Neuromuscular function after exercise-induced muscle damage: theoretical and applied implications

Exercise-induced muscle damage and running economy in humans

Running economy (RE), defined as the energy demand for a given velocity of submaximal running, has been identified as a critical factor of overall distance running performance. Plyometric and resistance trainings, performed during a relatively short period of time (~15-30 days), have been successfully used to improve RE in trained athletes. However, these exercise types, particularly when they are unaccustomed activities for the individuals, may cause delayed onset muscle soreness, swelling, and reduced muscle strength. Some studies have demonstrated that exercise-induced muscle damage has a negative impact on endurance running performance. Specifically, the muscular damage induced by an acute bout of downhill running has been shown to reduce RE during subsequent moderate and high-intensity exercise (>65% VO₂max). However, strength exercise (i.e., jumps, isoinertial and isokinetic eccentric exercises) seems to impair RE only for subsequent high-intensity exercise (~90% VO₂max). Finally, a single session of resistance exercise or downhill running (i.e., repeated bout effect) attenuates changes in indirect markers of muscle damage and blunts changes in RE.

Time course of muscle damage and inflammatory responses to resistance training with eccentric overload in trained individuals

The purpose of this study was to observe the time course of muscle damage and inflammatory responses following an eccentric overload resistance-training (EO) program. 3 females (23.8 ± 2.6 years; 70.9 ± 12.7 kg; 1.6 ± 0.08 m) and 5 males (23.8 ± 2.6 years; 75.1 ± 11.2 kg; 1.8 ± 0.1 m) underwent thirteen training sessions (4 × 8–10 eccentric-only repetitions—80% of eccentric 1RM, one-minute rest, 2x week⁻¹, during 7 weeks, for three exercises). Blood samples were collected prior to (Pre) and after two (P2), seven (P7), nine (P9), eleven (P11), and thirteen (P13) sessions, always 96 hours after last session. The reference change values (RCV) analysis was employed for comparing the responses, and the percentual differences between the serial results were calculated for each subject and compared with RCV_95%. Four subjects presented significant changes for creatine kinase at P2, and another two at P13; six for C-reactive protein at P2, and three at P11; two for neutrophils at P2, P4, and P13, respectively; and only one for white blood cells at P2, P4, P7, and P9, for lymphocyte at P7, P9, and P13, and for platelet at P4. We conclude that EO induced high magnitude of muscle damage and inflammatory responses in the initial phase of the program with subsequent attenuation.

Repeated bout effect was more expressed in young adult males than in elderly males and boys

This study investigated possible differences using the same stretch-shortening exercise (SSE) protocol on generally accepted monitoring markers (dependent variables: changes in creatine kinase, muscle soreness, and voluntary and electrically evoked torque) in males across three lifespan stages (childhood versus adulthood versus old age). The protocol consisted of 100 intermittent (30 s interval between jumps) drop jumps to determine the repeated bout effect (RBE) (first and second bouts performed at a 2-week interval). The results showed that indirect symptoms of exercise-induced muscle damage after SSE were more expressed in adult males than in boys and elderly males, suggesting that the muscles of boys and elderly males are more resistant to exercise-induced damage than those of adult males. RBE was more pronounced in adult males than in boys and elderly males, suggesting that the muscles of boys and elderly males are less adaptive to exercise-induced muscle damage than those of adult males.

The effects of eccentric exercise-induced muscle damage on running kinematics at different speeds

This study investigated the effects of knee localised muscle damage on running kinematics at varying speeds. Nineteen young women (23.2 ± 2.8 years; 164 ± 8 cm; 53.6 ± 5.4 kg), performed a maximal eccentric muscle damage protocol (5 × 15) of the knee extensors and flexors of both legs at 60 rad · s(-1). Lower body kinematics was assessed during level running on a treadmill at three speeds pre- and 48 h after. Evaluated muscle damage indices included isometric torque, muscle soreness and serum creatine kinase activity. The results revealed that all indices changed significantly after exercise, indicating muscle injury. Step length decreased and stride frequency significantly increased 48 h post-exercise only at the fastest running speed (3 m · s(-1)). Support time and knee flexion at toe-off increased only at the preferred transition speed and 2.5 m · s(-1). Knee flexion at foot contact, pelvic tilt and obliquity significantly increased, whereas hip extension during stance-phase, knee flexion during swing-phase, as well as knee and ankle joints range of motion significantly decreased 48 h post-exercise at all speeds. In conclusion, the effects of eccentric exercise of both knee extensors and flexors on particular tempo-spatial parameters and knee kinematics of running are speed-dependent. However, several pelvic and lower joint kinematics present similar behaviour at the three running speeds examined. These findings provide new insights into how running kinematics at different speeds are adapted to compensate for the impaired function of the knee musculature following muscle damage.

Efeitos de um tratamento combinado (vitamina C pré-exercício e alongamento FNP, tratamento com ultrassom pós-exercício) sobre marcadores de dano muscular induzido por exercício

CONTEXTO: Várias estratégias de recuperação têm sido utilizadas na tentativa de minimizar os sintomas da dor muscular de início tardio (DMIT). Contudo, evidências científicas que apoiem este efeito profilático (pré-exercício) e terapêutico (pós-exercício) de um tratamento combinado (FNP e vitamina C, ultrassom) no dano muscular são inexistentes. OBJETIVO: Investigar os efeitos de um tratamento combinado (FNP e vitamina C, ultrassom) nos marcadores bioquímicos (níveis enzimáticos) e funcionais (ângulo do cotovelo, circunferência de braço, taxa de dor) de dano muscular induzido por exercício. MÉTODO: Amostra randomizada controlada. LOCAL: Laboratório da Universidade. PARTICIPANTES: Alunos universitários masculinos participaram voluntariamente do estudo, o qual não reportou nenhuma dor muscular de início tardio por no mínimo seis meses antes do estudo. Posteriormente, os sujeitos foram agrupados aleatoriamente em subgrupos com mão controle e mão experimental. INTERVENÇÃO(ÕES): Programa de exercício para indução de dano muscular induzido por exercício envolvendo o teste de bíceps Scott (contração excêntrica com duas mãos). PROCEDIMENTO(S) PRINCIPAL(IS): Circunferência de braço relaxado, circunferência de braço flexionado, ângulo de cotovelo em descanso, circunferência de antebraço, amplitude de movimento de cotovelo flexionado, amplitude de movimento de cotovelo estendido, dano muscular induzido por exercício, força máxima voluntária isométrica e isocinética foram registrados basal, imediatamente após exercício e 24, 48, 72 e 96 horas após exercício. RESULTADOS: O subgrupo experimental manifestou redução de sintomas de DMIT em menor amplitude de movimento de cotovelo flexionado e amplitude de movimento de cotovelo estendido, menor perda de força isométrica e isocinética voluntária máxima (P < 0,05) em comparação com o subgrupo controle. Contudo, nenhum efeito na circunferência de braço relaxado, circunferência de braço flexionado, ângulo de cotovelo em descanso ou circunferência de antebraço foi observado (P >0,05). CONCLUSÃO: Este tratamento combinado foi eficiente em contração máxima voluntária isométrica, dor muscular de início tardio e taxa de intensidade de dor ao longo do tempo. Finalmente, os resultados sugerem que os tratamentos combinados são eficientes na manutenção de força isométrica e diminuição de dor muscular de início tardio e taxa de intensidade de dor.

Reduced short-interval intracortical inhibition after eccentric muscle damage in human elbow flexor muscles

The purpose of this study was to use paired-pulse transcranial magnetic stimulation (TMS) to examine the effect of eccentric exercise on short-interval intracortical inhibition (SICI) after damage to elbow flexor muscles. Nine young (22.5 ± 0.6 yr; mean ± SD) male subjects performed maximal eccentric exercise of the elbow flexor muscles until maximal voluntary contraction (MVC) force was reduced by ∼40%. TMS was performed before, 2 h after, and 2 days after exercise under Rest and Active (5% MVC) conditions with motor-evoked potentials (MEPs) recorded from the biceps brachii (BB) muscle. Peripheral electrical stimulation of the brachial plexus was used to assess maximal M-waves, and paired-pulse TMS with a 3-ms interstimulus interval was used to assess changes in SICI at each time point. The eccentric exercise resulted in a 34% decline in strength ( P < 0.001), a 41% decline in resting M-wave ( P = 0.01), changes in resting elbow joint angle (10°, P < 0.001), and a shift in the optimal elbow joint angle for force production (18°, P < 0.05) 2 h after exercise. This was accompanied by impaired muscle strength (27%, P < 0.001) and increased muscle soreness ( P < 0.001) 2 days after exercise, which is indicative of muscle damage. When the test MEP amplitudes were matched between sessions, we found that SICI was reduced by 27% in resting and 23% in active BB muscle 2 h after exercise. SICI recovered 2 days after exercise when muscle pain and soreness were present, suggesting that delayed onset muscle soreness from eccentric exercise does not influence SICI. The change in SICI observed 2 h after exercise suggests that eccentric muscle damage has widespread effects throughout the motor system that likely includes changes in motor cortex.

Human alpha-actinin-3 genotype association with exercise-induced muscle damage and the repeated-bout effect

Alpha-actinin-3 (ACTN3) is an integral part of the Z line of the sarcomere. The ACTN3 R577X (rs1815739) polymorphism determines the presence or absence of functional ACTN3, which may influence the extent of exercise-induced muscle damage. This study aimed to compare the impact of, and recovery from, muscle-damaging eccentric exercise on subjects with or without functional ACTN3. Seventeen young men (20-33 years old), homozygous for the R (n = 9) or X (n = 8) alleles, performed two bouts of stretch-shortening exercise (50 drop jumps) two weeks apart. Muscle soreness, plasma creatine kinase (CK) activity, jump height, maximal voluntary isometric torque (MVC), peak concentric isokinetic torque (IT), and electrically stimulated knee extension torques at 20 and 100 Hz were measured at baseline and at a number of time points up to 14 days after each bout. There were no significant baseline differences between the groups. However, significant time point × genotype interactions were observed for MVC (p = 0.021) and IT (p = 0.011) for the immediate effect of eccentric exercise in bout 1. The RR group showed greater voluntary force decrements (RR vs. XX: MVC, -33.3% vs. -24.5%; IT, -35.9% vs. -23.2%) and slower recovery. A repeated-bout effect was clearly observed, but there were no differences by genotype group. The ACTN3 genotype modulates the response of muscle function to plyometric jumping exercise, although the differences are modest. The ACTN3 genotype does not influence the clearly observed repeated-bout effect; however, XX homozygotes recover baseline voluntary torque values faster and thus may be able to undertake more frequent training sessions.

Effects of mixed-method cooling on recovery of medium-fast bowling performance in hot conditions on consecutive days

This investigation examined physiological and performance effects of cooling on recovery of medium-fast bowlers in the heat. Eight, medium-fast bowlers completed two randomised trials, involving two sessions completed on consecutive days (Session 1: 10-overs and Session 2: 4-overs) in 31 ± 3°C and 55 ± 17% relative humidity. Recovery interventions were administered for 20 min (mixed-method cooling vs. control) after Session 1. Measures included bowling performance (ball speed, accuracy, run-up speeds), physical demands (global positioning system, counter-movement jump), physiological (heart rate, core temperature, skin temperature, sweat loss), biochemical (creatine kinase, C-reactive protein) and perceptual variables (perceived exertion, thermal sensation, muscle soreness). Mean ball speed was higher after cooling in Session 2 (118.9 ± 8.1 vs. 115.5 ± 8.6 km · h⁻¹; P = 0.001; d = 0.67), reducing declines in ball speed between sessions (0.24 vs. -3.18 km · h⁻¹; P = 0.03; d = 1.80). Large effects indicated higher accuracy in Session 2 after cooling (46.0 ± 11.2 vs. 39.4 ± 8.6 arbitrary units [AU]; P = 0.13; d = 0.93) without affecting total run-up speed (19.0 ± 3.1 vs. 19.0 ± 2.5 km · h⁻¹; P = 0.97; d = 0.01). Cooling reduced core temperature, skin temperature and thermal sensation throughout the intervention (P = 0.001-0.05; d = 1.31-5.78) and attenuated creatine kinase (P = 0.04; d = 0.56) and muscle soreness at 24-h (P = 0.03; d = 2.05). Accordingly, mixed-method cooling can reduce thermal strain after a 10-over spell and improve markers of muscular damage and discomfort alongside maintained medium-fast bowling performance on consecutive days in hot conditions.

[Trigger points - Diagnosis and treatment concepts with special reference to extracorporeal shockwaves]

The 70-year-old trigger point theory has experienced a growing scientific confirmation and clinical significance as a consequence of recent muscle pain research. The trigger point pain formation is caused by high levels of vasoneuroactive substances. Depending on intensity and duration of the muscle stimulus the central pain processing is modified and leads to characteristic referred pain patterns. The most effective conventional forms of treatment are aimed at a direct mechanical manipulation of the trigger point as are new forms of therapy with focused and radial shockwaves. By using high pressures the focused shockwaves in particular are suitable to provoke local and referred pain and thus simplify the trigger point diagnosis. The empirically found therapeutic effect of shockwaves on muscles is hypothetical and can be explained in analogy with validated reactions of shockwaves in non-muscle tissues. Overall, the shockwave therapy on muscles represents a confirmation and extension of the existing trigger point therapy. It seems to be suitable for treating functional muscular disorders and myofascial pain syndromes within the locomotor system.

Effects of repeated bouts of squatting exercise on sub-maximal endurance running performance

It is well established that exercise-induced muscle damage (EIMD) has a detrimental effect on endurance exercise performed in the days that follow. However, it is unknown whether such effects remain after a repeated bout of EIMD. Therefore, the purpose of this study was to examine the effects of repeated bouts of muscle-damaging exercise on sub-maximal running exercise. Nine male participants completed baseline measurements associated with a sub-maximal running bout at lactate turn point. These measurements were repeated 24-48 h after EIMD, comprising 100 squats (10 sets of 10 at 80 % body mass). Two weeks later, when symptoms from the first bout of EIMD had dissipated, all procedures performed at baseline were repeated. Results revealed significant increases in muscle soreness and creatine kinase activity and decreases in peak knee extensor torque and vertical jump performance at 24-48 h after the initial bout of EIMD. However, after the repeated bout, symptoms of EIMD were reduced from baseline at 24-48 h. Significant increases in oxygen uptake (.VO2), minute ventilation (.VE), blood lactate ([BLa]), rating of perceived exertion (RPE), stride frequency and decreases in stride length were observed during sub-maximal running at 24-48 h following the initial bout of EIMD. However, following the repeated bout of EIMD, .VO2, .VE, [BLa], RPE and stride pattern responses during sub-maximal running remained unchanged from baseline at all time points. These findings confirm that a single resistance session protects skeletal muscle against the detrimental effects of EIMD on sub-maximal running endurance exercise.

Power loss is greater following lengthening contractions in old versus young women

Compared with isometric and dynamic velocity-constrained (isokinetic) tasks, less is known regarding velocity-dependent (isotonic) muscle power and recovery in older adults following repeated fatiguing lengthening contractions. We investigated voluntary and evoked neuromuscular properties of the dorsiflexors in nine old (68.3 ± 6.1 years) and nine young women (25.1 ± 1.3 years) during and following 150 lengthening contractions for up to 30 min of recovery. At baseline, the old were ~21% weaker for maximum isometric voluntary contraction (MVC) torque (P < 0.05), ~21% slower for peak loaded shortening velocity (P < 0.05), and ~39% less powerful compared with the young (P < 0.05). Following the task, MVC torque was depressed equally (~28%) for both groups (P < 0.05), but power was reduced ~19% in the old and only ~8% in the young (P < 0.05). Both measures remained depressed during the 30-min recovery period. Peak twitch torque (P (t)) was ~50% lower in the old at task termination, whereas the young were unchanged. However, by 5 min of recovery, P (t) was reduced similarly (~50%) in both groups, and neither recovered by 30 min. The old were affected more by low-frequency torque depression than the young, as shown by the ~40% and ~20% decreases in the stimulated 10:50 Hz ratio at task termination respectively, whereas both groups were affected similarly (~50%) 5 min into recovery, and neither recovered by 30 min. Thus, the coexistence of fatigue and muscle damage induced by the repetitive lengthening contractions impaired excitation-contraction coupling and cross-bridge function to a greater extent in the old, leading to a more pronounced initial loss of power than the young for up to 10 min following the exercise However, power remained blunted in both groups during the 30-min recovery period. These results indicate that older women are more susceptible to power loss than young following lengthening contractions, likely owing to a greater impairment in calcium kinetics.

Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis

INTRODUCTION

Exhaustive and/or unaccustomed exercise, mainly involving eccentric muscle actions, induces temporary muscle damage, evidenced by delayed onset muscle soreness (DOMS) and decreased muscle function. Different strategies to recover from its signs and symptoms have been studied and, as a result, a significant number of articles on this issue have been published.

OBJECTIVE

To assess whether some modalities currently used in physiotherapy such as massage, cryotherapy, stretching and low-intensity exercise are effective for treating the signs and symptoms of exercise-induced muscle damage.

METHODS

Randomized controlled trials (RCTs), written in English or Portuguese, that included physiotherapeutic interventions [i.e., massage, cryotherapy, stretching and low-intensity exercise, on adult human subjects (18-60 years old) of both gender] were searched on electronic databases including MEDLINE, CINHAL, EMBASE, PEDro and SPORTDiscus.

MAIN OUTCOME MEASURES

"Muscle soreness" and "muscle strength" were the outcome measures included in the meta-analysis.

RESULTS

Thirty-five studies were included; nine analysed the effects of massage, 10 examined the effects of cryotherapy, nine investigated the effects of stretching and seven focused on low-intensity exercise intervention. Massage was the only intervention with positive effects, reducing soreness at 24 h, on average, 0.33 on 10 cm visual analog scale (95 percent CI: -0.59, -0.07) and increasing muscle recovery by 1.87 percent (95 percent CI: 0.30, 3.44). Additionally, there is inconclusive evidence to support the use of cryotherapy, while there is little evidence to prove the efficacy of stretching and low-intensity exercise.

CONCLUSION

Massage proved slightly effective in the relief of symptoms and signs of exercise-induced muscle damage. Therefore, its mean effect was too small to be of clinical relevance. There is a lack of evidence to support the use of cryotherapy, stretching and low-intensity exercise.

Neuromuscular, biochemical and perceptual post-match fatigue in professional rugby league forwards and backs

In this study, we investigated changes in creatine kinase, perceptual and neuromuscular fatigue of professional rugby league players after match-play. Twenty-three male rugby league players (10 backs, 13 forwards) had their creatine kinase, perceptual ratings of fatigue, attitude to training, muscle soreness, and flight time in a countermovement jump measured before and 1 and 2 days after (day 1 and day 2 respectively) league matches. Total playing time, offensive and defensive contacts were also recorded for each player. Creatine kinase was higher both 1 and 2 days after than before matches (P < 0.05) in forwards and backs. Similarly, perceived fatigue and muscle soreness were higher than pre-match on both days 1 and 2 (P < 0.05), but did not differ between groups (P > 0.05). Jump performance was lower on day 1 but not day 2 for both groups (P < 0.05). While total playing time was longer in backs (P < 0.05), relative frequencies for all contacts were greater in forwards (P < 0.05). Contacts for forwards were correlated with all markers of fatigue (P < 0.05), but only flight time was correlated with offensive contacts in backs (P < 0.05). Despite the mechanisms of fatigue being different between forwards and backs, our results highlight the multidimensional nature of fatigue after a rugby league match and that these markers do not differ between positions.

The effect of sports specialization on musculus quadriceps function after exercise-induced muscle damage

The primary aim of the present study was to examine the effect of eccentric exercise-induced (100 submaximal eccentric contractions at an angular velocity of 60° s⁻¹, with 20-s rest intervals) muscle damage on peripheral and central fatigue of quadriceps muscle in well-trained long-distance runners, sprint runners, volleyball players, and untrained subjects. We found that (i) indirect symptoms of exercise-induced muscle damage (prolonged decrease in maximal voluntary contraction, isokinetic concentric torque, and electrically induced (20 Hz) torque) were most evident in untrained subjects, while there were no significant differences in changes of muscle soreness and plasma creatine kinase 48 h after eccentric exercise between athletes and untrained subjects; (ii) low-frequency fatigue was greater in untrained subjects and volleyball players than in sprint runners and long-distance runners; (iii) in all subjects, electrically induced (100 Hz) torque decreased significantly by about 20%, while central activation ratio decreased significantly by about 8% in untrained subjects and sprint runners, and by about 3%-5% in long-distance runners and volleyball players. Thus, trained subjects showed greater resistance to exercise-induced muscle damage for most markers, and long-distance runners had no advantage over sprint runners or volleyball players.

Exercise-induced dehydration with and without environmental heat stress results in increased oxidative stress

While in vitro work has revealed that dehydration and hyperthermia can elicit increased cellular and oxidative stress, in vivo research linking dehydration, hyperthermia, and oxidative stress is limited. The purpose of this study was to investigate the effects of exercise-induced dehydration with and without hyperthermia on oxidative stress. Seven healthy male, trained cyclists (power output (W) at lactate threshold (LT): 199 ± 19 W) completed 90 min of cycling exercise at 95% LT followed by a 5-km time trial (TT) in 4 trials: (i) euhydration in a warm environment (EU-W, control), (ii) dehydration in a warm environment (DE-W), (iii) euhydration in a thermoneutral environment (EU-T), and (iv) dehydration in a thermoneutral environment (DE-T) (W: 33.9 ± 0.9 °C; T: 23.0 ± 1.0 °C). Oxidized glutathione (GSSG) increased significantly postexercise in dehydration trials only (DE-W: p < 0.01, DE-T: p = 0.03), and while not significant, total glutathione (TGSH) and thiobarbituric acid reactive substances (TBARS) tended to increase postexercise in dehydration trials (p = 0.08 for both). Monocyte heat shock protein 72 (HSP72) concentration was increased (p = 0.01) while lymphocyte HSP32 concentration was decreased for all trials (p = 0.02). Exercise-induced dehydration led to an increase in GSSG concentration while maintenance of euhydration attenuated these increases regardless of environmental condition. Additionally, we found evidence of increased cellular stress (measured via HSP) during all trials independent of hydration status and environment. Finally, both 90-min and 5-km TT performances were reduced during only the DE-W trial, likely a result of combined cellular stress, hyperthermia, and dehydration. These findings highlight the importance of fluid consumption during exercise to attenuate thermal and oxidative stress during prolonged exercise in the heat.

Monitoring markers of muscle damage during a 3 week periodized drop-jump exercise programme

The aim of this study was to examine changes in indirect markers of muscle damage during 3 weeks of stretch-shortening exercise with a progressively increasing load and continued modulation of various key training variables. Eight healthy untrained men performed a drop-jump programme involving a progressive increase in load impact with respect to the number of jumps performed, drop (platform) height, squat depth amplitude, and addition of weights. Maximal concentric and isometric knee extensor strength were assessed immediately before and 10 min after each training session. Voluntary and 100 Hz-stimulation-evoked torque decreased acutely after each training session relative to pre-exercise values (P < 0.05) but recovered before the subsequent training session. Post-exercise plasma creatine kinase activity increased from 162.2 ± 56.2 IU · l(-1) to 284.3 ± 116.3 IU · l(-1) at 48 h after the first training session (P < 0.05) and remained marginally elevated throughout the training period. The present results indicate that detrimental muscle damage can be avoided with drop-jump training even with the gradual introduction of more demanding exercise induced by increasing the volume, intensity, and muscle stretch amplitude. These findings suggest that the human neuromuscular system is highly adaptable to progressively varied loading demands during stretch-shortening exercise training.

Effects of the homeopathic remedy arnica on attenuating symptoms of exercise-induced muscle soreness

OBJECTIVE

To evaluate the clinical efficacy of Arnica at a high potency (200c), on moderating delayed onset muscle soreness and accompanying symptoms of muscle dysfunction.

METHODS

Twenty subjects completed a maximal eccentric exercise protocol with the non-dominate elbow flexors to induce delayed onset muscle soreness. Either Arnica or placebo tablets were administered in a random, double- blinded fashion immediately after exercise and at 24 hours and 72 hours after exercise. Before exercise, immediately post-exercise, and at 24, 48, 72, and 96 hours post-exercise, assessments of delayed onset muscle soreness and muscle function included: 1) muscle soreness and functional impairment; 2) maximum voluntary contraction torque; 3) muscle swelling; and 4) range of motion tests to document spontaneous muscle shortening and muscle shortening ability. Blood samples drawn before exercise and at 24, 48, and 96 hours after exercise were used to measure muscle enzymes as indirect indices of muscle damage.

RESULTS

Regardless of the intervention, the extent of delayed onset muscle soreness and elevations in muscle enzymes were similar on the days following the eccentric exercise protocol. The post-exercise time profiles of decreases in maximum voluntary contraction torque and muscle shortening ability and increases in muscle swelling and spontaneous muscle shortening were similar for each treatment intervention.

CONCLUSIONS

The results of this study did not substantiate the clinical efficacy of Arnica at a high potency on moderating delayed onset muscle soreness and accompanying symptoms of muscle dysfunction. Despite the findings of this study, future investigations on the clinical efficacy of homeopathic interventions should consider incorporating research strategies that emphasize differential therapeutics for each patient rather than treating a specific disease or symptom complex, such as DOMS, with a single homeopathic remedy.

The effects of vibration therapy on muscle force loss following eccentrically induced muscle damage

The purpose of this study was to investigate the effects of acute vibration therapy (VT) on performance recovery after a bout of strenuous eccentric exercise. Eight healthy males completed 300 maximal eccentric contractions of the quadriceps of one leg on an isokinetic dynamometer. Immediately after exercise and 12 and 24 h post-exercise, the subjects underwent either VT or a control treatment of no VT. Five sets of 1 min VT was performed at 26 Hz, with 6 mm peak-to-peak displacement, on a commercially available vibration machine. At least 2 weeks after the initial trial, the subjects completed the second trial using the contralateral leg and other treatment. Peak and average peak isometric tension and isokinetic concentric and eccentric torque were measured prior to exercise and 24 and 48 h post-exercise. Treatment with VT resulted in significantly (all P < 0.05) greater decrements in peak (-38%) and average peak eccentric (-39%) torque 24 h after eccentric exercise as compared to a control treatment (-24 and -29%, respectively). These results suggest that the use of 26 Hz VT in the first 24 h after damaging exercise may be detrimental to the magnitude of force loss and/or recovery over this period.

Interactive processes link the multiple symptoms of fatigue in sport competition

Muscle physiologists often describe fatigue simply as a decline of muscle force and infer this causes an athlete to slow down. In contrast, exercise scientists describe fatigue during sport competition more holistically as an exercise-induced impairment of performance. The aim of this review is to reconcile the different views by evaluating the many performance symptoms/measures and mechanisms of fatigue. We describe how fatigue is assessed with muscle, exercise or competition performance measures. Muscle performance (single muscle test measures) declines due to peripheral fatigue (reduced muscle cell force) and/or central fatigue (reduced motor drive from the CNS). Peak muscle force seldom falls by >30% during sport but is often exacerbated during electrical stimulation and laboratory exercise tasks. Exercise performance (whole-body exercise test measures) reveals impaired physical/technical abilities and subjective fatigue sensations. Exercise intensity is initially sustained by recruitment of new motor units and help from synergistic muscles before it declines. Technique/motor skill execution deviates as exercise proceeds to maintain outcomes before they deteriorate, e.g. reduced accuracy or velocity. The sensation of fatigue incorporates an elevated rating of perceived exertion (RPE) during submaximal tasks, due to a combination of peripheral and higher CNS inputs. Competition performance (sport symptoms) is affected more by decision-making and psychological aspects, since there are opponents and a greater importance on the result. Laboratory based decision making is generally faster or unimpaired. Motivation, self-efficacy and anxiety can change during exercise to modify RPE and, hence, alter physical performance. Symptoms of fatigue during racing, team-game or racquet sports are largely anecdotal, but sometimes assessed with time-motion analysis. Fatigue during brief all-out racing is described biomechanically as a decline of peak velocity, along with altered kinematic components. Longer sport events involve pacing strategies, central and peripheral fatigue contributions and elevated RPE. During match play, the work rate can decline late in a match (or tournament) and/or transiently after intense exercise bursts. Repeated sprint ability, agility and leg strength become slightly impaired. Technique outcomes, such as velocity and accuracy for throwing, passing, hitting and kicking, can deteriorate. Physical and subjective changes are both less severe in real rather than simulated sport activities. Little objective evidence exists to support exercise-induced mental lapses during sport. A model depicting mind-body interactions during sport competition shows that the RPE centre-motor cortex-working muscle sequence drives overall performance levels and, hence, fatigue symptoms. The sporting outputs from this sequence can be modulated by interactions with muscle afferent and circulatory feedback, psychological and decision-making inputs. Importantly, compensatory processes exist at many levels to protect against performance decrements. Small changes of putative fatigue factors can also be protective. We show that individual fatigue factors including diminished carbohydrate availability, elevated serotonin, hypoxia, acidosis, hyperkalaemia, hyperthermia, dehydration and reactive oxygen species, each contribute to several fatigue symptoms. Thus, multiple symptoms of fatigue can occur simultaneously and the underlying mechanisms overlap and interact. Based on this understanding, we reinforce the proposal that fatigue is best described globally as an exercise-induced decline of performance as this is inclusive of all viewpoints.

Predictive value of strength loss as an indicator of muscle damage across multiple drop jumps

The aim of the present study was to compare the time-course of indirect symptoms of exercise-induced muscle damage after 50 and 100 drop jumps. A high-force, low intensity exercise protocol was used to avoid discrepancies regarding metabolic fatigue immediately after exercise. Healthy untrained men performed 50 ("50 group", n = 13) or 100 ("100 group", n = 13) intermittent (30-s interval between each jump) drop jumps, respectively, from the height of 0.5 m with a counter-movement to a 90° knee flexion angle and immediate maximal rebound. Voluntary and electrically evoked knee extensor strength was assessed using an isokinetic dynamometer immediately before and at 2 min after exercise, as well as 3, 7, and 14 days after exercise. Creatine kinase (CK) activity and muscle soreness within 7 days after exercise were also determined. The results showed that the decrease in voluntary isometric and isokinetic torque as well as 100 Hz stimulation torque at the end of the 50 and 100 drop jumps was very similar, while substantial differences were found in low-frequency fatigue, shift in optimal knee joint angle, muscle soreness, and CK activity. In addition, there was slower muscle strength recovery after the 100 drop jumps. It is concluded that the predictive value of strength loss immediately after exercise as an indicator of muscle damage decreases as the jump number increases. Still, stimuli must be large enough for muscle torque to reach the reduction plateau. Therefore, magnitude of exercise becomes a major factor in accuracy of muscle damage predictions.

Comparison in eccentric exercise-induced muscle damage among four limb muscles

This study tested the hypothesis that changes in indirect markers of muscle damage following maximal eccentric exercise would be smaller for the knee extensors (KE) and flexors (KF) compared with the elbow flexors (EF) and extensors (EE). A total of 17 sedentary men performed five sets of six maximal isokinetic (90° s(-1)) eccentric contractions of EF (range of motion, ROM: 90°-0°, 0 = full extension), EE (55°-145°), KF (90°-0°), and KE (30°-120°) using a different limb with a 4-5-week interval in a counterbalanced order. Changes in maximal isometric and concentric isokinetic strength, optimum angle, limb circumference, ROM, plasma creatine kinase activity and myoglobin concentration, muscle soreness, and echo-intensity of B-mode ultrasound images before and for 5 days following exercise were compared amongst the four exercises using two-way repeated-measures ANOVA. All variables changed significantly following EF, EE, and KF exercises, but KE exercise did not change the optimum angle, limb circumference, and echo-intensity. Compared with KF and KE, EF and EE showed significantly greater changes in all variables, without significant differences between EF and EE. Changes in all variables were significantly greater for KF than KE. For the same subjects, the magnitude of change in the dependent variables following exercise varied among the exercises. These results suggest that the two arm muscles are equally more susceptible to muscle damage than leg muscles, but KF is more susceptible to muscle damage than KE. The difference in the susceptibility to muscle damage seems to be associated with the use of muscles in daily activities.

Effects of eccentric exercise-induced muscle damage on intramyocellular lipid concentration and high energy phosphates

Eccentric exercise is known to cause changes to the ultrastructure of skeletal muscle and, in turn, may alter the ability of the muscle to store and utilise intracellular substrates such as intramyocellular lipid (IMCL). The purpose of this study was to test the hypothesis that exercise-induced muscle damage (EIMD) results in IMCL accumulation. Six males (31 ± 6 years; mean ± SD, and 72.3 ± 9.7 kg body mass) performed 300 unilateral, maximal, isokinetic, eccentric contractions (Ecc) (30° s(-1)) of the quadriceps on an isokinetic dynamometer, followed immediately by an equal amount of work by the contralateral leg but with concentric action (Con). Phosphate compounds and IMCL content of the vastus lateralis of both legs were measured using (31)P and (1)H magnetic resonance spectroscopy. IMCL content was higher in Ecc than Con 24 h post but the reverse was evident 48 h post-exercise (P = 0.046). A significant time × trial interaction for resting [P(i)] (P = 0.045), showed increases in Ecc across time but no change in Con. A significant main effect of trial (P = 0.002) was apparent indicating the Ecc leg had marked metabolic dysfunction. The P(i)/PCr ratio showed a significant effect of trial (P = 0.001) with an increase evident in Ecc leg, primarily due to increases in [P(i)]. The present study highlights changes in IMCL content of skeletal muscle following EIMD.

Effect of milk-based carbohydrate-protein supplement timing on the attenuation of exercise-induced muscle damage

Exercise-induced muscle damage (EIMD) leads to decrements in muscle performance and increases in intramuscular enzymes measured in the plasma, and to delayed onset of muscle soreness (DOMS), partly due to the activation of degradative pathways. It has been shown that milk-based carbohydrate-protein (CHO-P) can limit changes in markers of EIMD, possibly by attenuating protein degradation and (or) increasing protein synthesis. However, the timing of supplementation has received limited attention, and this may alter the response. This study examined the effects of acute milk-based CHO-P supplementation timing on the attenuation of EIMD. Four independent matched groups of 8 healthy males consumed milk-based CHO-P before (PRE), immediately after (POST), or 24 h after (TWENTY-FOUR) muscle-damaging exercise. Active DOMS, isokinetic muscle performance, reactive strength index (RSI), and creatine kinase (CK) were assessed immediately before and 24, 48, and 72 h after EIMD. POST and TWENTY-FOUR demonstrated a benefit in limiting changes in active DOMS, peak torque, and RSI over 48 h, compared with PRE. PRE showed a possible benefit in reducing increases in CK over 48 h and limiting changes in other variables over 72 h. Consuming milk-based CHO-P after muscle-damaging exercise is more beneficial in attenuating decreases in muscle performance and increases in active DOMS at 48 h than ingestion prior to exercise.

Neuromuscular adaptations to training, injury and passive interventions: implications for running economy

Performance in endurance sports such as running, cycling and triathlon has long been investigated from a physiological perspective. A strong relationship between running economy and distance running performance is well established in the literature. From this established base, improvements in running economy have traditionally been achieved through endurance training. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced running economy. This improvement in running economy has been hypothesized to be a result of enhanced neuromuscular characteristics such as improved muscle power development and more efficient use of stored elastic energy during running. Changes in indirect measures of neuromuscular control (i.e. stance phase contact times, maximal forward jumps) have been used to support this hypothesis. These results suggest that neuromuscular adaptations in response to training (i.e. neuromuscular learning effects) are an important contributor to enhancements in running economy. However, there is no direct evidence to suggest that these adaptations translate into more efficient muscle recruitment patterns during running. Optimization of training and run performance may be facilitated through direct investigation of muscle recruitment patterns before and after training interventions. There is emerging evidence that demonstrates neuromuscular adaptations during running and cycling vary with training status. Highly trained runners and cyclists display more refined patterns of muscle recruitment than their novice counterparts. In contrast, interference with motor learning and neuromuscular adaptation may occur as a result of ongoing multidiscipline training (e.g. triathlon). In the sport of triathlon, impairments in running economy are frequently observed after cycling. This impairment is related mainly to physiological stress, but an alteration in lower limb muscle coordination during running after cycling has also been observed. Muscle activity during running after cycling has yet to be fully investigated, and to date, the effect of alterations in muscle coordination on running economy is largely unknown. Stretching, which is another mode of training, may induce acute neuromuscular effects but does not appear to alter running economy. There are also factors other than training structure that may influence running economy and neuromuscular adaptations. For example, passive interventions such as shoes and in-shoe orthoses, as well as the presence of musculoskeletal injury, may be considered important modulators of neuromuscular control and run performance. Alterations in muscle activity and running economy have been reported with different shoes and in-shoe orthoses; however, these changes appear to be subject-specific and non-systematic. Musculoskeletal injury has been associated with modifications in lower limb neuromuscular control, which may persist well after an athlete has returned to activity. The influence of changes in neuromuscular control as a result of injury on running economy has yet to be examined thoroughly, and should be considered in future experimental design and training analysis.

The decrease in electrically evoked force production is delayed by a previous bout of stretch-shortening cycle exercise

AIM

Unaccustomed physical exercise with a large eccentric component is accompanied by muscle damage and impaired contractile function, especially at low stimulation frequencies. A repeated bout of eccentric exercise results in less damage and improved recovery of contractile function. Here we test the hypotheses that (1) a prior stretch-shortening cycle (SSC) exercise protects against impaired muscle function during a subsequent bout of SSC exercise and (2) the protection during exercise is transient and becomes less effective as the exercise progresses.

METHODS

Healthy untrained men (n = 7) performed SSC exercise consisting of 100 maximal drop jumps at 30 s intervals. The same exercise was repeated 4 weeks later. Peak quadriceps muscle force evoked by electrical stimulation at 15 (P15) and 50 (P50) Hz was measured before exercise, after 10, 25, 50 and 100 jumps as well as 1 and 24 h after exercise.

RESULTS

P15 and P50 were higher during the initial phase of the repeated bout compared with the first exercise bout, but there was no difference between the bouts at the end of the exercise periods. P15 and P50 were again larger 24 h after the repeated bout. The P15/P50 ratio during exercise was not different between the two bouts, but it was higher after the repeated bout.

CONCLUSION

A prior bout of SSC exercise temporarily protects against impaired contractile function during a repeated exercise bout. The protection can again be seen after exercise, but the underlying mechanism then seems to be different.

Repeated bout effect is absent in resistance trained men: an electromyographic analysis

A prior bout of exercise is well known to confer protection from subsequent eccentric bouts (i.e. repeated bout effect; RBE), which may be fostered through neural adaptations, specifically a shift in the frequency content of the surface electromyogram (EMG). It is currently not clear whether chronically resistance trained men are capable of a RBE driven by neural adaptations. Eleven resistance trained men (23.5+/-3.4 yrs) performed 100 eccentric actions of the barbell bench press exercise, followed by an equivalent bout 14 days later. Indirect markers of muscle damage (i.e. force production, soreness) along with surface EMG were measured before and through 48 h of recovery. Median frequency and maximal isometric force demonstrated time main effects (p>0.05), but no RBE. A prior bout of eccentric exercise does not confer a RBE for indirect markers of muscle injury or elicit changes in the frequency content of the EMG signal in resistance trained men.