Relationship between exercise-induced muscle soreness, pain thresholds, and skin temperature in men and women

Differences in landing biomechanics in the presence of delayed onset muscle soreness following or not active recovery

OBJECTIVE

Delayed onset muscle soreness (DOMS) can reduce joint range of motion and strength, cause edema, and increase joint stiffness. Here we set out to determine whether quadriceps DOMS followed by an active recovery low-intensity exercise alters jump landing biomechanics.

METHODS

3D landing kinematics, kinetics, and DOMS were evaluated in 26 healthy adults (15 women) performing drop and vertical jump landings before and after a squat protocol to induce quadriceps DOMS. In the presence of DOMS, half of the participants (n = 13) performed a low-intensity exercise for active recovery (10-minute treadmill walking), while the other half (n = 13) did not. Descriptive statistics and generalized estimative equations were applied to determine the effects of DOMS and active recovery on landing kinematics and kinetics.

RESULTS

DOMS decreased knee and ankle flexion angles and increased knee and ankle frontal plane angles during vertical jumps. DOMS elicited a longer time to reach peak ground reaction force during drop jumps. Low-intensity exercise for active recovery reduced DOMS perception but did not alter the biomechanics of landing.

CONCLUSION

DOMS changes landing strategy. However, including a low-intensity exercise for active recovery before landing practice did not change the kinematics and kinetics of landing.

Hot But Not Cold Water Immersion Mitigates the Decline in Rate of Force Development Following Exercise-Induced Muscle Damage

PURPOSE

In recent years, there has been significant advancement in the guidelines for recovery protocols involving heat or cold water immersion. However, comparison between the effects of hot and cold water immersion on key markers of neuromuscular recovery following exercise-induced muscle damage (EIMD) is lacking.

METHODS

Thirty physically active males completed an individualized and tailored EIMD protocol immediately followed by one of the following recovery interventions: cold water immersion (11°C, CWI 11 ), hot water immersion (41°C, HWI 41 ), or warm-bath control (36°C, CON 36 ). Gastrointestinal temperature was tracked throughout HWI 41 . Knee extensors' maximal isokinetic strength (peak torque ( Tpeak )) and explosive strength (late-phase rate of force development (RFD 100-200 )) were measured before EIMD (pre-), 24 h (post-24 h), and 48 h (post-48 h) post-EIMD. In addition, pressure pain threshold (PPT) was measured to quantify the recovery from muscle soreness. Surface electromyography signals (sEMG) from the vastus lateralis were captured to extract the rates of electromyography rise (REMGR) and the spectral power in the low-frequency band.

RESULTS

At post-48 h, Tpeak returned to baseline values following both CWI 11 (-8.3% ± 6.8%, P = 0.079) and HWI 41 (-1.4% ± 4.1%, P = 1). In contrast, RFD 100-200 (-2.3% ± 29.3%, P = 1) and PPT (+5.6% ± 14.6%, P = 1) returned to baseline values at post-48 h only following HWI 41 . Spectral analysis of the sEMG signal revealed that the low-frequency band was significantly increased following CWI 11 (+9.0% ± 0.52%, P = 0.012). REMGR was unchanged regardless of the condition (all P > 0.05).

CONCLUSIONS

A single session of HWI 41 , rather than CWI 11 , improved the recovery of the late-phase rate of force development following EIMD in physically active males. This suggests that in athletic contexts where a rapid force development is a key performance determinant, hot bath should be preferred over cold bath.

Acute ingestion of acetaminophen improves cognitive and repeated high intensity short-term maximal performance in well-trained female athletes: a randomized placebo-controlled trial

This study examined the effect of acute acetaminophen (ACTP) ingestion on physical performance during the 5 m shuttle run test (5mSRT), attention, mood states, and the perception of perceived exertion (RPE), pain (PP), recovery (PRS), and delayed onset of muscle soreness (DOMS) in well-trained female athletes. In a randomized, placebo-controlled, double-blind, crossover trial, fifteen well-trained female athletes (age 21 ± 2 years, height 165 ± 6 cm, body mass 62 ± 5 kg) swallowed either 1.5 g of ACTP or 1.5 g of placebo. The profile of mood states (POMS) and digit cancellation (DCT) were assessed 45 min postingestion, and 5mSRT was performed 60 min postingestion. The RPE and PP were determined immediately after each 30-s repetition of the 5mSRT, and the PRS and DOMS were recorded at 5 min and 24 h post-5mSRT. For the 5mSRT, ACTP ingestion improved the greatest distance (+ 10.88%, p < 0.001), total distance (+ 11.33%, p = 0.0007) and fatigue index (+ 21.43%, p = 0.0003) compared to PLA. Likewise, the DCT score was better on the ACTP (p = 0.0007) than on the PLA. RPE, PP, PRS, and DOMS scores were improved after ACTP ingestion (p < 0.01 for all comparisons) compared to PLA. POMS scores were enhanced with ACTP ingestion compared to PLA (p < 0.01). In conclusion, this study indicates that acute acetaminophen ingestion can improve repeated high intensity short-term maximal performance, attention, mood states, and perceptions of exertion, pain, recovery, and muscle soreness in well-trained female athletes, suggesting potential benefits for their overall athletic performance and mood state.

Assessment of alternative metrics in the application of infrared thermography to detect muscle damage in sports

Objective.The association between muscle damage and skin temperature is controversial. We hypothesize that including metrics that are more sensitive to individual responses by considering variability and regions representative of higher temperature could influence skin temperature outcomes. Here, the objective of the study was to determine whether using alternative metrics (TMAX, entropy, and pixelgraphy) leads to different results than mean, maximum, minimum, and standard deviation (SD) skin temperature when addressing muscle damage using infrared thermography.Approach.Thermal images from four previous investigations measuring skin temperature before and after muscle damage in the anterior thigh and the posterior lower leg were used. The TMAX, entropy, and pixelgraphy (percentage of pixels above 33 °C) metrics were applied.Main results.On 48 h after running a marathon or half-marathon, no differences were found in skin temperature when applying any metric. Mean, minimum, maximum, TMAX, and pixelgraphy were lower 48 h after than at basal condition following quadriceps muscle damage (p< 0.05). Maximum skin temperature and pixelgraphy were lower 48 h after than the basal condition following muscle damage to the triceps sural (p< 0.05). Overall, TMAX strongly correlated with mean (r= 0.85) and maximum temperatures (r= 0.99) and moderately with minimum (r= 0.66) and pixelgraphy parameter (r= 0.64). Entropy strongly correlates with SD (r= 0.94) and inversely moderately with minimum temperature (r= -0.53). The pixelgraphy moderately correlated with mean (r= 0.68), maximum (r= 0.62), minimum (r= 0.58), and TMAX (r= 0.64).Significance.Using alternative metrics does not change skin temperature outcomes following muscle damage of lower extremity muscle groups.

Cell-free DNA kinetics in response to muscle-damaging exercise: A drop jump study

A significant increase in circulating cell-free DNA (cfDNA) occurs with physical exercise, which depends on the type of exertion and the duration. The aims of this study were as follows: (1) to investigate the time course of cfDNA and conventional markers of muscle damage from immediately after to 96 h after muscle-damaging exercise; and (2) to investigate the relationship between cfDNA and indicators of primary (low-frequency fatigue and maximal voluntary isometric contraction) and secondary (creatine kinase and delayed-onset muscle soreness) muscle damage in young healthy males. Fourteen participants (age, 22 ± 2 years; weight, 84.4 ± 11.2 kg; height, 184.0 ± 7.4 cm) performed 50 intermittent drop jumps at 20 s intervals. We measured cfDNA and creatine kinase concentrations, maximal voluntary isometric contraction torque, low-frequency fatigue and delayed-onset muscle soreness before and at several time points up to 96 h after exercise. Plasma cfDNA levels increased from immediately postexercise until 72 h postexercise (P < 0.01). Elevation of postexercise cfDNA was correlated with both more pronounced low-frequency fatigue (r = -0.52, P = 3.4 × 10-11) and delayed-onset muscle soreness (r = 0.32, P = 0.00019). Levels of cfDNA change in response to severe primary and secondary muscle damage after exercise. Levels of cfDNA exhibit a stronger correlation with variables related to primary muscle damage than to secondary muscle damage, suggesting that cfDNA is a more sensitive marker of acute loss of muscle function than of secondary inflammation or damaged muscle fibres.

Effect of different Volumes of exercise on skin temperature responses over the following 24 hours

Skin temperature responses have been advocated to indicate exercise-induced muscle soreness and recovery status. While the evidence is contradictory, we hypothesize that the presence of muscle damage and the time window of measurement are confounding factors in the skin temperature response. The objective was to determine whether skin temperature is influenced by different workloads and the time course of temperature measurements over the following 24 h. 24 trained male military were assigned to one of three groups: GC group (n = 8) serving as control not performing exercises, GE group (n = 8) performing a simulated military combat protocol in an exercise track with different obstacles but designed not to elicit muscle damage, and the GEMD group (n = 8) performing the simulated military combat protocol plus 5 sets of 20 drop jumps, with 10-sec between repetitions and with 2-min of rest between sets aiming to induce muscle damage. Skin temperature was measured using infrared thermography before exercise (Pre) and 4 (Post4h), 8 (Post8h) and 24h (Post24h) post-exercise. Perception of pain (DOMS) was evaluated Pre, Post24h, and Post48h, and countermovement jump height was evaluated at Pre and Post24h. DOMS did not differ between groups in the Pre and Post24h measures but GEMD presented higher DOMS than the other groups at Post48h (p < 0.001 and large effect size). Jump height did not differ for GEMD and GC, and GE presented higher jump height at Post24h than GC (p = 0.02 and large effect size). Skin temperature responses of GEMD and GG were similar in all measurement moments (p > 0.22), and GE presented higher skin temperature than the GC and the GEMD groups at Post24h (p < 0.01 and large effect sizes). In conclusion, although physical exercise elicits higher skin temperature that lasts up to 24 h following the efforts, muscle soreness depresses this response.

Precision Agriculture: Assessment of Ergonomic Risks of Assisted Driving System

Background: the precision agriculture field optimizes resource use, enhancing performance. However, this leads to exposure to ergonomic risks for operators, in particular, tractor drivers, potentially causing musculoskeletal disorders (MSDs). This study investigates how the display position in a semi-automatic tractor system influences operator comfort and muscle activation during harrowing operations. Methods: the assessment of muscular strain involved the use of surface electromyographic devices, while posture was evaluated throughout the analysis of the distribution of pressure exerted by the operator’s body on the seat, which was observed using two barometric pads, each positioned on the backrest and base of the seat. Finally, infrared thermography (IRT), a non-invasive tool to assess muscle activation, was used to measure the surface temperature of the driver’s back. The results showed a significantly greater muscular activation display for the position of display in semi-automatic driving at 50° and 80°. Conclusions: this study showed how the position of the display on the vehicle negatively influences posture, exposing workers to the risk of developing fatigue and, therefore, discomfort, with the potential onset of MSDs. The combined use of sEMG and IRT allowed for a non-invasive, cheap, and repeatable mechanical and functionality analysis.

Assessment of Dyspnoea, Physical Activity, and Back Pain Levels in Students at Medical Universities after the COVID-19 Pandemic in Poland

OBJECTIVES

The purpose of this research was to assess the extent of dyspnoea, physical activity (PA), and back pain complaints and the association of dyspnoea, PA, and back pain complaints with PA in post-COVID-19 students at medical universities in Poland.

METHODS

An online survey was carried out among Polish medical students (213 women and 204 men) who had had a positive test for SARS-CoV-2 within the last year. The Medical Research Council (MRC) dyspnoea scale was used to assess the degree of dyspnoea. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of PA. The Oswestry Disability Index (ODI) and the Neck Disability Index (NDI) were used to assess back discomfort.

RESULTS

The study group had average levels of PA, with median total activity significantly lower in women (median total activity for women was 1189 and for men was 2044, while the standard deviation for women was 1419 and for men was 1450). More than 93% of the students reported no symptoms of dyspnoea. The following results were observed for ODI (median of 1.2 for women and 1.7 for men and standard deviation of 3.1 for women and 4.0 for men) and for NDI (median of 2.8 for women and 2.5 for men, standard deviation of 4.3 for women and 4.0 for men). Cervical spine pain was more frequent and severe. There are small, statistically significant correlations between the MRC and IPAQ measures and the ODI and NDI and IPAQ.

CONCLUSIONS

In the study group of students of medicine, dyspnoea linked with a history of COVID-19 is not an issue. Post-pandemic PA levels should be increased in this group, with particular attention to female students. Urgent measures are also needed to prevent cervical pain in students at medical universities in Poland.

Effects of Maximal Eccentric Trunk Extensor Exercise on Lumbar Extramuscular Connective Tissue: A Matched-Pairs Ultrasound Study

Recently, it has been shown that the extramuscular connective tissue (ECT) is likely involved in delayed onset muscle soreness (DOMS). Therefore, the aim of the present study was to investigate the effects of maximal trunk extension eccentric exercise (EE) on ECT thickness, self-reported DOMS, ECT stiffness, skin temperature, and possible correlations between these outcomes. Healthy adults (n = 16, 29.34 ± 9.87 years) performed fatiguing EE of the trunk. A group of highly active individuals (TR, n = 8, > 14 h of sport per week) was compared with a group of less active individuals (UTR, n = 8, < 2 h of sport per week). Ultrasound measurements of ECT thickness, stiffness with MyotonPro and IndentoPro, skin temperature with infrared thermography, and pain on palpation (100 mm visual analog scale, VAS) as a surrogate for DOMS were recorded before (t0), immediately (t1), 24 h (t24), and 48 h (t48) after EE. ECT thickness increased after EE from t0 to t24 (5.96 mm to 7.10 mm, p = 0.007) and from t0 to t48 (5.96 mm to 7.21 mm, p < 0.001). VAS also increased from t0 to t24 (15.6 mm to 23.8 mm, p < 0.001) and from t0 to t48 (15.6 mm to 22.8 mm, p < 0.001). Skin temperature increased from t1 to t24 (31.6° Celsius to 32.7° Celsius, p = 0.032) and t1 to t48 (31.6° Celsius to 32.9° Celsius, p = 0.003), while stiffness remained unchanged (p > 0.05). Correlation analysis revealed no linear relationship between the outcomes within the 48-hour measurement period. The results may confirm previous findings of possible ECT involvement in the genesis of DOMS in the extremities also for the paraspinal ECT of trunk extensors. Subsequent work should focus on possible interventions targeting the ECT to prevent or reduce DOMS after strenuous muscle EE.

Pain-Pressure Threshold Changes throughout Repeated Assessments with No Sex Related Differences

Algometers are commonly used to measure the pain-pressure threshold (PPT) in various tissues, such as muscle, tendons, or fascia. However, to date, it is not clear if the repeated application of a PPT assessment can adjust the pain thresholds of the various muscles. Therefore, the purpose of this study was to investigate the repeated application of PPT tests (20 times) in the elbow flexor, knee extensor, and ankle plantar flexor muscles in both sexes. In total, 30 volunteers (15 females, 15 males) were tested for their PPT using an algometer on the respective muscles in random order. We found no significant difference in the PPT between the sexes. Moreover, there was an increase in the PPT in the elbow flexors and knee extensors, starting with the eighth and ninth assessments (out of 20), respectively, compared to the second assessment. Additionally, there was a tendency to change between the first assessment and all the other assessments. In addition, there was no clinically relevant change for the ankle plantar flexor muscles. Consequently, we can recommend that between two and a maximum of seven PPT assessments should be applied so as not to overestimate the PPT. This is important information for further studies, as well as for clinical applications.

Skin temperature normalizes faster than pressure pain thresholds, pain intensity, and pain distribution during recovery from eccentric exercise

INTRODUCTION

Acute musculoskeletal injuries have diverse symptomatology and a multidimensional recovery process, including changes in swelling, redness, hyperalgesia, and expanded pain distribution. In a small proportion of cases, the tissue heals, although these symptoms persist, reflecting altered peripheral and central pain mechanisms. However, the otherwise healthy multidimensional recovery process following damage and pain is less than clear. The objective was to assess mechanical muscle hyperalgesia, skin temperature, and pain intensity and distribution during the recovery process in response to eccentric exercise in the hamstring muscles.

METHODS

Twenty-four healthy males participated in four sessions (Day-0, Day-2, Day-4, and Day-7). Exercise-induced muscle soreness was induced on Day-0 by five sets of 20 repetitions of an eccentric exercise involving the hamstrings on the dominant leg. Each session included assessments of thermography, pressure pain thresholds (PPTs), pain intensity, and area of exercise-induced pain.

RESULTS

Decreased PPTs (P < 0.005), higher pain intensity (P < 0.001), and a larger area of pain (P < 0.001) were displayed on Day-2 and Day-4 than Day-0. Skin temperature decreased on Day-2 than Day-0 (P < 0.01) and returned to baseline assessments by Day-4, despite lower temperature than the contralateral tight (P < 0.01). Further, there was a positive correlation between pain intensity and area on Day-2 and Day-4 (P < 0.005), but no for changes in skin temperature.

CONCLUSION

Thermographic changes and pain-related variables altered following eccentric exercise demonstrate different recovery times. These results provide insights into potential mechanisms and measures that can be used to assess recovery from exercise-induced damage.

Exercise induced muscle damage and repeated bout effect: an update for last 10 years and future perspectives

Exercise-induced muscle damage (EIMD) and repeated bout effect (RBE) are widely researched across various populations. EIMD is the muscle damage occurring after one bout of unaccustomed exercise while RBE is the attenuation of the same muscle damage in subsequent second bout. RBE seems to have significant implications for exercise prescription. Despite existence of vast literature, there is lack of clarity on the effects of EIMD and RBE in a healthy population. The purpose of this study is to review the literature on EIMD and RBE in healthy participants published during the last 10 years. The search of major databases (including Scopus, Google Scholar and PubMed) was conducted using specific keywords ‘Exercise induced muscle damage’, ‘Repeated bout effect’, ‘Healthy participants’ ‘Pre-conditioning’, ‘Eccentric exercise’. Studies published from 2011 onwards which included EIMD and RBE assessment in healthy participants were included in this review. Database searching revealed a total of 38 studies on EIMD and RBE in healthy participants. Three major themes of papers were identified that focused on EIMD and RBE along with (1) age related differences, (2) sex-based differences, and (3) response in athletes. Findings of this comprehensive review suggests that both EIMD and RBE are age, and sex specific. Delayed onset muscle soreness played a major role in both EIMD and RBE in all the population types. Female participants are less susceptible to EIMD as compared to age-matched male counterparts. Moreover, both EIMD and RBE are more elicited in middle aged and younger adults as compared to children and older adults while the magnitude of RBE turns out to be minimal in trained individuals due to persisting adaptations.

Effects of nociceptive and mechanosensitive afferents sensitization on central and peripheral hemodynamics following exercise-induced muscle damage

This study aims to test the separated and combined effects of mechanoreflex activation and nociception through exercise-induced muscle damage (EIMD) on central and peripheral hemodynamics before and during single passive leg movement (sPLM). Eight healthy young males undertook four experimental sessions, in which a sPLM was performed on the dominant limb while in each specific session the contralateral was: 1) in a resting condition (CTRL), 2) stretched (ST), 3) resting after EIMD called delayed onset muscle soreness (DOMS) condition, or 4) stretched after EIMD (DOMS + ST). EIMD was used to induce DOMS in the following 24-48 h. Femoral blood flow (FBF) was assessed using Doppler ultrasound whereas central hemodynamics were assessed via finger photoplethysmography. Leg vascular conductance (LVC) was calculated as FBF/mean arterial pressure (MAP). RR-intervals were analyzed in the time (root mean squared of successive intervals; RMSSD) and frequency domain [low frequency (LF)/high frequency (HF)]. Blood samples were collected before each condition and gene expression analysis showed increased fold changes for P2X4 and IL1β in DOMS and DOMS + ST compared with baseline. Resting FBF and LVC were decreased only in the DOMS + ST condition (-26 mL/min and -50 mL/mmHg/min respectively) with decreased RMSSD and increased LF/HF ratio. MAP, HR, CO, and SV were increased in ST and DOMS + ST compared with CTRL. Marked decreases of Δpeaks and AUC were observed for FBF (Δ: -146 mL/min and -265 mL respectively) and LVC (Δ: -8.66 mL/mmHg/min and ±1.7 mL/mmHg/min respectively) all P < 0.05. These results suggest that the combination of mechanoreflex and nociception resulted in decreased vagal tone and concomitant rise in sympathetic drive that led to increases in resting central hemodynamics with reduced limb blood flow before and during sPLM.NEW & NOTEWORTHY Exercise-induced muscle damage (EIMD) is a well-known model to study mechanical hyperalgesia and muscle peripheral nerve sensitizations. The combination of static stretching protocol on the damaged limb extensively increases resting central hemodynamics with reduction in resting limb blood flow and passive leg movement-induced hyperemia. The mechanism underlining these results may be linked to reduction of vagal tone with concomitant increase in sympathetic activity following mechano- and nociceptive activation.

Gender difference in effects of proprioceptive neuromuscular facilitation stretching on flexibility and stiffness of hamstring muscle

Objective: This study investigated the acute effects of PNF stretching on hamstring flexibility and muscle stiffness of lower limbs between genders.

Methods: 15 male and 15 female university students without any injury histories on lower limbs in the past 3 months were included in this study were selected. All subjects were measured by MyotonPRO before and after stretching to determine the muscle stiffness of the biceps femoris muscle (BF), semitendinosus muscle (ST) of the hamstring and the medial gastrocnemius muscles (MG), lateral gastrocnemius muscles (LG), and the soleus (SOL) of the triceps surae muscles. Additionally, their flexibility was measured using the sit-and-reach test (the SR test) and passive hip range of motion (ROM). Differences based on time (pre-stretching vs. post-stretching) and sex (females vs. males) were assessed using 2 × 2 repeated measures AVONA.

Results: There was a significant decrease in the stiffness of the hamstring and triceps surae muscles after stretching (BF, MG, LG, and SOL: p < 0.001; ST: p = 0.003). The muscle stiffness of the hamstring and triceps surae muscles is larger in males than in females at all time points (p < 0.001). There was a significant increase in hip flexion angle and the SR test in males and females after PNF stretching (p < 0.001); However, there was no difference in the change in the muscle stiffness and the flexibility between genders (p > 0.05).

Conclusion: PNF stretching helped improve hamstring flexibility and decrease muscle stiffness. Stretching the hamstrings can also contribute to a decrease in the stiffness of the triceps surae muscles. The muscle stiffness of males before and after stretching is always greater than that of females. However, there was no difference in the change of improvement in stretching between genders.