45–60 s. Clinical Scenario After an intense bout of physical activity, most individuals, both unaccustomed and accustomed, experience some degree of delayed onset muscle soreness (DOMS). 1 – 3 DOMS occurs due to the inflammatory response that is triggered when the intracellular muscle structure
Ryan Anthony, Michael J. Macartney, and Gregory E. Peoples
Unaccustomed exercise, especially involving muscle-lengthening or “eccentric” contractions, results in a transient reduction in muscle function with accompanying soreness, tenderness, and general muscle stiffness termed Delayed Onset Muscle Soreness (DOMS) ( Clarkson & Hubal, 2002 ). Most often
Carrie Plaskett, Peter M. Tiidus, and Lori Livingston
Ten volunteers (19-23 years old) performed 9 sets of 12 bilateral knee-extension exercises at 60% 1RM. Following exercise, 4 ultrasound treatments (5-cm transducer head, 1.0-MHz frequency, pulsed mode at 1.0 W/cm2) were applied for 8 min daily to the quadriceps muscle of a randomly selected treatment leg. The placebo leg received similar treatment with the ultrasound apparatus turned off. Knee-extension peak torque values and delayed onset muscle soreness (DOMS) were assessed on each leg prior to exercise and at 20 min and 24, 48, 72, and 96 hr postexercise. Postexercise peak torques declined to 60-70% of preexercise values and returned to normal by 96 hr. DOMS sensation peaked 24 hr postexercise and diminished thereafter. No significant differences in peak torque or DOMS were noted between ultrasound- or placebo-treated legs at any time postexercise. Hence ultrasound, as applied in this study, does not appear to be effective in enhancing postexercise muscle strength recovery or in diminishing DOMS.
Matthew R. Nelson, Robert K. Conlee, and Allen C. Parcell
In Delayed Onset Muscle Soreness (DOMS), muscles become sore 24 to 48 hours after eccentric and unaccustomed activity. Fiber stiffness, due to decreased muscle glycogen, may predispose muscle to greater damage during eccentric exercise. This study sought to determine if inadequate carbohydrate intake following a protocol to decrease muscle glycogen would increase DOMS after 15 min of downhill running. Thirty-three male subjects (age, 18–35 years) were randomized into 3 groups for testing over a 7-day period. The depletion (DEP) group (n = 12) underwent a glycogen depletion protocol prior to a 15-min downhill run designed to induce DOMS. The repletion (FED) group (n = 10) underwent a glycogen depletion protocol followed by a carbohydrate repletion protocol (>80% CHO) prior to downhill running. The third (ECC) group (n = 11) performed only the downhill running protocol. Subjective muscle soreness, isometric force production, relaxed knee angle, and thigh circumference were measured pretreatment and on days 1, 2, 3, 4, and 6 post treatment. Subjective muscle soreness for all groups increased from 0 cm pretreatment to 3.05 ± 0.72 cm (on a 10-cm scale) on day 1 post treatment (p < .05). All groups were significantly different from baseline measurements until day 4 post treatment. Each group experienced a decline in isometric force from 281 ± 45 N pre-to 253 ± 13 N on day 1 post treatment (p < .05). The decrease in isometric force persisted in all groups for 4 days post treatment. Increases in thigh circumference and relaxed knee angle elevations in all 3 groups were statistically different (p < .05) from pretreatment until day 4. No differences were noted between groups for any of the parameters examined. In the current study, 15 min of downhill running is sufficient to cause DOMS with the associated functional and morphological changes; however, inadequate carbohydrate intake after a glycogen depleting exercise does not appear to exacerbate DOMS and the associated symptoms.
Ken A. van Someren, Adam J. Edwards, and Glyn Howatson
This study examined the effects of β-hydroxy-β-methylbutyrate (HMB) and α-ketoisocaproic acid (KIC) supplementation on signs and symptoms of exercise-induced muscle damage following a single bout of eccentrically biased resistance exercise. Six non-resistance trained male subjects performed an exercise protocol designed to induce muscle damage on two separate occasions, performed on the dominant or non-dominant arm in a counter-balanced crossover design. Subjects were assigned to an HMB/KIC (3 g HMB and 0.3 g α-ketoisocaproic acid, daily) or placebo treatment for 14 d prior to exercise in the counter-balanced crossover design. One repetition maximum (1RM), plasma creatine kinase activity (CK), delayed onset muscle soreness (DOMS), limb girth, and range of motion (ROM) were determined pre-exercise, at 1h, 24 h, 48 h, and 72 h post-exercise. DOMS and the percentage changes in 1RM, limb girth, and ROM all changed over the 72 h period (P < 0.05). HMB/KIC supplementation attenuated the CK response, the percentage decrement in 1RM, and the percentage increase in limb girth (P < 0.05). In addition, DOMS was reduced at 24 h post-exercise (P < 0.05) in the HMB/KIC treatment. In conclusion, 14 d of HMB and KIC supplementation reduced signs and symptoms of exercise-induced muscle damage in non-resistance trained males following a single bout of eccentrically biased resistance exercise.
Thilo Hotfiel, Marion Kellermann, Bernd Swoboda, Dane Wildner, Tobias Golditz, Casper Grim, Martin Raithel, Michael Uder, and Rafael Heiss
Muscle injuries are one of the most common sports injuries, presenting an incidence up to 10% to 55% of all injuries. 1 – 3 Delayed onset muscle soreness (DOMS), an entity of ultrastructural muscle injury is classified as an overexertion-functional muscle disorder type Ib according to the “Munich
Kevin S. O’Fallon, Diksha Kaushik, Bozena Michniak-Kohn, C. Patrick Dunne, Edward J. Zambraski, and Priscilla M. Clarkson
The flavonoid quercetin is purported to have potent antioxidant and anti-inflammatory properties. This study examined if quercetin supplementation attenuates indicators of exercise-induced muscle damage in a doubleblind laboratory study. Thirty healthy subjects were randomized to quercetin (QU) or placebo (PL) supplementation and performed 2 separate sessions of 24 eccentric contractions of the elbow flexors. Muscle strength, soreness, resting arm angle, upper arm swelling, serum creatine kinase (CK) activity, plasma quercetin (PQ), interleukin-6 (IL-6), and C-reactive protein (CRP) were assessed before and for 5 d after exercise. Subjects then ingested nutrition bars containing 1,000 mg/d QU or PL for 7 d before and 5 d after the second exercise session, using the opposite arm. PQ reached 202 ± 52 ng/ml after 7 d of supplementation and remained elevated during the 5-d postexercise recovery period (p < .05). Subjects experienced strength loss (peak = 47%), muscle soreness (peak = 39 ± 6 mm), reduced arm angle (–7° ± 1°), CK elevations (peak = 3,307 ± 1,481 U/L), and arm swelling (peak = 11 ± 2 mm; p < .0001), indicating muscle damage and inflammation; however, differences between treatments were not detected. Eccentric exercise did not alter plasma IL-6 (peak = 1.9 pg/ml) or CRP (peak = 1.6 mg/L) relative to baseline or by treatment. QU supplementation had no effect on markers of muscle damage or inflammation after eccentric exercise of the elbow flexors.
Paul G. Montgomery and Will G. Hopkins
Australian Football is an intense team sport played over ~120 min on a weekly basis. To determine the effects of game and training load on muscle soreness and the time frame of soreness dissipation, 64 elite Australian Football players (age 23.8 ± 1.8 y, height 183.9 ± 3.8 cm, weight 83.2 ± 5.0 kg; mean ± SD) recorded perceptions of muscle soreness, game intensity, and training intensity on scales of 1–10 on most mornings for up to 3 competition seasons. Playing and training times were also recorded in minutes. Data were analyzed with a mixed linear model, and magnitudes of effects on soreness were evaluated by standardization. All effects had acceptably low uncertainty. Game and training-session loads were 790 ± 182 and 229 ± 98 intensity-minutes (mean ± SD), respectively. General muscle soreness was 4.6 ± 1.1 units on d 1 postgame and fell to 1.9 ± 1.0 by d 6. There was a small increase in general muscle soreness (0.22 ± 0.07–0.50 ± 0.13 units) in the 3 d after high-load games relative to low-load games. Other soreness responses showed similar timelines and magnitudes of change. Training sessions made only small contributions to soreness over the 3 d after each session. Practitioners should be aware of these responses when planning weekly training and recovery programs, as it appears that game-related soreness dissipates after 3 d regardless of game load and increased training loads in the following week produce only small increases in soreness.
Douglas Paddon-Jones, Andrew Keech, and David Jenkins
We examined the effects of short-term β-hydroxy-β-methylbutyrate (HMB) supplementation on symptoms of muscle damage following an acute bout of eccentric exercise.
Non-resistance trained subjects were randomly assigned to a HMB supplement group (HMB, 40mg/kg body weight/day, n = 8) or placebo group (CON, n = 9). Supplementation commenced 6 days prior to a bout of 24 maximal isokinetic eccentric contractions of the elbow flexors and continued throughout post-testing. Muscle soreness, upper arm girth, and torque measures were assessed pre-exercise, 15 min post-exercise, and 1,2,3, 4,7, and 10 days post-exercise.
No pre-test differences between HMB and CON groups were identified, and both performed a similar amount of eccentric work during the main eccentric exercise bout (p > .05). HMB supplementation had no effect on swelling, muscle soreness, or torque following the damaging eccentric exercise bout (p > .05).
Compared to a placebo condition, short-term supplementation with 40mg/kg body weight/day of HMB had no beneficial effect on a range of symptoms associated with eccentric muscle damage. If HMB can produce an ergogenic response, a longer pre-exercise supplementation period may be necessary.
Andreas M. Kasper, S. Andy Sparks, Matthew Hooks, Matthew Skeer, Benjamin Webb, Houman Nia, James P. Morton, and Graeme L. Close
Rugby is characterized by frequent high-intensity collisions, resulting in muscle soreness. Players consequently seek strategies to reduce soreness and accelerate recovery, with an emerging method being cannabidiol (CBD), despite anti-doping risks. The prevalence and rationale for CBD use in rugby has not been explored; therefore, we recruited professional male players to complete a survey on CBD. Goodness of fit chi-square (χ2) was used to assess CBD use between codes and player position. Effects of age on use were determined using χ2 tests of independence. Twenty-five teams provided 517 player responses. While the majority of players had never used CBD (p < .001, V = 0.24), 26% had either used it (18%) or were still using it (8%). Significantly more CBD use was observed in rugby union compared with rugby league (p = .004, V = 0.13), but player position was not a factor (p = .760, V = 0.013). CBD use increased with players’ age (p < .001, V = 0.28), with mean use reaching 41% in the players aged 28 years and older category (p < .0001). The players using CBD primarily used the Internet (73%) or another teammate (61%) to obtain information, with only 16% consulting a nutritionist. The main reasons for CBD use were improving recovery/pain (80%) and sleep (78%), with 68% of players reporting a perceived benefit. These data highlight the need for immediate education on the risks of CBD, as well as the need to explore the claims regarding pain and sleep.