Pain management interventions for combat sport and martial arts athletes including pencak silat: a systematic review

Abstract

Combat and martial arts, including Pencak silat, expose athletes to repetitive high-impact loading that generates acute pain, delayed-onset muscle soreness, and cumulative musculoskeletal strain, yet the evidence base for managing this pain remains fragmented. This systematic literature review synthesised controlled evidence on pain-management and recovery interventions in combat and martial arts athletes. The review followed the PRISMA 2020 framework, searching Scopus, PubMed, and ScienceDirect for records published between 2002 and 2026. A total of 1,444 records were identified; after removing 16 duplicates and screening 1,428 titles and abstracts, 52 reports were assessed in full text and 7 studies met all eligibility criteria. Methodological quality was appraised with the Mixed Methods Appraisal Tool. The included studies evaluated dry needling and manual therapy, cryotherapy and compression, topical pharmacological gels, and neurodynamic mobilisation, consistently reporting raised pressure-pain thresholds, improved perfusion, and attenuated soreness relative to sham or passive control. No study specifically recruited Pencak silat athletes, exposing a critical evidence gap. These findings support multimodal, mechanism-targeted pain care while underscoring the urgent need for Pencak-Silat-specific controlled trials. Future research should standardise outcomes and prioritise underrepresented traditional martial arts.