Efeitos da terapia manual realizada por profissionais na dor muscular de início tardio em praticantes de atividade física e atletas

Abstract

Aim: To analyze, through a systematic review with structured narrative synthesis, the effects of professionally applied manual therapy on the reduction of delayed onset muscle soreness (DOMS). Methods: A systematic review of randomized controlled trials investigating DOMS following sports massage, classical massage, manual myofascial release, or trigger point release techniques was conducted. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, SPORTDiscus, and SciELO without year restrictions, using descriptors related to “delayed onset muscle soreness,” “massage,” “manual therapy,” and “myofascial release.” Physically active adults and athletes exposed to experimental DOMS induction protocols were included. Methodological quality was assessed using the PEDro Scale. Results: Eighteen randomized controlled trials were included. Interventions comprised sports/classical massage (effleurage, petrissage, tapotement), manual myofascial release, and ischemic trigger point compression. Manual therapy reduced DOMS in the majority of studies (17/18), with mean reductions ranging from approximately 28% to 42%, and exceeding 45% in protocols involving sustained pressure and greater tissue specificity. Immediate post-exercise application demonstrated the most consistent effects, although interventions performed at 24–48 hours also showed benefits. Methodological quality was predominantly moderate to good (PEDro scores 4–8), with limitations mainly related to participant and therapist blinding. Conclusion: Professionally applied manual therapy demonstrates consistent evidence of clinically relevant reduction in DOMS in physically active adults and athletes. Effects appear to depend on technique type and timing of application, with stronger findings when delivered immediately post-exercise. Although promising, the true magnitude of effect should be interpreted cautiously due to the moderate methodological quality of the included studies.