Percussive Massage, Foam Rolling, and Hamstring Function: What Can TMG, Shear Wave Elastography, and MyotonPro Tell Us?
- Complete Performance
- 3 days ago
- 13 min read
Percussive massage devices and foam rollers have become common tools in sport, rehabilitation, and performance settings. Athletes use them before training, clinicians use them during treatment, and coaches often include them in warm-up or recovery routines.
The logic is attractive: if a muscle feels stiff, tight, or restricted, applying mechanical pressure, vibration, or repeated percussive impulses may improve mobility, reduce stiffness, enhance readiness, and possibly improve performance.
But as with many popular interventions, the most important question is not whether the method feels useful.
The real question is:
Does it produce measurable improvements in muscle function?
Our recent study, “Effects of Percussive Massage vs. Foam Rolling on Hamstring Function: A Comparative Study Using Shear Wave Elastography, Tensiomyography, and MyotonPro,” investigated exactly this question. The study examined the acute effects of vibration foam rolling and percussive massage on hamstring range of motion, maximal voluntary isometric contraction, and biceps femoris muscle stiffness using three different assessment technologies: shear wave elastography, tensiomyography, and MyotonPro.
This work also aligns with our previous research interests: understanding how commonly used warm-up, recovery, and rehabilitation interventions influence neuromuscular function, muscle stiffness, and performance-related outcomes.
In practice, foam rolling and percussive massage are often used because they are simple, accessible, and easy to implement. However, simplicity should not be confused with effectiveness. If these tools are used before sprinting, jumping, high-speed running, strength training, or return-to-play testing, we need to understand what they actually do to the hamstrings.
Do they improve range of motion?
Do they reduce muscle stiffness?
Do they enhance force production?
Or do they mainly change how the athlete feels?
These are important questions for sport scientists, physiotherapists, strength and conditioning coaches, and rehabilitation professionals.
Why Focus on the Hamstrings?
The hamstrings are not just “posterior thigh muscles.”
They are essential for sprinting, jumping, deceleration, cutting, kicking, and many other high-speed sport actions. They contribute to hip extension, knee flexion, pelvic control, and lower-limb stability during demanding athletic movements.
This makes them extremely important for performance, but also highly vulnerable.
Hamstring injuries are among the most common injuries in sport. They often lead to time loss, reduced performance, high recurrence rates, and difficult return-to-play decisions. In many sports, especially those involving sprinting and rapid acceleration, the hamstrings are exposed to repeated high-force and high-velocity demands.
During sprinting, the hamstrings must tolerate rapid lengthening, high eccentric loads, and fast transitions between force absorption and force production. This is one reason why the biceps femoris, especially the long head, is frequently involved in hamstring strain injuries.
From a practical standpoint, many athletes report hamstring tightness, discomfort, or stiffness during periods of heavy training, fatigue, or return to sport. Practitioners often respond with interventions such as foam rolling, massage guns, stretching, manual therapy, or mobility work.
However, the feeling of tightness is not always the same as mechanical stiffness.
Feeling “looser” is not always the same as being more prepared to produce force.
And reducing stiffness is not always automatically beneficial if it comes with reduced force capacity or reduced neuromuscular readiness.
That is why objective measurement matters.
What Was the Purpose of Our Study?
The purpose of our study was to compare the acute effects of two commonly used interventions:
Percussive massage
and
Vibration foam rolling
Both interventions were applied to the hamstrings using a practical dose of 3 × 30 seconds. This is important because in applied sport settings, warm-up time is often limited. Coaches and practitioners need to know whether short, time-efficient interventions can provide meaningful benefits.
The study included seventeen physically active participants who completed both interventions on separate testing days in a randomized cross-over design. Muscle stiffness of the biceps femoris long head was assessed before and immediately after the intervention using three methods: shear wave elastography, MyotonPro, and tensiomyography. Sit-and-reach performance was used to assess posterior chain flexibility, and maximal voluntary isometric contraction was used to assess hamstring strength output.
The study therefore allowed us to examine not only whether percussive massage or vibration foam rolling changed hamstring function, but also whether three popular technologies provide similar or different information about muscle stiffness.
What Did Our Study Show?
The main findings were practically important.
First, neither vibration foam rolling nor percussive massage produced a significant improvement in range of motion.
This is important because both interventions are commonly used with the expectation that they will immediately improve flexibility or reduce the sensation of tightness.
Second, neither intervention significantly changed biceps femoris muscle stiffness, regardless of whether stiffness-related properties were assessed using shear wave elastography, tensiomyography, or MyotonPro.
Third, maximal voluntary isometric contraction torque was slightly reduced from pre- to post-testing. However, this finding should be interpreted carefully. The reduction appeared as a main effect of time, not as a specific negative effect of either percussive massage or vibration foam rolling. This means that the decrease may reflect general testing-related fatigue rather than a direct harmful effect of the interventions themselves.
Finally, no significant associations were found between the stiffness-related outcomes obtained from shear wave elastography, TMG, and MyotonPro. This suggests that these devices should not be used or interpreted interchangeably.
In simple terms:
A short application of percussive massage or vibration foam rolling did not meaningfully improve hamstring range of motion or reduce biceps femoris stiffness.
At the same time, the findings do not mean these tools are useless.
Rather, they suggest that their effects are probably more complex, more dose-dependent, and more context-specific than often presented in practice.
Percussive Massage: Useful Tool or Overrated Performance Strategy?
Percussive massage devices, often called massage guns, deliver repeated mechanical impulses to the muscle. They are popular because they are easy to use, time-efficient, portable, and often perceived as effective by athletes.
The proposed mechanisms behind percussive massage include:
increased local blood flow, reduced perceived muscle tightness, altered sensory input, increased stretch tolerance, modulation of muscle tone, and reduced discomfort.
From a clinical or recovery perspective, these mechanisms may be useful. Athletes often report that percussive massage helps them feel better, move more freely, or reduce the sensation of tightness.
But the performance question is more complex.
If the goal is to sprint, jump, accelerate, decelerate, or produce high levels of force, then the intervention should ideally improve readiness without compromising force output.
In our study, percussive massage did not significantly improve range of motion or reduce measured biceps femoris stiffness. Maximal voluntary isometric torque decreased slightly from pre- to post-testing, but this decrease was not specific to percussive massage and may have been influenced by the testing procedure itself.
This creates a more balanced message.
Percussive massage may still be useful for comfort, recovery, or perceived readiness. But practitioners should be careful when presenting it as a guaranteed acute performance-enhancing intervention.
For the hamstrings, this is especially important because these muscles must produce and tolerate high forces during sprinting, deceleration, and change of direction.
Foam Rolling and Vibration Foam Rolling: Mobility Tool or Performance Enhancer?
Foam rolling is one of the most common self-myofascial techniques in sport. Vibration foam rolling adds mechanical vibration to the traditional rolling stimulus.
The proposed mechanisms are similar to percussive massage and include mechanical compression, sensory stimulation, changes in stretch tolerance, possible alterations in muscle tone, improved perception of movement comfort, and potential changes in soft-tissue compliance.
Foam rolling is often promoted as a way to improve range of motion without negatively affecting performance. Some research supports acute improvements in flexibility following foam rolling, and vibration foam rolling may in some contexts produce greater range-of-motion effects than traditional foam rolling.
However, our hamstring-focused findings were more cautious.
The vibration foam rolling protocol did not significantly improve sit-and-reach performance and did not meaningfully alter biceps femoris stiffness. The protocol was short and practical, which makes it relevant to applied sport settings, but this same short duration may also help explain why meaningful changes were not observed.
The paper also notes that studies reporting reductions in stiffness after foam rolling or percussive massage often used longer intervention durations, typically between approximately 120 and 360 seconds. Therefore, the lack of effect in our study may be partly related to the short intervention duration, although it is likely not the only explanation.
This is important because athletes often use foam rolling immediately before training or competition. If the aim is comfort, relaxation, or perceived readiness, foam rolling may still have a place. But if the aim is acute enhancement of hamstring force output or mechanical stiffness reduction, practitioners should not simply assume that a short bout will produce meaningful benefits.
Why Measurement Technology Matters
Modern sport science is moving beyond simple performance testing.
Jump height, sprint time, range of motion, and strength tests are useful. But they do not always explain what is happening inside the muscle.
This is where technologies such as tensiomyography, shear wave elastography, and MyotonPro become valuable.
Each device provides a different window into muscle function and mechanical behavior. However, one of the most important messages from our study is that these technologies should not be treated as interchangeable.
It is common in applied practice to hear broad statements such as:
“The muscle is stiff.”
But stiffness is not one universal measurement.
A muscle can show increased shear modulus on elastography, altered radial displacement on TMG, or increased superficial mechanical stiffness on MyotonPro. These variables may all relate to the broader concept of muscle mechanical properties, but they are not the same thing.
This is why the lack of correlation between SWE, TMG, and MyotonPro is so important.
It suggests that these devices are likely capturing different aspects of the muscle’s mechanical profile rather than measuring one identical construct.
What Is Tensiomyography?
Tensiomyography, or TMG, is a non-invasive method used to assess skeletal muscle contractile properties.
It works by applying a brief electrical stimulus to the muscle and measuring the radial displacement of the muscle belly. From this response, several parameters can be extracted, including delay time, contraction time, sustain time, relaxation time, and maximal displacement.
TMG is particularly useful because it provides insight into contractile behavior, not only external performance. It can help describe how the muscle responds to an electrically evoked stimulus and how its mechanical response changes following fatigue, training, recovery interventions, or rehabilitation.
In the hamstring context, TMG is especially interesting because the hamstrings are involved in rapid stretch-shortening actions, sprinting, and deceleration. Their ability to contract quickly and recover efficiently may be relevant for both performance and rehabilitation monitoring.
However, TMG should not be viewed simply as a “stiffness device.”
It provides information about evoked contractile response and muscle belly displacement. These characteristics may be related to muscle stiffness, but they are not identical to tissue shear modulus measured with elastography or superficial mechanical stiffness assessed with MyotonPro.
What Is Shear Wave Elastography?
Shear wave elastography is an ultrasound-based method used to estimate tissue mechanical properties.
It measures the speed of shear waves travelling through tissue. In general, faster shear wave propagation indicates a stiffer tissue, and the result is often expressed as shear modulus.
This makes shear wave elastography highly valuable for evaluating localized muscle stiffness, especially in specific muscles or regions of interest.
For the hamstrings, this is particularly useful because stiffness may vary between muscles and even within different regions of the same muscle. The biceps femoris, semitendinosus, and semimembranosus may not respond identically to fatigue, stretching, strengthening, or recovery interventions.
Shear wave elastography allows researchers and clinicians to examine tissue-level mechanical behavior more directly than general flexibility tests.
However, it also requires technical expertise, standardized positioning, and careful interpretation. Probe placement, joint position, muscle relaxation, examiner pressure, anatomical variation, and data processing can all influence the result.
In our study, the authors also noted that assessing the biceps femoris can be challenging because of anatomical variation and regional differences within the muscle. This is an important limitation for both research and applied practice.
What Is MyotonPro?
MyotonPro is a portable device used to assess mechanical properties of superficial soft tissues.
It applies a brief mechanical impulse to the tissue and measures the tissue’s damped oscillation response. From this response, it can estimate parameters such as muscle tone, dynamic stiffness, elasticity, mechanical relaxation, and creep.
One of the main advantages of MyotonPro is its practicality.
It is portable, relatively quick to use, and easier to implement in field or clinical environments compared with ultrasound-based methods. This makes it attractive for sport scientists, physiotherapists, and performance practitioners who want to monitor muscle mechanical properties in applied settings.
However, practicality does not mean it measures the same thing as shear wave elastography or TMG.
MyotonPro assesses superficial tissue response to a mechanical impulse. SWE estimates tissue shear modulus using ultrasound. TMG evaluates radial muscle displacement after electrical stimulation.
These are different methods, based on different mechanical principles, and they should be interpreted accordingly.
Why the Three Devices Should Not Be Used Interchangeably
One of the most valuable parts of our study is not only the intervention comparison, but also the device comparison.
Although SWE, TMG, and MyotonPro are often discussed under the broad umbrella of “muscle stiffness,” they do not measure the same thing.
Shear wave elastography uses acoustic radiation force to generate shear waves and estimate tissue shear modulus.
MyotonPro assesses transverse mechanical compliance through damped surface oscillation.
Tensiomyography evaluates radial displacement following an electrically evoked contraction.
Because each technique relies on a different physiological and mechanical principle, it is understandable that their results were not significantly correlated.
This does not necessarily mean that one device is right and the others are wrong.
Instead, it means that each device may capture a different dimension of muscle behavior.
Therefore, the better question is not:
“Which device measures stiffness best?”
The better question is:
“Which aspect of muscle function do I want to understand?”
If the goal is to examine localized tissue stiffness, shear wave elastography may be highly informative.
If the goal is to assess evoked contractile properties and muscle belly displacement, TMG may be more appropriate.
If the goal is quick field-based monitoring of superficial mechanical properties, MyotonPro may be useful.
The strength of these technologies is not that they all provide the same answer.
Their strength is that, when interpreted correctly, they may help us understand different dimensions of hamstring function.
Why These Interventions Matter for Hamstring Health
Even though our recent study did not show acute improvements in range of motion or stiffness, interventions such as foam rolling and percussive massage remain relevant.
Why?
Because hamstring management is not only about maximal performance.
It is also about comfort, readiness, recovery, tissue sensitivity, perception of tightness, movement confidence, and long-term load management.
The hamstrings are exposed to high demands during sport. They must tolerate rapid lengthening, high eccentric loads, repeated accelerations, decelerations, and fatigue. During return to play, they must gradually regain the capacity to produce force, absorb force, and regulate force under sport-specific conditions.
This is why practitioners are constantly looking for strategies that may support hamstring preparation and recovery.
However, interventions must be used for the right reason.
Foam rolling and percussive massage may be useful when the goal is to reduce perceived tightness, improve movement comfort, support recovery routines, increase tolerance to movement, or provide an adjunct to a broader rehabilitation plan.
But they should not be treated as guaranteed acute performance-enhancing strategies.
For hamstrings, this distinction matters.
A player may feel better after using a massage gun or foam roller, but if the goal is sprinting, jumping, or maximal force production, feeling better is not enough. We need to know whether the intervention supports the specific physical demands that follow.
Practical Takeaways for Coaches, Physiotherapists, and Sport Scientists
1. Do not confuse perception with performance
An athlete may feel looser after foam rolling or percussive massage, but that does not necessarily mean range of motion, stiffness, or force production has improved.
Subjective feedback matters, but it should not be the only outcome.
2. Be cautious before high-force hamstring tasks
If the session includes sprinting, maximal strength work, high-speed running, return-to-sport testing, or change-of-direction drills, practitioners should think carefully about the timing and purpose of passive or semi-passive interventions.
Percussive massage and foam rolling may be useful, but they should not replace an active warm-up or progressive neuromuscular preparation.
3. Use these tools as adjuncts, not replacements
Foam rolling and percussive massage should not replace structured warm-up, progressive loading, eccentric hamstring strengthening, sprint exposure, or individualized rehabilitation.
They may support preparation, but they are not the foundation of hamstring performance.
4. Match the device to the question
TMG, SWE, and MyotonPro are all useful, but they do not measure the same thing.
Practitioners should avoid saying “stiffness improved” without specifying how stiffness was assessed and which parameter changed.
5. Individual responses matter
Some athletes may respond positively to these interventions, while others may show no measurable benefit.
This is especially important in elite sport, where small differences in preparation can matter. Before using any intervention in competition or return-to-play settings, practitioners should understand how the individual athlete responds.
6. Timing and dosage matter
Short interventions may not be enough to change mechanical properties, while longer interventions may have different effects.
The right dose depends on the goal: mobility, recovery, comfort, rehabilitation, or performance preparation.
7. Do not forget the basics
For hamstring injury reduction and performance development, the foundation remains progressive loading, eccentric strength, sprint exposure, lumbopelvic control, fatigue resistance, and sport-specific return-to-play progression.
Percussive massage and foam rolling can support the process, but they cannot replace it.
Where Might Foam Rolling and Percussive Massage Still Be Useful?
The current findings do not mean that foam rolling or percussive massage should be abandoned.
Rather, they should be used more intelligently.
These interventions may still be useful in recovery sessions, during low-intensity preparation, as part of mobility-focused routines, in rehabilitation when comfort and movement exposure are priorities, with athletes who perceive clear benefit, or when combined with active warm-up and progressive loading.
The mistake is not using these tools.
The mistake is expecting them to do everything.
Foam rolling and percussive massage are not magic solutions. They are tools. Like every tool, their value depends on the context, the timing, the dosage, the athlete, and the outcome we are trying to influence.
Final Word
Foam rolling and percussive massage are popular because they are simple, accessible, and often feel good.
But popularity should not be confused with effectiveness.
Our recent study showed that a short practical dose of vibration foam rolling or percussive massage did not significantly improve hamstring range of motion or alter biceps femoris stiffness. A slight reduction in maximal voluntary isometric torque was observed from pre- to post-testing, but this should be interpreted cautiously because it was not specific to either intervention and may reflect general testing-related fatigue.
For hamstrings, this message is particularly important.
These muscles are central to sprinting, cutting, jumping, deceleration, and injury prevention. They need to be strong, responsive, tolerant to high-speed loading, and well prepared for sport-specific demands.
Therefore, interventions targeting the hamstrings should be judged not only by how they feel, but by how they influence function.
TMG, shear wave elastography, and MyotonPro can all help us better understand muscle responses, but they should be interpreted carefully and used according to their specific strengths.
The practical conclusion is simple:
Use foam rolling and percussive massage as tools, not magic solutions.
They may support recovery, comfort, and preparation, but they should not replace structured warm-up, progressive strength training, sprint exposure, or individualized hamstring rehabilitation.
In performance and rehabilitation, the goal is not simply to make the hamstrings feel looser.
The goal is to make them function better.
We had a great time together :)
Author: Assist. Prof. Armin Paravlić, PhD
Complete Performance Education
References
Fischer J, Seguel JM, Drole K, Konrad A, Tilp M, Paravlić AH. Effects of Percussive Massage vs. Foam Rolling on Hamstring Function: A Comparative Study Using Shear Wave Elastography, Tensiomyography, and MyotonPro. BMC Sports Science, Medicine and Rehabilitation. 2026. doi:10.1186/s13102-026-01732-7.
Paravlić AH, Segula J, Drole K, Hadžić V, Pajek M, Vodičar J. Tissue Flossing Around the Thigh Does Not Provide Acute Enhancement of Neuromuscular Function. Frontiers in Physiology. 2022;13:870498.
Paravlić AH, Zubac D, Šimunič B. Reliability of the twitch evoked skeletal muscle electromechanical efficiency: A ratio between tensiomyogram and M-wave amplitudes. Journal of Electromyography and Kinesiology. 2017;37:108–116.
Afonso J, Rocha-Rodrigues S, Clemente FM, Aquino M, Nikolaidis PT, Sarmento H, et al. The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk. Frontiers in Physiology. 2021;12:694604.
Wilke J, Müller AL, Giesche F, Power G, Ahmedi H, Behm DG. Acute Effects of Foam Rolling on Range of Motion in Healthy Adults: A Systematic Review with Multilevel Meta-analysis. Sports Medicine. 2020;50:387–402.
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Ferreira RM, Silva R, Vigário P, Martins PN, Casanova F, Fernandes RJ, et al. The Effects of Massage Guns on Performance and Recovery: A Systematic Review. Journal of Functional Morphology and Kinesiology. 2023;8:138.
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