European Journal of Applied Physiology

, Volume 104, Issue 3, pp 417–426 | Cite as

Recovery after an Ironman triathlon: sustained inflammatory responses and muscular stress

  • Oliver Neubauer
  • Daniel König
  • Karl-Heinz WagnerEmail author
Original Article


Ultra-endurance exercise, such as an Ironman triathlon, induces muscle damage and a systemic inflammatory response. As the resolution of recovery in these parameters is poorly documented, we investigated indices of muscle damage and systemic inflammation in response to an Ironman triathlon and monitored these parameters 19 days into recovery. Blood was sampled from 42 well-trained male triathletes 2 days before, immediately after, and 1, 5 and 19 days after an Ironman triathlon. Blood samples were analyzed for hematological profile, and plasma values of myeloperoxidase (MPO), polymorphonuclear (PMN) elastase, cortisol, testosterone, creatine kinase (CK) activity, myoglobin, interleukin (IL)-6, IL-10 and high-sensitive C-reactive protein (hs-CRP). Immediately post-race there were significant (P < 0.001) increases in total leukocyte counts, MPO, PMN elastase, cortisol, CK activity, myoglobin, IL-6, IL-10 and hs-CRP, while testosterone significantly (P < 0.001) decreased compared to prerace. With the exception of cortisol, which decreased below prerace values (P < 0.001), these alterations persisted 1 day post-race (P < 0.001; P < 0.01 for IL-10). Five days post-race CK activity, myoglobin, IL-6 and hs-CRP had decreased, but were still significantly (P < 0.001) elevated. Nineteen days post-race most parameters had returned to prerace values, except for MPO and PMN elastase, which had both significantly (P < 0.001) decreased below prerace concentrations, and myoglobin and hs-CRP, which were slightly, but significantly higher than prerace. Furthermore, significant relationships between leukocyte dynamics, cortisol, markers of muscle damage, cytokines and hs-CRP after the Ironman triathlon were noted. This study indicates that the pronounced initial systemic inflammatory response induced by an Ironman triathlon declines rapidly. However, a low-grade systemic inflammation persisted until at least 5 days post-race, possibly reflecting incomplete muscle recovery.


Ultra-endurance exercise Muscle damage Systemic inflammatory response Immunoendocrine responses Recovery phase 



The present data are part of a larger study that was funded by the Austrian Science Fund (FWF). The authors would like to thank the participants for their effort, Prof. Haber and Dr. Zeibig for their medical assistance and Mr. Andrew Bulmer for the valuable discussion during the preparation of the manuscript.


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Oliver Neubauer
    • 1
  • Daniel König
    • 2
  • Karl-Heinz Wagner
    • 1
    Email author
  1. 1.Department of Nutritional Sciences, Faculty of Life SciencesUniversity of ViennaViennaAustria
  2. 2.Centre for Internal Medicine, Division of Rehabilitation, Prevention and Sports MedicineFreiburg University HospitalFreiburgGermany

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