Skip to content
hyperbaric.app
sportsrecoveryresearchevidencemild hyperbaric

Hyperbaric Oxygen for Sports Recovery: What Controlled Trials Found

Does HBOT speed recovery from muscle soreness or sprains? Most controlled trials say no. What athletes use, what studies found and when medical HBOT does help.

Updated September 14, 2026
11 min read
by Hyperbaric.app

This content is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional. Read full disclaimer

Controlled trials of hyperbaric oxygen therapy (HBOT) for muscle soreness and minor sports injuries have mostly been negative or mixed. A Cochrane review of nine small randomised trials found no clear benefit for delayed onset muscle soreness (DOMS), ankle sprains or knee ligament injuries, and HBOT started straight after exercise was linked to slightly more soreness two to three days later. A 2025 meta-analysis found faster recovery on a pooled measure of muscle injury, but still no reduction in soreness.

Two other facts matter before you book a "recovery" session. Many chambers in sports and wellness settings are soft-shell mild chambers that were never tested in most of these trials. And medical HBOT does have an accepted role in sport-related trauma, but for severe crush injuries and open fractures treated in hospital, not for everyday soreness.

What do athletes actually use?

"Hyperbaric recovery" can mean two very different things:

FactorMild (soft-shell) chamberMedical (hard-shell) HBOT
Where you find itWellness centres, health spas and recovery settingsHospital and medical hyperbaric centres
PressureBelow 1.5 ATA, often around 1.3 ATAUsually about 2.0-3.0 ATA
OxygenAir or oxygen mixes well below 95%Close to 100% medical oxygen
Typical cleared useMild symptoms of acute mountain sicknessSpecific medical indications, such as crush injury and decompression sickness
Used in most recovery trials below?No (only the two small studies described below)Yes, at 2.0-2.5 ATA

A 2025 narrative review on HBOT for high-performance athletes in Undersea and Hyperbaric Medicine notes that mild HBOT has been used to aid post-exercise recovery and reduce fatigue. It also notes that the vessels used for mild HBOT are typically intended for treating altitude sickness only, and that using them for other purposes, including athletic recovery, raises safety and regulatory concerns. An example is the FDA 510(k) summary for the Flexi-Lite soft chamber, cleared for mild symptoms of acute mountain sickness at pressures below 4 psi. For more on the two chamber types, see our hard-shell vs soft-shell guide.

Does HBOT help with DOMS and muscle damage?

DOMS is the muscle soreness and weakness that follows unaccustomed exercise, especially eccentric exercise, where muscles work while lengthening. It has been the most studied use of HBOT in sport, because researchers can create it on purpose in volunteers and compare groups fairly.

StudyParticipants and injuryHBOT vs comparisonResult
Staples et al., 199966 untrained men, quadriceps DOMS100% oxygen at 2.0 ATA, 1 hour a day, vs air at 1.2 ATAFaster recovery of eccentric strength; no difference in pain
Mekjavic et al., 200024 men, elbow flexor DOMSOxygen at 2.5 ATA for 60 min on 7 days vs normal-oxygen gas at the same pressureNo difference in strength recovery, soreness or arm swelling
Webster et al., 200212 men, calf muscle damage100% oxygen at 2.5 ATA for 60 min, 3 sessions, vs air at 1.3 ATALittle difference overall (faster recovery only in isometric strength and pain ratings); authors say HBOT "cannot be recommended"
Babul et al., 200316 women, quadriceps DOMS100% oxygen at 2.0 ATA for 60 min daily vs 21% oxygen at 1.2 ATANo differences in pain, strength, swelling, blood markers or MRI

Pooled reviews tell a similar story:

  • Cochrane review (2005). Bennett and colleagues included nine small randomised trials with 219 participants. Pooling the seven DOMS trials showed consistently higher pain at 48 and 72 hours in the HBOT group when HBOT was started immediately, and no difference in longer-term pain, swelling or muscle strength. The authors concluded there was insufficient evidence to establish an effect and that HBOT may increase interim pain in DOMS.
  • Meta-analysis (2025). A review of 10 randomised trials with 299 participants in Archives of Physical Medicine and Rehabilitation found that HBOT significantly improved recovery on a pooled measure of exercise-induced muscle injury. It did not reduce exercise-induced muscle soreness overall.
  • Systematic review (2026). A review of 19 clinical studies in musculoskeletal conditions in BMC Musculoskeletal Disorders found that randomised trials in DOMS and exercise-induced muscle damage showed no significant benefit. Evidence for ligament healing was limited.

A 2022 literature review in Undersea and Hyperbaric Medicine described the evidence as mixed, with early and frequent treatment appearing to matter in the studies that did find an effect.

What about ankle sprains and ligament injuries?

  • Ankle sprain. In a randomised double-blind trial of 32 people with acute ankle sprains, three sessions of oxygen at 2 ATA were compared with air at 1.1 ATA. A joint function score improved more in the HBOT group, but time to recovery was the same (16.0 days with HBOT vs 15.4 days with air), and swelling, pain and range of motion did not differ.
  • Knee MCL injury. A 2019 study of rugby players in Japan with grade 2 medial collateral ligament injuries reported a shorter return to play in 16 players who had HBOT than in 16 who did not (31.4 vs 42.1 days). It was not randomised, and return-to-play times were compared retrospectively. Results like this are worth testing in a proper trial, but they are not proof.

Do mild chambers at 1.3 ATA help recovery?

A few small studies have tested the lower pressures used in mild chambers:

  • A 2022 crossover study of 10 healthy men used 60 minutes at 1.3 ATA with 31% oxygen after an hour of hard cycling. Mood questionnaire scores for fatigue and tension fell within an hour in the mild chamber trial but not in the control trial, heart rate recovered faster, and markers of oxidative stress did not differ.
  • A 2024 crossover study of 12 Chinese university athletes used 60 minutes at 1.25 ATA with 26-28% oxygen after 90 minutes of cycling. Perceived exertion was lower and heart rate recovered faster than with normal air, and some blood markers recovered faster after six sessions. Jump performance did not differ.

Both studies were very small, and neither abstract describes blinding participants to the condition they received. For context, Mitchell and Bennett note that breathing air at 1.3 ATA gives the same oxygen dose as breathing 27% oxygen at normal pressure. The Undersea and Hyperbaric Medical Society (UHMS) considers mild hyperbaric oxygen unproven.

Can HBOT improve performance?

This is a different question from recovery. One double-blind randomised trial of 37 healthy master athletes aged 40-50 compared 40 sessions of 100% oxygen at 2 ATA for one hour with a sham at 1.02 ATA. Of the 31 athletes analysed, those who had HBOT showed a larger increase in VO2max and in markers of mitochondrial function. It is a single small trial, run by the Sagol Center group in Israel, and several authors disclosed employment with, or shares in, AVIV Scientific Ltd. We did not find an independent replication.

When is medical HBOT relevant for athletes?

Medical HBOT is not a recovery tool, but some sports injuries fall into accepted indications. These are treated in hospital by trauma and hyperbaric teams, alongside surgery and standard care.

  • Crush injuries and open fractures. The European Committee for Hyperbaric Medicine recommends HBOT for open fractures with crush injury (its strongest recommendation, Type 1) and suggests it for crush injuries with open wounds but no fracture, where tissue viability or infection is a concern (Type 2). The UHMS lists crush injury, compartment syndrome and other acute traumatic ischaemias among its approved indications. In a randomised double-blind trial of 36 patients with crush injuries, 17 of 18 in the HBOT group healed completely compared with 10 of 18 in the placebo group, and one patient needed further surgery compared with six.
  • Avascular necrosis. Avascular (aseptic) necrosis of bone is on the UHMS list, and the 2026 musculoskeletal review found the most consistent evidence for avascular necrosis and bone marrow oedema.
  • Concussion. The UHMS states that HBOT for traumatic brain injury is still considered investigational.

If you still want to try HBOT for recovery

  • Set expectations. Based on the trials, do not expect less soreness, and evidence for faster recovery is inconsistent.
  • Watch the timing. The Cochrane review found higher pain at 48-72 hours when HBOT started immediately after muscle-damaging exercise.
  • Know what you are buying. Ask for the chamber type, pressure and oxygen percentage.
  • Consider side effects. Middle ear barotrauma is one of the most common side effects of HBOT, and temporary short-sightedness can follow several weeks of treatment at 2.0 ATA or higher, according to a review of HBOT side effects. See our guide to HBOT side effects.
  • Check supervision and safety. Read how to choose an HBOT clinic before you commit to a package.

For an overview of other wellness claims and how strong the evidence is for each, see wellness benefits of HBOT. To compare providers, find a hyperbaric clinic near you.

Sources

This article is for information only and is not medical advice. Serious injuries need assessment by a qualified clinician, and whether HBOT is appropriate should be decided with a physician.

Back to all articles