STUDY DESIGN: Randomized controlled trial. BACKGROUND: Post-exercise recovery techniques are widely used, but little research has examined effectiveness. OBJECTIVES: Examine the effectiveness of massage and pneumatic compression on recovery from a 161-km ultramarathon. METHODS: Participants of the 2015 161-km Western States Endurance Run were randomized to a 20-minute post-race intervention of massage, intermittent sequential pneumatic compression or supine rest. Each subject completed two 400 m runs at maximum speed before the race, and on days 3 and 5 after the race, and also provided muscle pain and soreness ratings and overall muscular fatigue scores before and for 7 days after the race. RESULTS: Of 72 race finishers completing the study, comparison among intervention groups revealed no significant group or interaction effect on 400 m run time, but there was a significant (p < 0.0001) time effect. The subjective outcome variables also showed no group effect and significant (p < 0.0001) time effects. Interaction effects were present for both lower body muscle pain and soreness rating (p = 0.0017) and overall muscular fatigue score (p < 0.0001). Post testing showed a difference among groups only immediately post-treatment. At this time point, massage showed a lower (p < 0.0001) muscle pain and soreness rating than the control group, whereas both massage (p < 0.0001) and pneumatic compression (p < 0.01) showed lower overall muscular fatigue scores compared with the control group. CONCLUSION: Single 20-minute sessions of post-race massage and intermittent sequential pneumatic compression provide some immediate subjective benefit. There is no evidence, however, that such treatments provide extended subjective or functional benefits of clinical importance. LEVEL OF EVIDENCE: Therapy, level 1b.

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