Sports Medicine

, Volume 38, Issue 6, pp 483–503 | Cite as

The Prevention and Treatment of Exercise-Induced Muscle Damage

Review Article

Abstract

Exercise-induced muscle damage (EIMD) can be caused by novel or unaccustomed exercise and results in a temporary decrease in muscle force production, a rise in passive tension, increased muscle soreness and swelling, and an increase in intramuscular proteins in blood. Consequently, EIMD can have a profound effect on the ability to perform subsequent bouts of exercise and therefore adhere to an exercise training programme. A variety of interventions have been used prophylactically and/or therapeutically in an attempt to reduce the negative effects associated with EIMD. This article focuses on some of the most commonly used strategies, including nutritional and pharmacological strategies, electrical and manual therapies and exercise. Long-term supplementation with antioxidants or β-hydroxy-β-methylbutyrate appears to provide a prophylactic effect in reducing EIMD, as does the ingestion of protein before and following exercise. Although the administration of high-dose NSAIDs may reduce EIMD and muscle soreness, it also attenuates the adaptive processes and should therefore not be prescribed for long-term treatment of EIMD. Whilst there is some evidence that stretching and massage may reduce muscle soreness, there is little evidence indicating any performance benefits. Electrical therapies and cryotherapy offer limited effect in the treatment of EIMD; however, inconsistencies in the dose and frequency of these and other interventions may account for the lack of consensus regarding their efficacy. Both as a cause and a consequence of this, there are very few evidence-based guidelines for the application of many of these interventions. Conversely, there is unequivocal evidence that prior bouts of eccentric exercise provide a protective effect against subsequent bouts of potentially damaging exercise. Further research is warranted to elucidate the most appropriate dose and frequency of interventions to attenuate EIMD and if these interventions attenuate the adaptation process. This will both clarify the efficacy of such strategies and provide guidelines for evidence-based practice.

References

  1. 1.
    Armstrong RB, Warren GL, Warren JA. Mechanisms of exercise—induced muscle fibre injury. Sports Med 1991; 12: 184–207PubMedCrossRefGoogle Scholar
  2. 2.
    Woledge RC, Cutin NA, Homsher E. Energetic aspects of muscle contraction. Monogr Physiol Soc 1985; 41: 1–357PubMedGoogle Scholar
  3. 3.
    Dudley GA, Tesch PA, Miller BJ, et al. Importance of eccentric actions in performance adaptations to resistance training. Aviat Space Environ Med 1991; 62: 543–50PubMedGoogle Scholar
  4. 4.
    Newham DJ, Mc Phail G, Mills KR, et al. Ultrastructure changes after concentric and eccentric contractions of human muscle. J Neurol Sci 1983; 61: 109–22PubMedCrossRefGoogle Scholar
  5. 5.
    Enoka RM. Eccentric contractions require unique activation strategies by the nervous system. J Appl Physiol 1996; 81: 2339–46PubMedGoogle Scholar
  6. 6.
    Hortobágyi T, Hill JP, Houmard JA, et al. Adaptive response to muscle lengthening and shortening in humans. J Appl Physiol 1996; 80: 765–72PubMedGoogle Scholar
  7. 7.
    Beltman JGM, van der Vliet MR, Sargeant AJ, et al. Metabolic cost of lengthening, isometric and shortening contractions in maximally stimulated rat skeletal muscle. Acta Physiol Scand 2004; 182: 179–87PubMedCrossRefGoogle Scholar
  8. 8.
    Clarkson PM. Eccentric exercise and muscle damage. Int J Sports Med 1997; 18: S314–7CrossRefGoogle Scholar
  9. 9.
    Proske U, Morgan DL. Muscle adaptation from eccentric exercise: mechanisms, mechanical sounds, adaptation and clinical applications. J Physiol 2001; 537: 333–45PubMedCrossRefGoogle Scholar
  10. 10.
    Warren GL, Lowe DA, Armstrong RB. Measurement tools used in the study of eccentric contraction—induced injury. Sports Med 1999; 27: 43–59PubMedCrossRefGoogle Scholar
  11. 11.
    Hather BM, Tesch PA, Buchanan P, et al. Influence of eccentric actions on skeletal muscle adaptations to resistance training. Acta Physiol Scand 1991; 143: 177–85PubMedCrossRefGoogle Scholar
  12. 12.
    Higbie EJ, Cureton KJ, Warren GL, et al. Effects of concentric and eccentric training on muscle strength, cross sectional area, and neural activation. J Appl Physiol 1996; 81: 2173–81PubMedGoogle Scholar
  13. 13.
    Adams GR, Cheung DC, Haddad F, et al. Skeletal muscle hypertrophy in response to isometric, lengthening, and shortening bouts of equivalent duration. J Appl Physiol 2004; 96: 1613–8PubMedCrossRefGoogle Scholar
  14. 14.
    Hortobágyi T, Barrier J, Beard D, et al. Greater initial adaptation to submaximal muscle lengthening than maximal shortening. J Appl Physiol 1996; 81: 1677–82PubMedGoogle Scholar
  15. 15.
    LaStayo PC, Reich TE, Urquhart M, et al. Chronic eccentric exercise: improvements in muscle strength can occur with little demand for oxygen. Am J Physiol 1999; 276: R611–5Google Scholar
  16. 16.
    Hortobágyi T, Money J, Zheng D, et al. Muscle adaptations to 7 days of exercise in young and older humans: eccentric overload versus standard resistance training. J Aging Phys Activ 2002; 10: 290–305Google Scholar
  17. 17.
    Yu JG, Furst DO, Thornell LE. The mode of myofibril remodelling in human skeletal muscle affected by DOMS induced by eccentric contractions. Histochem Cell Biol 2003; 119: 383–93PubMedGoogle Scholar
  18. 18.
    Yu JG, Carlsson L, Thornell LE. Evidence for myofibril remodeling as opposed to myofibril damage in human muscles with DOMS: an ultrastructural and immunoelectron microscopic study. Histochem Cell Biol 2004; 121: 219–27PubMedCrossRefGoogle Scholar
  19. 19.
    Armstrong RB. Mechanisms of exercise—induced delayed muscular soreness: a brief review. Med Sci Sports Exerc 1984; 16: 529–38PubMedGoogle Scholar
  20. 20.
    Ebbeling CB, Clarkson PM. Exercise—induced muscle damage and adaptation. Sports Med 1989; 7: 207–34PubMedCrossRefGoogle Scholar
  21. 21.
    Armstrong RB. Initial events in exercise—induced muscular injury. Med Sci Sports Exerc 1990; 22: 429–35PubMedGoogle Scholar
  22. 22.
    Clarkson PM, Sayers SP. Etiology of exercise—induced muscle damage. J Appl Physiol 1999; 24: 234–48Google Scholar
  23. 23.
    Lieber RL, Fridén J. Mechanisms of muscle injury after eccentric contraction. J Sci Med Sport 1999; 2: 253–65PubMedCrossRefGoogle Scholar
  24. 24.
    Kendall B, Eston R. Exercise—induced muscle damage and the protective role of estrogen. Sports Med 2002; 32: 103–23PubMedCrossRefGoogle Scholar
  25. 25.
    Close GL, Ashton T, Mc Ardle A, et al. The emerging role of free radicals in delayed onset muscle soreness and contraction induced muscle injury. Comp Biochem Physiol Mol Integr Physiol 2005; 142: 257–66CrossRefGoogle Scholar
  26. 26.
    McHugh MP. Recent advances in the understanding of the repeated bout effect against muscle damage from a single bout of eccentric exercise. Scand J Med Sci Sports 2003; 13: 88–97PubMedCrossRefGoogle Scholar
  27. 27.
    de Vries HA. Quantitative EMG investigation of the muscle spasm theory of muscle pain. Am J Phys Med 1966; 45: 119–34PubMedGoogle Scholar
  28. 28.
    Byrnes WC, Clarkson PM. Delayed onset muscle soreness and training. Clin Sports Med 1986; 5: 605–14PubMedGoogle Scholar
  29. 29.
    Gordon L, Buncke HJ, Townsend JJ. Histological changes in skeletal muscle after temporary independent occlusion of arterial and venous blood supply. Plast Reconstr Surg 1978; 61: 576–80PubMedCrossRefGoogle Scholar
  30. 30.
    Schwane JA, Armstong RB. Effect of training on skeletal muscle injury from downhill running in rats. J Appl Physiol 1983; 55: 969–75PubMedGoogle Scholar
  31. 31.
    Armstrong RB, Ogilvie RW, Schwane JA. Eccentric exercise induced injury to rat skeletal muscle. J Appl Physiol 1983; 54: 80–93PubMedGoogle Scholar
  32. 32.
    Abbott BC, Bigland B, Ritchie JM. The physiological cost of negative work. J Physiol 1952; 117: 380–90PubMedGoogle Scholar
  33. 33.
    Bigland-Richie B, Woods JJ. Integrated electromyogram and oxygen uptake during positive and negative work. J Physiol 1976; 260: 267–77Google Scholar
  34. 34.
    Talbot JA, Morgan DL. Quantitative analysis of sarcomere nonuniformities in active muscle following a stretch. J Muscle Res Cell Motil 1996; 17: 261–8PubMedCrossRefGoogle Scholar
  35. 35.
    Proske U, Allen TJ. Damage to skeletal muscle from eccentric exercise. Exerc Sport Sci Rev 2005; 33: 98–104PubMedCrossRefGoogle Scholar
  36. 36.
    Morgan DL. New insights into the behaviour of muscle during active lengthening. Biophys J 1990; 57: 209–21PubMedCrossRefGoogle Scholar
  37. 37.
    Morgan DL, Proske U. Popping sacromere hypothesis explains stretch—induced muscle damage. Clin Exp Pharmacol Physiol 2004; 31: 541–5PubMedCrossRefGoogle Scholar
  38. 38.
    Fridén J, Sjostrom M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. Int J Sports Med 1983; 4: 170–6PubMedCrossRefGoogle Scholar
  39. 39.
    Duncan CJ. Role of calcium in triggering rapid ultrastructural damage in muscle: a study with chemically skinned fibres. J Cell Sci 1987; 87: 581–94PubMedGoogle Scholar
  40. 40.
    Gissel H, Clausen T. Excitation—induced Ca2+ influx and skeletal muscle cell damage. Acta Physiol Scand 2001; 171: 327–34PubMedCrossRefGoogle Scholar
  41. 41.
    McNeil PL, Kahlee R. Disruption of fiber plasma membranes: role in exercise—induced damage. Am J Pathol 1992; 140: 1097–109PubMedGoogle Scholar
  42. 42.
    Yasuda T, Sakamoto K, Nosaka K, et al. Loss of sarcoplasmic reticulum membrane integrity after eccentric contraction. Acta Physiol Scand 1997; 161: 581–2PubMedCrossRefGoogle Scholar
  43. 43.
    Nielsen JS, Madsen K, Jørgensen LV, et al. Effects of lengthening contraction on calcium kinetics and skeletal muscle contractility in humans. Acta Physiol Scand 2005; 184: 203–14PubMedCrossRefGoogle Scholar
  44. 44.
    Byrd SK. Alterations in sarcoplasmic reticulum, a possible link to exercise—induced muscle damage. Med Sci Sports Exerc 1992; 24: 531–6PubMedGoogle Scholar
  45. 45.
    Jones DA, Newham DJ, Round JM, et al. Experimental human muscle damage: morphological changes in relation to other indices of damage. J Physiol 1986; 375: 435–48PubMedGoogle Scholar
  46. 46.
    Fridén J, Seger J, Sjostrom M, et al. Adaptive response in human skeletal muscle subjected to prolonged eccentric training. Int J Sports Med 1983; 4: 177–83PubMedCrossRefGoogle Scholar
  47. 47.
    Yu JG, Malm C, Thornell LE. Eccentric contractions leading to DOMS do not cause loss of desmin nor fibre necrosis in human muscle. Histochem Cell Biol 2002; 118: 29–34PubMedGoogle Scholar
  48. 48.
    Yu JG, Thornell LE. Desmin and actin alterations in human muscles affected by delayed onset muscle soreness: a high resolution immunocytochemical study. Histochem Cell Biol 2002; 118: 171–9PubMedGoogle Scholar
  49. 49.
    Warren GL, Hermann KM, Ingalls CP, et al. Decreased EMG median frequency during a second bout of eccentric contractions. Med Sci Sports Exerc 2000; 32: 820–9PubMedCrossRefGoogle Scholar
  50. 50.
    Warren GL, Ingalls CP, Lowe DA, et al. Excitation—contraction coupling: major role in contraction—induced muscle injury. Exerc Sport Sci Rev 2001; 29: 82–7PubMedCrossRefGoogle Scholar
  51. 51.
    Morgan DL, Allen DG. Early events in stretch—induced muscle damage. J App Physiol 1999; 87: 2007–15Google Scholar
  52. 52.
    Allen DG. Eccentric muscle damage: mechanisms of early reduction of force. Acta Physiol Scand 2001; 171: 311–9PubMedCrossRefGoogle Scholar
  53. 53.
    Reichsman F, Scordilis SP, Clarkson PM, et al. Muscle protein changes following eccentric exercise in humans. Eur J Appl Physiol Occup Physiol 1991; 62: 245–50PubMedCrossRefGoogle Scholar
  54. 54.
    Fridén J, Lieber RL. Eccentric exercise—induced injuries to contractile and cytoskeletal muscle fibre components. Acta Physiol Scand 2001; 171: 321–6PubMedCrossRefGoogle Scholar
  55. 55.
    Fridén J, Sjostrom M, Ekblom B. A morphological study of delayed muscle soreness. Experientia 1981; 37: 506–7PubMedCrossRefGoogle Scholar
  56. 56.
    Hortobágyi T, Houmard J, Fraser D, et al. Normal forces and myofibrillar disruption after repeated eccentric exercise. J Appl Physiol 1998; 84: 492–8PubMedGoogle Scholar
  57. 57.
    Sorichter S, Mair J, Koller A, et al. Creatine kinase, myosin heavy chain and magnetic resonance imaging after eccentric exercise. J Sports Sci 2001; 19: 687–91PubMedCrossRefGoogle Scholar
  58. 58.
    McMahon TA. Muscles, reflexes and locomotion. Princeton (NJ): Princeton University Press, 1984Google Scholar
  59. 59.
    McCully KK, Faulkner JA. Characteristics of lengthening contractions associated with injury to skeletal muscle fibres. J Appl Physiol 1986; 61: 293–9PubMedGoogle Scholar
  60. 60.
    McHugh MP, Connolly DAJ, Eston RG, et al. Electromyographic analysis of exercise resulting in symptoms of muscle damage. J Sports Sci 2000; 18: 163–72PubMedCrossRefGoogle Scholar
  61. 61.
    Nosaka K, Newton M. Differences in the magnitude of damage between maximal and submaximal eccentric loading. J Strength Cond Res 2002; 16: 202–8PubMedGoogle Scholar
  62. 62.
    Child RB, Saxton JM, Donnolly AE. Comparison of eccentric knee extensor muscle actions at two muscle lengths on indices of damage and angle—specific force production in humans. J Sports Sci 1998; 16: 301–8PubMedCrossRefGoogle Scholar
  63. 63.
    Nosaka K, Sakamoto K. Effect of elbow joint angle on the magnitude of muscle damage to the elbow flexors. Med Sci Sports Exerc 2001; 33: 22–9PubMedGoogle Scholar
  64. 64.
    McHugh MP, Pasiakos S. The role of exercising muscle length in the protective adaptation to a single bout of eccentric exercise. Eur J Appl Physiol 2004; 93: 286–93PubMedCrossRefGoogle Scholar
  65. 65.
    Nosaka K, Newton M, Sacco P, et al. Partial protection against muscle damage by eccentric actions at short muscle lengths. Med Sci Sports Exerc 2005; 37: 746–53PubMedCrossRefGoogle Scholar
  66. 66.
    Fridén J, Lieber RL. Structural and mechanical basis of exercise—induced muscle injury. Med Sci Sports Exerc 1992; 24: 521–30PubMedGoogle Scholar
  67. 67.
    Teague B, Schwane JA. Effects of intermittent eccentric contractions on symptoms of muscle microinjury. Med Sci Sports Exerc 1995; 27: 1378–84PubMedGoogle Scholar
  68. 68.
    Lee J, Goldfarb AH, Rescino MH, et al. Eccentric exercise effect on blood oxidative—stress markers and delayed onset of muscle soreness. Med Sci Sports Exerc 2002; 34: 443–8PubMedCrossRefGoogle Scholar
  69. 69.
    Goldfarb AH. Nutritional antioxidants as therapeutic and preventive modalities in exercise—induced muscle damage. Can J Appl Physiol 1999; 24: 249–66PubMedCrossRefGoogle Scholar
  70. 70.
    Bryer SC, Goldfarb AH. Effect of high dose vitamin C supplementation on muscle soreness, damage, function, and oxidative stress to eccentric exercise. Int J Sport Nutr Exerc Metab 2006; 16: 270–80PubMedGoogle Scholar
  71. 71.
    Kaminsky M, Boal R. An effect of ascorbic acid on delayedonset muscle soreness. Pain 1992; 50: 317–21CrossRefGoogle Scholar
  72. 72.
    Thompson D, Williams C, Mc Gregor SJ, et al. Prolonged vitamin C supplementation and recovery from demanding exercise. Int J Sport Nutr Exerc Metab 2001; 11: 466–81PubMedGoogle Scholar
  73. 73.
    Connolly DA, Lauzon C, Agnew J, et al. The effects of vitamin C supplementation on symptoms of delayed onset muscle soreness. J Sports Med Phys Fitness 2006; 46: 462–7PubMedGoogle Scholar
  74. 74.
    Childs A, Jacobs C, Kaminsky T, et al. Supplementation with vitamin C and N—acetyl—cystein increases oxidative stress in humans after acute muscle injury induced by eccentric exercise. Free Radic Biol Med 2001; 1: 745–53CrossRefGoogle Scholar
  75. 75.
    Close GL, Ashton T, Cable T, et al. Ascorbic acid supplementation does not attenuate post—exercise muscle soreness following muscle—damaging exercise but may delay the recovery process. Br J Nutr 2006; 95: 976–81PubMedCrossRefGoogle Scholar
  76. 76.
    Sacheck JM, Milbury PE, Cannon JG, et al. Effect of vitamin E and eccentric exercise on selected biomarkers of oxidative stress in young and elderly men. Free Radic Biol Med 2003; 34: 1575–88PubMedCrossRefGoogle Scholar
  77. 77.
    Mc Bride JM, Kraemer WJ, Triplett-McBride T, et al. Effect of resistance exercise on free radical production. Med Sci Sports Exerc 1998; 30: 67–72PubMedGoogle Scholar
  78. 78.
    Beaton LJ, Allen DA, Tarnopolsky M. A, et al. Contraction induced muscle damage is unaffected by vitamin E supplementation. Med Sci Sports Exerc 2002; 34: 798–805PubMedCrossRefGoogle Scholar
  79. 79.
    Shafat A, Butler P, Jensen RL, et al. Effects of dietary supplementation with vitamins C and E on muscle function during and after eccentric contractions in humans. Eur J Appl Physiol 2004; 93: 196–202PubMedCrossRefGoogle Scholar
  80. 80.
    Goldfarb AH, Bloomer RJ, Mc Kenzie MJ. Combined antioxidant treatment effects on blood oxidative stress after eccentric exercise. Med Sci Sports Exerc 2005; 37: 234–9PubMedCrossRefGoogle Scholar
  81. 81.
    Mastaloudis A, Traber MG, Carstensen K, et al. Antioxidants did not prevent muscle damage in response to an ultramarathon run. Med Sci Sports Exerc 2006; 38: 72–80PubMedGoogle Scholar
  82. 82.
    Petersen EW, Ostrowski K, Ibfelt T, et al. Effect of vitamin supplementation on cytokine response and on muscle damage after strenuous exercise. Am J Physiol Cell Physiol 2001; 280: C1570–5Google Scholar
  83. 83.
    Jakeman P, Maxwell S. Effect of antioxidant vitamin supplementation on muscle function after eccentric exercise. Eur J Appl Physiol Occup Physiol 1993; 67: 426–30PubMedCrossRefGoogle Scholar
  84. 84.
    Cleak MJ, Eston RG. Delayed onset muscle soreness: mechanisms and management. J Sports Sci 1992; 10: 325–41PubMedCrossRefGoogle Scholar
  85. 85.
    Bloomer RJ, Goldfarb AH. Can nutritional supplements reduce exercise—induced skeletal muscle damage? Strength Cond J 2003; 25: 30–7CrossRefGoogle Scholar
  86. 86.
    Sacheck JM, Blumberg JB. Role of vitamin E and oxidative stress in exercise. Nutrition 2001; 17: 809–14PubMedCrossRefGoogle Scholar
  87. 87.
    Connolly DAJ, Mc Hugh MP, Padilla-Zakour OI. Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damage. Br J Sports Med 2006; 40: 679–83PubMedCrossRefGoogle Scholar
  88. 88.
    Costill DL, Pascoe DD, Fink JW, et al. Impaired muscle glycogen after eccentric exercise. J Appl Physiol 1990; 69: 46–50PubMedGoogle Scholar
  89. 89.
    Zehnder M, Muelli M, Buchli R, et al. Further glycogen decrease during early recovery after eccentric exercise despite a high carbohydrate intake. Eur J Nutr 2004; 43: 148–59PubMedCrossRefGoogle Scholar
  90. 90.
    Widrick JJ, Costill DL, Mc Conell GK, et al. Time course of muscle glycogen accumulation after eccentric exercise. J Appl Physiol 1992; 72: 1999-2004Google Scholar
  91. 91.
    Close GL, Ashton T, Cable T, et al. Effects of dietary carbohydrate on delayed onset muscle soreness and reactive oxygen species after contraction induced muscle damage. Br J Sports Med 2005; 39: 948–53PubMedCrossRefGoogle Scholar
  92. 92.
    Nelson MR, Conlee RK, Parcell AC. Inadequate carbohydrate intake following prolonged exercise does not increase muscle soreness after 15 minutes of downhill running. Int J Sport Nutr Exerc Metab 2004; 14: 171–84PubMedGoogle Scholar
  93. 93.
    Shimomura Y, Yamamoto Y, Bajotto G, et al. Nutraceutical effects of branched—chain amino acids on skeletal muscle. J Nutr 2006; 136: 529S–32SPubMedGoogle Scholar
  94. 94.
    Nosaka K, Sacco P, Mawatari K. Effects of amino acid supplementation on muscle soreness and damage. Int J Sport Nutr Exerc Metab 2006; 16: 620–35PubMedGoogle Scholar
  95. 95.
    Saunders MJ, Kane MD, Todd K. Effects of a carbohydrate protein beverage on cycling endurance and muscle damage. Med Sci Sports Exerc 2004; 36: 1233–8PubMedCrossRefGoogle Scholar
  96. 96.
    Wojcik JR, Walberg-Rankin J, Smith LL, et al. Comparison of carbohydrate and milk—based beverages on muscle damage and glycogen following exercise. Int J Sport Nutr Exerc Metab 2001; 11: 406–19PubMedGoogle Scholar
  97. 97.
    Slater GJ, Jenkins D. Beta—hydroxy—beta—methylbutyrate (HMB) supplementation and the promotion of muscle growth and strength. Sports Med 2000; 30: 105–16PubMedCrossRefGoogle Scholar
  98. 98.
    van Koevering M, Nissen S. Oxidation of leucine and a—ketoisocaproate to β—hydroxy—β—methylbutyrate in vivo. Am J Physiol 1992; 262: E27–31Google Scholar
  99. 99.
    Nissen S, Abumrad N. Nutritional role of HMB. Nutr Biochem 1997; 8: 300–11CrossRefGoogle Scholar
  100. 100.
    Nissen S, Sharp R, Ray M, et al. The effect of leucine metabolite β—hydroxy—β—methylbutyrate on muscle metabolism during resistance exercise training. J Appl Physiol 1996; 81: 2095–104PubMedGoogle Scholar
  101. 101.
    Gallagher PM, Carrithers JA, Godard MP, et al. β—hydroxy—β—methylbutyrate ingestion, Part 1: effects on strength and fat free mass. Med Sci Sports Exerc 2000; 32: 2109–15PubMedCrossRefGoogle Scholar
  102. 102.
    Jowko E, Ostaszewski P, Jank M, et al. Creatine and β—hydroxy—β—methylbutyrate (HMB) additively increase lean body mass and muscle strength during a weight—training programme. Nutr 2001; 17: 558–66CrossRefGoogle Scholar
  103. 103.
    Panton LB, Rathmacher JA, Baier S, et al. Nutritional supplementation of the leucine metabolite β—hydroxy—β—methylbutyrate (HMB) during resistance training. Nutr 2000; 16: 734–9CrossRefGoogle Scholar
  104. 104.
    Kreider RB, Ferreira M, Wilson M, et al. Effects of calcium β—hydroxy—β—methylbutyrate (HMB) supplementation during resistance training on markers of catabolism, body composition and strength. Int J Sports Med 1999; 20: 503–9PubMedCrossRefGoogle Scholar
  105. 105.
    Slater G, Jenkins D, Logan P, et al. β—hydroxy—β—methylbutyrate (HMB) supplementation does not affect changes in strength or body composition during resistance training in trained men. Int J Sport Nutr Exerc Metab 2001; 11: 384–96PubMedGoogle Scholar
  106. 106.
    Knitter AE, Panton L, Rathmacher JA, et al. Effects of beta—hydroxy—beta—methylbutyrate on muscle damage after a prolonged run. J Appl Physiol 2000; 89: 1340–4PubMedGoogle Scholar
  107. 107.
    Paddon-Jones D, Keech A, Jenkins D. Short—term beta—hydroxy—beta—methylbutyrate supplementation does not reduce symptoms of eccentric muscle damage. Int J Sport Nutr Exerc Metab 2001; 11: 442–50PubMedGoogle Scholar
  108. 108.
    van Someren KA, Edwards AJ, Howatson G. Supplementation with β—hydroxy—β—methylbutyrate (HMB) and a—ketoisocaproic acid (KIC) reduces signs and symptoms of exercise—induced muscle damage in man. Int J Sport Nutr Exerc Metab 2005; 15: 413–24PubMedGoogle Scholar
  109. 109.
    Francis KT, Hoobler T. Effects of aspirin on delayed muscle soreness. J Sports Med Phys Fitness 1987; 27: 333–7PubMedGoogle Scholar
  110. 110.
    Hasson SM, Daniels JC, Divine JG, et al. Effects of ibuprofen use on muscle soreness, damage, and performance: a preliminary investigation. Med Sci Sports Exerc 1993; 25: 9–17PubMedCrossRefGoogle Scholar
  111. 111.
    Gulick DT, Kimura IF. Delayed onset muscle soreness: what is it and how do we treat it? J Sports Rehab 1996; 5: 234–43Google Scholar
  112. 112.
    Sayers SP, Knight CA, Clarkson PM, et al. Effect of ketoprofen on muscle function and sEMG activity after eccentric exercise. Med Sci Sports Exerc 2001; 33: 702–10PubMedGoogle Scholar
  113. 113.
    Connolly DAJ, Sayers SP, Mc Hugh MP. Treatment and prevention of delayed onset muscle soreness. J Strength Cond Res 2002; 17: 197–208Google Scholar
  114. 114.
    Cheung K, Hume PA, Maxwell L. Delayed onset muscle soreness; treatment strategies and performance factors. Sports Med 2003; 33: 145–64PubMedCrossRefGoogle Scholar
  115. 115.
    Baldwin-Lanier A. Use of anti—inflammatory drugs following exercise—induced muscle injury. Sports Med 2003; 33: 177–85PubMedCrossRefGoogle Scholar
  116. 116.
    O’Grady M, Hackney AC, Schneider K, et al. Diclofenac sodium (Voltaren) reduced exercise—induced injury in human skeletal muscle. Med Sci Sports Exerc 2000; 32: 1191–6PubMedCrossRefGoogle Scholar
  117. 117.
    Pizza FX, Cavender D, Stockard A, et al. Anti—inflammatory doses of ibuprofen: effect on neutrophils and exercise—induced muscle injury. Int J Sports Med 1999; 20: 98–102PubMedGoogle Scholar
  118. 118.
    Tokmakidis SP, Kokkinidis EA, Smilios I, et al. The effects of ibuprofen on delayed muscle soreness and muscular performance after eccentric exercise. J Strength Cond Res 2003; 17: 53–9PubMedGoogle Scholar
  119. 119.
    Donnelly AW, Maughan RJ, Whiting PH. Effects of ibuprofen on exercise—induced muscle soreness and indices of muscle damage. Br J Sports Med 1990; 24: 191–5PubMedCrossRefGoogle Scholar
  120. 120.
    Gulick DT, Kimura IF, Sitler M, et al. Various treatment techniques on signs and symptoms of delayed onset muscle soreness. J Athl Train 1996; 31: 145–52PubMedGoogle Scholar
  121. 121.
    Petersen JM, Trappe TA, Mylona E, et al. Ibuprofen and acetaminophen: effects on muscle inflammation after eccentric exercise. Med Sci Sports Exerc 2003; 35: 892–6CrossRefGoogle Scholar
  122. 122.
    Bougie JD. Management for delayed—onset muscular soreness: a review of the literature. Sports Chiroprac Rehabil 1997; 11: 1–10Google Scholar
  123. 123.
    Adams SS, Bough RG, Cliffe EE, et al. Absorption, distribution and toxicity of ibuprofen. Toxi Appl Pharm 1969; 15: 310–30CrossRefGoogle Scholar
  124. 124.
    Southorn BG, Palmer RM. Inhibitors of phospholipase A2 block the stimulation of protein synthesis by insulin in L6 myoblasts. Biochem J 1990; 270: 737–9PubMedGoogle Scholar
  125. 125.
    Trappe TA, White F, Lambert CP, et al. Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis. Am J Physiol Endocrinol Metab 2002; 282: E551–6Google Scholar
  126. 126.
    Mishra DK, Friden J, Schmitz MC, et al. Anti—inflammatory medication after muscle injury: a treatment resulting in short term improvement but subsequent loss of muscle function. J Bone Joint Surg Am 1995; 77: 1510–9PubMedGoogle Scholar
  127. 127.
    Soltow QA, Betters JL, Sellman JE, et al. Ibuprofen inhibits skeletal muscle hypertrophy in rats. Med Sci Sports Exerc 2006; 38: 840–6PubMedCrossRefGoogle Scholar
  128. 128.
    Weerapong P, Hume PA, Kolt GS. Preventative strategies for exercise—induced muscle damage. Crit Rev Phys Rehab Med 2004; 16: 133–50CrossRefGoogle Scholar
  129. 129.
    Herbert R, Gabriel M. Effects of stretching before and after exercising on muscle soreness and risk of injury: systematic review. Br J Sports Med 2002; 325: 1–5Google Scholar
  130. 130.
    LaRoche DP, Connolly DA. Effects of stretching on passive muscle tension and response to eccentric exercise. Am J Sports Med 2006; 34: 1000–7CrossRefGoogle Scholar
  131. 131.
    Pizza FX, Koh TJ, Mc Gregor SJ, et al. Muscle inflammatory cells after passive stretches, isometric contractions, and lengthening contractions. J Appl Physiol 2002; 92: 1873–8PubMedCrossRefGoogle Scholar
  132. 132.
    Koh TJ, Brooks SV. Lengthening contractions are not required to induce protection from contraction—induced muscle injury. Am J Physiol Regul Integr Comp Physiol 2001; 281: R155–61Google Scholar
  133. 133.
    Rodenburg JB, Steenbeek D, Schiereck P, et al. Warm—up, stretching and massage diminish harmful effects of eccentric exercise. Int J Sports Med 1994; 15: 414–9PubMedCrossRefGoogle Scholar
  134. 134.
    Johansson PH, Lindstrom L, Sundelin G, et al. The effects of pre—exercise stretching on muscular soreness, tenderness and force loss following heavy eccentric exercise. Scand J Med Sci Sports 1999; 9: 219–25PubMedCrossRefGoogle Scholar
  135. 135.
    Lund H, Vestergaard-Poulsen P, Kanstrup IL, et al. The effect of passive stretching on delayed onset muscle soreness, and other detrimental effects following eccentric exercise. Scand J Med Sci Sports 1998; 8: 216–21PubMedCrossRefGoogle Scholar
  136. 136.
    High DM, Howley ET, Franks BD. The effects of static stretching and warm—up on prevention of delayed—onset muscle soreness. Res Q Exerc Sport 1989; 60: 357–61PubMedGoogle Scholar
  137. 137.
    Reisman S, Walsh LD, Proske U. Warm—up stretches reduce sensations of stiffness and soreness after eccentric exercise. Med Sci Sports Exerc 2005; 37: 929–36PubMedGoogle Scholar
  138. 138.
    Tiidus PM. Massage and ultrasound as therapeutic modalities in exercise induced muscle damage. Can J Appl Physiol 1999; 24: 267–78PubMedCrossRefGoogle Scholar
  139. 139.
    Smith LL, Keating MN, Holbert D, et al. The effects of athletic massage on delayed onset muscle soreness, creatine kinase, and neutrophil count: a preliminary report. J Orthop Sports Phys Ther 1994; 19: 93–9PubMedGoogle Scholar
  140. 140.
    Zainuddin Z, Newton M, Sacco P, et al. Effects of massage on delayed—onset muscle soreness, swelling, and recovery of muscle function. J Athl Train 2005; 40: 174–80PubMedGoogle Scholar
  141. 141.
    Hilbert JE, Sforzo GA, Swensen T. The effects of massage on delayed onset muscle soreness. Br J Sports Med 2003; 37: 72–5PubMedCrossRefGoogle Scholar
  142. 142.
    Mancinelli CA, Davis DS, Aboulhosn L, et al. The effects of massage on delayed onset muscle soreness and physical performance in female collegiate athletes. Phys Ther Sport 2006; 7: 5–13CrossRefGoogle Scholar
  143. 143.
    Ernst E. Does post—exercise massage treatment reduce delayed onset muscle soreness? A systematic review. Br J Sports Med 1998; 32: 212–4PubMedCrossRefGoogle Scholar
  144. 144.
    Moraska A. Sports massage: a comprehensive review. J Sports Med Phys Fitness 2005; 45: 370–80PubMedGoogle Scholar
  145. 145.
    Denegar CR, Perrin DH, Rogol A, et al. Influence of transcutaneous electrical nerve stimulation on pain, range of motion, and serum cortisol concentration in females experiencing delayed onset muscle soreness. J Orthop Sports Phys Ther 1989; 11: 100–3PubMedGoogle Scholar
  146. 146.
    Melzack R, Wall PD. Pain mechanisms: a new theory. Sci 1965; 19: 971–9CrossRefGoogle Scholar
  147. 147.
    Denegar CR, Perrin DH. Effect of transcutaneous electrical nerve stimulation, cold, and a combination treatment on pain, decreased range of motion, and strength loss associated with delayed onset muscle soreness. J Athl Train 1992; 27: 200–6PubMedGoogle Scholar
  148. 148.
    Weber MD, Servedio FJ, Woodall WR. The effects of three modalities on delayed—onset muscle soreness. J Orthop Sports Phys Ther 1994; 20: 236–42PubMedGoogle Scholar
  149. 149.
    Allen JD, Mattacola CG, Perrin DH. Effect of microcurrent stimulation on delayed—onset muscle soreness: a double—blind comparison. J Athl Train 1999; 34: 334–7PubMedGoogle Scholar
  150. 150.
    Lambert MI, Marcus P, Burgess T, et al. Electro—membrane microcurrent therapy reduces signs and symptoms of muscle damage. Med Sci Sports Exerc 2002; 34: 602–7PubMedCrossRefGoogle Scholar
  151. 151.
    Butterfield DL, Draper DO, Richard MD, et al. The effects of high—volt pulsed current electrical stimulation on delayed onset muscle soreness. J Athl Train 1997; 32: 15–20PubMedGoogle Scholar
  152. 152.
    Tourville TW, Connolly DA, Reed BV. Effects of sensory—level high—volt pulsed electrical current on delayed—onset muscle soreness. J Sports Sci 2006; 24: 941–9PubMedCrossRefGoogle Scholar
  153. 153.
    Brukner P, Khan K. Principles of treatment. In: Kesteven S, Pike C, editors. Clinical sports medicine. 2nd ed. Sydney (NSW): McGraw—Hill, 2001: 127–59Google Scholar
  154. 154.
    Hasson SM, Mundorf R, Barnes WS, et al. Effects of ultrasound on muscle soreness and performance [abstract]. Med Sci Sports Exerc 1989; 21: S36Google Scholar
  155. 155.
    Ciccone CD, Leggin BG, Callamaro JJ. Effects of ultrasound and trolamine salicylate phonophoresis on delayed—onset muscle soreness. Phys Ther 1991; 71: 666–75PubMedGoogle Scholar
  156. 156.
    Robertson VJ. Dosage and treatment response in randomized clinical trials of therapeutic ultrasound. Phys Ther Sport 2002; 3: 124–33Google Scholar
  157. 157.
    Meeusen R, Lievens P. The use of cryotherapy in sports injuries. Sports Med 1986; 3: 398–414PubMedCrossRefGoogle Scholar
  158. 158.
    Swenson C, Sward L, Karlsson J. Cryotherapy in sports medicine. Scand J Med Sci Sports 1996; 6: 193–200PubMedCrossRefGoogle Scholar
  159. 159.
    Zachazewski JE, Quillen WS, Magee DJ. Athletic injuries and rehabilitation. Philadelphia (PA): WB Saunders, 1996Google Scholar
  160. 160.
    Merrick MA, Rankin JM, Andres FA, et al. A preliminary examination of cryotherapy and secondary injury in skeletal muscle. Med Sci Sports Exerc 1999; 31: 1515–21Google Scholar
  161. 161.
    Yackzan L, Adams C, Francis KT. The effects of ice massage on delayed muscle soreness. Am J Sports Med 1984; 12: 159–65PubMedCrossRefGoogle Scholar
  162. 162.
    Isabel WK, Durrant E, Myrer W, et al. The effects of ice massage, ice massage with exercise, and exercise on the prevention and treatment of delayed onset muscle soreness. J Athl Train 1992; 27: 208–17Google Scholar
  163. 163.
    Howatson G, van Someren KA. Ice massage: effects on exercise—induced muscle damage. J Sports Med Phys Fitness 2003; 43: 500–5PubMedGoogle Scholar
  164. 164.
    Howatson G, Gaze D, van Someren KA. The efficacy of ice massage in the treatment of exercise—induced muscle damage. Scand J Med Sci Sports 2005; 15: 416–22PubMedCrossRefGoogle Scholar
  165. 165.
    Paddon-Jones DJ, Quigley BM. Effects of cryotherapy on muscle soreness and strength following eccentric exercise. Int J Sports Med 1997; 18: 588–93PubMedCrossRefGoogle Scholar
  166. 166.
    Eston R, Peters D. Effects of cold water immersion on the symptoms of exercise—induced muscle injury. J Sports Sci 1999; 17: 231–8PubMedCrossRefGoogle Scholar
  167. 167.
    Yanagisawa O, Niitsu M, Yoshioka H, et al. The use of magnetic resonance imaging to evaluate the effects of cooling on skeletal muscle after strenuous exercise. Eur J Appl Physiol 2003; 89: 53–62PubMedCrossRefGoogle Scholar
  168. 168.
    Sellwood KL, Brukner P, Williams D, et al. Ice—water immersion and delayed—onset muscle soreness: a randomised controlled trial. Br J Sports Med 2007; 41: 392–7PubMedCrossRefGoogle Scholar
  169. 169.
    Zainuddin Z, Sacco P, Newton P, et al. Light concentric exercise has a temporarily analgesic effect on delayed—onset muscle soreness, but no effect on recovery from eccentric contractions. Appl Physiol Nutr Metab 2006; 31: 126–34PubMedCrossRefGoogle Scholar
  170. 170.
    Allen TJ, Dumont TL, Mac Intyre DL. Exercise—induced muscle damage: mechanisms, prevention and treatment. Physiother Can 2004; 56: 67–79CrossRefGoogle Scholar
  171. 171.
    Hough T. Ergographic studies in muscular soreness. Am J Applied Physiol 1902; 7: 76–92Google Scholar
  172. 172.
    Nosaka K, Clarkson PM. Influence of previous concentric exercise on eccentric exercise—induced muscle damage. J Sports Sci 1997; 15: 477–83PubMedCrossRefGoogle Scholar
  173. 173.
    Evans RK, Knight KL, Draper DO, et al. Effects of warm—up before eccentric exercise on direct markers of muscle damage. Med Sci Sports Exerc 2002; 34: 1892–9PubMedCrossRefGoogle Scholar
  174. 174.
    Hasson SM, Barnes WS, Hunter M, et al. Therapeutic effects of high speed voluntary muscle contractions on muscle soreness and performance. J Orthop Sports Phys Ther 1989; 10: 499–507Google Scholar
  175. 175.
    Martin V, Millet GY, Lattier G, et al. Effects of recovery modes after knee extensor muscles eccentric contractions. Med Sci Sports Exerc 2004; 36: 1907–15PubMedCrossRefGoogle Scholar
  176. 176.
    Nosaka K, Sakamoto K, Newton M, et al. How long does the protective effect on eccentric exercise—induced muscle damage last? Med Sci Sports Exerc 2001; 33: 1490–5PubMedCrossRefGoogle Scholar
  177. 177.
    Nosaka K, Newton MJ, Sacco P, et al. Attenuation of protective effect against eccentric exercise—induced muscle damage. Can J Appl Physiol 2005; 30: 529–42PubMedCrossRefGoogle Scholar
  178. 178.
    Fielding RA, Violan MA, Svetkey L, et al. Bean effects of prior exercise on eccentric exercise-induced neutrophilia and enzyme release. Med Sci Sports Exerc 2000; 32: 359–64PubMedCrossRefGoogle Scholar
  179. 179.
    Nosaka K, Clarkson PM. Muscle damage following repeated bouts of high force eccentric exercise. Med Sci Sports Exerc 1995; 27: 1263–9PubMedGoogle Scholar
  180. 180.
    Mc Hugh MP, Connolly DAJ, Eston RG, et al. Exercise—induced muscle damage and potential mechanisms for the repeated bout effect. Sports Med 1999; 27: 157–70PubMedCrossRefGoogle Scholar
  181. 181.
    Sacco P, Jones DA. The protective effect of damaging eccentric exercise against repeated bouts of exercise in the mouse tibialis anterior muscle. Exp Physiol 1992; 77: 757–60PubMedGoogle Scholar
  182. 182.
    Ingalls CP, Warren GL, Zhang J-Z, et al. Dihydropyridine and ryanodine receptor binding after eccentric contractions in mouse skeletal muscle. J Appl Physiol 2004; 96: 1619–25PubMedCrossRefGoogle Scholar
  183. 183.
    Ingalls CP, Wenke JC, Nofal T, et al. Adaptation to lengthening contraction—induced injury in mouse muscle. J Appl Physiol 2004; 97: 1067–76PubMedCrossRefGoogle Scholar
  184. 184.
    Byrnes WC, Clarkson PM, White JS, et al. Delayed onset muscle soreness following repeated bouts of downhill running. J Appl Physiol 1985; 59: 710–5PubMedGoogle Scholar
  185. 185.
    Balnave CD, Thompson MW. Effects of training on eccentric exercise—induced muscle damage. J Appl Physiol 1993; 75: 1545–51PubMedGoogle Scholar
  186. 186.
    Eston RG, Finney S, Baker S, et al. Muscle tenderness and peak torque changes after downhill running following a prior bout of isokinetic eccentric exercise. J Sports Sci 1996; 14: 291–9PubMedCrossRefGoogle Scholar
  187. 187.
    Pizza FX, Davis BH, Henrickson SD, et al. Adaptation to eccentric exercise: effect on CD64 and CD11b/CD18 expression. J Appl Physiol 1996; 80: 47–55PubMedGoogle Scholar
  188. 188.
    Brown SJ, Child RB, Day SH, et al. Exercise—induced skeletal muscle damage and adaptation following repeated bouts of eccentric muscle contractions. J Sports Sci 1997; 15: 215–22PubMedCrossRefGoogle Scholar
  189. 189.
    Brockett CL, Morgan DL, Proske U. Human hamstring muscles adapt to eccentric exercise by changing optimum length. Med Sci Sports Exerc 2001; 33: 783–90PubMedGoogle Scholar
  190. 190.
    Miyama M, Nosaka K. Muscle damage and soreness following repeated bouts of consecutive drop jumps. Adv Exerc Sports Physio 2004; 10: 63–9Google Scholar
  191. 191.
    Clarkson PM, Tremblay I. Exercise—induced muscle damage, repair, and adaptation in humans. J Appl Physiol 1998; 65: 1–6Google Scholar
  192. 192.
    Ebbeling CB, Clarkson PM. Muscle adaptation prior to recovery following eccentric exercise. Med Sci Sports Exerc 1990; 15: 529–38Google Scholar
  193. 193.
    Mc Hugh MP, Connolly DAJ, Eston RG, et al. Electromyographic analysis of repeated bout effect. J Sports Sci 2001; 19: 163–70PubMedCrossRefGoogle Scholar
  194. 194.
    Chen TC. Effects of a second bout of maximal eccentric exercise on muscle damage and electromyography activity. Eur J Appl Physiol 2003; 89: 115–21PubMedCrossRefGoogle Scholar
  195. 195.
    Mair J, Mayr M, Muller E, et al. Rapid adaptation to eccentric exercise—induced muscle damage. Int J Sports Med 1995; 16: 352–6PubMedCrossRefGoogle Scholar
  196. 196.
    Nosaka K, Newton M. Repeated eccentric exercise bouts do not exacerbate muscle damage and repair. J Strength Cond Res 2002; 16: 117–22PubMedGoogle Scholar
  197. 197.
    Newham DJ, Jones DA, Clarkson PM. Repeated high—force eccentric exercise: effects on muscle pain and damage. J Appl Physiol 1987; 63: 1381–6PubMedGoogle Scholar
  198. 198.
    Howatson G, van Someren KA, Hortobágyi T. Repeated bout effect after maximal eccentric exercise. Int J Sports Med 2007; 28: 557–63PubMedCrossRefGoogle Scholar
  199. 199.
    Nosaka K, Sakamoto K, Newton M, et al. The repeated bout effect of reduced—load eccentric exercise on elbow flexor muscle damage. Eur J Appl Physiol 2001; 85: 34–40PubMedCrossRefGoogle Scholar
  200. 200.
    Nosaka K, Newton M. Concentric or eccentric training effect on eccentric exercise—induced muscle damage. Med Sci Sports Exerc 2002; 34: 63–9PubMedGoogle Scholar
  201. 201.
    Pettitt RW, Symonds DJ, Eisenman PA, et al. Eccentric strain at long muscle length evokes the repeated bout effect. J Strength Cond Res 2005; 19: 918–24PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  1. 1.School of Human SciencesSt Mary’s University CollegeStrawberry HillUK
  2. 2.English Institute of SportSt Mary’s University CollegeUK

Personalised recommendations