Changes in indicators of inflammation after eccentric exercise of the elbow flexors

The microcycle of inflammation and performance changes after a basketball match

Basketball incorporates intense eccentric muscle activity that induces muscle microtrauma and an inflammatory response. This study investigated time-dependent inflammatory and performance responses during a weekly microcycle after a basketball match. Twenty elite-standard players underwent a trial that comprised a match followed by a 6-day simulated in-season microcycle. The trial was preceded by a control condition that did not have a match. Blood sampling and tests of maximal-intensity exercise performance and muscle damage occurred before each condition, immediately after the match and daily thereafter for 6 consecutive days. The match induced marked increases in heart rate, lactate, ammonia, glucose, non-esterified fatty acids and triglycerides. Performance deteriorated for 24-48 h after the match, whereas knee flexor and extensor soreness increased for 48 and 24 h post-match, respectively. Inflammatory (leukocytes, C-reactive protein, creatine kinase activity, adhesion molecules, cortisol, uric acid and cytokines) and oxidative stress (malondialdehyde, protein carbonyls, oxidised glutathione, antioxidant capacity, catalase and glutathione peroxidase) markers increased for ~24 h and subsided thereafter. Reduced glutathione declined for 24 h after exercise. These results suggest that a basketball match elicits moderate and relatively brief (~24-48 h) inflammatory responses, is associated with marked but short-lived performance deterioration, but is less stressful than other intermittent-type sports.

Muscle as a secretory organ

Skeletal muscle is the largest organ in the body. Skeletal muscles are primarily characterized by their mechanical activity required for posture, movement, and breathing, which depends on muscle fiber contractions. However, skeletal muscle is not just a component in our locomotor system. Recent evidence has identified skeletal muscle as a secretory organ. We have suggested that cytokines and other peptides that are produced, expressed, and released by muscle fibers and exert either autocrine, paracrine, or endocrine effects should be classified as "myokines." The muscle secretome consists of several hundred secreted peptides. This finding provides a conceptual basis and a whole new paradigm for understanding how muscles communicate with other organs such as adipose tissue, liver, pancreas, bones, and brain. In addition, several myokines exert their effects within the muscle itself. Many proteins produced by skeletal muscle are dependent upon contraction. Therefore, it is likely that myokines may contribute in the mediation of the health benefits of exercise.

Influence of physical activity and nutrition on obesity-related immune function

Research examining immune function during obesity suggests that excessive adiposity is linked to impaired immune responses leading to pathology. The deleterious effects of obesity on immunity have been associated with the systemic proinflammatory profile generated by the secretory molecules derived from adipose cells. These include inflammatory peptides, such as TNF- α , CRP, and IL-6. Consequently, obesity is now characterized as a state of chronic low-grade systemic inflammation, a condition considerably linked to the development of comorbidity. Given the critical role of adipose tissue in the inflammatory process, especially in obese individuals, it becomes an important clinical objective to identify lifestyle factors that may affect the obesity-immune system relationship. For instance, stress, physical activity, and nutrition have each shown to be a significant lifestyle factor influencing the inflammatory profile associated with the state of obesity. Therefore, the purpose of this review is to comprehensively evaluate the impact of lifestyle factors, in particular psychological stress, physical activity, and nutrition, on obesity-related immune function with specific focus on inflammation.

Anti-inflammatory interventions and skeletal muscle injury: benefit or detriment?

Exercise, eccentric contractions, acute trauma, and disease are all causal mechanisms of skeletal muscle injury. After skeletal muscle is injured, it undergoes sequential phases of degeneration, inflammation, regeneration, and fibrosis. Events that occur in response to inflammation trigger regenerative processes. However, since inflammation causes pain, decreases skeletal muscle function, has a negative effect on performance, and contributes to fibrosis, which is one of the leading causes of delayed regeneration, the general practice has been to reduce inflammation. The problem with this approach is that preventing inflammation may hinder recovery. Current treatment options for inflammation are not necessarily effective and, in some cases, they may be unsafe. This review focuses on the question of whether the most beneficial course of treatment should be to block inflammation or if it is sensible to allow inflammatory processes to progress naturally. If blocking inflammation is perceived as a beneficial approach, it is not yet known at what time point during the inflammatory response it is most sensible to interfere. To address these issues, this review evaluates the effects of various anti-inflammatory agents on recovery processes in response to exercise-induced, traumatic, and disease-associated models of skeletal muscle injury. A collective analysis such as this should lay the foundation for future work that systematically manipulates the inflammatory response to most effectively promote regeneration and functional recovery in injured skeletal muscle, while reducing the negative effects of inflammatory processes such as pain and fibrosis.

Effects of taurine supplementation following eccentric exercise in young adults

The purpose of the present study was to investigate the effects of taurine supplementation on muscle performance, oxidative stress, and inflammation response after eccentric exercise (EE) in males. Twenty-one participants (mean age, 21 ± 6 years; weight, 78.2 ± 5 kg; height, 176 ± 7 cm) were selected and randomly divided into two groups: placebo (n = 10) and taurine (n = 11). Fourteen days after starting supplementation, subjects performed EE (3 sets until exhaustion, with EE of the elbow flexors on the Scott bench, 80% 1 repetition maximum (RM)). Blood samples were collected and muscle performance was measured on days 1, 14, 16, 18, and 21 after starting the supplements. Then, performance, muscle damage, oxidative stress, and inflammatory markers were analyzed. The taurine supplementation resulted in increased strength levels and thiol total content and decreased muscle soreness, lactate dehydrogenase level, creatine kinase activity, and oxidative damage (xylenol and protein carbonyl). Antioxidant enzymes (superoxide dismutase, catalase, and gluthatione peroxidase) and inflammatory markers (tumor necrosis factor, interleukin-1β (IL-1β), and interleukin-10 (IL-10)) were not altered during the recovery period compared with the placebo group. The results suggest that taurine supplementation represents an important factor in improving performance and decreasing muscle damage and oxidative stress but does not decrease the inflammatory response after EE.

The effect of fasting on indicators of muscle damage

Many studies have tested the consumption of foods and supplements to reduce exercise-induced muscle damage, but fasting itself is also worthy of investigation due to reports of beneficial effects of caloric restriction and/or intermittent fasting on inflammation and oxidative stress. This preliminary investigation compared indicators of exercise-induced muscle damage between upper-body untrained participants (N=29, 22yrs old (SD=3.34), 12 women) who completed 8h water-only fasts or ate a controlled diet in the 8h prior to five consecutive laboratory sessions. All sessions were conducted in the afternoon hours (i.e., post meridiem) and the women completed the first session while in the follicular phase of their menstrual cycles. Measures of muscle pain, resting elbow extension, upper arm girth, isometric strength, myoglobin (Mb), total nitric oxide (NO), interleukin 1beta (IL1b), and tumor necrosis factor alpha (TNFa) were collected before and after eccentric contractions of the non-dominant elbow flexors were completed. The fasting group's loss of elbow extension was less than the post-prandial group (p<.05, eta(2)=.10), but the groups did not change differently across time for any other outcome measures. However, significantly higher NO (p<.05, eta(2)=.22) and lower TNFa (p<.001, eta(2)=.53) were detected in the fasting group than the post-prandial group regardless of time. These results suggest intermittent fasting does not robustly inhibit the signs and symptoms of exercise-induced muscle damage, but such fasting may generally affect common indirect markers of muscle damage.

Dynamic, but not static, pain sensitivity predicts exercise-induced muscle pain: covariation of temporal sensory summation and pain intensity

Cross-section studies suggest that measures of pain sensitivity, derived from quantitative sensory testing (QST), are elevated in persons with chronic pain conditions. However, little is known about whether development of chronic pain is preceded by elevated pain sensitivity or pain sensitivity increases as a result of prolonged experience of pain. Here we used QST to test static (single suprathreshold stimuli) and dynamic (temporal sensory summation) pain processing of thermal stimuli. Muscle pain was induced using high-intensity exercise (DOMS). Multi-level modeling approaches determined the daily covariation among static and dynamic QST measures and pain intensity. Variation in responses to static pain sensitivity was not associated with pain intensity from DOMS while, in contrast, variation in dynamic pain sensitivity was positively associated with variation in pain intensity from DOMS. This finding supports the use of TSS as a marker of the central pain state and potentially as an appropriate measure for treatment monitoring.

Efeitos de um tratamento combinado (vitamina C pré-exercício e alongamento FNP, tratamento com ultrassom pós-exercício) sobre marcadores de dano muscular induzido por exercício

CONTEXTO: Várias estratégias de recuperação têm sido utilizadas na tentativa de minimizar os sintomas da dor muscular de início tardio (DMIT). Contudo, evidências científicas que apoiem este efeito profilático (pré-exercício) e terapêutico (pós-exercício) de um tratamento combinado (FNP e vitamina C, ultrassom) no dano muscular são inexistentes. OBJETIVO: Investigar os efeitos de um tratamento combinado (FNP e vitamina C, ultrassom) nos marcadores bioquímicos (níveis enzimáticos) e funcionais (ângulo do cotovelo, circunferência de braço, taxa de dor) de dano muscular induzido por exercício. MÉTODO: Amostra randomizada controlada. LOCAL: Laboratório da Universidade. PARTICIPANTES: Alunos universitários masculinos participaram voluntariamente do estudo, o qual não reportou nenhuma dor muscular de início tardio por no mínimo seis meses antes do estudo. Posteriormente, os sujeitos foram agrupados aleatoriamente em subgrupos com mão controle e mão experimental. INTERVENÇÃO(ÕES): Programa de exercício para indução de dano muscular induzido por exercício envolvendo o teste de bíceps Scott (contração excêntrica com duas mãos). PROCEDIMENTO(S) PRINCIPAL(IS): Circunferência de braço relaxado, circunferência de braço flexionado, ângulo de cotovelo em descanso, circunferência de antebraço, amplitude de movimento de cotovelo flexionado, amplitude de movimento de cotovelo estendido, dano muscular induzido por exercício, força máxima voluntária isométrica e isocinética foram registrados basal, imediatamente após exercício e 24, 48, 72 e 96 horas após exercício. RESULTADOS: O subgrupo experimental manifestou redução de sintomas de DMIT em menor amplitude de movimento de cotovelo flexionado e amplitude de movimento de cotovelo estendido, menor perda de força isométrica e isocinética voluntária máxima (P < 0,05) em comparação com o subgrupo controle. Contudo, nenhum efeito na circunferência de braço relaxado, circunferência de braço flexionado, ângulo de cotovelo em descanso ou circunferência de antebraço foi observado (P >0,05). CONCLUSÃO: Este tratamento combinado foi eficiente em contração máxima voluntária isométrica, dor muscular de início tardio e taxa de intensidade de dor ao longo do tempo. Finalmente, os resultados sugerem que os tratamentos combinados são eficientes na manutenção de força isométrica e diminuição de dor muscular de início tardio e taxa de intensidade de dor.

Two maximal isometric contractions attenuate the magnitude of eccentric exercise-induced muscle damage

This study investigated whether maximal voluntary isometric contractions (MVC-ISO) would attenuate the magnitude of eccentric exercise-induced muscle damage. Young untrained men were placed into one of the two experimental groups or one control group (n = 13 per group). Subjects in the experimental groups performed either two or 10 MVC-ISO of the elbow flexors at a long muscle length (20° flexion) 2 days prior to 30 maximal isokinetic eccentric contractions of the elbow flexors. Subjects in the control group performed the eccentric contractions without MVC-ISO. No significant changes in maximal voluntary concentric contraction peak torque, peak torque angle, range of motion, upper arm circumference, plasma creatine kinase (CK) activity and myoglobin concentration, muscle soreness, and ultrasound echo intensity were evident after MVC-ISO. Changes in the variables following eccentric contractions were smaller (P < 0.05) for the 2 MVC-ISO group (e.g., peak torque loss at 5 days after exercise, 23% ± 3%; peak CK activity, 1964 ± 452 IU·L–1; peak muscle soreness, 46 ± 4 mm) or the 10 MVC-ISO group (13% ± 3%, 877 ± 198 IU·L–1, 30 ± 4 mm) compared with the control (34% ± 4%, 6192 ± 1747 IU·L–1, 66 ± 5 mm). The 10 MVC-ISO group showed smaller (P < 0.05) changes in all variables following eccentric contractions compared with the 2 MVC-ISO group. Therefore, two MVC-ISO conferred potent protective effects against muscle damage, whereas greater protective effect was induced by 10 MVC-ISO, which can be used as a strategy to minimize muscle damage.

Changes in bone alkaline phosphatase and procollagen type-1 C-peptide after static and dynamic exercises

We investigated the effects of two types of nonweight-bearing exercise on changes in bone-specific alkaline phosphatase (BAP) and procollagen type 1 C-peptide (PIP). BAP is a specific marker of bone synthesis, whereas P1P reflects synthesis of type 1 collagen in other organs as well as bone. Eight participants performed static and dynamic unilateral knee extensions. BAP and PIP were measured before, and at 1, 2, 24, 48, and 72 hr after exercise. PIP increased at 24 hr after a static knee extension exercise, whereas BAP did not change during the experimental period. We found no changes in these markers after dynamic exercise. These results imply that type I collagen synthesis in tendons increases after static exercise.

Non-uniform muscle adaptations to eccentric exercise and the implications for training and sport

Due to the variations in morphological and architectural characteristics of fibers within a skeletal muscle, regions of a muscle may be differently affected by eccentric exercise. Although eccentric exercise may be beneficial for increasing muscle mass and can be beneficial for the treatment of tendinopathies, the non-uniform effect of eccentric exercise results in regional muscle damage and as a consequence, non-uniform changes in muscle activation. This regional muscle weakness can contribute to muscle strength imbalances and may potentially alter the load distribution on joint structures, increasing the risk of injury. In this brief review, the non-uniform effects of eccentric exercise are reviewed and their implications for training and sport are considered.

Magnitude of spinal muscle damage is not statistically associated with exercise-induced low back pain intensity

BACKGROUND CONTEXT

Findings on imaging of noncontractile anatomic abnormalities and the intensity of low back pain have weak associations because of false-positive rates among asymptomatic individuals. This association might be stronger for contractile tissues.

PURPOSE

The purpose of this study was to examine the relationship between location and reports of pain intensity in the low back and exercise-induced muscle damage to the lumbar paraspinal muscles.

STUDY DESIGN

Nondiagnostic observational study in a laboratory setting.

METHODS

Delayed onset muscle soreness was induced in the low back of healthy pain-free volunteers. Measures of pain intensity (100-mm visual analog scale [VAS]) and location (area on the pain diagram) were taken before and 48 hours after exercise. Muscle damage was quantified using mechanical pain thresholds, motor performance deficits, and transverse relaxation time (T2)-weighted magnetic resonance imaging (MRI). Changes pre- to postexercise in signal intensity on T2-weighted imaging within the erector spinae, pain intensity, pain area, mechanical pain threshold, and isometric torque were assessed using paired t tests. Bivariate correlations were conducted to assess associations among muscle damage, pain intensity, and pain drawing area.

RESULTS

Twenty participants volunteered (11 women; average age, 22.3 years; average body mass index, 23.5) for study participation. Reports of pain intensity at 48 hours ranged from 0 to 59 mm on the VAS. Muscle damage was confirmed by reductions in mechanical threshold (p=.011) and motor performance (p<.001) and by changes in T2-weighted MRI (p=.007). This study was powered to find an association of at least r=0.5 to be statistically significant. Correlations of continuous variables revealed no significant correlations between pain intensity and measures of muscle damage (ranging between -0.075 and 0.151). There was a significant association between the remaining torque deficit at 48 hours and pain area.

CONCLUSIONS

The results of this study indicate that there was no association between the magnitude of muscle damage in the lumbar erector spinae and reported pain intensity in the low back. In future studies, larger cohorts may report statistically significant associations, but our data suggest that there will be low magnitude potentially indicating limited clinical relevance.

Effects of the homeopathic remedy arnica on attenuating symptoms of exercise-induced muscle soreness

OBJECTIVE

To evaluate the clinical efficacy of Arnica at a high potency (200c), on moderating delayed onset muscle soreness and accompanying symptoms of muscle dysfunction.

METHODS

Twenty subjects completed a maximal eccentric exercise protocol with the non-dominate elbow flexors to induce delayed onset muscle soreness. Either Arnica or placebo tablets were administered in a random, double- blinded fashion immediately after exercise and at 24 hours and 72 hours after exercise. Before exercise, immediately post-exercise, and at 24, 48, 72, and 96 hours post-exercise, assessments of delayed onset muscle soreness and muscle function included: 1) muscle soreness and functional impairment; 2) maximum voluntary contraction torque; 3) muscle swelling; and 4) range of motion tests to document spontaneous muscle shortening and muscle shortening ability. Blood samples drawn before exercise and at 24, 48, and 96 hours after exercise were used to measure muscle enzymes as indirect indices of muscle damage.

RESULTS

Regardless of the intervention, the extent of delayed onset muscle soreness and elevations in muscle enzymes were similar on the days following the eccentric exercise protocol. The post-exercise time profiles of decreases in maximum voluntary contraction torque and muscle shortening ability and increases in muscle swelling and spontaneous muscle shortening were similar for each treatment intervention.

CONCLUSIONS

The results of this study did not substantiate the clinical efficacy of Arnica at a high potency on moderating delayed onset muscle soreness and accompanying symptoms of muscle dysfunction. Despite the findings of this study, future investigations on the clinical efficacy of homeopathic interventions should consider incorporating research strategies that emphasize differential therapeutics for each patient rather than treating a specific disease or symptom complex, such as DOMS, with a single homeopathic remedy.

Comparison in muscle damage between maximal voluntary and electrically evoked isometric contractions of the elbow flexors

This study compared between maximal voluntary (VOL) and electrically stimulated (ES) isometric contractions of the elbow flexors for changes in indirect markers of muscle damage to investigate whether ES would induce greater muscle damage than VOL. Twelve non-resistance-trained men (23-39 years) performed VOL with one arm and ES with the contralateral arm separated by 2 weeks in a randomised, counterbalanced order. Both VOL and ES (frequency 75 Hz, pulse duration 250 μs, maximally tolerated intensity) exercises consisted of 50 maximal isometric contractions (4-s on, 15-s off) of the elbow flexors at a long muscle length (160°). Changes in maximal voluntary isometric contraction torque (MVC), range of motion, muscle soreness, pressure pain threshold and serum creatine kinase (CK) activity were measured before, immediately after and 1, 24, 48, 72 and 96 h following exercise. The average peak torque over the 50 isometric contractions was greater (P < 0.05) for VOL (32.9 ± 9.8 N m) than ES (16.9 ± 6.3 N m). MVC decreased greater and recovered slower (P < 0.05) after ES (15% lower than baseline at 96 h) than VOL (full recovery). Serum CK activity increased (P < 0.05) only after ES, and the muscles became more sore and tender after ES than VOL (P < 0.05). These results showed that ES induced greater muscle damage than VOL despite the lower torque output during ES. It seems likely that higher mechanical stress imposed on the activated muscle fibres, due to the specificity of motor unit recruitment in ES, resulted in greater muscle damage.

Time-course of changes in oxidative stress and antioxidant status responses following a soccer game

Exercise-induced muscle damage is associated with an acute-phase inflammatory response characterized by phagocyte infiltration into muscle and free radical production. Although soccer includes intense eccentric muscle actions that cause muscle damage, the oxidative stress responses after a soccer game are currently unknown. The present investigation attempted to determine the responses of circulating levels of oxidative stress and antioxidant status markers during recovery from a soccer game. Twenty soccer players (experimental group) were assigned to 2 different teams that competed against each other (2 × 45 minutes). Ten other players served as controls (rested). Creatine kinase (CK) activity, uric acid, leukocyte count, malondialdehyde (MDA), protein carbnyls (PC), reduced (GSH) and oxidized glutathione (GSSG), antioxidant capacity (TAC), catalase, glutathione peroxidase activity (GPX), delayed-onset of muscle soreness (DOMS), and anaerobic performance (speed, vertical jump performance) were measured before and following (immediately post, 24 hours, 48 hours, 72 hours) the game. Performance deteriorated (2-17%, p < 0.05) throughout recovery. Leukocytosis developed (p < 0.05) immediately following the game and at 24 hours. Both CK and DOMS (3-8-fold, p < 0.05) increased from baseline and remained elevated (p < 0.05) through 48 hours. Thiobarbituric acid reactive substances (TBARS), PC, uric acid, GPX, and TAC increased (13-67%, p < 0.05) throughout recovery, whereas catalase was elevated (38%, p < 0.05) only immediately after the game. GSH/GSSG declined (17-75%, p < 0.05) throughout recovery. Our results suggest that oxidative stress is markedly upregulated by a soccer game, probably as a part of the exercise-induced inflammatory response, and is accompanied by a marked deterioration of anaerobic performance for as long as 72 hours.

Neuromuscular consequences of an extreme mountain ultra-marathon

We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM) with 9500 m of positive and negative elevation change. For this purpose, (i) the fatigue induced by the MUM and (ii) the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF) and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22), and 2, 5, 9 and 16 days after the MUM (n = 11) in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (-35% [95% CI: -28 to -42%] and -39% [95% CI: -32 to -46%] for KE and PF, respectively), with alteration of maximal voluntary activation, mainly for KE (-19% [95% CI: -7 to -32%]). Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144 ± 94 to 13,633 ± 12,626 UI L(-1)), myoglobin (from 32 ± 22 to 1,432 ± 1,209 µg L(-1)), and C-Reactive Protein (from <2.0 to 37.7 ± 26.5 mg L(-1)). Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration) were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline.

Acute resistance exercise results in catecholaminergic rather than hypothalamic-pituitary-adrenal axis stimulation during exercise in young men

Exercise is a paradigm of a stress situation. The adaptive response to stressors comprises the activation of the hypothalamic-pituitary-adrenal (HPA) axis and components of the autonomic sympathetic system. An aseptic inflammatory reaction is triggered by exercise, involving the stimulation of the so-called proinflammatory cytokines, such as tumor necrosis factor α (TNFα), interleukin-1 (IL-1), and IL-6. The anti-inflammatory cytokines IL-2, IL-8, and IL-10 increase moderately during resistance exercise. To investigate the effect of a short bout of resistance exercise on components of the stress and inflammatory responses during the exercise period, 17 healthy, young, untrained male volunteers were studied during 3 equal consecutive cycles of resistance exercises of 30 min total duration. Blood sampling was performed at baseline and at the end of each cycle. Lactate, cortisol, catecholamines (epinephrine, norepinephrine), IL-1α, IL-1β, IL-2, IL-6, IL-8, IL-10, epidermal growth factor (EGF), and monocyte chemotactic protein-1 (MCP-1) were measured at all time-points. Circulating levels of catecholamines and lactate increased significantly (P < 0.05) whereas cortisol did not. During the time course of the exercise, circulating levels of TNFα, IL-2, and EGF increased, whereas MCP-1 decreased significantly. IL-1α, IL-1β, IL-6, IL-8, and IL-10 levels did not change significantly. Statistically significant positive linear correlations were found between areas under the curve for increases in levels of IL-2 and TNFα, TNFα and cortisol, as well as epinephrine and norepinephrine. We conclude that acute resistance exercise results in catecholaminergic, but not HPA axis stimulation during exercise, in parallel with a mild inflammatory reaction. The absence of a major inflammatory reaction and of a cortisol increase during acute resistance exercise makes this a good candidate for the exercise of sedentary individuals.

Whey protein isolate attenuates strength decline after eccentrically-induced muscle damage in healthy individuals

Background

We examined the effects of short-term consumption of whey protein isolate on muscle proteins and force recovery after eccentrically-induced muscle damage in healthy individuals.

Methods

Seventeen untrained male participants (23 ± 5 yr, 180 ± 6 cm, 80 ± 11 kg) were randomly separated into two supplement groups: i) whey protein isolate (WPH; n = 9); or ii) carbohydrate (CHO; n = 8). Participants consumed 1.5 g/kg.bw/day supplement (~30 g consumed immediately, and then once with breakfast, lunch, in the afternoon and after the evening meal) for a period of 14 days following a unilateral eccentric contraction-based resistance exercise session, consisting of 4 sets of 10 repetitions at 120% of maximum voluntary contraction on the leg press, leg extension and leg flexion exercise machine. Plasma creatine kinase and lactate dehydrogenase (LDH) levels were assessed as blood markers of muscle damage. Muscle strength was examined by voluntary isokinetic knee extension using a Cybex dynamometer. Data were analyzed using repeated measures ANOVA with an alpha of 0.05.

Results

Isometric knee extension strength was significantly higher following WPH supplementation 3 (P < 0.05) and 7 (P < 0.01) days into recovery from exercise-induced muscle damage compared to CHO supplementation. In addition, strong tendencies for higher isokinetic forces (extension and flexion) were observed during the recovery period following WPH supplementation, with knee extension strength being significantly greater (P < 0.05) after 7 days recovery. Plasma LDH levels tended to be lower (P = 0.06) in the WPH supplemented group during recovery.

Conclusions

The major finding of this investigation was that whey protein isolate supplementation attenuated the impairment in isometric and isokinetic muscle forces during recovery from exercise-induced muscle injury.

Comparison in eccentric exercise-induced muscle damage among four limb muscles

This study tested the hypothesis that changes in indirect markers of muscle damage following maximal eccentric exercise would be smaller for the knee extensors (KE) and flexors (KF) compared with the elbow flexors (EF) and extensors (EE). A total of 17 sedentary men performed five sets of six maximal isokinetic (90° s(-1)) eccentric contractions of EF (range of motion, ROM: 90°-0°, 0 = full extension), EE (55°-145°), KF (90°-0°), and KE (30°-120°) using a different limb with a 4-5-week interval in a counterbalanced order. Changes in maximal isometric and concentric isokinetic strength, optimum angle, limb circumference, ROM, plasma creatine kinase activity and myoglobin concentration, muscle soreness, and echo-intensity of B-mode ultrasound images before and for 5 days following exercise were compared amongst the four exercises using two-way repeated-measures ANOVA. All variables changed significantly following EF, EE, and KF exercises, but KE exercise did not change the optimum angle, limb circumference, and echo-intensity. Compared with KF and KE, EF and EE showed significantly greater changes in all variables, without significant differences between EF and EE. Changes in all variables were significantly greater for KF than KE. For the same subjects, the magnitude of change in the dependent variables following exercise varied among the exercises. These results suggest that the two arm muscles are equally more susceptible to muscle damage than leg muscles, but KF is more susceptible to muscle damage than KE. The difference in the susceptibility to muscle damage seems to be associated with the use of muscles in daily activities.

Time course of changes in performance and inflammatory responses after acute plyometric exercise

The objectives of the present investigation were to study the inflammatory and performance responses after an acute bout of intense plyometric exercise during a prolonged recovery period. Participants were randomly assigned to either an experimental group (P, n = 12) that performed intense plyometric exercises or a control group (C, n = 12) that rested. The delayed onset of muscle soreness (DOMS), knee range of motion (KROM), creatine kinase (CK) and lactate dehydrogenase (LDH) activities, white blood cell count, C reactive protein (CRP), uric acid (UA), cortisol, testosterone, IL-6, IL-1b strength (isometric and isokinetic), and countermovement (CMJ) and static (SJ) jumping performance were measured at rest, immediately postexercise and at 24, 48, 72, 96, and 120 hours of recovery. Lactate was measured at rest and postexercise. Strength remained unchanged throughout recovery, but CMJ and SJ declined (p < 0.05) by 8-20%. P induced a marked rise in DOMS, CK, and LDH (peaked 24-48 hours postexercise) and a KROM decline. An acute-phase inflammatory response consisting of leukocytosis (postexercise and at 24 hours), an IL-6, IL-1b, CRP, and cortisol elevation (during the first 24 hours of recovery) and a delayed increase of UA (peaked at 48 hours) and testosterone (peaked at 72 hours) was observed in P. The results of this investigation indicate that performing an acute bout of intense plyometric exercise may induce a short-term muscle damage and marked but transient inflammatory responses. Jumping performance seems to deteriorate for as long as 72 hours postexercise, whereas strength appears to remain unchanged. The acute-phase inflammatory response after a plyometric exercise protocol appears to follow the same pattern as in other exercise models. These results clearly indicate the need of sufficient recovery between successive plyometric exercise training sessions.

Neural and morphological changes in response to a 20-day intense eccentric training protocol

The purpose of this study was to examine the time course of adaptation through 20 days of eccentric training and 5 days of detraining. A total of 22 untrained subjects trained one arm every 2nd day for 20 days. Subjects performed maximal isokinetic eccentric biceps brachii training at 90 degrees /s (six sets of eight reps). Muscle thickness (reported in cm) via ultrasound, strength (reported in Nm) and muscle activation (electromyography) were measured before, during, and after training (nine time points). Strength in the trained arm decreased after 8 days of training (65.6 +/- 4.1 to 57.5 +/- 3.5; p < 0.05) and remained decreased throughout the study. Agonist muscle activation amplitude of the trained arm increased after 14 days of training (p < 0.05) and remained elevated throughout the study. Antagonist muscle activation decreased after 20 days of training (p < 0.05). Muscle thickness increased after 8 days of training (3.66 +/- 0.11 to 3.90 +/- 0.12; p < 0.05) and remained above baseline until the end of training (3.97 +/- 0.12). After 5 days of detraining, muscle thickness decreased (3.97 +/- 0.12 vs. 3.85 +/- 0.11; p < 0.05), but remained higher than baseline (p < 0.05). Muscle thickness did not change significantly in the untrained arm at any time point. In conclusion, the early increase in biceps brachii muscle thickness coupled with a significant decrease in strength is an indicator of muscle damage leading to swelling and impaired muscle function. The persistent decrease in strength, despite an increase in muscle activation, suggests that the recovery interval was inadequate to allow complete repair of muscle damage. Intense eccentric training performed every 2nd day leads to a prolonged impairment of muscle strength in previously untrained individuals.

Seven weeks of instability and traditional resistance training effects on strength, balance and functional performance

The objective of the study was to compare the effect of a 7-week unstable and stable resistance training program on measures of strength, balance, and functional performance. Forty participants were divided into unstable or stable resistance training groups. Training was conducted twice a week for 7 weeks. Pre- and post-testing measures included leg extension strength, static and dynamic balance, sit-ups, long jump, hopping test for time, shuttle run, and sprint. Results showed that there was no overall difference between unstable and stable resistance training and the training effects were independent of gender. All measures except sprint time improved with training. Interaction effects demonstrated that unstable resistance training did provide an advantage for number of sit-ups performed (p = 0.03; 8.9%) and the right leg hopping test (6.2%; p = 0.0001). This study has demonstrated that instability resistance training may be considered as effective as traditional stable resistance training for inexperienced resistance trainers. Based on the present study and the literature, instability resistance training should be incorporated in conjunction with traditional stable training to provide a greater variety of training experiences without sacrificing training benefits.

The decrease in electrically evoked force production is delayed by a previous bout of stretch-shortening cycle exercise

AIM

Unaccustomed physical exercise with a large eccentric component is accompanied by muscle damage and impaired contractile function, especially at low stimulation frequencies. A repeated bout of eccentric exercise results in less damage and improved recovery of contractile function. Here we test the hypotheses that (1) a prior stretch-shortening cycle (SSC) exercise protects against impaired muscle function during a subsequent bout of SSC exercise and (2) the protection during exercise is transient and becomes less effective as the exercise progresses.

METHODS

Healthy untrained men (n = 7) performed SSC exercise consisting of 100 maximal drop jumps at 30 s intervals. The same exercise was repeated 4 weeks later. Peak quadriceps muscle force evoked by electrical stimulation at 15 (P15) and 50 (P50) Hz was measured before exercise, after 10, 25, 50 and 100 jumps as well as 1 and 24 h after exercise.

RESULTS

P15 and P50 were higher during the initial phase of the repeated bout compared with the first exercise bout, but there was no difference between the bouts at the end of the exercise periods. P15 and P50 were again larger 24 h after the repeated bout. The P15/P50 ratio during exercise was not different between the two bouts, but it was higher after the repeated bout.

CONCLUSION

A prior bout of SSC exercise temporarily protects against impaired contractile function during a repeated exercise bout. The protection can again be seen after exercise, but the underlying mechanism then seems to be different.

Intramuscular adaptations to eccentric exercise and antioxidant supplementation

Prophylactic supplementation of N-acetyl-cysteine (NAC) and epigallocatechin gallate (EGCG) was studied for physiological and cellular changes in skeletal muscle after eccentric muscle contractions. Thirty healthy, active males (20.0 +/- 1.8 years, 160 +/- 7.1 cm, 76.1 +/- 17.0 kg) ingested for 14 days either 1,800 mg of NAC, 1,800 mg of EGCG, or 1,000 mg of fiber (glucomannan) placebo (PLC) in a double blind, prophylactic fashion. Subjects completed one eccentric exercise bout (100 repetitions at 30 degrees /s) using the dominant knee extensors. Strength and soreness were assessed, and blood and muscle samples obtained before and 6, 24, 48, and 72 h with no muscle sample being collected at 72 h. Separate mixed factorial repeated measures ANOVA (P < 0.05) were used for all statistical analysis. All groups experienced significantly reduced peak torque production after 6 and 24 h, increased soreness at all time points from baseline [with even greater soreness levels 24 h after exercise in PLC when compared to EGCG and NAC (P < 0.05)], increased lactate dehydrogenase at 6 h, and increased creatine kinase 6, 24 and 48 h after exercise. No significant group x time interaction effects were found for serum cortisol, neutrophil counts, and the neutrophil:lymphocyte ratio; although, all values experienced significant changes 6 h after exercise (P < 0.05), but at no other time points. At 48 h after the exercise bout the Neu:Lym ratio in EGCG was significantly less than NAC (P < 0.05), whereas there was a trend (P = 0.08) for the EGCG values to be less when compared to PLC at this time point. Markers of intramuscular mitochondrial and cytosolic apoptosis were assessed (e.g., bax, bcl-2, cytochrome C, caspase-3 content/enzyme activity, and total DNA content). Significant increases (P < 0.05) in muscle levels of bax and bcl-2 were observed in all groups with no significant differences between groups, whereas no changes (P > 0.05) were reported for cytochrome C, caspase-3 content, caspase-3 enzyme activity, and total DNA. Caspase-3 enzyme activity was significantly greater in all groups 48 h after exercise when compared to baseline (P < 0.05) and 6 h (P < 0.05) after exercise. An eccentric bout of muscle contractions appears to significantly increase muscle damage, markers of mitochondrial apoptosis, apoptotic enzyme activity, and whole-blood cell markers of inflammation with no changes in oxidative stress. While soreness ratings were blunted in the two supplementation groups 24 h after exercise when compared to PLC values, more research is needed to determine the potential impact of EGCG and NAC supplementation on changes related to oxidative stress, apoptosis, and eccentric exercise.

Effect of resistive exercise on muscle damage in water and on land

The purpose of this study was to compare the effects of resistance exercise in water and on land on blood levels of creatine kinase (CK), a known indirect marker of muscle damage. Nine men (age: 23 +/- 1.58 years; weight: 79.37 +/- 11.15 kg; height: 176.33 +/- 4.09 cm), who had not practiced resistance training for at least 6 months before this experiment, performed 3 sets of maximum elbow flexion and extension exercises in water and on land, separated by 2-minute periods of rest. A 10-repetition maximum test was used to load control on land with free weights, and in water the exercise was performed at maximum velocity with aquatic resistance equipment. The duration of the exercise in water was the same as that performed on land, to reproduce the same metabolic route. Plasma CK activity was determined using a commercially available kit (Labtest Enzymatic-UV) before exercise, after exercise, and at 24 and 48 hours after exercise. Significant increases in CK were found at 48 hours postexercise on land (preexercise land: 160.75 +/- 96.05 UxL; 48 hours: 326.87 +/- 240.84 UxL), and significant differences were found between land and water (preexercise water: 147.75 +/- 46.48 UxL; 48 hours: 121.75 +/- 30.86 UxL) for this measure. However, no significant differences were found in water. In conclusion, the water environment influenced the absence of significant muscle damage. This type of exercise protocol may be appropriate for situations in which limited muscle tissue damage is desired.

Changes in B-mode ultrasound echo intensity following injection of bupivacaine hydrochloride to rat hind limb muscles in relation to histologic changes

This study tested the hypothesis that infiltration of inflammatory cells in muscle fibers would increase echo intensity (image brightness) of B-mode ultrasound images. Bupivacaine hydrochloride (BPVC) or saline solution (SAL) was injected to the tibialis anterior (TA) muscles of 14- to 23-wk-old male Wistar rats. Ultrasound images were taken from the muscles before and at 0, 2, 4, 6, 9, 12, 24, 48, 72, 120, 168 and 336 h after the injection and analyzed for the echo intensity (echogenicity) expressed as the mean value of image pixel value of a region-of-interest. Changes in the echo intensity were compared between BPVC-injected and control or SAL-injected muscles. In the subsequent study, rats (n = 2 per time point) were sacrificed after taking ultrasound image at 0, 2, 6, 12, 24, 48 and 168 h after BPVC injection to the right TA and SAL injection to the left TA to observe histologic changes under a light microscope and the relationship between echo intensity and inflammatory cells was assessed. No significant changes in echo intensity were observed for the control, but BPVC induced significant (p < 0.05) increases in the echo intensity peaking 0 to 24 h postinjection. SAL also increased echo intensity immediately after injection but returned to the baseline by 24 h postinjection. The time course of changes in the echo intensity did not match with the time course of increases in inflammatory cells in the muscle. It is concluded that infiltration of inflammatory cells is not a direct cause of the increased echo intensity.

Muscle damage responses of the elbow flexors to four maximal eccentric exercise bouts performed every 4 weeks

Since little is known about the repeated bout effect of more than two eccentric exercise bouts, this study compared muscle damage responses among four exercise bouts. Fifteen young (21.8 +/- 1.9 years) men performed four bouts of 30 maximal isokinetic eccentric contractions of the elbow flexors every 4 weeks. Maximal voluntary elbow flexion isometric and concentric strength, range of motion at the elbow joint (ROM), upper arm circumference, blood markers of muscle damage, and muscle soreness were measured before and up to 120 h following each bout. Changes in all measures following the second to fourth bouts were significantly (P < 0.05) smaller than those after the first bout. The decreases in strength and ROM immediately after the fourth bout were significantly (P < 0.05) smaller than other bouts. It is concluded that the first bout confers the greatest adaptation, but further adaptation is induced when the exercise is repeated more than three times.