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Eccentric exercise per se does not affect muscle damage biomarkers: early and late phase adaptations



Acute high-intensity unaccustomed eccentric exercise performed by naive subjects is accompanied by disturbances in muscle damage biomarkers. The aim of the study was to investigate whether a causal relationship indeed exists between eccentric exercise and muscle damage.


Twenty-four men randomly assigned into a concentric only or an eccentric-only training group and performed 10 weeks of isokinetic resistance exercise (one session/week of 75 maximal knee extensors actions). Physiological markers of muscle function and damage (i.e., range of motion, delayed onset muscle soreness, isometric, concentric and eccentric peak torque) were assessed prior to and 1–3 and 5 days post each session. Biochemical markers of muscle damage (creatine kinase) and inflammation (C-reactive protein) were measured prior and 2 days post each session.


After the first bout, eccentric exercise induced greater muscle damage compared to concentric exercise; however, during the nine following sessions, this effect progressively diminished, while after the 10th week of training, no alterations in muscle damage biomarkers were observed after either exercise protocol. Additionally, strength gains at the end of the training period were comparable between the two groups and were mode-specific.


(1) eccentric exercise per se does not affect muscle damage biomarkers; (2) muscle damage occurs as a result of muscle unaccustomedness to this action type; (3) exercise-induced muscle damage is not a prerequisite for increased muscle strength. Collectively, we believe that muscle unaccustomedness to high-intensity eccentric exercise, and not eccentric exercise per se, is the trigger for muscle damage as indicated by muscle damage biomarkers.

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There is availability of code, data and material of the present investigation.



Creatine kinase


C-reactive protein


Delayed onset muscle soreness


Pain-free range of motion


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Authors and Affiliations



PV and NMG conceived and designed research; MNV, TAA, PNC, KA, NMG, PV performed formal analysis and investigation; PV wrote the manuscript—original draft preparation. All authors read and approved the manuscript.

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Correspondence to Vassilis Paschalis.

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The authors declare that they have no conflict of interest.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the local University (ERC-002/2019).

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Informed consent was obtained from all individual participants included in the study.

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No personal data are published.

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Communicated by Nicolas Place.

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Margaritelis, N.V., Theodorou, A.A., Chatzinikolaou, P.N. et al. Eccentric exercise per se does not affect muscle damage biomarkers: early and late phase adaptations. Eur J Appl Physiol 121, 549–559 (2021).

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  • Concentric
  • Eccentric
  • Exercise
  • Muscle damage
  • Strength