Exercise-induced muscle damage: What is it, what causes it and what are the nutritional solutions?

Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review

Post-exercise recovery strategies influence the body's ability to restore physiological homeostasis, replenish energy stores, repair muscle damage, and promote desired adaptations, which improve exercise performance. This narrative review examines the impact of nutritional strategies commonly used for enhancing recovery and subsequent exercise performance, particularly when athletes face short recovery periods. Carbohydrate ingestion is essential for glycogen replenishment, especially within the initial hours post-exercise, with its impact dependent on the types, timing, and amount. Protein is essential for accelerating muscle recovery and achieving a positive nitrogen balance, depending on the type and dosage. The co-ingestion of carbohydrates with proteins or fats is explored for its role in maximizing glycogen resynthesis and muscle repair, with evidence supporting the addition of protein to suboptimal carbohydrate intake for enhanced recovery. Moreover, this review addresses the potential benefits of creatine and caffeine co-ingestion for accelerating glycogen synthesis and improving subsequent performance. Hydration strategies, including the use of milk-based beverages and electrolyte solutions, are also discussed, emphasizing their importance in maintaining fluid balance and optimizing recovery. This review also highlights the emerging role of micronutrients such as omega-3 fatty acids, antioxidants, and sodium bicarbonate in reducing muscle damage and improving acid-base balance. Evidence supports the tailored use of these nutritional strategies, particularly for athletes managing tight competition/training schedules. Future research should focus on refining individualized approaches for recovery and investigating the impact of novel supplements on subsequent performance.

Polyphenols and post-exercise muscle damage: a comprehensive review of literature

Recent research highlights the significant role of polyphenols in alleviating post-exercise muscle damage, thus positioning them as a valuable nutritional strategy for athletes and fitness enthusiasts. Polyphenols, naturally occurring bioactive compounds abundant in fruits, vegetables, tea, wine, and other plant-based foods, are recognized for their potent antioxidant and anti-inflammatory properties. This dual mechanism is critical for combating oxidative stress and inflammation-two factors that intensify during vigorous physical activity and contribute to muscle soreness and damage. Among various polyphenols, compounds like quercetin have particularly emerged as effective agents for promoting muscle recovery and enhancing exercise performance. These protective effects are facilitated through several mechanisms, including the modulation of inflammatory pathways, acceleration of muscle repair processes, and enhancement of mitochondrial function, all of which bolster overall muscle health. As ongoing studies yield deeper insights, the potential of polyphenols to enhance athletic performance and overall health will become increasingly substantiated, leading towards their strategic incorporation into exercise nutrition protocols. Therefore, we reviewed relevant studies in order to show how efficient polyphenols can be in reducing muscle fatigue and damage and what are the exact mechanisms.

The reliability of functional and systemic markers of muscle damage in response to a flywheel squat protocol

PURPOSE

To characterize the magnitude, timescale, and reliability of changes in functional and systemic outcome markers following moderate (MIR) and high (HIR) isoinertial resistance flywheel squat protocols (FSP).

METHODS

Twenty-four resistance-trained males completed two exercise trials (ET1 & ET2) separated by 32 days. Functional and systemic markers were assessed at pre-exercise (PRE), immediately post-exercise (IP), and 24 (24H), 48 (48H), and 72 (72H) hours post-exercise. Three-way group x trial x time repeated measures ANOVAs were conducted to compare all dependent variables between groups (MIR & HIR) and experimental trials across time. Test-retest reliability between trials was assessed using intraclass correlation coefficients (ICC).

RESULTS

At IP, both groups exhibited significantly decreased active range of motion, perceived recovery status, squat maximal voluntary isometric contraction force, and vertical jump performance, along with significantly increased muscle thickness and echo intensity (ultrasound), muscle soreness, and creatine kinase when compared to PRE. Most outcomes remained perturbed at 24H and 48H, especially in the HIR group. By 72H, only a subset of variables remained significantly changed from PRE. No significant attenuation of outcomes between trials were observed and test-retest reliability between trials was excellent for the FSP and moderate to excellent for most outcomes in both groups.

CONCLUSION

Our findings indicate that the FSP is a robust and repeatable exercise stimulus capable of eliciting significant exercise-induced muscle damage and reliable subsequent perturbations to functional and systemic markers of muscle damage. Our findings also support the use of crossover designs in future EIMD research designs with resistance-trained men.

Early warning system for player recovery? A series of case studies illustrating the application of individualised adaptive reference ranges in the longitudinal blood monitoring of English Premier League soccer players

Blood biomarkers can provide objective insight into a player's physiological state of recovery. Individualised approaches to biomarker monitoring may be of higher potential value in assessing player health and recovery compared to population-based reference ranges. We aimed to explore the application of individualised adaptive reference ranges (IARR) in English Premier League (EPL) soccer players using a POC biomarker for C-Reactive Protein (CRP) as a marker of inflammation. Using historical data collected from players' CRP values during the 2019-2020 season, we evaluated the effectiveness of static and IARR in identifying abnormal values and reported sensitivity and specificity at a 5% significance level. Our analysis confirmed that monitoring with IARR is more effective in identifying true abnormalities compared to population-based static reference ranges, particularly when the intra-individual variability is considerably lower than inter-individual variability. The application of IARR for blood monitoring data could assist the practitioner in identifying periods where a player may require performance (e.g. workload management and recovery practices) or medical support from the multi-disciplinary team. However, IARR serve more as an early warning system than a diagnostic tool. Thus, significant care is needed to prevent misuse and misinterpretation when implementing this strategy in real-world settings.

Influence of puberty on high intensity exercise induced skeletal muscle damage and inflammatory response in sedentary boys

The present investigation examined the influence of age and pubertal transition on magnitude of muscle damage and inflammatory response following high intensity incremental treadmill running till volitional exhaustion in sixty-four sedentary prepubertal (n ​= ​32) and postpubertal (n ​= ​32) boys who were randomly recruited in the study. Muscle damage and inflammatory markers like creatine kinase (CK), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotranferase (AST), C-Reactive Protein (CRP) and Interleukin-6 (IL-6) were estimated before and after exercise. Serum CK, LDH, AST, ALT, CRP and IL-6 levels significantly increased after exercise in both the groups in comparison to respective pre-exercise values. Although CK, LDH, CRP and IL-6 responses were significantly higher in postpubertal boys, no intergroup variation was noted in post-exercise ALT activity. Age and body mass index (BMI) had significant positive correlation with post-exercise CK, LDH, AST, CRP, and IL-6 levels. Muscle injury and inflammation were significantly higher in postpubertal boys, suggesting a rise in these responses as a function of age and muscle mass during onset of puberty. Post-exercise release pattern of ALT was not influenced by age and puberty. Data also revealed that concentric endurance exercise did not induce extensive muscle damage and inflammation in both the groups. Drastic elevation in IL-6 level despite lower muscle damage implied that this marker was released from contracting muscle fibers independent of muscle damage and acute inflammation. The magnitude of this post-exercise IL-6 release increased as a function of age and BMI.

Impact of different doses of cold water immersion (duration and temperature variations) on recovery from acute exercise-induced muscle damage: a network meta-analysis

Objective

This network meta-analysis and systematic review evaluated the recovery impacts of varying cold water immersion (CWI) protocols on acute exercise-induced muscle damage.

Methods

We searched CNKI, PubMed, Cochrane Library, Web of Science, and Embase from January 2000 to September 2024 for randomized controlled trials examining CWI's recovery effects on acute muscle damage. Data extraction, study screening, and risk of bias assessment were conducted independently by two reviewers. Analyses were performed using Stata 16.0.

Results

A total of 55 RCTs were included, with 42 reporting delayed onset muscle soreness (DOMS), 36 reporting jump performance (JUMP), and 30 reporting creatine kinase (CK) levels. Network meta-analysis showed that compared with the control group, MD-MT-CWI: Medium-duration medium-temperature cold water immersion (10-15 min, 11°C-15°C) [SMD = -1.45, 95%CI(-2.13, -0.77), P < 0.01] and MD-LT-CWI: Medium-duration low-temperature cold water immersion (10-15 min, 5°C-10°C) [SMD = -1.12, 95%CI(-1.78, -0.47), P = 0.01] significantly reduced DOMS; MD-LT-CWI (10-15 min, 5°C-10°C) [SMD = 0.48, 95%CI(0.20, 0.77), P = 0.01] and MD-MT-CWI (10-15 min, 11°C-15°C) [SMD = 0.42, 95%CI(0.15, 0.70), P = 0.02] significantly improved JUMP; MD-MT-CWI (10-15 min, 11°C-15°C) [SMD = -0.85, 95%CI(-1.36, -0.35), P = 0.01] and MD-LT-CWI (10-15 min, 5°C-10°C) [SMD = -0.90, 95%CI(-1.46, -0.34), P = 0.02] significantly reduced CK. Cumulative probability ranking showed that MD-LT-CWI (10-15 min, 5°C-10°C) was the most effective for improving JUMP and reducing CK, while MD-MT-CWI (10-15 min, 11°C-15°C) was the most effective for reducing DOMS.

Conclusion

Different dosages of cold water immersion (varying in duration and temperature) had different effects on recovery from acute exercise-induced muscle damage. We found that MD-LT-CWI (10-15 min, 5°C-10°C) was most effective for improving biochemical markers (CK) and neuromuscular recovery, while MD-MT-CWI (10-15 min, 11°C-15°C) was most effective for reducing muscle soreness. In practice, we recommend using MD-LT-CWI (10-15 min, 5°C-10°C) and MD-MT-CWI (10-15 min, 11°C-15°C) to reduce Exercise-induced muscle damage (EIMD). However, due to the limitations of the included studies, further high-quality studies are needed to verify these conclusions.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42024602359.

The effect of tart cherry juice (TCJ) supplementation on exercise-induced muscle damage (EIMD) in an athletic population

Introduction

This systematic review and meta-analysis quantified the effect of tart cherry juice (TCJ) supplementation on exercise-induced muscle damage (EIMD). Evidence supported TCJ's beneficial effects on muscular function and inflammatory biomarkers interleukin (IL)-6 and IL-8.

Method

PubMed, Scopus, and Web of Science were searched up to January 2024. Risk of bias was assessed using RevMan® software. Mean differences and 95% confidence intervals (CIs) of maximal voluntary isometric contraction (MVIC), inflammatory markers, creatine kinase (CK), and visual analog scale (VAS) score were pooled using fixed- or random-effect models. Heterogeneity was assessed using Chi-square or I 2 statistics.

Results

Ten trials were included in the analysis. TCJ supplementation significantly improved MVIC [weighted mean difference (WMD) = 9.13%, 95% CI (6.42-11.84), I 2 = 62.3%] and decreased IL-6 [WMD = -0.4 pg/ml, 95% CI (-0.68 to -0.11), I 2 = 62.2%] and IL-8 [WMD = -0.3 pg/ml, 95% CI (-0.6 to -0.0), I 2 = 46.3%]. No significant changes were found in CK, C-reactive protein, IL-1β, tumor necrosis factor-alpha, or VAS score. Dose-response analysis revealed a significant non-linear association between daily TCJ dose and MVIC effect size.

Conclusion

TCJ supplementation may improve muscle function and some inflammatory biomarkers in EIMD. Further high-quality studies with larger sample sizes are needed to determine TCJ's long-term effects.

The Order of Concurrent Training Affects Acute Immunological Stress Responses and Measures of Muscular Fitness in Female Youth Judo Athletes

This study aimed to examine the acute effects of concurrent muscle strength and sport-specific endurance exercise order on immunological stress responses, metabolic response, muscular-fitness, and rating-of-perceived-exertion (RPE) in highly trained youth female judo athletes. Thirteen female participants randomly performed two concurrent training (CT) sessions; strength-endurance and endurance-strength. Immune response, metabolic response, muscular fitness (i.e., countermovement jump-derived force and power [CMJ-force and CMJ-power]), and RPE were measured at different time points (i.e., PRE, MID, POST, POST6h, and POST22h). There were significant time × order interactions for lymphocytes (p = 0.006, ES = 1.31), granulocyte-lymphocyte ratio (p = 0.002, ES = 1.56), and systemic inflammation index (p = 0.029, ES = 1.11), blood glucose and lactate (p < 0.001, ES = 2.09 and p = 0.0018, ES = 1.51, respectively), CMJ-force (p = 0.033, ES = 1.26), and CMJ-power (p = 0.007, ES = 1.40) as well as RPE (p < 0.001, ES = 2.05). CT-induced acute (i.e., POST) but not delayed (i.e., POST6h and POST22h) order-dependent immune cell count alterations in highly trained youth female judo athletes. All markers of the immune system went back to baseline values at POST22h. Metabolic responses were slightly higher following the endurance exercise (irrespective of the applied exercise order). CMJ-measures and RPE fluctuated during both CT sessions but returned to baseline 6 h post-exercise.

Recycle, repair, recover: the role of autophagy in modulating skeletal muscle repair and post-exercise recovery

Skeletal muscle is a highly plastic tissue that can adapt relatively rapidly to a range of stimuli. In response to novel mechanical loading, e.g. unaccustomed resistance exercise, myofibers are disrupted and undergo a period of ultrastructural remodeling to regain full physiological function, normally within 7 days. The mechanisms that underpin this remodeling are believed to be a combination of cellular processes including ubiquitin-proteasome/calpain-mediated degradation, immune cell infiltration, and satellite cell proliferation/differentiation. A relatively understudied system that has the potential to be a significant contributing mechanism to repair and recovery is the autophagolysosomal system, an intracellular process that degrades damaged and redundant cellular components to provide constituent metabolites for the resynthesis of new organelles and cellular structures. This review summarizes our current understanding of the autophagolysosomal system in the context of skeletal muscle repair and recovery. In addition, we also provide hypothetical models of how this system may interact with other processes involved in skeletal muscle remodeling and provide avenues for future research to improve our understanding of autophagy in human skeletal muscle.

Passive heating in sport: context-specific benefits, detriments, and considerations

Exercise and passive heating share some acute physiological responses. These include increases in body temperature, sweat rate, blood flow, heart rate, and redistribution of plasma and blood volume. These responses can vary depending on the heating modality or dose (e.g., temperature, duration, body coverage) and are beneficial to athletes in specific scenarios. These scenarios include being applied to increase muscle or force production, induce rapid weight loss, stimulate thermoregulatory or cardiovascular adaptation, or to accelerate recovery. The rationale being to tailor the specific passive heating protocol to target the desired physiological response. However, some acute responses to passive heating may also be detrimental to sporting outcomes, such as exercising in the heat, having unintended residual negative effects on performance or perceptions of fatigue, or even resulting in hospitalisation if implemented inappropriately. Accordingly, the effects of passive heating should be carefully considered prior to implementation by athletes, coaches, and support staff. Therefore, the purpose of this review is to evaluate the physiological responses to different modes and doses of passive heating and explore the various sport contexts where these effects may either benefit or hinder athletes. Understanding these responses can aid the implementation of passive heating in sport and identify potential recommended heating protocols in each given scenario.

Comparing the Effects of Collagen Hydrolysate and Dairy Protein on Recovery from Eccentric Exercise: A Double Blind, Placebo-Controlled Study

BACKGROUND

Consuming collagen hydrolysate (CH) may improve symptoms of exercise-induced muscle damage (EIMD); however, its acute effects have not been compared to dairy protein (DP), the most commonly consumed form of protein supplement. Therefore, this study compared the effects of CH and DP on recovery from EIMD.

METHODS

Thirty-three males consumed either CH (n = 11) or DP (n = 11), containing 25 g of protein, or an isoenergetic placebo (n = 11) immediately post-exercise and once daily for three days. Indices of EIMD were measured before and 30 min and 24, 48, and 72 h after 30 min of downhill running on a -15% slope at 80% of VO2max speed.

RESULTS

Downhill running induced significant EIMD, with time effects (all p < 0.001) for the delayed onset of muscle soreness (visual analogue scale), countermovement jump height, isometric midthigh pull force, maximal voluntary isometric contraction force, running economy, and biomarkers of muscle damage (creatine kinase) and inflammation (interleukin-6, high-sensitivity C-reactive protein). However, no group or interaction effects (all p > 0.05) were observed for any of the outcome measures.

CONCLUSIONS

These findings suggest that the post-exercise consumption of CH or DP does not improve indices of EIMD during the acute recovery period in recreationally active males.

Hydrogen gas inhalation prior to high-intensity training reduces attenuation of nitric oxide bioavailability in male rugby players

Background

Inhalation of hydrogen gas (H2) as an antioxidant supplement may alleviate exercise-induced oxidative damage and protect post-exercise hydrogen peroxide signaling, which may help mediate beneficial exercise adaptation. The aims of this study were to determine the effects of H2 inhalation on plasma nitric oxide (NO) level and its synthesis precursor in professional athletes.

Methods

A randomized, placebo-controlled, double-blind, crossover trial was conducted with professional male rugby players for 3 weeks. Participants underwent 1 week of H2 supplementation and 1 week of placebo treatment prior to daily sessions of high-intensity exercise training, separated by 1 week of low-intensity training as a washout.

Results

Two-way (supplementation and time) repeated-measures analyses of variance showed that NO, L-arginine, and tetrahydrobiopterin levels in the H2 inhalation group were significantly higher than those in the placebo group after exercise (D6) and remained higher after 24 h of rest (D7). Levels of hydroxydeoxyguanosine and interleukin 6 were lower in the H2 inhalation week than in the placebo week on D6 and D7. In addition, total antioxidant levels were significantly higher with H2 inhalation than with placebo.

Significance

These results suggest that H2 inhalation helps to maintain NO signaling after exercise and to alleviate inflammation and oxidative stress induced by high-intensity exercise training in professional athletes.

Acute effects of intra-training carbohydrate ingestion in CrossFit® trained adults: a randomized, triple-blind, placebo-controlled crossover trial

Carbohydrate (CHO) intake during exercise could decrease the subjective perceived exertion and promote recovery; however, the effects of intra-training CHO ingestion remain uncertain in CrossFit® (CF) sessions. Therefore, the aim of this randomized, triple-blind, placebo-controlled crossover trial was to investigate the effect of acute CHO intake during a CF session on the delayed onset muscle soreness (DOMS), the perceived exertion (RPE), performance, recovery, and metabolic markers (capillary lactate and glucose) in CF athletes. Twenty-three male athletes trained in CF ingested CHO (60 g of maltodextrin + fructose) or a placebo (PLA) during a CF session. DOMS was assessed 24 and 48 h after the CF session. The Counter Movement Jump (CMJ) test and the Deep Squat test at 70% of the athlete's body weight (AST70) were performed before, immediately after, and 24 h after the session. Perceived exertion, Feeling Scale (FS), Gastrointestinal Distress Score (GDS), heart rate, capillary lactate, and glucose were assessed across the session. CHO supplementation did not improve DOMS (all P ≥ 0.127), CMJ, or AST70 parameters (all P ≥ 0.053) compared to PLA. There were no differences between CHO and PLA in RPE, FS, GDS, heart rate (all P ≥ 0.088), performance (e.g., nº of repetitions; all P ≥ 0.556), or lactate levels (P = 0.810). However, glucose levels increased from the back squat to the WOD and remained stable after the AMRAP (P < 0.001). In conclusion, acute CHO intake during a CF session did not improve DOMS, perceived exertion, performance, recovery, or metabolic markers in CF athletes. TRN: NCT06440343. Date: 2024-05-10.

Evaluation of curcumin intake in reducing exercise-induced muscle damage in athletes: a systematic review

BACKGROUND

Sports practice, particularly eccentric exercises, induces significant muscular changes, including muscle fiber injuries, strength loss, pain, and increased permeability of the muscle membrane. The duration of muscle recovery depends on factors such as exercise intensity and the specific muscle groups engaged. The inflammatory response plays a crucial role in muscle regeneration, involving various cell types. Curcumin, especially when its stability is enhanced through encapsulation, exhibits potent antioxidant and anti-inflammatory properties. Supplementing with curcumin can reduce muscle damage and inflammation caused by eccentric exercise, making it a potential remedy for athletes.

OBJECTIVE

The objective of this systematic review is to assess the scientific evidence supporting the efficacy of curcumin in reducing muscle damage caused by sports.

METHODS

A structured search in SCOPUS, Medline, and Web of Science databases was conducted in March 2023, including all available articles. The strategy involved selecting English articles without time constraints, using the search terms "curcumin" AND "Exercise-Induced Muscle Damage" (ALL(curcumin AND "Exercise-Induced Muscle Damage")). Titles and abstracts were screened to assess eligibility. Studies were chosen based on PICOS criteria, and quality was evaluated using the reliable PEDro scale. The eligibility criteria included adults without any diagnosed diseases who regularly exercise (at least three times per week) and follow a consistent pattern of curcumin intake before, during, or after exercise.

RESULTS

The comprehensive search identified 11 relevant studies investigating the effects of curcumin supplementation in sport-simulated interventions. These studies suggest that curcumin intake may help reduce muscle symptoms associated with eccentric exercises, thereby improving pain perception. Effective use of curcumin depends on factors such as dosage, bioavailability, and timing, with post-exercise ingestion appearing to be more beneficial.

CONCLUSIONS

Curcumin demonstrates a significant potential to relieve muscle-related symptoms, especially delayed-onset muscle soreness (DOMS) that arises from eccentric exercises, thus potentially improving the well-being of those who are trained. It also appears to have the capability to lower biomarkers associated with inflammation and boost antioxidant levels. Nevertheless, for future studies, the bioavailability of curcumin must be considered, as it is a key factor in its efficacy.

Nutritional approaches applied to recovery of skeletal muscle injury immobilization: a review of nutrition aid for sport trauma

Skeletal muscle (SM) injuries are a very common occurrence among athletes during training and/or competitive periods, resulting in time loss and absence from sports. Of several existing interventions to improve SM recovery, the nutritional approach has emerged as integral part to improve the physiological response and maintain the body composition to promote a rapid and safe return to play. Growing evidence supports that the physiological response to SM injuries results in a number of changes, suggesting the relevance of a personalized nutritional approach, according to the degree of immobilization, SM mass loss, strength and function. Therefore, we aimed to review the current evidence of the nutritional approach applied to SM injuries recovery in athletes, highlighting energy intake, use the main nutrients and elements for the SM recovery, such as proteins, carbohydrates, vitamins and omega-3 fatty acids. Currently, evidence from injured athletes is scarce, and so specific guidelines cannot be established, calling from greater research into nutritional interventions in SM injury recovery in athletes.

Temporal changes in thiol-oxidized plasma albumin are associated with recovery from exercise-induced muscle damage after a marathon

Exercise-induced muscle damage (EIMD) can affect athlete performance and is a risk factor for major muscle injury. The temporal profile of thiol-oxidized albumin, a marker of oxidative stress, has shown potential in assessing recovery from EIMD in non-athletically trained participants but not yet in trained participants. Our primary aim was to assess whether there are changes in the level of thiol-oxidized albumin after a marathon in athletically trained participants. Twenty participants completed a marathon and collected daily dried blood spots from 3 days prior to and 7 days after the marathon to measure thiol-oxidized albumin using a novel methodology (OxiDx). Participants were also assessed for indirect markers of EIMD prior to and on days 2 and 5 post-marathon. The level of thiol-oxidized albumin peaked at 2 days and remained elevated until 5 days after the marathon and correlated with indirect measures of EIMD. Furthermore, time of recovery for thiol-oxidized albumin varied between participants, some recovered at 3 days post-marathon whereas others extended beyond 7 days post marathon. Tracking temporal changes in the level of thiol-oxidized albumin has potential to be useful in managing recovery from EIMD in athletes, particularly considering the ease of the OxiDx methodology.

A Multi-ingredient Supplement Reduced Markers of Muscle Damage after a Rugby Match in Collegiate Male Players

ABSTRACT

Eccentric exercise and collisions that lead to muscle damage are common place among athletes. This study aimed to investigate the effect of a multi-ingredient supplement (MIS), containing the extracts of turmeric, chicken meat, and apple and ancient peat, on markers of muscle damage in collegiate male players following a rugby match. A position-matched, double-blind, randomized, and crossover design was employed in this study. Each trial consisted of a 14-day supplementation period, followed by a 15-a-side rugby match. A total of 13 participants, eight forward and five backs, with a mean height of 1.76 ± 0.08 m and a mean weight of 86.0 ± 22.8 kg, were included. Blood samples were collected before, immediately, 24 h, and 48 h after the match. Both the MIS ( P < 0.001, d = 1.86) and placebo trials ( P = 0.002, d = 1.97) exhibited a significant increase in plasma creatine kinase and lactate dehydrogenase (LDH) concentrations from the baseline immediately after the match. However, plasma creatine kinase concentration in the MIS trial was significantly lower at 24 h postmatch compared to the placebo trial ( P = 0.029, d = 0.90). Moreover, plasma LDH concentration returned to the baseline level 24 h after the match in the MIS trial, while it remained elevated in the placebo trial ( P = 0.001, d = 1.07). In either trials, the plasma tumor necrosis factor-α and malondialdehyde concentrations were not significantly different. In conclusion, the MIS can alleviate muscle damage markers after a rugby match without changes in inflammation and oxidative stress markers.

Greater Neuromuscular and Perceptual Fatigue after Low versus High Loads in the Bench Press: A Preliminary Study Applying Frequentist and Bayesian Group Analyses with Subject-by-Subject Case Series Reports

Background/Objective: This study investigated the differences in acute fatigue following resistance training performed with low versus high loads in the bench press (BP). Methods: Trained males (n = 5, 21.2 ± 2.77 years; 81.86 ± 6.67 kg; 177 ± 7.52 cm) undertook three protocols with 50%RM and three with 85%RM with volume equalized between protocols: muscular failure protocols (TF, RTP1 and 2), half-maximum repetition protocols (RTP3 and 4), and cluster set protocols (RTP5 and 6). Mechanical performance, lactate, and perceptual responses were analyzed during protocols and at post 0, 24, and 48 h using frequentist (p < 0.05) and Bayesian approaches. Results: Moderate to large (ES ≥ 0.3) and trivial to moderate (ES < 0.3) effects were observed at 0 and 24 h post-session, respectively, across all protocols. TF protocols, particularly RTP1, showed the greatest impairments when compared to the other RTP (ES ≥ 0.3). The Bayesian analysis supported the frequentist results, showing strong-decisive evidence for our data under the model that included protocols as predictors for mechanical, metabolic, and perceptual variables during protocols. Inter-individual variability in responses was observed in the neuromuscular tests, potentially related to the strength level and perceptual responses. Conclusions: In summary, TF generates greater fatigue, while reducing set volume to half of maximum repetitions or including intra-set rest that helps to mitigate fatigue symptoms.

The phytochemical composition and unexplored potential of Australian native plants for application in physical activity-related muscle recovery and inflammation: a literature review

Native plants are adaptable in various environmental conditions in part through the production of unique phytochemicals which may have beneficial effects on human health. Native Australian fruits contain higher phytochemical and antioxidant levels than most Western fruits, suggesting potential for greater health benefits arising from their consumption. These beneficial effects, in turn, may be mediated by the inhibition of inflammatory pathways as well as oxidative stress via the regulation of reactive oxygen (ROS) and/or nitrogen (RNS) species levels. Unaccustomed or strenuous exercise causes muscle damage and soreness, that may be driven by increased ROS and inflammation. There is growing interest in the application of polyphenol-rich food supplementation for the alleviation of exercise-induced oxidative stress, for the reduction of exercise-induced inflammation and improvement of muscle recovery. Therefore, the aim of this review was to provide an overview of the phytochemical and bioactive composition of some Australian native plant foods and their potential use for functional food development in the management of muscle recovery and inflammation. Native plant foods and food products could be beneficial for reducing inflammation, though it is important to note that most of the research in this field has been conducted in animal models or in vitro, in addition to there being little data on skeletal muscle inflammation. Further studies, particularly in humans, would be needed to confirm these effects and to determine the appropriate dosages and forms of native foods and food products for consumption to reduce inflammation and enhance muscle recovery.

The effects of hydrotherapy and cryotherapy on recovery from acute post-exercise induced muscle damage-a network meta-analysis

BACKGROUND

This systematic review and network meta-analysis assessed via direct and indirect comparisons the recovery effects of hydrotherapy and cold therapy at different temperatures on exercise induced muscle damage.

METHODS

Five databases were searched in English and Chinese. The included studies included exercise interventions such as resistance training, high-intensity interval training, and ball games, which the authors were able to define as activities that induce the appearance of EIMD. The included RCTs were analyzed using the Cochrane Risk of Bias tool. Eligible studies were included and and two independent review authors extracted data. Frequentist network meta-analytical approaches were calculated based on standardized mean difference (SMD) using random effects models. The effectiveness of each intervention was ranked and the optimal intervention was determined using the surface under the cumulative ranking curve (SUCRA) indicator.

RESULTS

57 studies with 1220 healthy participants were included, and four interventions were examined: Cold Water Immersion (CWI), Contrast Water Therapy (CWT), Thermoneutral or Hot Water Immersion (TWI/HWI), and Cryotherapy(CRYO). According to network meta-analysis, Contrast Water Immersion (SUCRA: 79.9% )is most effective in recovering the biochemical marker Creatine Kinase. Cryotherapy (SUCRA: 88.3%) works best to relieve Delayed Onset Muscle Soreness. In the recovery of Jump Ability, cryotherapy (SUCRA: 83.7%) still ranks the highest.

CONCLUSION

We found that CWT was the best for recovering biochemical markers CK, and CRYO was best for muscle soreness and neuromuscular recovery. In clinical practice, we recommend the use of CWI and CRYO for reducing EIMD.

SYSTEMATIC REVIEW REGISTRATION

[PROSPERO], identifier [CRD42023396067].

Challenges in Conducting Exercise Recovery Studies in Older Adults and Considerations for Future Research: Findings from a Nutritional Intervention Study

Maximising the potential benefit of resistance exercise (RE) programs by ensuring optimal recovery is an important aim of exercise prescription. Despite this, research surrounding recovery from RE in older adults is limited and inconsistent. The following randomised controlled trial was designed to investigate the efficacy of milk consumption for improving recovery from RE in older adults. However, the study encountered various challenges that may be applicable to similar studies. These include recruitment issues, a lack of measurable perturbations in muscle function following RE, and potential learning effects amongst participants. Various considerations for exercise research have arisen from the data which could inform the design of future studies in this area. These include (i) recruitment-consider ways in which the study design could be altered to aid recruitment or allow a longer recruitment period; (ii) learning effects and familiarisation-consider potential learning effects of outcome measures and adjust familiarisation accordingly; (iii) identify, validate and optimise protocols for outcome measures that are applicable for the specific population; (iv) adjust the exercise protocol according to the specific aims of the study (e.g., are you replicating a usual exercise bout or is the intent to cause large amounts of muscle damage?).

Match-related fatigue in basketball: A systematic review

This study aimed to systematically review fatigue responses following basketball match-play and during congested match schedules, considering performance, physiological, athlete-reported, and sleep-related outcomes. Relevant articles published until 23 January 2024 were searched using Scopus, Web of Science, and SPORTDiscus. After screening, 44 studies were included in the systematic review. The main findings indicate that, in most cases, vertical jumping and linear sprinting showed significant decrements at match-end (<1 hour post-match) compared to pre-match [small-to-very large effect sizes (ES)], with persistent (≥1 hour post-match) impairments lasting 24-48 hours in jumping (only in males, small-to-very large ES) and linear sprinting (moderate-to-very large ES). Physiological changes generally included significant increases (moderate-to-very large ES) in cortisol and nutrient metabolism markers at match-end, alongside persistent increases in muscle damage (mainly at 13-72 hours post-match) and inflammation (13-48 hours). Finally, match-play generally increased muscle soreness (mainly at 24-48 hours, moderate-to-very large ES) and perceived fatigue (mainly at match-end), with unclear effects on mood, and no apparent impact on sleep-related outcomes. Research assessing congested match schedules is limited, although possible worsening in muscle damage, inflammation, perceived fatigue and well-being were observed in male players. Overall, these findings indicate an impairment in some of the reviewed performance, physiological, and athlete-reported outcomes.

Temporal tracking of cysteine 34 oxidation of plasma albumin as a biomarker of muscle damage following a bout of eccentric exercise

PURPOSE

Exercise-induced muscle damage (EIMD) results in the generation of reactive oxygen species (ROS), but little is known about the temporal profile of change in ROS post-EIMD and how ROS levels relate to the onset of and recovery from EIMD. Our primary aim was to examine the effect of EIMD on the pattern of change in the blood level of thiol-oxidised albumin, a marker of oxidative stress.

METHODS

Seven male participants were subjected on separate days to eccentric muscle contraction to cause EIMD or a no-exercise condition. After each session, the participants collected daily dried blood spots to measure thiol-oxidised albumin and returned to the laboratory every 2 days for the assessment of indirect markers of EIMD, namely maximal voluntary contraction (MVC), delayed onset muscle soreness (DOMS), creatine kinase (CK), and myoglobin.

RESULTS

Eccentric exercise resulted in a significant decrease in MVC and increase in DOMS, CK, myoglobin, and thiol-oxidised albumin with the latter reaching above baseline level within 24-48 h post-exercise. All the markers of EIMD returned to baseline level within 6 days post-exercise, but not the level of thiol-oxidised albumin which remained elevated for 10 days after exercise. There was a moderate correlation between changes in thiol-oxidised albumin and DOMS, but no significant relationship between any other markers of muscle damage.

CONCLUSION

The levels of thiol-oxidised albumin increase in response to EIMD and remain elevated for several days post-exercise. The temporal pattern of change in the level of thiol-oxidised albumin suggests that this may be a useful biomarker of muscle repair post-EIMD.

Advances in relieving exercise fatigue for curcumin: Molecular targets, bioavailability, and potential mechanism

Intense and prolonged physical activity can lead to a decrease in muscle capacity, making it difficult to maintain the desired exercise intensity and resulting in exercise fatigue. The long-term effects of exercise fatigue can be very damaging to the body, so it is an urgent problem to be addressed. The intervention of foodborne active substances will be an effective measure. There is growing evidence that the molecular structure and function of curcumin have a positive effect on relieving fatigue. In this review, we summarize curcumin's molecular structure, which enables it to bind to a wealth of molecular targets, regulate signaling pathways, and thus alleviate exercise fatigue through a variety of mechanisms, including reducing oxidative stress, inhibiting inflammation, reducing metabolite accumulation, and regulating energy metabolism. The effects of curcumin on fatigue-related markers were analyzed from the perspective of animal models and human models and based on the bidirectional interaction between curcumin and intestinal microbiota: Intestinal microbiota can transform curcumin, and curcumin regulates gut microbiota through metabolic pathways, providing a new perspective for alleviating fatigue. This review contributes to a more comprehensive understanding of the possible molecular mechanisms of curcumin in anti-fatigue and provides a new possibility for the development of functional foods in the future.

Effects of a Dietary Microalgae (Arthrospira platensis) Supplement on Stress, Well-Being, and Performance in Water Polo Players: A Clinical Case Series

BACKGROUND

A common tactic used by athletes to improve performance, lessen tiredness, and hasten recovery is dietary supplementation. We aimed to assess the role of a microalgae dietary liquid supplement additivated with Copper 22.5% NRV in water polo players' performance.

METHODS

Twenty male water polo players were split into two groups: ten (spirulina group) took a twice-daily nutritional supplement containing 15 mL of spirulina liquid extract (titrated in Phycocyanin 1 mg/mL) and additivated with Copper 22.5% NRV for eight weeks, and ten (the placebo group) did not take the supplement. Subjective evaluations were finished using the Athlete's Subjective Performance Scale (ASPS). Levels of the biomarker creatine phosphokinase (CPK) were also assessed.

RESULTS

The spirulina group's mean total ASPS score increased significantly from baseline to follow-up and was significantly better than that of the placebo group (p < 0.001). Conversely, ASPS ratings in the placebo group slightly decreased. A positive correlation between spirulina supplementation and less severe ASPS was found using correlation matrix analysis. However, there was a slight difference in CPK levels from the baseline to the follow-up in the spirulina group.

CONCLUSIONS

A dietary supplement comprising spirulina and copper may help water polo players' subjective performance measurements by lowering muscular tension. Larger, randomized controlled trials are yet required.

Ten "Cheat Codes" for Measuring Oxidative Stress in Humans

Formidable and often seemingly insurmountable conceptual, technical, and methodological challenges hamper the measurement of oxidative stress in humans. For instance, fraught and flawed methods, such as the thiobarbituric acid reactive substances assay kits for lipid peroxidation, rate-limit progress. To advance translational redox research, we present ten comprehensive "cheat codes" for measuring oxidative stress in humans. The cheat codes include analytical approaches to assess reactive oxygen species, antioxidants, oxidative damage, and redox regulation. They provide essential conceptual, technical, and methodological information inclusive of curated "do" and "don't" guidelines. Given the biochemical complexity of oxidative stress, we present a research question-grounded decision tree guide for selecting the most appropriate cheat code(s) to implement in a prospective human experiment. Worked examples demonstrate the benefits of the decision tree-based cheat code selection tool. The ten cheat codes define an invaluable resource for measuring oxidative stress in humans.

Meta-analysis of the effect of curcumin supplementation on skeletal muscle damage status

OBJECTIVES

Meta-analysis was conducted to examine the effect of supplemental curcumin intake on skeletal muscle injury status and to propose an optimal intervention program.

METHODS

In accordance with the procedures specified in the PRISMA statement for systematic reviews and meta-analyses of randomized controlled trials, the Review Manager 5.3 was used to analyze the results of creatine kinase (CK), muscle soreness, interleukin-6 (IL-6), and range of motion (ROM) as outcome indicators in the 349 subjects included in the 14 articles.

RESULTS

The effect size of curcumin supplementation on muscle soreness, mean difference (MD) = -0.61; the relationship between curcumin supplementation and muscle soreness for time of measurement (I2 = 83.6%)、the relationship between curcumin supplementation and muscle soreness for period of intervention (I2 = 26.2%)、the relationship between whether one had been trained (I2 = 0%) and supplementation dose (I2 = 0%) were not heterogeneous for the relationship between curcumin supplementation and muscle soreness; The effect size on CK, MD = -137.32; the relationship between curcumin supplementation and CK (I2 = 79.7%)、intervention period (I2 = 91.9%)、whether or not trained (I2 = 90.7%)、and no heterogeneity in the relationship between curcumin supplementation and CK for the time of measurement (I2 = 0%); The effect size MD = 4.10 for the effect on ROM; The effect size for IL-6 was MD = -0.33.

CONCLUSIONS

This meta-analysis highlights that curcumin supplementation significantly mitigates skeletal muscle damage, with notable improvements in CK levels, muscle soreness, IL-6 levels, and ROM. The results highlight the importance of curcumin dosage and timing, revealing that prolonged supplementation yields the best results, especially for untrained individuals or those less exposed to muscle-damaging exercise. For muscle soreness and ROM enhancement, a pre-emptive, low-dose regimen is beneficial, while immediate post-exercise supplementation is most effective at reducing CK and IL-6 levels.

Amino acids regulating skeletal muscle metabolism: mechanisms of action, physical training dosage recommendations and adverse effects

Maintaining skeletal muscle mass is important for improving muscle strength and function. Hence, maximizing lean body mass (LBM) is the primary goal for both elite athletes and fitness enthusiasts. The use of amino acids as dietary supplements is widespread among athletes and physically active individuals. Extensive literature analysis reveals that branched-chain amino acids (BCAA), creatine, glutamine and β-alanine may be beneficial in regulating skeletal muscle metabolism, enhancing LBM and mitigating exercise-induced muscle damage. This review details the mechanisms of these amino acids, offering insights into their efficacy as supplements. Recommended dosage and potential side effects are then outlined to aid athletes in making informed choices and safeguard their health. Lastly, limitations within the current literature are addressed, highlighting opportunities for future research.

Through the Lens of Movement-Evoked Pain: A Theoretical Framework of the "Pain-Movement Interface" to Guide Research and Clinical Care for Musculoskeletal Pain Conditions

Over 120 million Americans report experiencing pain in the past 3 months. Among these individuals, 50 million report chronic pain and 17 million report pain that limits daily life or work activities on most days (ie, high-impact chronic pain). Musculoskeletal pain conditions in particular are a major contributor to global disability, health care costs, and poor quality of life. Movement-evoked pain (MEP) is an important and distinct component of the musculoskeletal pain experience and represents an emerging area of study in pain and rehabilitation fields. This focus article proposes the "Pain-Movement Interface" as a theoretical framework of MEP that highlights the interface between MEP, pain interference, and activity engagement. The goal of the framework is to expand knowledge about MEP by guiding scientific inquiry into MEP-specific pathways to disability, high-risk clinical phenotypes, and underlying individual influences that may serve as treatment targets. This framework reinforces the dynamic nature of MEP within the context of activity engagement, participation in life and social roles, and the broader pain experience. Recommendations for MEP evaluation, encompassing the spectrum from high standardization to high patient specificity, and MEP-targeted treatments are provided. Overall, the proposed framework and recommendations reflect the current state of science in this emerging area of study and are intended to support future efforts to optimize musculoskeletal pain management and enhance patient outcomes. PERSPECTIVE: Movement-evoked pain (MEP) is a distinct component of the musculoskeletal pain experience and emerging research area. This article introduces the "Pain-Movement Interface" as a theoretical framework of MEP, highlighting the interface between MEP, pain interference, and activity engagement. Evaluating and treating MEP could improve rehabilitation approaches and enhance patient outcomes.

Omega-3 Fatty Acid Supplementation on Post-Exercise Inflammation, Muscle Damage, Oxidative Response, and Sports Performance in Physically Healthy Adults-A Systematic Review of Randomized Controlled Trials

Omega-3 is a family of n-3 polyunsaturated fatty acids (PUFAs), which have been used to treat a wide variety of chronic diseases, due mainly to their antioxidant and anti-inflammatory properties, among others. In this context, omega-3 could be post-exercise recovery agent and sports supplement that could improve performance by preserving and promoting skeletal muscle mass and strength. No conclusive evidence, however, exists about the potential effects of omega-3 on post-exercise biomarkers and sports performance in physically healthy adults. Based on the PRISMA in Exercise, Rehabilitation, Sports Medicine, and Sports Science (PERSiST) guidelines, we systematically reviewed studies indexed in Web of Science, Scopus, and Medline to assess the effects of omega-3 on post-exercise inflammation, muscle damage, oxidant response, and sports performance in physically healthy adults. The search was performed on original articles published in the last 10 years up to 5 May 2024, with a controlled trial design in which omega-3 supplementation was compared with a control group. Among 14,971 records identified in the search, 13 studies met the selection criteria. The duration of the interventions ranged from 1 day to 26 weeks of supplementation and the doses used were heterogeneous. Creatine kinase (CK) and lactate dehydrogenase (LDH) were significantly higher (p < 0.05) in the control group in 3 of the 4 studies where these markers were analyzed. C-reactive protein (CRP) was significantly higher (p < 0.05) in the control group of 2 of the 13 studies where this marker was analyzed. The delayed onset muscle soreness (DOMS) gave mixed results. Interleukin 6 (IL-6) showed improvements with supplementation, but tumor necrosis factor-α (TNF-α) displayed no differences. The consumption of n-3 PUFAs improved some indicators of oxidative stress such as reduced glutathione (GSH)/oxidized glutathione (GSSG) ratio. Additional evidence is needed to establish clear recommendations regarding the dose and length of n-3 PUFA supplements. These may benefit the post-exercise inflammatory response, mitigate muscle damage, and decrease oxidative stress caused by exercise. However, studies did not evaluate omega-3 status at baseline or following supplementation and therefore the observations must be treated with caution.

Lacticaseibacillus paracasei PS23 increases ghrelin levels and modulates microbiota composition: a post-hoc analysis of a randomized controlled study

Muscle damage can occur due to excessive, high-intensity, or inappropriate exercise. It is crucial for athletes and sports enthusiasts to have access to ways that expedite their recovery and alleviate discomfort. Our previous clinical trial demonstrated the anti-inflammatory and muscle damage-ameliorating properties of Lacticaseibacillus paracasei PS23 (PS23), prompting us to further explore the role of this probiotic in muscle damage recovery. This post-hoc analysis of a randomized controlled study investigated potential mediators between the intake of PS23 and the prevention of strength loss after muscle damage. We recruited 105 students from a sports university who had participated in the previously published clinical trial. These participants were randomly allocated to three groups, receiving capsuled live PS23 (L-PS23), heat-treated PS23 (HT-PS23), or a placebo over a period of six weeks. Baseline and endpoint measurements were taken for the levels of circulating ghrelin and other blood markers, stress, mood, quality of life, and the fecal microbiota. A significant increase in ghrelin levels was recorded in the L-PS23 group compared to the other groups. Additionally, both L-PS23 and HT-PS23 interventions led to positive shifts in the gut microbiota composition, particularly in elevated Lacticaseibacillus, Blautia, and Lactobacillus populations. The abundance of these bacteria was positively correlated with exercise performance and inversely correlated with inflammatory markers. In conclusion, dietary supplementation with PS23 may enhance exercise performance and influence muscle damage by increasing ghrelin levels and modulating the gut microbiota composition. Further clarification of the possible mechanisms and clinical implications is required.

Effect of Spirulina Nigrita® Supplementation on Indices of Exercise-Induced Muscle Damage after Eccentric Protocol of Upper Limbs in Apparently Healthy Volunteers

Spirulina is a supplement with antioxidant and anti-inflammatory properties that may enhance performance and recovery after intense exercise. The present study aimed to investigate the effects of Spirulina Nigrita® on physical performance, and recovery markers after intense eccentric exercise in healthy moderately physically active volunteers. In a double-blind crossover design, participants were supplemented either with spirulina (42 mg Kg-1 BW per day) or a placebo for 15 days before conducting an eccentric exercise protocol using the non-dominant arm. A six-week washout period was required between conditions. Performance and mobility markers such as isometric peak torque (PTQ), ligament range of motion (ROM), and perceived muscle discomfort (VAS) were assessed and blood samples (CK, LDH) were obtained at 1, 24, 48, and 72 h post-exercise. No significant differences were noticed between the two conditions on any of the investigated markers, indicating that spirulina supplementation has no positive effect on isometric muscle performance or alleviation of exercise-induced muscle damage (EIMD) symptoms in the specific population.

The Influence of a Polyphenol-Rich Red Berry Fruit Juice on Recovery Process and Leg Strength Capacity after Six Days of Intensive Endurance Exercise in Recreational Endurance Athletes

BACKGROUND

Various nutritional strategies are increasingly used in sports to reduce oxidative stress and promote recovery. Chokeberry is rich in polyphenols and can reduce oxidative stress. Consequently, chokeberry juices and mixed juices with chokeberry content are increasingly used in sports. However, the data are very limited. Therefore, this study investigates the effects of the short-term supplementation of a red fruit juice drink with chokeberry content or a placebo on muscle damage, oxidative status, and leg strength during a six-day intense endurance protocol.

METHODS

Eighteen recreational endurance athletes participated in a cross-over high intensity interval training (HIIT) design, receiving either juice or a placebo. Baseline and post-exercise assessments included blood samples, anthropometric data, and leg strength measurements.

RESULTS

A significant increase was measured in muscle damage following the endurance protocol in all participants (∆ CK juice: 117.12 ± 191.75 U/L, ∆ CK placebo: 164.35 ± 267.00 U/L; p = 0.001, η2 = 0.17). No group effects were detected in exercise-induced muscle damage (p = 0.371, η2 = 0.010) and oxidative status (p = 0.632, η2 = 0.000). The reduction in strength was stronger in the placebo group, but group effects are missing statistical significance (∆ e1RM juice: 1.34 ± 9.26 kg, ∆ e1RM placebo: -3.33 ± 11.49 kg; p = 0.988, η2 = 0.000).

CONCLUSION

Although a reduction in strength can be interpreted for the placebo treatment, no statistically significant influence of chokeberry could be determined. It appears that potential effects may only occur with prolonged application and a higher content of polyphenols, but further research is needed to confirm this.

Nutritional interventions for exercise-induced muscle damage: an umbrella review of systematic reviews and meta-analyses of randomized trials

CONTEXT

Several meta-analyses have been conducted on the effect of nutritional interventions on various factors related to muscle damage. However, the strength of the evidence and its clinical significance are unclear.

OBJECTIVES

This umbrella review aimed to provide an evidence-based overview of nutritional interventions for exercise-induced muscle damage (EIMD).

DATA SOURCES

PubMed, Scopus, and ISI Web of Science were systematically searched up to May 2022.

DATA EXTRACTION

Systematic reviews and meta-analyses of randomized controlled trials investigating nutritional interventions' effects on recovery following EIMD were included. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

RESULTS

Fifty-three randomized controlled trial meta-analyses were included, evaluating 24 nutritional interventions on 10 different outcomes. The results revealed a significant effect of hydroxymethylbutyrate (HMB) supplementation and l-carnitine supplementation for reducing postexercise creatine kinase; HMB supplementation for reducing lactate dehydrogenase; branched-chain amino acids and leaf extract supplementation for reducing the delayed onset of muscle soreness; and l-carnitine, curcumin, ginseng, polyphenols, and anthocyanins for reducing muscle soreness, all with moderate certainty of evidence.

CONCLUSIONS

Supplementation with HMB, l-carnitine, branched-chain amino acids, curcumin, ginseng, leaf extract, polyphenols, and anthocyanins showed favorable effects on some EIMD-related outcomes.

PROTOCOL REGISTRATION

PROSPERO registration no. CRD42022352565.

Differential Effects of Endurance Exercise on Musculoskeletal and Hematopoietic Modulation in Old Mice

One of the most important strategies for successful aging is exercise. However, the effect of exercise can differ among individuals, even with exercise of the same type and intensity. Therefore, this study aims to confirm whether endurance training (ETR) has the same health-promoting effects on the musculoskeletal and hematopoietic systems regardless of age. Ten weeks of ETR improved endurance exercise capacity, with increased skeletal muscle mitochondrial enzymes in both young and old mice. In addition, age-related deterioration of muscle fiber size and bone microstructure was improved. The expression levels of myostatin, muscle RING-finger protein-1, and muscle atrophy F-box in skeletal muscle and peroxisome proliferator-activated receptor-γ in the femur increased with age but decreased after ETR. ETR differentially modulated hematopoietic stem cells (HSCs) depending on age; ETR induced HSC quiescence in young mice but caused HSC senescence in old mice. ETR has differential effects on modulation of the musculoskeletal and hematopoietic systems in old mice. In other words, endurance exercise is a double-edged sword for successful aging, and great effort is required to establish exercise strategies for healthy aging.

Reduction in systemic muscle stress markers after exercise-induced muscle damage following concurrent training and supplementation with specific collagen peptides - a randomized controlled trial

Introduction

Collagen peptide supplementation in conjunction with exercise has been shown to improve structural and functional adaptations of both muscles and the extracellular matrix. This study aimed to explore whether specific collagen peptide (SCP) supplementation combined with a concurrent training intervention can improve muscular stress after exercise-induced muscle damage, verified by reliable blood markers.

Methods

55 sedentary to moderately active males participating in a concurrent training (CT) intervention (3x/week) for 12 weeks were administered either 15 g of SCP or placebo (PLA) daily. Before (T1) and after the intervention (T2), 150 muscle-damaging drop jumps were performed. Blood samples were collected to measure creatine kinase (CK), lactate dehydrogenase (LDH), myoglobin (MYO) and high-sensitivity C-reactive protein (hsCRP) before, after, and at 2 h, 24 h and 48 h post exercise.

Results

A combination of concurrent training and SCP administration showed statistically significant interaction effects, implying a lower increase in the area under the curve (AUC) of MYO (p = 0.004, ηp2 = 0.184), CK (p = 0.01, ηp2 = 0.145) and LDH (p = 0.016, ηp2 = 0.133) in the SCP group. On closer examination, the absolute mean differences (ΔAUCs) showed statistical significance in MYO (p = 0.017, d = 0.771), CK (p = 0.039, d = 0.633) and LDH (p = 0.016, d = 0.764) by SCP supplementation.

Conclusion

In conclusion, 12 weeks of 15 g SCP supplementation combined with CT intervention reduced acute markers of exercise-induced muscle damage and improved post-exercise regenerative capacity, as evidenced by the altered post-exercise time course. The current findings indicate that SCP supplementation had a positive effect on the early phase of muscular recovery by either improving the structural integrity of the muscle and extracellular matrix during the training period or by accelerating membrane and cytoskeletal protein repair.

Clinical trial registration

https://www.clinicaltrials.gov/study/NCT05220371?cond=NCT05220371&rank=1, NCT05220371.

Comparative Effectiveness of Active Recovery and Static Stretching During Post-Exercise Recovery in Elite Youth Basketball

Purpose: To compare the effectiveness of active recovery (AR) versus static stretching (SS) during post-exercise recovery in basketball. Methods: Using a counterbalanced crossover design, 17 elite youth male players completed two 90-min training sessions, followed by either AR or SS. Differences in jump height (CMJ), heart rate variability (Ln-rMSSD), muscle soreness (VAS), perceived recovery (TQR) and hormonal biomarkers (cortisol, testosterone, testosterone:cortisol ratio) between interventions were assessed at pre-session, post-session (except hormonal biomarkers), post-recovery and 24 h post-session. Differences in Ln-rMSSD were additionally assessed upon awakening on training day, and the following morning. Results: No significant differences were found between interventions at corresponding time points (p > .05). However, the within-intervention time course of recovery differed, as CMJ values were lower at post-recovery, compared with all other time points, in SS only (p < .05, effect size [ES] moderate-to-very large). Additionally, Ln-rMSSD values failed to return to baseline at post-recovery in AR only (p < .05, ES large-to-very large). Similarly, TQR scores were impaired at post-session and post-recovery in AR only (p < .05, ES moderate-to-large). No differences were reported for the remaining variables (p > .05). Conclusion: Differences between AR and SS were probably due to short-term phenomena, indicating that neither strategy was likely superior for improving recovery in the longer term. Overall, neither strategy seemed to significantly improve post-exercise recovery.

Long-Chain Omega-3 Fatty Acid Supplementation and Exercise-Induced Muscle Damage: EPA or DHA?

PURPOSE

Long-chain omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) may enhance recovery from exercise-induced muscle damage (EIMD). However, it is unclear if the effects are due to EPA, DHA, or both. The purpose of this investigation was to examine the effect of EPA + DHA, EPA, and DHA compared with placebo (PL) on muscular recovery.

METHODS

Thirty males were randomized to 4 g·d -1 EPA + DHA ( n = 8), EPA ( n = 8), DHA ( n = 7), or PL ( n = 7). After 7-wk supplementation, a downhill running (20 min, 70% V̇O 2max , -16% gradient) plus jumping lunges (5 × 20 reps, 2-min rest intervals) muscle damage protocol was performed. Indices of muscle damage, soreness, muscle function, and inflammation were measured at baseline and throughout recovery. The omega-3 index (O3i; %EPA + %DHA in erythrocytes) was used to track tissue EPA and DHA status.

RESULTS

After supplementation, the O3i was significantly higher than PL in all experimental groups ( P < 0.001). Leg press performance was lower in the PL group at 24 h compared with EPA ( P = 0 .019) and at 72 h for EPA ( P = 0.004) and DHA ( P = 0 .046). Compared with PL, muscle soreness was lower in the DHA ( P = 0.015) and EPA ( P = 0.027) groups at 48 h. Albeit nonsignificant, EPA + DHA tended to attenuate muscle soreness ( d = 1.37) and leg strength decrements ( d = 0.75) compared with PL. Jump performance and power metrics improved more rapidly in the EPA and DHA groups (time effects: P < 0.001). Measures of inflammation, range of motion, and muscle swelling were similar between groups ( P > 0.05).

CONCLUSIONS

Compared with PL, 4 g·d -1 of EPA or DHA for 52 d improves certain aspects of recovery from EIMD. EPA + DHA did not clearly enhance recovery. Equivalent dosing of EPA + DHA may blunt the performance effects observed in EPA or DHA alone.

Recovery markers in elite climbers after the national boulder climbing championship

This study aimed to investigate recovery markers among elite climbers following the National Boulder Championship. We assessed maximum isometric hand grip strength (HS), forearm swelling (circumference), delayed soreness in forearm muscles, tiredness, and exercise readiness at several time points: pre-competition, immediately post-competition (within 4 min after their last effort), and 12, 24, 48, and 60 h post-competition. Maximum isometric hand grip strength decreased by 6.38 ± 1.32% (p = 0.006) post-12 h, returning to pre-competition values post-24 h (all p > 0.05). Forearm circumference (FC) increased 1.78 ± 1.77% (p < 0.001) post-competition, returning to pre-competition values post-12 h (all p > 0.05). Forearm pain (FP) increased post-competition (p = 0.002) and post-12 h (p < 0.001), returning to pre-competition values post-24 h (all p > 0.05). Tiredness increased post-competition (p < 0.001), post-12 h (p < 0.001), and post-24 h (p < 0.001), returning to pre-competition values post-48 h (all p > 0.05). Climbing readiness was reduced post-competition (p < 0.001), post-12 h (p < 0.001), post-24 h (p < 0.001), and post-48 h (p = 0.005), only returning to pre-competition values post-60 h (p = 0.189). Visual analysis of individual data pointed out a relatively small variability in the HS and FC markers, while FP, tiredness, and readiness exhibited larger individual variations. These findings indicate that different recovery patterns exist for the analyzed markers, suggesting that athletes may require up to 60 h after a competition to fully recover and regain their ability to face new competitive challenges.

Dynamic palmitoylation of STX11 controls injury-induced fatty acid uptake to promote muscle regeneration

Different types of cells uptake fatty acids in response to different stimuli or physiological conditions; however, little is known about context-specific regulation of fatty acid uptake. Here, we show that muscle injury induces fatty acid uptake in muscle stem cells (MuSCs) to promote their proliferation and muscle regeneration. In humans and mice, fatty acids are mobilized after muscle injury. Through CD36, fatty acids function as both fuels and growth signals to promote MuSC proliferation. Mechanistically, injury triggers the translocation of CD36 in MuSCs, which relies on dynamic palmitoylation of STX11. Palmitoylation facilitates the formation of STX11/SNAP23/VAMP4 SANRE complex, which stimulates the fusion of CD36- and STX11-containing vesicles. Restricting fatty acid supply, blocking fatty acid uptake, or inhibiting STX11 palmitoylation attenuates muscle regeneration in mice. Our studies have identified a critical role of fatty acids in muscle regeneration and shed light on context-specific regulation of fatty acid sensing and uptake.

Age-Associated Differences in Recovery from Exercise-Induced Muscle Damage

Understanding the intricate mechanisms governing the cellular response to resistance exercise is paramount for promoting healthy aging. This narrative review explored the age-related alterations in recovery from resistance exercise, focusing on the nuanced aspects of exercise-induced muscle damage in older adults. Due to the limited number of studies in older adults that attempt to delineate age differences in muscle discovery, we delve into the multifaceted cellular influences of chronic low-grade inflammation, modifications in the extracellular matrix, and the role of lipid mediators in shaping the recovery landscape in aging skeletal muscle. From our literature search, it is evident that aged muscle displays delayed, prolonged, and inefficient recovery. These changes can be attributed to anabolic resistance, the stiffening of the extracellular matrix, mitochondrial dysfunction, and unresolved inflammation as well as alterations in satellite cell function. Collectively, these age-related impairments may impact subsequent adaptations to resistance exercise. Insights gleaned from this exploration may inform targeted interventions aimed at enhancing the efficacy of resistance training programs tailored to the specific needs of older adults, ultimately fostering healthy aging and preserving functional independence.

Acute Antioxidant Response to Two Types of Exercises: 2000 M Run vs. Burpee Test

Physical activity results in oxidative stress, as evidenced by the increased production of reactive oxygen, nitrogen species, and inflammatory mediators. The management of these components is instrumental for antioxidant adaptation to exercise and post-exercise recovery. Therefore, the present report aims to study the antioxidant response to two types of exercise (a 2000 m run and a burpee test) in healthy volunteers after a long period of inactivity (1-2 months). Antioxidant enzyme activities and oxidative stress markers (protein carbonyls and malondialdehyde content) were measured in neutrophils, peripheral blood mononuclear cells, and plasma. These parameters were determined under basal conditions and immediately post-exercise. Compared to those in basal state, neutrophil superoxide dismutase (28.3 vs. 22.9 pkat/109 cells), glutathione peroxidase (147.5 vs. 120.1 nkat/109 cells), and catalase (106.3 vs. 57.9 k/109 cells) were activated significantly (p < 0.05) after the burpee test. Peripheral blood mononuclear cells exhibited only significant (p < 0.05) catalase activation (113.6 vs. 89.4 k/109 cells) after the burpee test. Other enzymes, such as glutathione reductase and myeloperoxidase, tended to increase post-exercise, although the differences from baseline were not significant. Finally, compared to basal conditions, the protein carbonyl (24.5 vs. 14.5 mmol/L) and malondialdehyde (39.6 vs. 18.3 mmol/L) contents increased significantly (p < 0.05) in neutrophils and in plasma (115.1 vs. 97.8 and 130.2 vs. 123.4 μmol/L, respectively) after the burpee test. In conclusion, high-intensity exercise seems to induce immediate oxidative stress in inactive individuals, and the acute antioxidant response was slightly greater after the burpee test than after the 2000 m run. Glutathione-dependent antioxidant systems are activated immediately as protective mechanisms.

Effects of Vaccinium berries (blueberries, cranberries and bilberries) on oxidative stress, inflammation, exercise performance, and recovery - a systematic review

Exercise-induced muscle damage is common in athletes and recreational exercisers and can lead to muscle soreness, weakness, and impaired muscle function. The precise mechanisms are unclear but oxidative stress and inflammation are thought to play a role. (Poly)phenols are substances abundant in Vaccinium berries that have been suggested to possess antioxidant and anti-inflammatory effects that could help improve exercise performance and/or recovery from exercise. The objective of this systematic review was to evaluate the benefits of Vaccinium berry supplementation on exercise performance and recovery, as well as on exercise-induced oxidative and inflammatory biomarkers in healthy individuals. A comprehensive search was conducted in PubMed, ProQuest Medline, Web of Science, Cochrane Library, and Scopus. Studies were included if the participants were healthy individuals who were supplemented with any Vaccinium berry or Vaccinium berry-based products in comparison to a control group. Of the 13 articles included in this review, no significant differences in the exercise performance were found and only one study reported benefits for markers of recovery. Interleukins and c-reactive protein were the most frequently reported biomarkers, but there was limited evidence that Vaccinium berry supplementation impacted them post-exercise. Most studies were of high quality and showed a low risk of bias. Vaccinium berry supplementation is not effective in modulating markers of exercise-induced inflammation and oxidative distress in healthy individuals; nevertheless, more studies are required to evaluate their effects on exercise performance and recovery in this population.

Hot water immersion: Maintaining core body temperature above 38.5°C mitigates muscle fatigue

PURPOSE

Hot water immersion (HWI) has gained popularity to promote muscle recovery, despite limited data on the optimal heat dose. The purpose of this study was to compare the responses of two exogenous heat strains on core body temperature, hemodynamic adjustments, and key functional markers of muscle recovery following exercise-induced muscle damage (EIMD).

METHODS

Twenty-eight physically active males completed an individually tailored EIMD protocol immediately followed by one of the following recovery interventions: HWI (40°C, HWI40 ), HWI (41°C, HWI41 ) or warm water immersion (36°C, CON36 ). Gastrointestinal temperature (Tgi ), hemodynamic adjustments (cardiac output [CO], mean arterial pressure [MAP], and systemic vascular resistance [SVR]), pre-frontal cortex deoxyhemoglobin (HHb), ECG-derived respiratory frequency, and subjective perceptual measures were tracked throughout immersion. In addition, functional markers of muscle fatigue (maximal concentric peak torque [Tpeak ]) and muscle damage (late-phase rate of force development [RFD100-200 ]) were measured prior to EIMD (pre-), 24 h (post-24 h), and 48 h (post-48 h) post-EIMD.

RESULTS

By the end of immersion, HWI41 led to significantly higher Tgi values than HWI40 (38.8 ± 0.1 vs. 38.0°C ± 0.6°C, p < 0.001). While MAP was well maintained throughout immersion, only HWI41 led to increased (HHb) (+4.2 ± 1.47 μM; p = 0.005) and respiratory frequency (+4.0 ± 1.21 breath.min-1 ; p = 0.032). Only HWI41 mitigated the decline in RFD100-200 at post-24 h (-7.1 ± 31.8%; p = 0.63) and Tpeak at post-48 h (-3.1 ± 4.3%, p = 1).

CONCLUSION

In physically active males, maintaining a core body temperature of ~25 min within the range of 38.5°C-39°C has been found to be effective in improving muscle recovery, while minimizing the risk of excessive physiological heat strain.

Re‑examining the mechanism of eccentric exercise‑induced skeletal muscle damage from the role of the third filament, titin (Review)

Intense and unaccustomed eccentric exercise has been extensively studied for its ability to induce muscle damage. However, the underlying mechanism of this phenomenon still requires further clarification. This knowledge gap arises from the need for explanation of the eccentric contraction through the sliding filament theory. The two-filament sarcomere model, which is consisted of thin and thick filaments, forms the basis of the sliding filament theory. The mechanisms of concentric and isometric contractions at the cellular and molecular levels are effectively described by this model. However, when relying solely on the cross-bridge swing, the sliding filament theory fails to account for specific observations, such as the stability of the descending limb of the force-length relationship curve. Recent evidence indicated that titin and the extracellular matrix (ECM) may play a protective role by interacting with the thick and thin filaments. During an eccentric contraction, titin serves as a third filament in the sarcomere, which helps regulate changes in passive force. The two-filament sarcomere model has limitations in explaining eccentric contraction, thus this compensates for those shortcomings. The present review explored the potential of replacing the two-filament sarcomere model with a three-filament sarcomere model, incorporating thin filaments, thick filaments and titin. This revised model offers a more comprehensive explanation of eccentric contraction phenomena. Furthermore, the sliding filament theory was investigated in the context of the three-filament sarcomere model. The double-layer protection mechanism, which involves increased titin stiffness and the ECM during eccentric contraction was explored. This mechanism may enhance lateral force transmission between muscle fibers and the ECM, resulting in sarcolemma and ECM shear deformation. These findings provided insight into the mechanism of eccentric exercise-induced skeletal muscle damage. Considering the three-filament sarcomere model and the double-layer protection mechanism, the present review offered a more logical and comprehensive understanding of the mechanism behind eccentric exercise-induced muscle damage.

Association between Gray-Scale Ultrasound Imaging and Serological Creatine Kinase for Quantifying Exercise-Induced Muscle Damage: An Observational Study

Limited evidence has verified if ultrasound imaging (US) can detect post-exercise muscle damage based on size, shape, and brightness metrics. This study aimed to analyze the correlation between creatine kinase (CK) concentration and (as a biomarker of muscle damage) changes in US gray-scale metrics after an exercise-induced muscle damage protocol. An observational study was conducted at a private university lab located in Madrid. Twenty-five untrained and asymptomatic volunteers were enrolled in this study. Baseline demographic data and body composition metrics were collected. In addition, the rectus femoris US data and CK concentration were assessed at baseline and after inducing muscle damage (24 and 48 h later). After calculating time differences for all the outcomes, the correlation between the changes observed with US and biomarkers was assessed. Significant CK concentration increases were found 24 h (p = 0.003) and 48 h (p < 0.001) after exercise. However, no significant changes in muscle size, shape, or brightness were found in any location (p > 0.05 for all). In addition, no significant associations were found between CK changes and US changes (p > 0.05 for all). Gray-scale US is not a sensitive tool for detecting muscle damage, as a protocol of exercise-induced muscle damage confirmed with CK produced no significant gray-scale US changes after 24 or 48 h. In addition, US and CK changes after 24 and 48 h were not associated with each other.

Prolonged sleep deprivation induces a cytokine-storm-like syndrome in mammals

Most animals require sleep, and sleep loss induces serious pathophysiological consequences, including death. Previous experimental approaches for investigating sleep impacts in mice have been unable to persistently deprive animals of both rapid eye movement sleep (REMS) and non-rapid eye movement sleep (NREMS). Here, we report a "curling prevention by water" paradigm wherein mice remain awake 96% of the time. After 4 days of exposure, mice exhibit severe inflammation, and approximately 80% die. Sleep deprivation increases levels of prostaglandin D2 (PGD2) in the brain, and we found that elevated PGD2 efflux across the blood-brain-barrier-mediated by ATP-binding cassette subfamily C4 transporter-induces both accumulation of circulating neutrophils and a cytokine-storm-like syndrome. Experimental disruption of the PGD2/DP1 axis dramatically reduced sleep-deprivation-induced inflammation. Thus, our study reveals that sleep-related changes in PGD2 in the central nervous system drive profound pathological consequences in the peripheral immune system.

Betalains Alleviate Exercise-Induced Oxidative Stress, Inflammation, and Fatigue and Improve Sports Performance: an Update on Recent Advancement

PURPOSE OF REVIEW

Beetroot juice is a popular natural food supplement commonly consumed for its health and ergogenic benefits. It contains an abundance of phytochemical compounds, which have been shown to enhance sports endurance and recovery. Among them, nitrate is well-studied and known for improving performance during exercise. On the other hand, betalains, the bioactive pigment, have shown various biological activities including antioxidant, anti-inflammatory, and anti-hypertensive, which may improve exercise performance and post-exercise recovery. Additionally, free radical scavenging activities of betalains could increase nitric oxide availability in the blood, thereby improving blood flow and oxygen supply during strenuous exercise. This review article provides a critical discussion of the non-pathological conditions induced by prolonged or strenuous exercise and betalains' potential in reducing such conditions including muscle damage, inflammation, and fatigue. Additionally, the real-time application of betalains as an ergogenic compound in competitive athletes has been discussed. Finally, future directions and conclusions on the potential of betalains as a natural ergogenic aid in sport endurance are outlined.

RECENT FINDINGS

Betalains in beetroot are the major water-soluble nitrogen-containing pigment possessing high antioxidant, anti-inflammatory, and anti-fatigue activities. Betalain supplementation could alleviate exercise-induced oxidative stress, inflammation, and fatigue in competitive athletes. Betalains have the potential to become a natural ergogenic aid or nutraceutical compound for sports people during exercise and competitive performance.

Assessment of selected muscle damage markers and zonulin concentration after maximum-intensity exercise in men with type 1 diabetes treated with a personal insulin pump

AIM

Exercise-induced muscle damage depends on exercise intensity and duration and on individual susceptibility. Mechanical and metabolic stress may disturb the intestinal microflora. The study evaluated selected muscle damage markers and zonulin concentration after maximum-intensity exercise in type 1 diabetes (T1D) men compared with healthy controls.

METHODS

The study involved 16 T1D participants and 28 controls matched by age (22.7 [21.3-25.1] vs. 22.6 [20.9-26.3] years), body mass index (24.2 ± 1.6 vs. 24.2 ± 1.9 kg/m2), and body fat percentage (16.1 ± 5.2 vs. 14.9 ± 4.6%). The T1D group had 11.3 ± 5.1 years of diabetes duration and a suboptimal mean glycated haemoglobin level of 7.2 ± 1.1%. The subjects underwent a graded running treadmill test until exhaustion. Lactate concentration was assessed in arterialized blood at baseline and 3 and 20 min after the test. Cortisol, testosterone, tumour necrosis factor α, myoglobin, lactate dehydrogenase, zonulin, and vitamin D levels were evaluated in cubital fossa vein blood before and 60 min after the test.

RESULTS

T1D patients presented higher baseline zonulin, myoglobin concentration, testosterone/cortisol ratio, and lower maximal oxygen uptake. On adjusting for the baseline values, the groups differed in zonulin, lactate dehydrogenase, and myoglobin levels, testosterone/cortisol ratio, and lactate concentration determined 20 min after exercise (P < 0.05).

CONCLUSION

Maximum-intensity exercise increased muscle and intestinal damage in T1D participants. In patients with lower physical activity, very-high-intensity exercise should be recommended with caution. Observing the anabolic-catabolic index may help individualize effort intensity in T1D individuals.