Skip to main content

Local high-frequency vibration therapy following eccentric exercises reduces muscle soreness perception and posture alterations in elite athletes



Exercise-induced muscle damage produces painful sensations (delayed onset of muscle soreness, DOMS). DOMS causes compensatory postural adaptations, which in turn affect athletes’ walking and running gait biomechanics. It is still debated whether the postural changes are due to impaired proprioception or pain perception. To disambiguate between these two contrasting hypotheses, we designed a study that tested post-exercise postural adjustments in two groups of athletes: a group who was administered a vibration therapy (VT), to attenuate pain perception, and a control group.


Thirty professional futsal players were tested on five different occasions: baseline, eccentric exercises (EE) session day, 24, 48 and 72 h after EE. Vibration therapy (120 Hz) was applied on legs muscles for 15 min in the experimental group, while no vibration was applied in the control group. The measurements included: isokinetic evaluation, stabilometric test, perceived soreness evaluation and serum levels of creatine kinase, and lactate dehydrogenase.


48 h after EE, the control group showed changes in biomechanical parameters (antero-rotations of pelvis, p < 0.05). A substantial alteration in the hip kinematics was found, associated to a reduced contractile force (p < 0.01) and soreness perception. On the contrary, the VT group did not show any change in posture and pain perception. High-intensity VT decreases EE effects on muscle strength and DOMS.


DOMS significantly changes athletes’ posture; but postural changes disappear following a VT therapy that decreases pain perception. It is concluded that soreness perception is the main cause of postural changes and that its effects can be counteracted using VT therapy.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2



Analysis of variance


Creatine kinase


Centers of mass


Center of pressure


Cranio subsystem




Delayed onset of muscle soreness


Eyes closed


Eccentric exercise


Exercise-induced muscle damage




Eyes open


Intraclass correlation coefficients


Lactate dehydrogenase


Maximal voluntary contraction


Pressure pain threshold


Pelvic subsystem


Spina iliaca anterior superior


Spina iliaca posterior superior


Vibration therapy


Whole body vibration


  1. Ahmaidi S, Granier P, Taoutaou Z, Mercier J, Dubouchaud H, Prefaut C (1996) Effects of active recovery on plasma lactate and anaerobic power following repeated intensive exercise. Med Sci Sports Exerc 28:450–456

    Article  CAS  PubMed  Google Scholar 

  2. Bakhtiary AH, Safavi-Farokhi Z, Aminian-Far A, Rezasoltani A (2007) Influence of vibration on delayed onset of muscle soreness following eccentric exercise * COMMENTARY. Br J Sports Med 41:145–148

    Article  PubMed  Google Scholar 

  3. Barnes MJ, Perry BG, Mündel T, Cochrane DJ (2012) The effects of vibration therapy on muscle force loss following eccentrically induced muscle damage. Eur J Appl Physiol 112:1189–1194

    Article  PubMed  Google Scholar 

  4. Bisciotti GN (2015) Groin pain syndrome: an association of different pathologies and a case presentation. Muscles Ligaments Tendons J 5:214–222

    Article  Google Scholar 

  5. Boudreau S, Farina D, Kongstad L, Buus D, Redder J, Sverrisdóttir E, Falla D (2011) The relative timing of trunk muscle activation is retained in response to unanticipated postural-perturbations during acute low back pain. Exp Brain Res 210:259–267

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Broadbent S, Rousseau JJ, Thorp RM, Choate SL, Jackson FS, Rowlands DS (2010) Vibration therapy reduces plasma IL6 and muscle soreness after downhill running. Br J Sports Med 44:888–894

    Article  CAS  PubMed  Google Scholar 

  7. Brockett C, Warren N, Gregory JE, Morgan DL, Proske U (1997) A comparison of the effects of concentric versus eccentric exercise on force and position sense at the human elbow joint. Brain Res 771:251–258

    Article  CAS  PubMed  Google Scholar 

  8. Byrne C, Twist C, Eston R (2004) Neuromuscular function after exercise-induced muscle damage: theoretical and applied implications. Sports Med 34:49–69

    Article  PubMed  Google Scholar 

  9. Casale R, Ring H, Rainoldi A (2009) High frequency vibration conditioning stimulation centrally reduces myoelectrical manifestation of fatigue in healthy subjects. J Electromyogr Kinesiol 19:998–1004

    Article  PubMed  Google Scholar 

  10. Chapman DW, Newton M, McGuigan M, Nosaka K (2008) Effect of lengthening contraction velocity on muscle damage of the elbow flexors. Med Sci Sports Exerc 40:926–933

    Article  PubMed  Google Scholar 

  11. Clarkson PM, Nosaka K, Braun B (1992) Muscle function after exercise-induced muscle damage and rapid adaptation. Med Sci Sports Exerc 24:512–520

    CAS  PubMed  Google Scholar 

  12. Cochrane DJ (2017) Effectiveness of using wearable vibration therapy to alleviate muscle soreness. Eur J Appl Physiol 117:501–509

    Article  PubMed  Google Scholar 

  13. Cochrane DJ, Loram ID, Stannard SR, Rittweger J (2009) Changes in joint angle, muscle-tendon complex length, muscle contractile tissue displacement, and modulation of EMG activity during acute whole-body vibration. Muscle Nerve 40:420–429

    Article  PubMed  Google Scholar 

  14. Cohen J (1988) Statistical power analysis for the behavioral sciences. Academic Press, London

    Google Scholar 

  15. Edge J, Mündel T, Weir K, Cochrane DJ (2009) The effects of acute whole body vibration as a recovery modality following high-intensity interval training in well-trained, middle-aged runners. Eur J Appl Physiol 105:421–428

    Article  CAS  PubMed  Google Scholar 

  16. Gandevia SC, Enoka RM, McComas AJ, Stuart DG, Thomas CK (1995) Neurobiology of muscle fatigue. Springer, Berlin, pp. 515–525

    Google Scholar 

  17. Grimshaw P (2007) Sport and exercise biomechanics. Taylor & Francis Group, New York

    Google Scholar 

  18. Holland PW, Welsch RE (1977) Robust regression using iteratively reweighted least-squares. Commun Stat Theory Methods 6:813–827

    Article  Google Scholar 

  19. Howatson G, Goodall S, van Someren KA (2009) The influence of cold water immersions on adaptation following a single bout of damaging exercise. Eur J Appl Physiol 105:615–621

    Article  PubMed  Google Scholar 

  20. Iodice P, Bellomo RG, Gialluca G, Fanò G, Saggini R (2011) Acute and cumulative effects of focused high-frequency vibrations on the endocrine system and muscle strength. Eur J Appl Physiol 111:897–904

    Article  CAS  PubMed  Google Scholar 

  21. Iodice P, Cesinaro S, Romani GL, Pezzulo G (2015a) More gain less pain: balance control learning shifts the activation patterns of leg and neck muscles and increases muscular parsimony. Exp Brain Res 233:2103–2114

    Article  PubMed  Google Scholar 

  22. Iodice P, Scuderi N, Saggini R, Pezzulo G (2015b) Multiple timescales of body schema reorganization due to plastic surgery. Hum Mov Sci 42:54–70

    Article  PubMed  Google Scholar 

  23. Kellis E, Baltzopoulos V (1996) Resistive eccentric exercise: effects of visual feedback on maximum moment of knee extensors and flexors. J Orthop Sport Phys Ther 23:120–124

    Article  CAS  Google Scholar 

  24. Kennedy DS, McNeil CJ, Gandevia SC, Taylor JL (2014) Fatigue-related firing of distal muscle nociceptors reduces voluntary activation of proximal muscles of the same limb. J Appl Physiol 116:385–394

    Article  PubMed  Google Scholar 

  25. Komi PV (2000) Stretch-shortening cycle: a powerful model to study normal and fatigued muscle. J Biomech 33:1197–1206

    Article  CAS  PubMed  Google Scholar 

  26. Larsen LH, Hirata RP, Graven-Nielsen T (2017) Pain-evoked trunk muscle activity changes during fatigue and DOMS. Eur J Pain 21:907–917

    Article  CAS  PubMed  Google Scholar 

  27. Linnamo V, Bottas R, Komi PV (2000) Force and EMG power spectrum during and after eccentric and concentric fatigue. J Electromyogr Kinesiol 10:293–300

    Article  CAS  PubMed  Google Scholar 

  28. Longo MR, Haggard P (2012) Implicit body representations and the conscious body image. Acta Psychol (Amst) 141:164–168

    Article  Google Scholar 

  29. Manimmanakorn N, Ross JJ, Manimmanakorn A, Lucas SJE, Hamlin MJ (2015) Effect of whole-body vibration therapy on performance recovery. Int J Sports Physiol Perform 10:388–395

    Article  PubMed  Google Scholar 

  30. Marklund P, Mattsson CM, Wåhlin-Larsson B, Ponsot E, Lindvall B, Lindvall L, Ekblom B, Kadi F (2013) Extensive inflammatory cell infiltration in human skeletal muscle in response to an ultraendurance exercise bout in experienced athletes. J Appl Physiol 114:66–72

    Article  CAS  PubMed  Google Scholar 

  31. Mazzocchi M, Dessy LA, Di Ronza S, Iodice P, Saggini R, Scuderi N (2014) A study of postural changes after abdominal rectus plication abdominoplasty. Hernia 18(4):473–480

    Article  CAS  PubMed  Google Scholar 

  32. Molina R, Denadai BS (2012) Dissociated time course recovery between rate of force development and peak torque after eccentric exercise. Clin Physiol Funct Imaging 32:179–184

    Article  PubMed  Google Scholar 

  33. Nosaka K, Newton M, Sacco P (2002) Delayed-onset muscle soreness does not reflect the magnitude of eccentric exercise-induced muscle damage. Scand J Med Sci Sports 12:337–346

    Article  PubMed  Google Scholar 

  34. O’Leary DP (1990) Robust regression computation using iteratively reweighted least squares. SIAM J Matrix Anal Appl 11:466–480

    Article  Google Scholar 

  35. Paschalis V, Giakas G, Baltzopoulos V, Jamurtas AZ, Theoharis V, Kotzamanidis C, Koutedakis Y (2007a) The effects of muscle damage following eccentric exercise on gait biomechanics. Gait Posture 25:236–242

    Article  PubMed  Google Scholar 

  36. Paschalis V, Nikolaidis MG, Giakas G, Jamurtas AZ, Pappas A, Koutedakis Y (2007b) The effect of eccentric exercise on position sense and joint reaction angle of the lower limbs. Muscle Nerve 35:496–503

    Article  CAS  PubMed  Google Scholar 

  37. Paschalis V, Nikolaidis MG, Giakas G, Jamurtas AZ, Owolabi EO, Koutedakis Y (2008) Position sense and reaction angle after eccentric exercise: the repeated bout effect. Eur J Appl Physiol 103:9–18

    Article  CAS  PubMed  Google Scholar 

  38. Peake J, Nosaka K, Suzuki K (2005) Characterization of inflammatory responses to eccentric exercise in humans. Exerc Immunol Rev 11:64–85

    PubMed  Google Scholar 

  39. Pezzulo G, Iodice P, Donnarumma F, Dindo H, Knoblich G (2017) Avoiding accidents at the champagne reception. Psychol Sci 28:338–345

    Article  PubMed  Google Scholar 

  40. Pietrangelo T, Mancinelli R, Toniolo L, Cancellara L, Paoli A, Puglielli C, Iodice P, Doria C, Bosco G, D’Amelio L, Di Tano G, Fulle S, Saggini R, Fano G, Reggiani C (2009) Effects of local vibrations on skeletal muscle trophism in elderly people: mechanical, cellular, and molecular events. Int J Mol Med 24:503–512

    Article  CAS  PubMed  Google Scholar 

  41. Proske U, Gregory JE, Morgan DL, Percival P, Weerakkody NS, Canny BJ (2004) Force matching errors following eccentric exercise. Hum Mov Sci 23:365–378

    Article  CAS  PubMed  Google Scholar 

  42. Reilly T, Atkinson G, Edwards B, Waterhouse J, Farrelly K, Fairhurst E (2007) Diurnal variation in temperature, mental and physical performance, and tasks specifically related to football (soccer). Chronobiol Int 24:507–519

    Article  PubMed  Google Scholar 

  43. Rhea MR, Bunker D, Marín PJ, Lunt K (2009) Effect of iTonic whole-body vibration on delayed-onset muscle soreness among untrained individuals. J Strength Cond Res 23:1677–1682

    Article  PubMed  Google Scholar 

  44. Richardson JTE (2011) Eta squared and partial eta squared as measures of effect size in educational research. Educ Res Rev 6:135–147

    Article  Google Scholar 

  45. Rittweger J, Schiessl H, Felsenberg D (2001) Oxygen uptake during whole-body vibration exercise: comparison with squatting as a slow voluntary movement. Eur J Appl Physiol 86:169–173

    Article  CAS  PubMed  Google Scholar 

  46. Ruhe A, Fejer R, Walker B (2013) On the relationship between pain intensity and postural sway in patients with non-specific neck pain. J Back Musculoskelet Rehabil 26:401–409

    Article  PubMed  Google Scholar 

  47. Saxton JM, Clarkson PM, James R, Miles M, Westerfer M, Clark S, Donnelly AE (1995) Neuromuscular dysfunction following eccentric exercise. Med Sci Sports Exerc 27:1185–1193

    Article  CAS  PubMed  Google Scholar 

  48. Souron R, Nosaka K, Jubeau M (2018) Changes in central and peripheral neuromuscular fatigue indices after concentric versus eccentric contractions of the knee extensors. Eur J Appl Physiol 118:805–816

    Article  PubMed  Google Scholar 

  49. Taylor JL, Butler JE, Gandevia SC (2000) Changes in muscle afferents, motoneurons and motor drive during muscle fatigue. Eur J Appl Physiol 83:106–115

    Article  CAS  PubMed  Google Scholar 

  50. Torres R, Vasques J, Duarte JA, Cabri JMH (2010) Knee proprioception after exercise-induced muscle damage. Int J Sports Med 31:410–415

    Article  CAS  PubMed  Google Scholar 

  51. Tsatalas T, Giakas G, Spyropoulos G, Paschalis V, Nikolaidis MG, Tsaopoulos DE, Theodorou AA, Jamurtas AZ, Koutedakis Y (2010) The effects of muscle damage on walking biomechanics are speed-dependent. Eur J Appl Physiol 110:977–988

    Article  PubMed  Google Scholar 

  52. Weerakkody NS, Whitehead NP, Canny BJ, Gregory JE, Proske U (2001) Large-fiber mechanoreceptors contribute to muscle soreness after eccentric exercise. J Pain 2:209–219

    Article  CAS  PubMed  Google Scholar 

  53. Zimmermann K, Leidl C, Kaschka M, Carr RW, Terekhin P, Handwerker HO, Forster C (2012) Central projection of pain arising from delayed onset muscle soreness (DOMS) in human subjects. PLoS One 7:e47230

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information




PI conceived and directed the study, carried out the experiments, analyzed the data and wrote the paper. PR supervised the eccentric exercise procedures, performed blood samples preparation and analysis, contributed to data interpretation and discussion. GP supervised the project, contributed to data interpretation, discussion and wrote the paper.

Corresponding author

Correspondence to Pierpaolo Iodice.

Additional information

Communicated by Olivier Seynnes.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Iodice, P., Ripari, P. & Pezzulo, G. Local high-frequency vibration therapy following eccentric exercises reduces muscle soreness perception and posture alterations in elite athletes. Eur J Appl Physiol 119, 539–549 (2019).

Download citation


  • Pain
  • Futsal
  • Vibration therapy
  • Muscle recovery
  • Balance
  • Isokinetic
  • Posture