Physical TheraPT

Recovery Optimization

From Rehab to Resilience: The Power of Maintenance Massage

If you’ve ever received massage therapy as part of your physical therapy care, you’ve likely experienced the benefits of recovery massage—decreased soreness, improved mobility, and faster healing. But what happens when you’re out of the acute phase? That’s where maintenance massage comes in—and it’s often the missing piece in staying injury-free and performing at your best.

While recovery massage gets much of the spotlight in the rehab process, maintenance massage is what keeps your system tuned and functioning well long after the initial problem has resolved. Let’s explore the distinct purposes of recovery and maintenance massage, why each matters, and why transitioning from one to the other should be part of your long-term plan.



Recovery Massage: A Tool for Healing

Recovery massage is typically prescribed during or immediately after an injury or intense physical stress. It targets soft tissues that are healing or under high demand. The goals are straightforward: reduce pain, manage inflammation, improve circulation, restore function, and help tissue recover from overload.

Studies consistently show that massage therapy can play a meaningful role in post-injury and post-exercise recovery. A meta-analysis published in Frontiers in Physiology found that massage significantly reduces delayed-onset muscle soreness (DOMS) and improves muscle performance markers such as strength and range of motion after strenuous exercise (Davis et al., 2020). Similarly, massage has been found to be effective in reducing perceived fatigue and supporting muscle recovery without impairing strength or power output (Poppendieck et al., 2016).

Massage also appears to positively impact inflammatory and healing pathways. A cellular-level study by Crane et al. (2012) found that massage downregulated genes associated with inflammation and promoted mitochondrial biogenesis in muscle tissue following exercise. This means massage doesn’t just feel good—it may help tissues repair more efficiently.

In rehab settings, recovery massage often occurs multiple times per week, especially in the early stages of healing. Sessions are more targeted, focusing on restoring mobility and reducing compensation patterns. Once pain and mobility have improved, the frequency of sessions typically decreases, paving the way for a maintenance plan.



Maintenance Massage: Investing in Resilience

In contrast to recovery massage, maintenance massage isn’t about fixing something that’s broken—it’s about keeping systems running smoothly. After you successfully recover from injury, transitioning into maintenance massage is a key strategy to prevent recurrence and improve long-term performance and body awareness.

Maintenance massage supports:

  • Circulation and metabolic exchange in muscles and fascia

  • Muscle tone balance in frequently used or overused areas

  • Joint mobility and tissue pliability

  • Stress reduction and parasympathetic nervous system activation

Although fewer studies focus exclusively on maintenance massage, the benefits are supported by broader research into regular manual therapy. For example, research published in International Journal of Therapeutic Massage & Bodywork found that regular massage over four weeks led to statistically significant decreases in reported musculoskeletal discomfort in healthy adults (Sherman et al., 2014).

Importantly, maintenance massage isn't “less important” just because it's not addressing an acute injury. For athletes or active individuals, maintenance massage becomes part of an ongoing performance strategy—much like strength training or mobility work.

Frequency can vary: for highly active individuals, once every 2–4 weeks is common. The techniques used are often broader and less intense than during the recovery phase, with a focus on tissue health and function rather than symptom relief.





The Transition: From Recovery to Maintenance

One of the most important shifts in the rehabilitation process is knowing when and how to transition from recovery massage to maintenance. That shift usually happens once:

  • Pain has decreased

  • Normal movement patterns have returned

  • The tissue is no longer in an acute inflammatory state

  • Function has improved with activity or return to sport

At this stage, the goal is no longer just healing—it’s sustainability.

Yet many patients disengage from bodywork once the acute phase ends. They “graduate” from PT and stop getting massage until the next injury arises. This stop-start cycle can lead to setbacks or recurrent issues that were preventable with consistent maintenance work.

Massage therapists working in sports and rehab settings understand this arc and can guide the timing and frequency of maintenance sessions. Maintenance massage isn’t about pampering—it’s an active part of an athletic recovery strategy.

 

Tools We Trust for Recovery

While nothing replaces the benefits of hands-on massage, there are a few tools we consistently recommend. Products like massage guns, Chirp wheels, and the VenomGo—combining targeted heat and vibration—can help boost circulation and ease muscle tension between sessions.

 
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Conclusion: Recovery Is a Phase—Maintenance Is a Mindset

Recovery massage is the hero during an injury—focused, intensive, and essential. But as tissues heal and performance returns, the work doesn’t stop there. Maintenance massage picks up the baton, helping you maintain the progress you’ve made and avoid returning to square one.

For active individuals—especially those who’ve just completed physical therapy—making maintenance massage a consistent part of your recovery strategy helps build resilience, prevent injuries, and optimize performance. Just as your training evolves with your goals, so too should your approach to bodywork.

In short: Recovery massage gets you out of trouble. Maintenance massage keeps you out of it.

 

References

  • Crane, J. D., Ogborn, D. I., Cupido, C., Melov, S., Hubbard, A., Bourgeois, J. M., ... & Tarnopolsky, M. A. (2012). Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Science Translational Medicine, 4(119), 119ra13. https://doi.org/10.1126/scitranslmed.3002882

  • Davis, H. L., Alabed, S., & Chico, T. J. (2020). Effect of sports massage on performance and recovery: A systematic review and meta-analysis. Frontiers in Physiology, 11, 748. https://doi.org/10.3389/fphys.2020.00748

  • Poppendieck, W., Wegmann, M., Ferrauti, A., Kellmann, M., Pfeiffer, M., & Meyer, T. (2016). Massage and performance recovery: A meta-analytical review. Sports Medicine, 46(2), 183–204. https://doi.org/10.1007/s40279-015-0420-x

  • Sherman, K. J., Cherkin, D. C., Kahn, J., Erro, J. H., Hrbek, A., Deyo, R. A., & Eisenberg, D. M. (2014). A survey of training and practice patterns of massage therapists in two US states. International Journal of Therapeutic Massage & Bodywork, 7(1), 10–17. https://doi.org/10.3822/ijtmb.v7i1.202

Crepitus: The Truth About Noisy Joints

Ever hear a pop when you squat, a crack when you roll your neck, or a grind when you climb stairs? That’s crepitus — the medical term for the noises or sensations that sometimes come from your joints.

Crepitus is common, and in most cases, it’s nothing to worry about. But sometimes, it can signal that your joint mechanics aren’t working as smoothly as they should. Let’s break down why it happens, when it’s normal, and when it may be worth a closer look.


What Exactly Is Crepitus?

Crepitus refers to the popping, cracking, grating, or crunching sounds (or sensations) that occur during joint movement. It can show up in many areas of the body, including the knees, shoulders, hips, spine, and even the jaw.

It’s not a condition by itself, but more of a sign that something is happening in or around the joint. A lot of times, that “something” is completely benign. Other times, it’s a clue that the joint is under stress (Drum et al., 2023).


Why Do Joints Make Noise?

There are several reasons joints produce crepitus, most of which are harmless:

  • Gas bubble formation (cavitation): Joints are lubricated by synovial fluid. When pressure inside the joint changes quickly, gas can form or collapse in the fluid, creating a distinct popping sound (Kawchuk et al., 2015; Fryer et al., 2017).

  • Tendons or ligaments snapping over bone: Soft tissues sometimes shift slightly during movement and then snap back into place, creating a click.

  • Surface changes in cartilage: If the smooth joint surfaces become uneven (such as in arthritis), movement can cause grinding or crackling noises.

  • Internal tissue catching: Soft tissue folds inside the joint, such as plica or meniscal edges, can occasionally cause popping or clicking (Drum et al., 2023).


How Common Is Crepitus?

You’re not alone if your joints make noise — crepitus is widespread, even in healthy people.

  • About 41% of knees in the general population show crepitus.

  • Even among people with no knee pain, roughly one-third still experience it.

  • In individuals with osteoarthritis, the numbers are higher — up to 81% report crepitus (Couch et al., 2025).

The takeaway? Joint noise is very common, and by itself, it doesn’t necessarily mean damage.


When Crepitus Is Harmless

Most of the time, crepitus is simply a mechanical quirk of how your joints move. It’s usually not a concern if:

  • The noise occurs without pain.

  • There’s no swelling, stiffness, or loss of motion.

  • It hasn’t been getting worse over time.

In these cases, there’s no reason to avoid movement — in fact, staying active can keep your joints healthier.


When Crepitus Might Signal a Problem

Crepitus deserves more attention when it’s paired with other symptoms. You may want to consult a physical therapist or physician if you notice:

  • Pain with movement or weight-bearing

  • Swelling, warmth, or stiffness in the joint

  • Locking, catching, or instability

  • Persistent or worsening grinding

  • Loss of function or activity limitations

In some cases, more intense crepitus has been linked with weaker surrounding muscles (like the quadriceps in the knee). This muscle imbalance can place more stress on the joint, making symptoms worse (Jakovacz et al., 2024).

Importantly, while crepitus is more common in people with osteoarthritis, studies show that crepitus alone does not reliably predict disease progression or need for joint replacement (Pazzinatto et al., 2018).


What You Can Do About Crepitus

If your crepitus is painless:

  • Keep moving. Regular activity nourishes cartilage and prevents stiffness.

  • Strengthen muscles. For example, strong quadriceps and hamstrings help reduce stress on the knee.

  • Stretch and mobilize. Increased flexibility can improve tendon and ligament function.


Simple Tools to Keep Your Joints Moving Smoothly

Crepitus can often be eased with tools that promote muscle relaxation and joint mobility. The Hypervolt massage gun with its heated attachment helps improve circulation, reduce muscle tension, and warm up tissues around the joints. Pairing it with gentle movements using an exercise ball encourages controlled mobility and improved joint function.

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If your crepitus is painful or comes with swelling or dysfunction:

  • Check in with a physical therapist. They can identify whether the crepitus is harmless or potentially linked to a condition like arthritis, tendon overload, or a fibrocartilage injury (meniscus, labrum).

  • Follow a guided plan. Targeted exercises, joint protection strategies, and activity modifications can help reduce pain and restore confidence in movement.


Bottom Line

Joint noise by itself, even if it sounds dramatic, is usually nothing to worry about. But if crepitus shows up alongside pain, swelling, or loss of function, it’s your body’s way of telling you to pay closer attention.

The good news? Most causes of crepitus respond well to exercise, physical therapy, and healthy movement habits. So the next time your joints crack, remember: noise without pain is normal; noise with pain deserves attention.


References

  • Couch, T. A., Hall, M., Hussain, S. M., Teichtahl, A. J., Wluka, A. E., & Wang, Y. (2025). Knee crepitus: A systematic review of prevalence, incidence, and associations with knee osteoarthritis. Osteoarthritis and Cartilage Open, 7(1), 100471.

  • Drum, E. E., Jauregui, J. J., Probasco, S. K., et al. (2023). Knee crepitus: Current evidence and clinical relevance. Musculoskeletal Care, 21(3), 442–449.

  • Fryer, G., Pearce, A. J., & Herbert, J. J. (2017). Cavitation onset in the metacarpophalangeal joint: A physiological explanation of joint cracking. PLoS ONE, 12(4), e0174190.

  • Jakovacz, N., Mészáros, Z., & Farkas, J. (2024). Relationship between knee crepitus intensity and quadriceps muscle thickness. Manual Therapy, 66, 107102.

  • Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PLoS ONE, 10(4), e0119470.

  • Pazzinatto, M. F., de Oliveira Silva, D., Azevedo, F. M., & Barton, C. J. (2018). Association between crepitus and progression of knee osteoarthritis: A longitudinal cohort study. Arthritis Care & Research, 70(3), 420–427.