How to Use Percussive Therapy Guns to Alleviate Soreness

Percussive therapy guns have likely been popping up on your Instagram feed for quite some time now. First introduced to the market with the Theragun in 2016, the deep tissue massage tools resembling a power drill are now everywhere, available at every price point, in every size and from endless brands. Before you add a percussive therapy gun to your recovery regiment, you should know exactly what they are, how to use them, and how exactly they can help your body heal. 

What Are Percussive Therapy Guns?

Percussive therapy guns are electronic devices, usually resembling a power drill, that allow the user to easily give themselves a deep, powerful soft tissue massage, explains Elizabeth Gardner, MD. “With a firm rubber ball or other attachment, for percussion, the gun repeatedly and rapidly pounds into the muscle and soft tissue, in order to improve muscle soreness and stiffness,” she says.  

Eric Holder, MD, compares the movement to “the pistoling effect seen with a jackhammer.” But instead of loosening up concrete, the oscillating repetitive movement works to help release muscle tension and break up muscle knots.  

While this might seem a little hardcore for some people, a percussive therapy gun can also be used in a more gentle manner. Many devices also provide vibration therapy—a lower amplitude of force, adds Gardner. “Vibration therapy may be a better option for patients with chronic pain or with sensitive muscle tissue that may not be able to tolerate more intense treatment.”

The Benefits

Research is limited as to the proven benefits of percussive therapy guns, but there is some evidence that using one can be beneficial for a variety of reasons.

• It May Help Reduce Delayed Onset Muscle Soreness (DOMS): Holder points to early evidence indicating that it may reduce Delayed Onset Muscle Soreness (DOMS)—the pain you might experience a few days post-workout. A January 2014 study published in Journal of Clinical and Diagnostic Research for Doctors found that vibration therapy (50 Hz vibration for five minutes) and massage therapy (15 minutes) were equally effective in “significantly” decreasing muscle soreness for exercisers compared to a control group. “DOMS is attributed to ultrastructural mild muscle injury that can occur with completing an unfamiliar or intense exercise, with peak soreness usually between 24 and 72 hours post-exercise,” Holder explains. “There is evidence that percussion therapy similar to massage can help to reduce or prevent DOMS.”
• It May Help Improve Blood Flow: Holder also points to evidence that using a percussive therapy gun may improve blood flow/circulation. When muscles are tense, knotted up, or inflamed, it can limit blood flow to the area. “Improved blood flow functions to reduce muscle soreness, inflammation, and associated muscle tension/knots,” he explains. 
• It May Improve Flexibility: Early evidence suggests that percussive therapy guns may be helpful in improving range of motion (ROM), similar to conventional massage by a therapist.
• It May Help Relieve Stress: Science has long since supported massage as effective short-term stress relief. While the science is limited as to the stress-relieving powers of percussive therapy, many people claim that because they function similarly, they also help release tension and relieve stress. 
• It May Help Improve Your Sleep: Therabody, aka Theragun, conducted a 2020 study and found that 87% of participants fell asleep faster after using a Theragun Percussive Massage Therapy device.

When to Use a Percussive Therapy Gun

There are several ways and situations in which using a massage gun can be effective, Gardner explains. 

• Before Workouts: Before a workout is a good time to use a massage gun for warm up, per Gardner, as it can help increase blood flow to the muscles that you intend to exercise. “Spend one minute on each muscle group that you will be working out, as well as on the adjacent, supporting muscles,” she suggests. “For example, if you are going to be running or doing a lower-body workout, be sure to massage the quads, hamstrings, glutes, lower back, and calves.” There is also some evidence that using one may improve range of motion of joints before working out, she adds.
• Post-Workout: Using the massage gun after a workout can help keep circulation strong, “in order to continue to deliver oxygen and nutrients to the tired muscles,” she says. “It may also help to decrease inflammation in the muscles, thus possibly reducing post-exercise."
• When You Experience Muscle Soreness: A massage gun is also commonly used in the treatment of sore muscles one to two days after a workout. “When using it on sore muscles, it is important to adjust the speed and intensity of the percussion to a level that doesn’t cause pain,” she points out.
• When You Experience Muscle Tension: Finally, Gardner reveals that percussion therapy may be useful for stress relief and to decrease general muscle tension. “Using it for one to two minutes over each of the major muscle groups has been advocated to help the body to relax.”

How to Use a Percussive Therapy Gun

Holder maintains that percussive therapy guns “tend to be very user-friendly.” However, it is important to use them correctly to reap the benefits and avoid injury. “I generally recommend to start on the lowest setting, monitor for tolerance, and increase the setting as needed,” he suggests.” 

Then, simply aim the tool at the muscle group that you are attempting to target and let the machine do the work. “You do not need to force/push the tool into your muscle but instead, let it hover or glide along the muscle to apply the percussion treatment.” Gardner specifies that you should spend one to two minutes on each targeted muscle group. She also stresses the importance of treating not only sore muscles, or the muscles that you intend to target in your workout, but also the adjacent and supporting muscles.

Massage guns are safe to use on sore muscles but should be avoided on the following areas:

• Directly on bone
• On bruises
• On open skin wounds or abrasions
• On areas where you have severe or unexplainable pain
• Those taking blood thinners or with bleeding disorders should speak to their physician before using

There are also some people who should think twice before picking up a percussive therapy gun. “You should talk to your doctor before using on injured areas, such as sprains or strains or tendonitis, or if you have arthritis, osteoporosis, fibromyalgia, or other orthopedic conditions,” says Gardner. It is also recommended that women who are pregnant speak to their physician before using a massage gun, “although as long as it is not used on the abdomen, it is generally thought to be safe, and even helpful to relieve muscle tension,” she says. “Also remember that massage guns are not a substitute for stretching, or a proper warm-up and cool-down in your workout,” she reminds. 

What Speed to Use

As Holder suggested, start with a lower speed and intensity and work your way up. “Pick a setting of speed and intensity that is not painful on your muscle,” Gardner adds. If you desire a “deeper, more focused treatment,” she suggests switching the head attachments. 

Potential Side Effects

There are a few key risks when using a percussive therapy gun, and they are usually associated with using the device incorrectly. “Using the percussive therapy device for longer than is recommended, or with too strong of a setting, risks injury to the superficial soft tissues,” Gardner explains. “This can include rupturing blood vessels, increasing nerve sensitivity, and damaging muscle fibers.”

The Takeaway

Both doctors agree that when used correctly, percussive therapy guns can be an effective treatment for muscle soreness and mild injuries as well as potentially prevent them. “However, when used inappropriately or excessively, they can be counterproductive and worsen pain and inflammation,” Gardner reminds. It’s also important to understand “that percussion therapy is not a replacement for a well-formatted workout and stretching regimen, proper rest, and adequate nutrition and hydration, but instead is a helpful, supplementary tool when used appropriately,” adds Holder. Finally, if you do have any questions or concerns involving preexisting injuries or medical conditions, always remember to consult with your medical doctor prior to picking one up.