This systematic review and meta-analysis examined the effects of creatine supplementation on recovery from exercise-induced muscle damage, and is reported according to the PRISMA guidelines. MEDLINE and SPORTDiscus were searched for articles from inception until April 2020. Inclusion criteria were adult participants (≥18 years); creatine provided before and/or after exercise versus a noncreatine comparator; measurement of muscle function recovery, muscle soreness, inflammation, myocellular protein efflux, oxidative stress; range of motion; randomized controlled trials in humans. Thirteen studies (totaling 278 participants; 235 males and 43 females; age range 20–60 years) were deemed eligible for analysis. Data extraction was performed independently by both authors. The Cochrane Collaboration Risk of Bias Tool was used to critically appraise the studies; forest plots were generated with random-effects model and standardized mean differences. Creatine supplementation did not alter muscle strength, muscle soreness, range of motion, or inflammation at each of the five follow-up times after exercise (<30 min, 24, 48, 72, and 96 hr; p > .05). Creatine attenuated creatine kinase activity at 48-hr postexercise (standardized mean difference: −1.06; 95% confidence interval [−1.97, −0.14]; p = .02) but at no other time points. High (I2; >75%) and significant (Chi2; p < .01) heterogeneity was identified for all outcome measures at various follow-up times. In conclusion, creatine supplementation does not accelerate recovery following exercise-induced muscle damage; however, well-controlled studies with higher sample sizes are warranted to verify these conclusions. Systematic review registration (PROSPERO CRD42020178735).
Miguel Sánchez-Moreno, David Rodríguez-Rosell, David Díaz-Cueli, Fernando Pareja-Blanco, and Juan José González-Badillo
Purpose: This study analyzed the effects of 3 training interventions: 1 isolated endurance training (ET) and 2 concurrent training (CT), which differed in the velocity loss (VL) magnitude allowed during the resistance training (RT) set: 15% (VL15) versus 45%, on strength and endurance running performance. Methods: A total of 33 resistance- and endurance-trained men were randomly allocated into 3 groups: VL15, VL 45%, and ET. ET was similar across all groups. The CT groups differed in the VL allowed during the RT set. Before and after the 8-week training program the following tests were performed: (1) running sprints, (2) vertical jump, (3) progressive loading test in the squat exercise, and (4) incremental treadmill running test up to maximal oxygen uptake. Results: Significant differences (P < .001) in RT volume (approximately 401 vs 177 total repetitions for VL 45% and VL15, respectively) were observed. Significant “group” × “time” interactions were observed for vertical jump and all strength-related variables: the CT groups attained significantly greater gains than ET. Moreover, a significant “group” × “time” interaction (P = .03) was noted for velocity at maximal oxygen uptake. Although all groups showed increases in velocity at maximal oxygen uptake, the VL15 group achieved greater gains than the ET group. Conclusions: CT interventions experienced greater strength gains than the ET group. Although all groups improved their endurance performance, the VL15 intervention resulted in greater gains than the ET approach. Therefore, moderate VL thresholds in RT performed during CT could be a good strategy for concurrently maximizing strength and endurance development.
Jennifer A. Bunn, Bradley J. Myers, and Mary K. Reagor
Purpose: To statistically evaluate the internal and external load metrics in different types of lacrosse drills. Methods: A total of 25 Division I collegiate female lacrosse players wore a heart rate monitor and a global positioning system during preseason training sessions. Seven measures determined training load, 2 internal measures and 5 external measures, across 5 different types of drills: stickwork, small-sided games, individual skills, conditioning, and team drills. Principal component analysis was used to determine which internal and external load variables were most associated with each drill type. Results: Stickwork extracted 2 principal components, explaining 45% and 17% of the variance. Small-sided games extracted 1 principal component, explaining 51% of the variance. Individual skills extracted 2 components, explaining 39% and 22% of the variance. Conditioning extracted 2 components, explaining 44% and 24% of the variance. Team drills extracted 2 components, explaining 52% and 18% of the variance. Conclusions: In 4 out of 5 training modes, the inclusion of both internal and external training-load measures was necessary to accurately decipher training load. For most drills, the first component is related to measures of external load, and the second component described the balance between internal and external load measures. Small-sided games extracted only external measures including the following: accelerations, total distance, and average speed. These results show that a combination of internal and external load measures is required to determine training load during certain training modes. This information can help coaches make decisions about desired training load for practice sessions.
Luis A. Marco-Contreras, Beatriz Bachero-Mena, David Rodríguez-Rosell, and Juan J. González-Badillo
Purpose: To analyze the relationships between the evolution of training-load values and countermovement jump (CMJ) as an indicator of stress and fatigue in a high-level 800-m runner during a whole season, including indoor (ID) and outdoor season (OD). Methods: Over 42 weeks, daily training load was quantified as the result of the product of the intensity and volume, and it was termed load index (LI). CMJ was measured in every running session after warm-up and immediately after the last effort of the session. Other jump-related variables such as CMJ height loss, average weekly CMJ, initial CMJ of the next consecutive session, and initial CMJ of the following week were studied. Results: A significant negative relationship was observed between LI and weekly CMJ (ID: r = −.68, P < .001, common variance [CV] = 46%; OD: r = −.73, P < .001, CV = 53%), initial CMJ of the following week (OD: r = −.71, P < .01, CV = 50%), and CMJ height loss (ID: r = −.58, P < .01, CV = 34%; OD: r = −.52, P < .01, CV = 27%). A significant positive relationship was observed between LI and initial CMJ of the next consecutive session when LI values were <8 (OD: r = .72; P < .01, CV = 52%). However, from values ≥8, the relationship turned into a significant negative one (ID: r = −.74; P < .01, CV = 55%; OD: r = −64, P < .01, CV = 41%). Conclusions: CMJ may be a valid indicator of the degree of stress or fatigue generated by specific training sessions of a competitive athlete within a single session, a week, or even the following week. There could be an individual limit LI value from which the training volume does not allow a positive effect on high-speed actions such as a CMJ in the next consecutive session.
Ibai Guridi Lopategui, Julen Castellano Paulis, and Ibon Echeazarra Escudero
Purpose: The objectives of the present study were (1) to analyze the internal and external load profile of training and competition carried out by semiprofessional football players during a 27-week period and (2) to examine the possible link between this type of periodization and players’ fitness status and their readiness to compete. Methods: Training and match data were obtained from 26 semiprofessional football players belonging to the reserve squad of a Spanish La Liga club during the 2018/19 season. For the purpose of this study, the distribution of external and internal load during a typical training microcycle, with 6 or 7 days between matches, was analyzed. Five types of sessions were considered: strength, duration, velocity, preofficial match, and official match. Results: The results showed a different internal and external load profile for each type of session, with the load being consistently higher during matches when compared with training sessions (28.9%–94% higher), showing significant differences in all the variables. There was a clear tapering strategy in the last days of the week to arrive with enough freshness to compete, shown by the decrease of the values in the 2 days before the match (15%–83% reduction, depending on the variable). Furthermore, the horizontal alternation of the load allowed the players to maintain their fitness level during the 27-week period. Conclusions: Our findings suggest that this weekly periodization approach could help achieve a double conditional target, allowing a short tapering strategy to face the match with enough freshness and serving as a strategy for maintaining or optimizing players’ physical performance during the season.
Kadhiresan R. Murugappan, Ariel Mueller, Daniel P. Walsh, Shahzad Shaefi, Akiva Leibowitz, and Todd Sarge
Rapid weight loss or “weight cutting” is a common but potentially harmful practice used in mixed martial arts competition. Following the official weigh-in, competitors refeed and rehydrate themselves in a process known as rapid weight gain (RWG) to realize a potential competitive advantage. While data from surveys and small series have indicated the majority of mixed martial arts athletes engage in rapid weight loss, there is a lack of officially collected data from sanctioning organizations describing its prevalence. The present investigation represents a summary of the data collected between December 2015 and January 2018 by the California State Athletic Commission. In total, 512 professional mixed martial artists (455 males and 57 females) were included. Of these, 503 (98%) athletes gained body mass between weigh-in and their bouts. Total RWG between weigh-in and competition was 5.5 ± 2.5 kg, corresponding to an 8.1% ± 3.6% body mass increase. Total RWG was 5.6 ± 2.5 kg (8.1% ± 3.6%) for males and 4.5 ± 2.3 kg (8.0% ± 3.8%) for females. More than one quarter of men and one third of women gained >10% body mass between weigh-in and competition. Athletes from leading international promotions gained more absolute, but not relative, body mass than those from regional promotions. Our findings indicate RWG is nearly ubiquitous in professional , with a similar prevalence in male and female athletes. Trends based on promotion suggest a larger magnitude of RWG in presumably more experienced and/or successful mixed martial artists from leading international promotions.
Konstantinos Papanikolaou, Panagiotis Tsimeas, Angeliki Anagnostou, Alexandros Varypatis, Christos Mourikis, Theofanis Tzatzakis, Dimitrios Draganidis, Dimitrios Batsilas, Theodoros Mersinias, Georgios Loules, Athanasios Poulios, Chariklia K. Deli, Alexios Batrakoulis, Athanasios Chatzinikolaou, Magni Mohr, Athanasios Z. Jamurtas, and Ioannis G. Fatouros
Purpose: To examine the recovery kinetics of exercise-induced muscle damage (EIMD), neuromuscular fatigue, and performance following small-sided games (SSGs) of different densities in soccer. Methods: Ten male players randomly completed 3 trials: a control trial (no SSGs), 4v4 SSGs (62.5 m2/player), and 8v8 SSGs (284.4 m2/player). External and internal load were monitored using GPS technology, heart-rate monitors, and rating of perceived exertion. Delayed-onset muscle soreness (DOMS), creatine kinase (CK), isokinetic strength, countermovement jump (CMJ), and sprint were determined at baseline, as well as at 24, 48, and 72 hours post-SSGs. Neuromuscular fatigue was assessed at baseline and at 1, 2, and 3 hours post-SSGs. Results: DOMS increased (P < .05) in 4v4 for 72 hours and in 8v8 for 24 hours with that of knee flexors being more pronounced than that of extensors. CK increased (P < .05) in 4v4 for 72 hours and in 8v8 for 24 hours. Neuromuscular fatigue increased (P < .05) in 4v4 for 2 hours and in 8v8 for 3 hours. Strength declined (P < .05) in 4v4 for 48 hours and in 8v8 for 72 hours. CMJ decreased (P < .05) in 4v4 for 24 hours and in 8v8 for 48 hours. Sprint decreased (P < .05) for 48 hours in 4v4 and for 72 hours in 8v8. Conclusions: SSGs are associated with a prolonged rise of EIMD and induce short-term neuromuscular fatigue and slow recovery kinetics of strength, jump, and sprinting performance. The time for complete recovery is longer for SSGs of lower density.
Gabriel Barreto, Luana Farias de Oliveira, Tiemi Saito, Rafael Klosterhoff, Pedro Perim, Eimear Dolan, Rosa Maria R. Pereira, Patrícia Campos-Ferraz, Fernanda R. Lima, and Bryan Saunders
Purpose: Women’s professional cycling has grown in popularity, and this increase is also apparent in Brazil, which has increased its female cycling calendar in recent years. The aim of this observational study was to (1) determine training and competition loads of a top-level Brazilian female cycling team, (2) evaluate nutrition and clinical health, and (3) measure whether exercise capacity changed throughout the season. Methods: Training and competition data were collected over the season using global positioning system monitors, while laboratory-based physiological and performance measures (incremental cycling test, 30-s Wingate, 4-km time trial) and clinical and nutritional analyses were performed at time points throughout the season. Results: Total distance covered over the year was 11,124 (2895) km (7382–14,698 km). Endurance capacity was reduced over the season (P = .005) but not anaerobic power (all P > .05). Nutrition and stress markers remained largely unchanged throughout the season, although there were some individual fluctuations in some measures, and testosterone concentration was low for some. Median estimated energy availability ranged between 32.3 and 56.8 kcal·kgLBM−1·d−1 during training and 26.4 and 53.8 kcal·kgLBM−1·d−1 during competition. Percentage of training spent in optimal estimated energy availability was generally low, with 3 athletes spending <35% within the optimal intake. Conclusions: Substantial training and competition loads of the monitored professional Brazilian female cyclists may have reduced exercise capacity toward the end of the season, indicative of a grueling yearlong schedule. Several athletes may have had suboptimal energy availability during the season, potentially affecting testosterone concentration. These data demonstrate the difficulties in maintaining optimal nutrition, health, and performance throughout a season in professional female cycling and highlight the need for quality sport-science support for this type of top-level athlete.
Haresh T. Suppiah, Richard Swinbourne, Jericho Wee, Vanes Tay, and Paul Gastin
Purpose: Elite athletes experience chronic sleep insufficiency due to training and competition schedules. However, there is little research on sleep and caffeine use of elite youth athletes and a need for a more nuanced understanding of their sleep difficulties. This study aimed to (1) examine the differences in sleep characteristics of elite youth athletes by individual and team sports, (2) study the associations between behavioral risk factors associated with obstructive sleep apnea and caffeine use with sleep quality, and (3) characterize the latent sleep profiles of elite youth athletes to optimize the sleep support strategy. Methods: A group (N = 135) of elite national youth athletes completed a self-administered questionnaire consisting of the Pittsburgh Sleep Quality Index (PSQI) and questions pertaining to obstructive sleep apnea, napping behavior, and caffeine use. K-means clustering was used to characterize unique sleep characteristic subgroups based on PSQI components. Results: Athletes reported 7.0 (SD = 1.2) hours of sleep. Out of the total group, 45.2% of the athletes had poor quality sleep (PSQI global >5), with team-sport athletes reporting significantly poorer sleep quality than individual-sport athletes. Multiple logistic regression analysis indicated that sport type significantly correlated with poor sleep quality. The K-means clustering algorithm classified athletes’ underlying sleep characteristics into 4 clusters to efficiently identify athletes with similar underlying sleep issues to enhance interventional strategies.Conclusion: These findings suggest that elite youth team-sport athletes are more susceptible to poorer sleep quality than individual-sport athletes. Clustering methods can help practitioners characterize sleep-related problems and develop efficient athlete support strategies.
Henning T. Langer, Agata A. Mossakowski, Suraj Pathak, Mark Mascal, and Keith Baar
Cannabidiol (CBD) has proven clinical benefits in the treatment of seizures, inflammation, and pain. The recent legalization of CBD in many countries has caused increased interest in the drug as an over-the-counter treatment for athletes looking to improve recovery. However, no data on the effects of CBD on the adaptive response to exercise in muscle are available. To address this gap, we eccentrically loaded the tibialis anterior muscle of 14 rats, injected them with a vehicle (n = 7) or 100 mg/kg CBD (n = 7), and measured markers of injury, inflammation, anabolic signaling, and autophagy 18 hr later. Pro-inflammatory signaling through nuclear factor kappa B (NF-kB) (Ser536) increased with loading in both groups; however, the effect was significantly greater (36%) in the vehicle group (p < .05). Simultaneously, anabolic signaling through ribosomal protein S6 kinase beta-1 (S6K1) (Thr389) increased after eccentric contractions in both groups with no difference between vehicle and CBD (p = .66). The ribosomal protein S6 phosphorylation (240/244) increased with stimulation (p < .001) and tended to be higher in the CBD group (p = .09). The ubiquitin-binding protein p62 levels were not modulated by stimulation (p = .6), but they were 46% greater in the CBD compared with the vehicle group (p = .01). Although liver weight did not differ between the groups (p = .99) and levels of proteins associated with stress were similar, we did observe serious side effects in one animal. In conclusion, an acute dose of CBD decreased pro-inflammatory signaling in the tibialis anterior without blunting the anabolic response to exercise in rats. Future research should determine whether these effects translate to improved recovery without altering adaptation in humans.