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The Role of Nutritional Supplements in the Prevention and Treatment of Resistance Exercise-Induced Skeletal Muscle Injury

Sports Medicine volume 37, pages 519–532 (2007)Cite this article

Abstract

The topic of exercise-induced skeletal muscle injury has received considerable attention in recent years. Likewise, strategies to minimise the injury resulting from heavy resistance exercise have been studied. Over the past 15 years, several investigations have been performed focused on the role of nutritional supplements to attenuate signs and symptoms of muscle injury. Of these, some have reported favourable results, while many others have reported no benefit of the selected nutrient. Despite these mixed findings, recommendations for the use of nutritional supplements for the purposes of attenuating muscle injury are rampant within the popular fitness media and athletic world, largely without scientific support. Those nutrients include the antioxidant vitamin C (ascorbic acid) and vitamin E (tocopherol), N-acetyl-cysteine, flavonoids, L-carnitine, astaxanthin, β-hydroxy-β-methylbutyrate, creatine monohydrate, essential fatty acids, branched-chain amino acids, bromelain, proteins and carbohydrates. A discussion of all published peer-reviewed articles in reference to these nutrients and their impact on resistance exercise-induced skeletal muscle injury is presented, in addition to a brief view into the potential mechanism of action for each nutrient.

Based on the current state of knowledge, the following conclusions can be made with regard to nutritional supplements and their role in attenuating signs and symptoms of skeletal muscle injury occurring as a consequence of heavy resistance exercise: (i) there appears to be a potential role for certain supplements (vitamin C, vitamin E, flavonoids, and L-carnitine); (ii) these supplements cannot effectively eliminate muscle injury, only attenuate certain signs and symptoms; (iii) it is presently unclear what the optimal dosage of these nutrients is (whether used alone or in combination); (iv) it is unclear what the optimal pretreatment period is; and (v) the effectiveness is largely specific to non-resistance trained individuals.

Ultimately, because so few studies have been conducted in this area, it is difficult to recommend with confidence the use of selected nutrients for the sole purpose of minimising signs and symptoms of resistance exercise-induced muscle injury, in particular with regard to resistance-trained individuals.

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References

  1. Byrne C, Twist C, Eston R. Neuromuscular function after exercise-induced muscle damage: theoretical and applied implications. Sports Med 2004; 34 (1): 49–69

    PubMed  Article  Google Scholar 

  2. Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med 2003; 33 (2): 145–64

    PubMed  Article  Google Scholar 

  3. Clarkson PM, Hubal MJ. Exercise-induced muscle damage in humans. Am I Phys Med Rehabil 2002; 81 (11 Suppl.): S52–69

    Article  Google Scholar 

  4. Friden J, Lieber RL. Eccentric exercise-induced injuries to contractile and cytoskeletal muscle fibre components. Acta Physiol Scand 2001; 171 (3): 321–6

    PubMed  Article  CAS  Google Scholar 

  5. Proske U, Allen TJ. Damage to skeletal muscle from eccentric exercise. Ex Sport Sci Rev 2005; 33 (2): 98–104

    Article  Google Scholar 

  6. Sorichter S, Puschendorf B, Mair J. Skeletal muscle injury induced by eccentric muscle acfion: muscle proteins as markers of muscle fiber injury. Ex Immun Rev 1999; 5: 5–21

    CAS  Google Scholar 

  7. McHugh MP. Recent advances in the understanding of the repeated bout effect the protective effect against muscle damage from a single bout of eccentric exercise. Scand J Med Sci Sports 2003; 13 (2): 88–97

    PubMed  Article  Google Scholar 

  8. Connolly DA, Sayers SP, McHugh MP. Treatment and prevention of delayed onset muscle soreness. J Strength Cond Res 2003; 17 (1): 197–208

    PubMed  Google Scholar 

  9. Mishra DK, Friden J, Schmitz MC, et al. Antiinflammatory medication after muscle injury: a treatment resulting in shortterm improvement but subsequent loss of muscle function. J Bone Joint Surg 1995; 77: 1510–9

    PubMed  CAS  Google Scholar 

  10. Goldfarb AH. Nutritional antioxidants as therapeufic and preventive modalities in exercise-induced muscle damage. Can J Appl Physiol 1999; 24 (3): 249–66

    PubMed  Article  CAS  Google Scholar 

  11. Lieber RL, Friden J. Selective damage of fast glycolytic muscle fibres with eccentric contraction of the rabbit fibialis anterior. Acta Physiol Scand 1988; 133 (4): 587–8

    PubMed  Article  CAS  Google Scholar 

  12. Nosaka K, Sakamoto K. Effect of joint angle on the magnitude of muscle damage to the elbow flexors. Med Sci Sports Exerc 2001; 33 (1): 22–9

    PubMed  CAS  Google Scholar 

  13. Lieber RL, Thornell L, Friden J. Muscle cytoskeleton dismption occurs within the first 15 minutes of cyclic eccentric contraclion. J Appl Physiol 1996; 80 (1): 278–84

    PubMed  Article  CAS  Google Scholar 

  14. Avery NG, Kaiser JL, Sharman MJ, et al. Effects of vitamin E supplementation on recovery fromrepeated bouts of resistance exercise. J Strength Cond Res 2003; 17 (4): 801–9

    PubMed  Google Scholar 

  15. Bloomer RJ, Goldfarb AH. Can nutritional supplements reduce exercise-induced skeletal muscle damage? J Strength Cond Res 2003 Oct; 25 (5): 30–7

    Article  Google Scholar 

  16. Beaton LJ, Allan DA, Tarnopolsky MA, et al. Contractioninduced muscle damage is unaffected by vitamin E supplementation. Med Sci Sports Exerc 2002; 34 (5): 798–805

    PubMed  Article  CAS  Google Scholar 

  17. Bloomer RJ, Fry AC, Schilling BE, et al. Astaxanthin supplementation does not attenuate muscle injury following eccentric exercise in resistance trained men. Int J Sport Nutr Exerc Metab 2005; 15: 401–12

    PubMed  CAS  Google Scholar 

  18. Bloomer RJ, Goldfarb AH, McKenzie MJ, et al. Effects of antioxidant therapy in females exposed to eccentric exercise. Int J Sport Nun Exerc Metab 2004; 14: 377–88

    CAS  Google Scholar 

  19. Childs A, Jacobs C, Kaminsky T, et al. Supplementation with vitamin C and Nacetylcysteine increases oxidative stress in humans after an acute muscle injury induced by eccentric exercise. Free Rad Biel Med 2001; 1 (6): 745–53

    Article  Google Scholar 

  20. Hoffman JR, Cooper J, Wendell M, et al. Effects of β-hydroxy-β-methylbutyrate on power performance and indices of muscle damage and stress during high-intensity training. J Strength Cond Res 2004; 18 (4): 747–52

    PubMed  Google Scholar 

  21. Kaminsky M, Boal R. An effect of ascorbic acid on delayedonset muscle soreness. Pain 1992; 50: 317–21

    Article  Google Scholar 

  22. Kreider RB, Ferreira M, Wilson M, et al. Effects of β-hydroxy-β-methylbutyrate (HMB) supplementation during resistance-training on markers of catabolism, body composition and strength. Int J Sports Med 1999; 20: 503–9

    PubMed  Article  CAS  Google Scholar 

  23. Lenn J, Uhl T, Mattacola C, et al. The effects of fish oil and isoflavones on delayed onset muscle soreness. Med Sci Sports Exerc 2002; 34 (10): 1605–13

    PubMed  Article  CAS  Google Scholar 

  24. McBride JM, Kraemer WJ, McBride T, et al. Effect of resistance exercise on free radical production. Med Sci Sports Exerc 1998; 30 (1): 67–72

    PubMed  Article  CAS  Google Scholar 

  25. Nissen SR, Sharp M, Ray JA, et al. Effect of leucine metabolite [β-hydroxy-β-methylbutyrate on muscle metabolism during resistance-exercise training. J Appl Physiol 1996; 81 (5): 2095–104

    PubMed  CAS  Google Scholar 

  26. Paddon-Jones D, Keech A, Jenkins D. Short-term beta-hydroxybeta-methylbutyrate supplementation does not reduce symptoms of eccentric muscle damage. Int J Sport Nun Exerc Metab 2001; 11 (4): 442–50

    CAS  Google Scholar 

  27. Phillips TAC, Childs DM, Green S, et al. A dietary supplement attenuates IL-6 and CRP after eccentric exercise in untrained males. Med Sci Sports Exerc 2003; 35 (12): 2032–7

    PubMed  Article  CAS  Google Scholar 

  28. Rawson ES, Gunn B, Clarkson PM. The effects of creatine supplementation on exercise-induced muscle damage. J Strength Cond Res 2001; 15 (2): 178–84

    PubMed  CAS  Google Scholar 

  29. 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 (1–2): 196–202

    PubMed  Article  CAS  Google Scholar 

  30. Shimonarra Y, Yamamoto Y, Bajotto G, et al. Nutraceutical effects of branched-chain amino acids on skeletal muscle. J Nutr 2006; 136 (2): 5295–32S

    Google Scholar 

  31. Stone MB, Merrick MA, Ingersoll CD, et al. Preliminary comparison of bromelain and ibuprofen for delayed onset muscle soreness management. Clin J Sport Med 2002; 12 (6): 373–8

    PubMed  Article  Google Scholar 

  32. Volek JS, Kraemer WJ, Ruben MR, et al. L-carnitine L-tartrate supplementation favorably affects markers of recovery from exercise stress. Am J Physiol Endocrinol Metab 2002; 282: E474–82

    PubMed  CAS  Google Scholar 

  33. Wojcik JR, Walberg-Rankin J, Smith LL, et al. Comparison of carbohydrate and ntilk-based beverage on muscle damage and glycogen following exercise. Int J Sport Nutr Ex Metab 2001; 11: 406–19

    CAS  Google Scholar 

  34. Bloomer RJ, Goldfarb AH. Anaerobic exercise and oxidative stress: a review. Can J Appl Physiol 2004; 29 (3): 245–63

    PubMed  Article  CAS  Google Scholar 

  35. McArdle A, Vasilaki A, Jackson M. Exercise and skeletal muscle ageing: cellular and molecular mechanisms. Aging Res Rev 2002; 1 (1): 79–93

    Article  CAS  Google Scholar 

  36. Vina J, Gomez-Cabrera MC, Hover A, et al. Free radicals in exhaustive physical exercise: mechanism of production, and protection by antioxidants. IUBMB Life 2000; 50 (4–5): 271–7

    PubMed  Article  CAS  Google Scholar 

  37. Zerba E, Komorowski ET, Faulkner JA. Free radical injury to skeletal muscles of young, adult and old mice. Am J Physiol 1990; 258: C429–35

    PubMed  CAS  Google Scholar 

  38. Jackson MJ. Exercise and oxygen radical production by muscle. In: Sen CK, Packer L, Hanninen O, editors. Handbook of oxidants and antioxidants in exercise. Amsterdam: Elsevier Science, 2000: 57–68

    Google Scholar 

  39. Packer JE, Slater TF, Wilson RL. Direct observation of a free radical interaction between vitamin E and vitamin C. Nature 1979; 278: 737–8

    PubMed  Article  CAS  Google Scholar 

  40. Alessio HM. Lipid peroxidation in healthy anddiseased models: influence of different types of exercise. In: Sen CK, Packer L, Hanninen O, editors. Handbook of oxidants and antioxidants in exercise. Amsterdam: Elsevier Science, 2000: 115–27

    Google Scholar 

  41. Warren GL, Lowe DA, Armstrong RB. Measurement tools used in the study of eccentric contraction-induced injury. Sports Med 1999; 27 (1): 43–59

    PubMed  Article  CAS  Google Scholar 

  42. Cale LA, Pagnin E, Davis PA, et al. Antioxidant effect of Lcarnitine and its short chain esters: relevance for the protection from oxidative stress related cardiovascular damage. Int J Cardiol 2006; 107 (1): 54–60

    Article  Google Scholar 

  43. Guerin M, Huntley ME, Olaizola M. Haematococcus astaxanthin: applications for human health and nutrition. Trends Biotechnol 2003; 21 (5): 210–6

    PubMed  Article  CAS  Google Scholar 

  44. Mortensen A, Skibsted LH, Truscoff TG. The interaction of dietary caroknoids with radical species. Arch Biochem Biophys 2001; 385 (1): 13–9

    PubMed  Article  CAS  Google Scholar 

  45. Am W, Naito Y, Sakuma K, et al. Astaxantlun limits exerciseinduced skeletal and cardiac muscle damage in once. Antioxid Redox Signal 2003; 5 (1): 139–44

    Article  Google Scholar 

  46. Harper A, Ken DJ, Gescher A, et al. Antioxidant effects of isoflavonoids and fgnans, and protection against DNA oxidation. Free Radic Res 1999; 31: 149–60

    PubMed  Article  CAS  Google Scholar 

  47. Osnowski K, Rhode T, Asp S, et al. Pro- and anfi-inflammatory cytokine balance in strenuous exercise in humans. J Physiol 1999; 515: 287–91

    Article  Google Scholar 

  48. More A. Leucine supplementation and intensive training. Sports Med 1999; 27 (6): 347–58

    Article  Google Scholar 

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. The author has no conflicts of interest that are directly relevant to the content of this review.

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  1. Department of Health and Sport Sciences, The University of Memphis, 161F Elma Neal Roane Fieldhouse, Memphis, Tennessee, 38152-3480, USA

    Richard J. Bloomer

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Correspondence to Richard J. Bloomer.

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Bloomer, R.J. The Role of Nutritional Supplements in the Prevention and Treatment of Resistance Exercise-Induced Skeletal Muscle Injury. Sports Med 37, 519–532 (2007). https://doi.org/10.2165/00007256-200737060-00005

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Keywords

  • Creatine Kinase
  • Resistance Exercise
  • Astaxanthin
  • Nutritional Supplement
  • Muscle Injury