The only shortfall is that you are limited to massaging the region under the single head. More information about the General Purpose Massager
The Ultimate Quad Head Massager
This machine has the same ergonomic shape and effectiveness as the General Purpose Massager, but has four heads so it can massage a much larger area. More information about the Ultimate Quad Head Massager
Professionals
DrGraeme massagers were originally built by Dr Graeme for use in his clinic, and to prescribe to his patients for additional self use at home. Now these are used by colleagues and other professionals for similar purposes. If you are a professional and wish to know more about this therapy, or possibly get a sample massager to trial please check out our practitioner page.
References
1. Poenaru D, Cinteza D, Petrusca I, Cioc L, Dumitrascu D. Local Application of Vibration in Motor Rehabilitation - Scientific and Practical Considerations. Maedica (Buchar)
2. Inaba R, Furuno T, Okada A. Effects of low- and high-frequency local vibration on the occurrence of intimal thickening of the peripheral arteries of rats. Scand J Work Environ Heal. 1988;14(5):312–6.
3. Lohman EB, Petrofsky JS, Maloney-Hinds C, Betts-Schwab H, Thorpe D. The effect of whole body vibration on lower extremity skin blood flow in normal subjects. Med Sci Monit. 2007;
4. Maloney-Hinds C, Petrofsky JS, Zimmerman G. The effect of 30 Hz vs. 50 Hz passive vibration and duration of vibration on skin blood flow in the arm. Med Sci Monit . 2008;14(3):CR112-6.
5. Nakagami G, Sanada H, Matsui N, Kitagawa A, Yokogawa H, Sekiya N, et al. Effect of vibration on skin blood flow in an in vivo microcirculatory model. Biosci Trends. 2007;1(3):161–6.
6. DrGraeme. The presence and treatment of myofascial trigger points in chronic shoulder pain DrGraeme.com. 2018.
7. Bron C, De Gast A, Dommerholt J, Stegenga B, Wensing M, Oostendorp RAB. Treatment of myofascial trigger points in patients with chronic shoulder pain: A randomized, controlled trial. BMC Med. 2011;9.
8. Lundeberg T. Long-term results of vibratory stimulation as a pain relieving measure for chronic pain. Pain. 1984;20(1):13–23.
9. Rabini A, De Sire A, Marzetti E, Gimigliano R, Ferriero G, Piazzini DB, et al. Effects of focal muscle vibration on physical functioning in patients with knee osteoarthritis: a randomized controlled trial. Eur J Phys Rehabil Med. 2015;
10. Noma T, Matsumoto S, Etoh S, Shimodozono M, kawahira K. Anti-spastic effects of the direct application of vibratory stimuli to the spastic muscles of hemiplegic limbs in post-stroke patients. Brain Inj. 2009;23(7–8):623–31.
11. Bakhtiary AH, Fatemi E, Khalili MA, Ghorbani R. Localised application of vibration improves passive knee extension in women with apparent reduced hamstring extensibility: A randomised trial. J Physiother. 2011;
12. Atha J, Ph D, Wheatley DW, Sc B. JOINT MOBILITY CHANGES DUE TO LOW FREQUENCY VIBRATION AND STRETCHING EXERCISE Br J Sports Med March. 1974;26–35.
13. BIERMAN W. INFLUENCE OF CYCLOID VIBRATION MASSAGE ON TRUNK FLEXION. Am J Phys Med Rehabil. 2006;
14. Hinman MR, Lundy R, Perry E, Robbins K, Viertel L. Comparative effect of ultrasound and deep oscillation on the extensibility of hamstring muscles. J Athl Med. 2013;
15. SANDS WA, MCNEAL JR, STONE MH, RUSSELL EM, JEMNI M. Flexibility Enhancement with Vibration. Med Sci Sport Exerc. 2006;38(4):720–5.
16. Kim J-Y, Kang D-H, Lee J-H, O S-M, Jeon J-K. The effects of pre-exercise vibration stimulation on the exercise-induced muscle damage. J Phys Ther Sci. 2017;29(1):119–22.
17. Imtiyaz S, Veqar Z, Shareef MY. To compare the effect of vibration therapy and massage in prevention of delayed onset muscle soreness (DOMS). J Clin Diagnostic Res. 2014;
18. Bakhtiary AH, Safavi-Farokhi Z, Aminian-Far A. Influence of vibration on delayed onset of muscle soreness following eccentric exercise. Br J Sports Med. 2007;
19. Kamandani R, Ghazalian F, Ebrahim K, Ghassembaglou N, Shiri Piraghaj M, Khorram A. The Effect of Acute Vibration Training on Delayed Onset Muscle Soreness in Young Non-Athlete Women. Heal Scope. 2015;
20. Broadbent S, Rousseau JJ, Thorp RM, Choate SL, Jackson FS, Rowlands DS. Vibration therapy reduces plasma IL6 and muscle soreness after downhill running. Br J Sports Med. 2010;44(12):888–94.
21. Lau WY, Nosaka K. Effect of vibration treatment on symptoms associated with eccentric exercise-induced muscle damage. Am J Phys Med Rehabil. 2011;
22. Veqar Z, Imtiyaz S. Vibration therapy in management of delayed onset muscle soreness. J Clin Diagnostic Res. 2014;8(6):10–3.
23. Germann D, El Bouse A, Shnier J, Abdelkader N, Kazemi M, Germann D, et al. Effects of local vibration therapy on various performance parameters: a narrative literature review. J Can Chiropr Assoc. 2018;62(3).
24. Gentili S, Uccioli L, Mugnaini S, Lella D, Richetta M, Magrini A. EFFECTS OF LOCAL VIBRATION THERAPY ON LOWER LIMB ’ S SENSORIMOTOR CONTROL IN WORKERS SUFFERING FROM DIABETIC FOOT – STATE OF ARTS AND STUDY ON A NEW PREVENTION AND THERAPEUTIC SYSTEM .
25. Weinheimer-Haus EM, Judex S, Ennis WJ, Koh TJ. Low-intensity vibration improves angiogenesis and wound healing in diabetic mice. PLoS One. 2014;9(3):3–10.
26. MEI R, XU Y, LI Q. Experimental Study on Mechanical Vibration Massage for Treatment of Brachial Plexus Injury in Rats. J Tradit Chinese Med. 2010;
27. McDonagh D, Wilson L, Haslam C, Weightman D. Good vibrations: Do electrical therapeutic massagers work? Ergonomics. 2005
28. Cheatham SW, Baker RT, Behm DG, Stull K, Kolber MJ. Mechanical percussion devices: A survey of practice patterns among healthcare professionals. Int J Sports Phys Ther. 2021;16(3):766–77.
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