This study aimed to determine the effectiveness of photobiomodulation therapy (PBMT) and cryotherapy, in isolated and combined forms, as muscle recovery techniques after muscle fatigue-inducing protocol. Forty volunteers were randomly divided into five groups: a placebo group (PG); a PBMT group (PBMT); a cryotherapy group (CG); a cryotherapy-PBMT group (CPG); and a PBMT-cryotherapy group (PCG). All subjects performed four sessions at 24-h intervals, during which they submitted to isometric assessment (MVC) and blood collection in the pre-exercise period, and 5 and 60 min post-exercise, while the muscle fatigue induction protocol occurred after the pre-exercise collections. In the remaining sessions performed 24, 48, and 72 h later, only blood collections and MVCs were performed. A single treatment with PBMT and/or cryotherapy was applied after only 2 min of completing the post-5-min MVC test at the first session. In the intragroup comparison, it was found that exercise led to a significant decrease (p < 0.05) in the production of MVC in all groups. Comparing the results of MVCs between groups, we observed significant increases in the MVC capacity of the PBMT, CPG, and PCG volunteers in comparison with both PG and CG (p < 0.05). We observed a significant decrease in the concentrations of the biochemical markers of oxidative damage (TBARS and PC) in all groups and muscle damage (creatine kinase—CK) in the PBMT, PCG, and CPG compared with the PG (p < 0.01). The clinical impact of these findings is clear because they demonstrate that the use of phototherapy is more effective than the use of cryotherapy for muscle recovery, additionally cryotherapy decreases PBMT efficacy.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Hohenauer E, Taeymans J, Baeyens JP, Clarys P, Clijsen R (2015) The effect of post-exercise cryotherapy on recovery characteristics: a systematic review and meta-analysis. PLoS One 28(10):e0139028
Knight KL (1995) Cryotherapy in sport injury management. Human Kinetics, Champaign
Jakeman JR, Macrae R, Eston R (2009) A single 10-min bout of cold-water immersion therapy after strenuous plyometric exercise has no beneficial effect on recovery from the symptoms of exercise-induced muscle damage. Ergonomics 52:456–460
Leal Junior ECP, Vanin AA, Miranda EF, Carvalho PTC, Dal Corso S, Bjordal JM (2015) Effect of phototherapy (low-level laser therapy and light-emitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis. Lasers Med Sci 30:925–939
de Almeida P, Lopes-Martins RA, De Marchi T, Tomazoni SS, Albertini R, Corrêa JC, Rossi RP, Machado GP, da Silva DP, Bjordal JM, Leal JEC (2012) Red (660nm) and infrared (830 nm) low-level laser therapy in skeletal muscle fatigue in humans: what is better? Lasers Med Sci 27:453–458
Leal JEC, Lopes-Martins RA, Frigo L, De Marchi T, Rossi RP, de Godoi V, Tomazoni SS, da Silva DP, Basso M, Lotti FP, Corsetti FV, Iversen VV, Bjordal JM (2010) Effects of low-level laser therapy (LLLT) in the development of exercise-induced skeletal muscle fatigue and changes in biochemical markers related to post-exercise recovery. J Orthop Sports PhysTher 40:524–532
De Marchi T, Leal JEC, Bortoli C et al (2012) Low-level laser therapy (LLLT) in human progressive-intensity running: effects on exercise performance, skeletal muscle status and oxidative stress. Lasers Med Sci 27:231–236
Huang YY, Chen AC, Carroll JD, Hamblin MR (2009) Biphasic dose response in low-level light therapy. Dose Response 7:358–383
Karu TI (1987) Photobiological fundamentals of low-power laser therapy. IEEE J Quantum Electron 23:1703–1719
Goldman JA, Chiapella J, Casey H, Bass N, Graham J, McClatchey W, Dronavalli RV, Brown R, Bennett WJ, Miller SB, Wilson CH, Pearson B, Haun C, Persinski L, Huey H, Muckerheide M (1980) Laser therapy of rheumatoid arthritis. Lasers Surg Med 1:93–101
Hegedus B, Viharos L, Gervain M, Gálfi M (2009) The effect of low-level laser in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial. Photomed Laser Surg 27:577–584
Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA (2006) Photoradiation in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 24:158–168
Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM (2008) Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy. Am J Sports Med 36:881–887
Basford JR, Sheffield CG, Harmsen WS (1999) Laser therapy: a randomized, controlled trial of the effects of low-intensity Nd:YAG laser irradiation on musculoskeletal back pain. Arch Phys Med Rehabil 80:647–652
Konstantinovic LM, Cutovic MR, Milovanovic AN, Jovic SJ, Dragin AS, Letic MD, Miler VM (2010) Low-level laser therapy for acute neck pain with radiculopathy: a double-blind placebo-controlled randomized study. Pain Med 11:1169–1178
Chow RT, Johnson MI, Lopes-Martins RA et al (2009) Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 374:1897–1908
Chow RT, Heller GZ, Barnsley L (2006) The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study. Pain 124:201–210
Lopes-Martins RA, Marcos RL, Leonardo PS et al (2006) Effect of low level laser (Ga-Al-As 655 nm) on skeletal muscle fatigue induced by electrical simulation in rats. J Appl Physiol 101:283–288
Fitts RH (1994) Cellular mechanisms of muscle fatigue. Physiol Rev 74:49–94
Camargo MZ, Siqueira CP, Preti MC, Nakamura FY, de Lima FM, Dias IF, Toginho F, Dde O, Ramos Sde P (2012) Effects of light emitting diode (LED) therapy and cold water immersion therapy on exercise-induced muscle damage in rats. Lasers Med Sci 27:1051–1058
da Costa Santos VB, de Paula Ramos S, Milanez VF, Corrêa JC, de Andrade Alves RI, Dias IF, Nakamura FY (2014) LED therapy or cryotherapy between exercise intervals in Wistar rats: anti-inflammatory and ergogenic effects. Lasers Med Sci 29:599–605
Leal Junior EC, de Godoi V, Mancalossi JL et al (2011) Comparison between cold water immersion therapy (CWIT) and light emitting diode therapy (LEDT) in short-term skeletal muscle recovery after high-intensity exercise in athletes: preliminary results. Lasers Med Sci 26:493–501
Leal Junior EC, Lopes-Martins RA, Rossi RP, De Marchi T, Baroni BM, de Godoi V, Marcos RL, Ramos L, Bjordal JM (2009) Effect of cluster multi-diode light emitting diode therapy (LEDT) on exercise-induced skeletal muscle fatigue and skeletal muscle recovery in humans. Lasers Surg Med 41:572–577
Graham CA, Stevenson J (2000) Frozen chips: an unusual cause of severe frostbite injury. Br J Sports Med 34:382–383
Moeller JL, Monroe J, McKeag DB (1997) Cryotherapy-induced common peroneal nerve palsy. Clin J Sport Med 7:212–216
Bassett FH 3rd, Kirkpatrick JS, Engelhardt DL, Malone TR (1992) Cryotherapy-induced nerve injury. Am J Sports Med 20:516–518
Wills ED (1996) Mechanism of lipid peroxide formation in animal tissues. Biochem J 99:667–676
Levine RL, Garland D, Oliver CN, Amici A, Climent I, Lenz AG, Ahn BW, Shaltiel S, Stadtman ER (1990) Determination of carbonyl content in oxidatively modified proteins. Methods Enzymol 186:464–478
Petrofsky JS, Khowailed IA, Lee H, Berk L, Bains GS, Akerkar S, Shah J, Al-Dabbak F, Laymon MS (2015) Cold vs. heat after exercise—is there a clear winner for muscle soreness. J Strength Cond Res 29:3245–3252
Leeder J, Gissane C, van Someren K, Gregson W, Howatson G (2012) Cold water immersion and recovery from strenuous exercise: a meta-analysis. Br J Sports Med 46:233–240
Cheung K, Hume P, Maxwell L (2003) Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med 33:145–164
Zainuddin Z, Newton M, Sacco P, Nosaka K (2005) Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. J Athl Train 40:174–180
Stay JC, Richard MD, Draper DO, Schulthies SS, Durrant E (1998) Pulsed ultrasound fails to diminish delayed-onset muscle soreness symptoms. J Athl Train 33:341–346
Arent SM, Pellegrino JK, Williams CA, Difabio DA, Greenwood JC (2010) Nutritional supplementation, performance, and oxidative stress in college soccer players. J Strength Cond Res 24:1117–1124
Alessio HM, Hagerman AE, Fulkerson BK, Ambrose J, Rice RE, Wiley RL (2000) Generation of reactive oxygen species after exhaustive aerobic and isometric exercise. Med Sci Sports Exerc 32:1576–1581
Fukuda S, Nojima J, Motoki Y, Yamaguti K, Nakatomi Y, Okawa N, Fujiwara K, Watanabe Y, Kuratsune H (2016) Um biomarcador potencial de fadiga : o estresse oxidativo e anti- oxidativo atividade. Biol Psychol 118:88–93
Reid MB, Haack KE, Franchek KM, Valberg PA, Kobzik L, West MS (1992) Reactive oxygen in skeletal muscle. I. intracellular oxidant kinetics and fatigue in vitro. J Appl Physiol 73:1797–1804
Ascensão A, Leite M, Rebelo AN, Magalhäes S, Magalhäes J (2011) Effects of cold water immersion on the recovery of physical performance and muscle damage following a one-off soccer match. J Sports Sci 29:217–225
Bailey DM, Erith SJ, Griffin PJ, Dowson A, Brewer DS, Gant N, Williams C (2007) Influence of cold-water immersion on indices of muscle damage following prolonged intermittent shuttle running. J Sports Sci 25:1163–1170
Pournot H, Bieuzen F, Duffield R, Lepretre PM, Cozzolino C, Hausswirth C (2011) Short term effects of various water immersions on recovery from exhaustive intermittent exercise. Eur J Appl Physiol 111:1287–1295
García-Manso JM, Rodríguez-Matoso D, Rodríguez-Ruiz D, Sarmiento S, de Saa Y, Calderón J (2011) Effect of cold-water immersion on skeletal muscle contractile properties in soccer players. Am J Phys Med Rehabil 90:356–363
de Almeida P, Tomazoni SS, Frigo L, de Carvalho PT, Vanin AA, Santos LA, Albuquerque-Pontes GM, De Marchi T, Tairova O, Marcos RL, Lopes-Martins RÁ, Leal-Junior EC (2014) What is the best treatment to decrease pro-inflammatory cytokine release in acute skeletal muscle injury induced by trauma in rats: low-level laser therapy, diclofenac, or cryotherapy? Lasers Med Sci 29:653–658
de Paiva PR, Tomazoni SS, Johnson DS, Vanin AA, Albuquerque-Pontes GM, Machado CD, Casalechi HL, de Carvalho PT, Leal-Junior EC (2016) Photobiomodulation therapy and/or cryotherapy in skeletal muscle restitution, what is better? A randomized, double-blinded, placebo-controlled clinical trial. Lasers Med Sci 31:1925–1933
Albuquerque-Pontes GM, Vieira RP, Tomazoni SS, Caires CO, Nemeth V, Vanin AA, Santos LA, Pinto HD, Marcos RL, Bjordal JM, de Carvalho PDT, Leal-Junior EC (2015) Effect of pre-irradiation with different doses, wavelengths, and application intervals of low-level laser therapy on cytochrome c oxidase activity in intact skeletal muscle of rats. Lasers Med Sci 30:59–66
Santos LA, Marcos RL, Tomazoni SS, Vanin AA, Antonialli FC, Grandinetti V.dos S, Albuquerque-Pontes GM, de Paiva PR, Lopes-Martins RÁ, de Carvalho PDT, Bjordal JM, Leal-Junior EC (2014) Effects of pre-irradiation of low-level laser therapy with different doses and wavelengths in skeletal muscle performance, fatigue, and skeletal muscle damage induced by tetanic contractions in rats. Lasers Med Sci 29:1617–1626
Antonialli FC, De Marchi T, Tomazoni SS, Vanin AA, dos Santos Grandinetti V, de Paiva PR, Pinto HD, Miranda EF, de Tarso Camillo de Carvalho P, Leal-Junior EC (2014) Phototherapy in skeletal muscle performance and recovery after exercise: effect of combination of super-pulsed laser and light-emitting diodes. Lasers Med Sci 29:1967–1976
Grandinétti V.dos S, Miranda EF, Johnson DS, de Paiva PR, Tomazoni SS, Vanin AA, Albuquerque-Pontes GM, Frigo L, Marcos RL, de Carvalho PDT, Leal-Junior EC (2015) The thermal impact of phototherapy with concurrent super-pulsed lasers and red and infrared LEDs on human skin. Lasers Med Sci 30:1575–1581
Miranda EF, Vanin AA, Tomazoni SS, Grandinetti V.dos S, de Paiva PR, Machado CS d, Monteiro KK, Casalechi HL, de Tarso PD, Carvalho C, Leal-Junior EC (2016) Using pre-exercise photobiomodulation therapy combining super-pulsed lasers and light-emitting diodes to improve performance in progressive cardiopulmonary exercise tests. J Athl Train 51:129–135
Vanin AA, Miranda EF, Machado CS, de Paiva PR, Albuquerque-Pontes GM, Casalechi HL, de Tarso Camillo de Carvalho P, Leal-Junior EC (2016) What is the best moment to apply phototherapy when associated to a strength training program? a randomized, double-blinded, placebo-controlled trial: phototherapy in association to strength training. Lasers Med Sci 31:1555–1564
Pinto HD, Vanin AA, Miranda EF, Tomazoni SS, Johnson DS, Albuquerque-Pontes GM, Junior AIO, Grandinetti VD, Casalechi HL, de Carvalho PT, Leal Junior EC (2016) Photobiomodulation therapy improves performance and accelerates recovery of high-level rugby players in field test: a randomized, crossover, double-blind, placebo-controlled clinical study. J Strength Cond Res 30:3329–3338
Professor Ernesto Cesar Pinto Leal-Junior receives research support from Multi Radiance Medical (Solon, OH - USA), a laser device manufacturer. Multi Radiance Medical had no role in the planning of this study, and the laser device used was not theirs. They had no influence on study design, data collection and analysis, decision to publish, or preparation of the manuscript. The remaining authors declare that they have no conflict of interests.
The study was approved by the Ethics Committee of the University of Caxias do Sul. In accordance with the Declaration of Helsinki, all subjects were advised about the procedure and they signed an informed consent prior to participation in the study (CAEE 31344214.3.3001.5341).
About this article
Cite this article
De Marchi, T., Schmitt, V.M., Machado, G.P. et al. Does photobiomodulation therapy is better than cryotherapy in muscle recovery after a high-intensity exercise? A randomized, double-blind, placebo-controlled clinical trial. Lasers Med Sci 32, 429–437 (2017). https://doi.org/10.1007/s10103-016-2139-9
- High-intensity exercise
- Oxidative stress
- Muscle damage