For decades, clients in the massage therapy field have been told that massage therapy works by ‘flushing lactic acid’ from muscle tissue and can facilitate athletic recovery because of it. This is a myth and has been debunked by modern research.
Where The Lactic Acid Myth Began
The lactic acid myth originates from 20th-century scientific misunderstandings, particularly a study by Otto Meyerhof in the 1920s, who incorrectly linked lactic acid to muscle fatigue. This misunderstanding was perpetuated because lactate was the first molecule to be identified in fatigued muscles, and its accumulation correlated with high-intensity exercise. This misunderstanding of lactate’s role in our cell’s bioenergetic pathways eventually led to the idea that lactic acid causes muscle soreness (Delayed Onset Muscle Soreness). This was later debunked and shown to be caused by micro-tears and inflammation in muscle tissue.
What Modern Science Says About Lactate
Meyerhof’s work and later discoveries of high lactate levels occurring when Lactate Threshold is reached led to a strong association between lactate accumulation and fatigue. However, this was a case of mistaking correlation for causation. For a long time, other molecules that actually contribute to muscle fatigue, such as inorganic phosphate, were not understood, leaving the incorrect assumption about lactic acid to persist. Modern science has revealed that lactic acid (or lactate) is not a waste product but a valuable fuel source that muscles can use directly for energy.
In fact, lactic acid disassociates into lactate and hydrogen ions (H+), and lactate acts as a buffer by helping to neutralize the accumulating hydrogen ions, thus raising the pH and reducing acidity in the bloodstream. This buffering action is a natural process where the base form of lactic acid, lactate, counteracts the acidic hydrogen ions, preventing the blood from becoming too acidic during intense physical activity.
Therefore, lactate is not a metabolic toxin but a vital intermediate in cellular energy dynamics. Produced during glycolysis under conditions of increased metabolic demand, lactate is utilized by oxidative tissues as a substrate for ATP resynthesis. Blood lactate concentrations typically normalize within 30–60 minutes post-exercise, indicating that interventions are not required for clearance.
Does Massage Really Flush Lactic Acid?
The notion that lactic acid causes muscle soreness was debunked in the 1980s but many massage therapists do not have the education or research literacy to understand what is actually occurring on a physiological level. Today, DOMS is understood to result of microscopic tears in muscle fibers during intense exercise, leading to inflammation and pain in the days following a workout. The body actually strengthens the muscles during the process of repairing these micro tears.
The assertion that massage accelerates lactate clearance has been directly evaluated in controlled studies. Comparative investigations have consistently demonstrated that active recovery (e.g., low-intensity cycling or jogging) is superior to massage or passive rest in promoting lactate kinetics following intense exercise. Massage Therapy has been shown on subjective recovery indices to be beneficial for post-athletic recovery, but does not exert a clinically significant effect on lactate metabolism.
Key Research Findings
| Author(s), Year | Study Design & Population | Findings |
| Guo et al., 2017 | Meta-analysis, massage effects on DOMS, performance, CK, lactate | Massage reduced DOMS and CK; no consistent evidence for enhanced lactate clearance. |
| Dakić et al., 2023 | Systematic review, massage in sport/exercise performance | Massage not effective in modulating lactate kinetics; benefits mediated through neuromodulatory and psychophysiological pathways. |
| Budak et al., 2023 | Semi-elite footballers, massage vs passive rest | Massage showed marginally faster lactate reduction vs passive rest, effect size modest and not superior to active recovery. |
What Massage Therapy Actually Helps With
Although massage does not expedite lactate clearance, empirical evidence supports its efficacy in mitigating delayed onset muscle soreness (DOMS), attenuating perceived exertion, and facilitating psychological recovery. Proposed mechanisms include improved micro circulation to affected tissue (in my opinion, one of the greatest benefits of massage therapy is enhanced perfusion in ischemic tissue), enhanced parasympathetic activation, and modulation of nociceptive signaling. Reductions in creatine kinase concentrations due to the increase in local circulation further suggest massage therapy’s role in mitigating exercise-induced muscle damage.
The prevalence of the lactic acid myth along with other perpetuated myths (flushing toxins myth) undermines efforts to align massage therapy with contemporary exercise science and conventional medicine. Transitioning toward accurate, evidence-based explanations strengthens professional credibility, client trust and relationships with healthcare workers.
Conclusion: Massage Therapy and Recovery
Massage therapy contributes meaningfully to recovery in athletic and clinical contexts, not by accelerating lactate clearance but through mechanisms related to circulatory facilitation, neuromuscular relaxation, psychophysiological modulation, and inflammation management. Evidence supports the integration of massage as a complementary recovery modality, best utilized alongside active recovery strategies, nutrition, and rest.
References
1. Guo, J. et al. (2017). Massage Alleviates Delayed Onset Muscle Soreness: A Meta-analysis. Front Physiol.
2. Dakić, M. et al. (2023). The Effects of Massage Therapy on Sport and Exercise Performance. Sports.
3. Budak, H. et al. (2023). Effect of Passive Rest and Sports Massage on Lactate Clearance. Med J Sport Sci.