Water Wins

You've probably heard you need to drink lots of water after a massage. But is that really necessary? Let's look at what the science actually says about hydration, massage, and athletic performance.

Why Water Matters for Athletes

Water makes up about 60% of your body weight and plays essential roles in nutrient transport, temperature regulation, and joint lubrication. For athletes and active individuals, staying hydrated is particularly important because it affects how your muscles and tissues function.[1]

When you're dehydrated, your tissues become stiffer and less flexible. Research shows that dehydration increases the force needed to compress soft tissues and reduces tissue thickness. Even mild dehydration (losing just 3% of your body weight in fluids) can decrease muscle endurance by about 8% and reduce strength by about 5%.[2][3]

Dehydration also creates extra stress on your muscles at the cellular level. Studies show that exercising while dehydrated increases oxidative stress and can impair muscle protein metabolism. Over time, severe dehydration may even slow down muscle recovery and glycogen (energy) storage after workouts.[4][5]

The Truth About Massage and "Toxins"

Here's the reality: the idea that massage releases toxins requiring extra water is a myth. There's no scientific evidence supporting this claim.[6][7][8]

Your body already has highly effective systems for removing waste products—your liver, kidneys, and lymphatic system handle this 24/7. Massage doesn't create a sudden release of toxins that needs to be flushed out with water.

What about lactic acid? This is another common misconception. Lactic acid doesn't cause muscle soreness, and it's cleared from your muscles within 30-60 minutes after exercise—long before you'd typically get a massage. Massage doesn't remove lactic acid, and you don't need extra water to flush it out.[9][10][11]

That said, massage does produce real physiological effects. Studies show it can temporarily reduce cortisol (a stress hormone), lower heart rate, and cause modest changes in inflammatory markers. But none of these effects require you to drink extra water.[12][13][14]

How Much Water Do You Actually Need?

For general health, aim for about 40-45 mL per kilogram of body weight per day from all beverages and food combined. For a 150-pound (68 kg) person, that's roughly 2.7-3 liters (90-100 ounces) total per day.[15][16]

If you're training hard or sweating heavily, you'll need more. A good rule of thumb: replace about 1.5 times the fluid you lose during exercise. For example, if you lose 1 pound during a workout, drink about 24 ounces of fluid.[17]

Simple ways to monitor your hydration:

• Check your urine color—pale yellow is ideal

• Pay attention to thirst during moderate activity

• Weigh yourself before and after intense workouts to estimate fluid loss

• Add 0.5-1 liter of water after high-sweat sessions

Important: Don't overdo it. Drinking excessive plain water during prolonged exercise can dilute your sodium levels and cause problems.

The Bottom Line

Hydration is important for athletic performance and recovery—but not because of massage. Staying well-hydrated helps maintain tissue flexibility, supports muscle function, and enables efficient recovery from training.[2][4][3]

After your next massage, feel free to drink water if you're thirsty. But don't feel pressured to chug extra water based on myths about toxins or lactic acid. Instead, focus on consistent daily hydration as part of your overall training and recovery strategy.

The real reason to stay hydrated isn't about flushing anything out—it's about keeping your body functioning at its best.

References

1. Water as an Essential Nutrient: The Physiological Basis of Hydration. Jéquier E, Constant F. European Journal of Clinical Nutrition. 2010;64(2):115-23. doi:10.1038/ejcn.2009.111.

2. Investigating the Impact of Dehydration and Hydration on in-Vivo Hip Soft Tissue Biomechanics. Khorami F, Foroutan Y, Sparrey CJ. PloS One. 2025;20(8):e0328054. doi:10.1371/journal.pone.0328054.

3. Effect of Hypohydration on Muscle Endurance, Strength, Anaerobic Power and Capacity and Vertical Jumping Ability: A Meta-Analysis. Savoie FA, Kenefick RW, Ely BR, Cheuvront SN, Goulet ED. Sports Medicine (Auckland, N.Z.). 2015;45(8):1207-27. doi:10.1007/s40279-015-0349-0.

4. Passive Dehydration Increases Oxidative Stress and mTOR Signalling Pathway Activation in Young Men Following Resistance Exercise. Luk HY, Jiwan NC, Appell CR, et al. The Journal of Physiology. 2025;603(12):3551-3570. doi:10.1113/JP288434.

5. Hydration, Hyperthermia, Glycogen, and Recovery: Crucial Factors in Exercise Performance-a Systematic Review and Meta-Analysis. López-Torres O, Rodríguez-Longobardo C, Escribano-Tabernero R, Fernández-Elías VE. Nutrients. 2023;15(20):4442. doi:10.3390/nu15204442.

6. Side-Effects of Massage Therapy: A Cross-Sectional Study of 100 Clients. Cambron JA, Dexheimer J, Coe P, Swenson R. Journal of Alternative and Complementary Medicine (New York, N.Y.). 2007;13(8):793-6. doi:10.1089/acm.2006.6401.

7. The Safety of Massage Therapy. Ernst E. Rheumatology (Oxford, England). 2003;42(9):1101-6. doi:10.1093/rheumatology/keg306.

8. The Mechanisms of Massage and Effects on Performance, Muscle Recovery and Injury Prevention. Weerapong P, Hume PA, Kolt GS. Sports Medicine (Auckland, N.Z.). 2005;35(3):235-56. doi:10.2165/00007256-200535030-00004.

9. Delayed Onset Muscle Soreness : Treatment Strategies and Performance Factors. Cheung K, Hume P, Maxwell L. Sports Medicine (Auckland, N.Z.). 2003;33(2):145-64. doi:10.2165/00007256-200333020-00005.

10. Delayed Muscle Soreness: A Review. Francis K. The Journal of Orthopaedic and Sports Physical Therapy. 1983;5(1):10-3. doi:10.2519/jospt.1983.5.1.10.

11. Lactate: Friend or Foe. Hall MM, Rajasekaran S, Thomsen TW, Peterson AR. PM & R : The Journal of Injury, Function, and Rehabilitation. 2016;8(3 Suppl):S8-S15. doi:10.1016/j.pmrj.2015.10.018.

12. Physiological Adjustments to Stress Measures Following Massage Therapy: A Review of the Literature. Moraska A, Pollini RA, Boulanger K, Brooks MZ, Teitlebaum L. Evidence-Based Complementary and Alternative Medicine : eCAM. 2010;7(4):409-18. doi:10.1093/ecam/nen029.

13. Influence of Classical Massage on Biochemical Markers of Oxidative Stress in Humans: Pilot Study. Skubisz Z, Kupczyk D, Goch A, et al. BioMed Research International. 2021;2021:6647250. doi:10.1155/2021/6647250.

14. Effect of Single Session of Swedish Massage on Circulating Levels of Interleukin-6 and Insulin-Like Growth Factor 1. Stenbäck V, Lehtonen I, Mäkelä KA, et al. International Journal of Molecular Sciences. 2024;25(17):9135. doi:10.3390/ijms25179135.

15. Hydration for Health Hypothesis: A Narrative Review of Supporting Evidence. Perrier ET, Armstrong LE, Bottin JH, et al. European Journal of Nutrition. 2021;60(3):1167-1180. doi:10.1007/s00394-020-02296-z.

16. Hydration and Health at Ages 40-70 Years in Salzburg Austria Is Associated With a Median Total Water Intake Over 40 mL/kg Including at Least 1 L/D Plain Drinking Water. Stookey JD, Langthaler PB, Felder TK, et al. Frontiers in Public Health. 2025;13:1668981. doi:10.3389/fpubh.2025.1668981.

17. Selected Issues for Nutrition and the Athlete: A Team Physician Consensus Statement. Medicine and Science in Sports and Exercise. 2013;45(12):2378-86. doi:10.1249/MSS.0000000000000174.

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.

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