Robert Trybulski1,2, Beata Borecka3, Vlad Adrian Geantă4,5, Robert Çitozi6, Viorel Petru Ardelean4,5
1Katowice Business University, Faculty of Medicine, Katowice 40-659, Poland
2Provita Żory Medical Center, Żory, Poland
3Physiotherapy Center “Baterie Zdrowia”, Zajączki Drugie, 42-160 Krzepice, Poland
4Department of Physical Education and Sport, Faculty of Physical Education and Sport, Aurel Vlaicu University of Arad, Elena Dragoi Street nr. 2-3, 310330 Arad, Romania
5Physical Activities Research Center, 2-4, Elena Dragoi, 310330 Arad, Romania
6Sports University of Tirana, Faculty of Physical Activity and Recreation, Department of Physical Activity, Recreation and Tourism, Tirana 1001, Albania
Sports Massage With or Without Ice Packs After Plyometric Exercise in Male Combat Athletes: A Three-Period Crossover Study
J. Anthr. Sport Phys. Educ. 2026, 10(4), Ahead of Print | DOI: 10.26773/jaspe.261003
Abstract
Whether local cooling adds to the recovery effects of sports massage after strenuous exercise remains uncertain. This study compared sports massage alone (SM), sports massage followed by ice packs (SM+ICE), and passive rest after plyometric exercise in male combat-sport athletes. Thirty athletes completed three treatment periods with 14-day washouts: SM, SM+ICE, and passive rest. Initial condition allocation was randomized, but chronological treatment sequences were unavailable for analysis. After a standardized plyometric protocol, active conditions involved seven sessions over 72 h. Each session included 20 min of bilateral quadriceps massage; SM+ICE additionally included 10 min of simultaneous bilateral ice-pack application. Rectus femoris stiffness and pressure pain threshold (PPT) were primary outcomes. Assessments occurred before and immediately after exercise and at 24, 48, and 72 h; the 72-h assessment followed the final treatment session. Multivariate repeated-measures models evaluated within-participant changes with Holm adjustment. All participants completed all conditions. The primary SM+ICE-versus-SM comparison showed greater reductions in rectus femoris stiffness with SM+ICE (Holm-adjusted p<0.001), but no additional PPT benefit (p=0.438). At 72 h, the SM+ICE–SM difference in change from immediately post-exercise was −26.30 N/m for stiffness (95% CI, −28.24 to −24.36) and −1.14 N for PPT (95% CI, −2.81 to 0.54). Exploratory secondary analyses showed higher reactive strength index and perceived-recovery scores with SM+ICE, and lower creatine kinase fold changes at 24 and 48 h. Adding ice packs to sports massage was associated with larger short-term stiffness reductions, without demonstrated additional PPT benefit. Secondary findings require replication. Missing treatment-order data, unblinded participants, unequal treatment duration, and post-treatment assessment at 72 h limit causal and practical inference.
Keywords
muscle stiffness, pressure pain threshold, creatine kinase, reactive strength index, perceived recovery
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