Acute and delayed peripheral and central neuromuscular alterations induced by a short and intense downhill trail run

Soft-Tissue Vibrations and Fatigue During Prolonged Running: Does an Individualized Midsole Hardness Play a Role?

Footwear has the potential to reduce soft-tissue vibrations (STV) but responses are highly subject-specific. Recent evidence shows that compressive garments minimizing STV have a beneficial effect on neuromuscular (NM) fatigue. The aim was to determine whether an individualized midsole hardness can minimize STV and NM fatigue during a half marathon. Twenty experienced runners were recruited for three visits: a familiarization session including the identification of midsole minimizing and maximizing STV amplitude (MIN and MAX, respectively), and two half marathon sessions at 95% of speed at the second ventilatory threshold. STV of the gastrocnemius medialis (GM) muscle, running kinetics, foot strike pattern, rating perceived exhaustion (RPE), and midsole liking were recorded every 3 km. NM fatigue was assessed on plantar flexors (PF) before (PRE) and after (POST) the half marathon. At POST, PF central and peripheral alterations and changes in contact time, step frequency, STV median frequency, and impact force frequency as well as foot strike pattern were found in both MIN and MAX. No significant differences in damping, STV main frequency, flight time, duty factor, and loading rate were observed between conditions whatever the time period. During the half marathon, STV amplitude of GM significantly increased over time for the MAX condition (+13.3%) only. Differences between MIN and MAX were identified for RPE and midsole liking. It could be hypothesized that, while significant, the effect of midsole hardness on STV is too low to substantially affect NM fatigue.

Cadence Modulation during Eccentric Cycling Affects Perception of Effort But Not Neuromuscular Alterations

INTRODUCTION

A recent study showed that cadence modulation during short eccentric cycling exercise affects oxygen consumption (V̇O 2 ), muscular activity (EMG), and perception of effort (PE). This study examined the effect of cadence on V̇O 2 , EMG, and PE during prolonged eccentric cycling and exercise-induced neuromuscular alterations.

METHODS

Twenty-two participants completed three sessions 2-3 wk apart: 1) determination of the maximal concentric peak power output, familiarization with eccentric cycling at two cadences (30 and 60 rpm at 60% peak power output), and neuromuscular testing procedure; 2) and 3) 30 min of eccentric cycling exercise at a cadence of 30 or 60 rpm. PE, cardiorespiratory parameters, and vastus lateralis and rectus femoris EMG were collected during exercise. The knee extensors' maximal voluntary contraction torque, the torque evoked by double stimulations at 100 Hz (Dt100) and 10 Hz (Dt10), and the voluntary activation level were evaluated before and after exercise.

RESULTS

V̇O 2 , EMG, and PE were greater at 30 than 60 rpm (all P < 0.05). Maximal voluntary contraction torque, evoked torque, and Dt10/Dt100 ratio decreased (all P < 0.01) without cadence effect (all P > 0.28). Voluntary activation level remained constant after both eccentric cycling exercises ( P = 0.87).

CONCLUSIONS

When performed at the same power output, eccentric cycling exercise at 30 rpm elicited a greater PE, EMG, and cardiorespiratory demands than pedaling at 60 rpm. Exercise-induced fatigability was similar in both eccentric cycling conditions without neural impairments, suggesting that eccentric cycling seemed to alter more specifically muscular function, such as the excitation-contraction coupling process. In a rehabilitation context, eccentric cycling at 60 rpm seems more appropriate because it will induce lower PE for similar strength loss compared with 30 rpm.

Long-Chain Omega-3 Fatty Acid Supplementation and Exercise-Induced Muscle Damage: EPA or DHA?

PURPOSE

Long-chain omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) may enhance recovery from exercise-induced muscle damage (EIMD). However, it is unclear if the effects are due to EPA, DHA, or both. The purpose of this investigation was to examine the effect of EPA + DHA, EPA, and DHA compared with placebo (PL) on muscular recovery.

METHODS

Thirty males were randomized to 4 g·d -1 EPA + DHA ( n = 8), EPA ( n = 8), DHA ( n = 7), or PL ( n = 7). After 7-wk supplementation, a downhill running (20 min, 70% V̇O 2max , -16% gradient) plus jumping lunges (5 × 20 reps, 2-min rest intervals) muscle damage protocol was performed. Indices of muscle damage, soreness, muscle function, and inflammation were measured at baseline and throughout recovery. The omega-3 index (O3i; %EPA + %DHA in erythrocytes) was used to track tissue EPA and DHA status.

RESULTS

After supplementation, the O3i was significantly higher than PL in all experimental groups ( P < 0.001). Leg press performance was lower in the PL group at 24 h compared with EPA ( P = 0 .019) and at 72 h for EPA ( P = 0.004) and DHA ( P = 0 .046). Compared with PL, muscle soreness was lower in the DHA ( P = 0.015) and EPA ( P = 0.027) groups at 48 h. Albeit nonsignificant, EPA + DHA tended to attenuate muscle soreness ( d = 1.37) and leg strength decrements ( d = 0.75) compared with PL. Jump performance and power metrics improved more rapidly in the EPA and DHA groups (time effects: P < 0.001). Measures of inflammation, range of motion, and muscle swelling were similar between groups ( P > 0.05).

CONCLUSIONS

Compared with PL, 4 g·d -1 of EPA or DHA for 52 d improves certain aspects of recovery from EIMD. EPA + DHA did not clearly enhance recovery. Equivalent dosing of EPA + DHA may blunt the performance effects observed in EPA or DHA alone.

Co-existence of peripheral fatigue of the knee extensors and jump potentiation after an incremental running test to exhaustion in endurance trained male runners

The aim of the present study was to investigate the effect of an incremental running exercise until exhaustion on twitch responses and jump capacity in endurance trained runners. For this purpose, 8 experienced endurance male runners were required to perform neuromuscular function tests before and after a submaximal running bout (control condition -CTR-) or an incremental running test to volitional exhaustion (experimental conditions -EXP-). The twitch interpolation technique was used to assess voluntary activation and muscle contractile properties before and after each condition (CTR and EXP). Countermovement jump was also used to assess the stretch-shortening cycle function before and after both conditions. In addition, rating of perceived exertion, heart rate, blood lactate and skin temperature were also recorded. Only EXP improved jump performance, however, it was also accompanied by a reduction in maximal voluntary contraction and the peak twitch force of the knee extensors evoked by electrical stimulation at 10 Hz (Db10). It is likely that reductions in maximal voluntary contraction may be related to an excitation-contraction coupling failure (i.e. low-frequency fatigue) as suggest the reduction in the Db10. The current results confirm that acute changes in jump performance may not be appropriate to evaluate acute fatigue in endurance trained runners.

Acute Neuromuscular Alterations of Ankle Evertors Induced by Short Trail Running: Sex-Related Considerations

Ravier, G, Dury, J, Grevillot, J, Girard, B, Bouzigon, R, and Michel, F. Acute neuromuscular alterations of ankle evertors induced by short trail running: sex-related considerations. J Strength Cond Res 37(10): 2008–2015, 2023—This study investigated the exercise-induced effects on the neuromuscular function of ankle evertors, balance control associated with trail running, and sex-related interactions. Fourteen male and 14 female medium-level runners completed a 16-km (400 D+) course. At rest and immediately after running, maximal voluntary isometric contraction (MVC) and rate of force development (RFD) for knee extension and ankle eversion, electromyographic (EMG) activity of peroneus muscles during MVC plateau (EMG) and the first 200 ms (EMG200), ankle angular velocity ( INV) during 20 weight-bearing inversion movements, and balance control during destabilizing single-leg task were evaluated. Repeated measures ANOVA-revealed changes in knee and ankle MVC (ankle: P = 0.0004, −12%) and RFD (ankle: P < 0.0001, −19%), EMG (P < 0.0001, −17%), EMG200 (P < 0.0001, −19%), and ankle INV (P < 0.0001, +35%) in response to trail running. Single-leg balance was not impaired. Sex-related differences were observed in EMG and EMG200 with higher values in men than in women. MVC and RFD were greater in men when expressed in absolute values, but not different relative to body mass. Single-leg balance and ankle INV did not differ between men and women. Finally, none of these variables showed any sex-related difference when considering pre-exercise to postexercise changes. This study demonstrated impairment in neuromuscular function of evertor muscles and ability in braking inversion in response to trail running. Sex-related differences were observed in neuromuscular activity but not in fatigability. These data suggest that coaches might implement strength exercises specifically designed for ankle lateral stability into their training program.

Performance Level Affects Full Body Kinematics and Spatiotemporal Parameters in Trail Running-A Field Study

Trail running is an emerging discipline with few studies performed in ecological conditions. The aim of this work was to investigate if and how biomechanics differ between more proficient (MP) and less proficient (LP) trail runners. Twenty participants (10 F) were recruited for a 9.1 km trail running time trial wearing inertial sensors. The MP athletes group was composed of the fastest five men and the fastest five women. Group differences in spatiotemporal parameters and leg stiffness were tested with the Mann-Whitney U-test. Group differences in joint angles were tested with statistic parametric mapping. The finish time was 51.1 ± 6.3 min for the MP athletes and 60.0 ± 5.5 min for the LP athletes (p < 0.05). Uphill sections: The MP athletes expressed a tendency to higher speed that was not significant (p > 0.05), achieved by combining higher step frequency and higher step length. They showed a tendency to shorter contact time, lower duty factor and longer flight time that was not significant (p > 0.05) as well as significantly lower knee flexion during the stance phase (p < 0.05). Downhill sections: The MP athletes achieved significantly higher speed (p < 0.05) through higher step length only. They showed significantly higher knee and hip flexion during the swing phase as well as higher trunk rotation and shoulder flexion during the stance phase (p < 0.05). No differences were found with respect to leg stiffness in the uphill or downhill sections (p > 0.05). In the uphill sections, the results suggest lower energy absorption and more favorable net mechanical work at the knee joint for the MP athletes. In the downhill sections, the results suggest that the more efficient motion of the swing leg in the MP athletes could increase momentum in the forward direction and full body center of mass' velocity at toe off, thus optimizing the propulsion phase.

Downhill running affects the late but not the early phase of the rate of force development

Purpose

This study aimed to evaluate the acute changes in the knee extensors maximum voluntary isometric contraction force (MVIC), rate of force development (RFD), and rate of EMG rise (RER) following a bout of downhill running.

Methods

MVIC and RFD at 0–50, 50–100, 100–200, and 0–200 ms were determined in thirteen men (22 ± 2 yr) before and after 30 min of downhill running (speed: 10 km h⁻¹; slope: − 20%). Vastus lateralis maximum EMG (EMG_max) and RER at 0–30, 0–50, and 0–75 ms were also recorded.

Results

MVIC, RFD_0–200, and EMG_max decreased by ~ 25% [Cohen’s d = − 1.09 (95% confidence interval: − 1.88/− 0.24)], ~ 15% [d = − 0.50 (− 1.26/0.30)], and ~ 22% [d = − 0.37 (− 1.13/0.42)] (all P < 0.05), respectively. RFD_100–200 was also reduced [− 25%; d = − 0.70 (− 1.47/0.11); P < 0.001]. No change was observed at 0–50 ms and 50–100 ms (P ≥ 0.05). RER values were similar at each time interval (all P > 0.05).

Conclusion

Downhill running impairs the muscle capacity to produce maximum force and the overall ability to rapidly develop force. No change was observed for the early phase of the RFD and the absolute RER, suggesting no alterations in the neural mechanisms underlying RFD. RFD_100–200 reduction suggests that impairments in the rapid force-generating capacity are located within the skeletal muscle, likely due to a reduction in muscle–tendon stiffness and/or impairments in the muscle contractile apparatus. These findings may help explain evidence of neuromuscular alterations in trail runners and following prolonged duration races wherein cumulative eccentric loading is high.

Neuromuscular, biomechanical, and energetic adjustments following repeated bouts of downhill running

PURPOSE

This study used downhill running as a model to investigate the repeated bout effect (RBE) on neuromuscular performance, running biomechanics, and metabolic cost of running.

METHODS

Ten healthy recreational male runners performed two 30-min bouts of downhill running (DR1 and DR2) at a -20% slope and 2.8 m/s 3 weeks apart. Neuromuscular fatigue, level running biomechanics during slow and fast running, and running economy parameters were recorded immediately before and after the downhill bouts, and at 24 h, 48 h, 72 h, 96 h, and 168 h thereafter (i.e., follow-up days).

RESULTS

An RBE was confirmed by attenuated muscle soreness and serum creatine kinase rise after DR2 compared to DR1. An RBE was also observed in maximum voluntary contraction (MVC) force loss and voluntary activation where DR2 resulted in attenuated MVC force loss and voluntary activation immediately after the run and during follow-up days. The downhill running protocol significantly influenced level running biomechanics; an RBE was observed in which center of mass excursion and, therefore, lower-extremity compliance were greater during follow-up days after DR1 compared to DR2. The observed changes in level running biomechanics did not influence the energy cost of running.

CONCLUSION

This study demonstrated evidence of adaptation in neural drive as well as biomechanical changes with the RBE after DR. The higher neural drive resulted in attenuated MVC force loss after the second bout. It can be concluded that the RBE after downhill running manifests as changes to global and central fatigue parameters and running biomechanics without substantially altering the energy cost of running.

Study of the kinetics of the determinants of performance during a mountain ultra marathon: Multidisciplinary protocol of the first Trail Scientifique de Clécy 2021 (Preprint)

Background

The growing interest of the scientific community in trail running has highlighted the acute effects of practice at the time of these races on isolated aspects of physiological and structural systems; biological, physiological, cognitive, and muscular functions; and the psychological state of athletes. However, no integrative study has been conducted under these conditions with so many participants and monitoring of pre-, per-, and postrace variables for up to 10 days over a distance close to 100 miles.

Objective

The aim of this study was to evaluate the kinetics of the performance parameters during a 156 km trail run and 6000 m of elevation gain in pre-, per-, and postrace conditions. The general hypothesis is based on significant alterations in the psychological, physiological, mechanical, biological, and cognitive parameters.

Methods

The Trail Scientifique de Clécy took place on November 11, 2021. This prospective experimental study provides a comprehensive exploration of the constraints and adaptations of psychophysiological and sociological variables assessed in real race conditions during a trail running of 156 km on hilly ground and 6000 m of elevation gain (D+). The study protocol allowed for repeatability of study measurements under the same experimental conditions during the race, with the race being divided into 6 identical loops of 26 km and 1000 m D+. Measurements were conducted the day before and the morning of the race, at the end of each lap, after a pit stop, and up to 10 days after the race. A total of 55 participants were included, 43 (78%) men and 12 (22%) women, who were experienced in ultra–trail-running events and with no contraindications to the practice of this sport.

Results

The launch of the study was authorized on October 26, 2021, under the trial number 21-0166 after a favorable opinion from the Comité de Protection des Personnes Ouest III (21.09.61/SIRIPH 2G 21.01586.000009). Of the 55 runners enrolled, 41 (75%) completed the race and 14 (25%) dropped out for various reasons, including gastric problems, hypothermia, fatigue, and musculoskeletal injuries. All the measurements for each team were completed in full. The race times (ie, excluding the measurements) ranged from 17.8206 hours for the first runner to 35.9225 hours for the last runner. The average time to complete all measurements for each lap was 64 (SD 3) minutes.

Conclusions

The Trail Scientifique de Clécy, by its protocol, allowed for a multidisciplinary approach to the discipline. This approach will allow for the explanation of the studied parameters in relation to each other and observation of the systems of dependence and independence. The initial results are expected in June 2022.

International Registered Report Identifier (IRRID)

RR1-10.2196/38027

The repeated bout effect influences lower-extremity biomechanics during a 30-min downhill run

The repeated bout effect in eccentric-biased exercises is a well-known phenomenon, wherein a second bout of exercise results in attenuated strength loss and soreness compared to the first bout. We sought to determine if the repeated bout effect influences changes in lower-extremity biomechanics over the course of a 30-min downhill run. Eleven male participants completed two bouts of 30-min downhill running (DR1 and DR2) at 2.8 m.s^-1 and -11.3° on an instrumented treadmill. Three-dimensional kinematics and ground reaction forces were recorded and used to quantify changes in spatiotemporal parameters, external work, leg stiffness, and lower extremity joint-quasi-stiffness throughout the 30-min run. Maximum voluntary isometric contraction (MVIC) and perceived quadriceps pain were assessed before-after, and throughout the run, respectively. DR2 resulted in attenuated loss of MVIC (P = 0.004), and perceived quadriceps pain (P < 0.001) compared to DR1. In general, participants ran with an increased duty factor towards the end of each running bout; however, increases in duty factor during DR2 (+5.4%) were less than during DR1 (+8.8%, P < 0.035). Significant reductions in leg stiffness (-11.7%, P = 0.002) and joint quasi-stiffness (up to -25.4%, all P < 0.001) were observed during DR1 but not during DR2. Furthermore, DR2 was associated with less energy absorption and energy generation than DR1 (P < 0.004). To summarize, the repeated bout effect significantly influenced lower-extremity biomechanics over the course of a downhill run. Although the mechanism(s) underlying these observations remain(s) speculative, strength loss and/or perceived muscle pain are likely to play a key role.HighlightsA 30-min downhill running bout increased contact time and reduced flight time transitioning to an increased duty factor.Lower-extremity stiffness also decreased and mechanical energy absorption increased over the course of the first 30-min downhill running bout.When the same bout of 30-min downhill running was performed three weeks later, the observed changes to lower extremity biomechanics were significantly attenuated.The findings from this study demonstrated, for this first time, a repeated bout effect for lower extremity biomechanics associated with downhill running.

Immediate voluntary activation deficits following submaximal eccentric contractions of knee extensors are associated with alterations of the sense of movement

The mechanisms underlying movement sense alterations following repeated eccentric contractions remain unclear. This study concomitantly investigated the effects of unilateral eccentric contractions on movement sense and on neuromuscular function at the knee before, immediately after (POST), 24 (POST24) and 48 (POST48) h after the exercise. Twelve participants performed sets of submaximal knee extensors (KE) eccentric contractions until a 20% decrease in maximal voluntary isometric contraction (MVIC) torque was reached. Threshold to detect passive movement (TTDPM) tasks were used to assess movement sense during both knee flexion (TTDPM_FLEX) and extension (TTDPM_EXT). KE fatigability was assessed using the interpolated twitch technique. TTDPM values expressed in seconds and the percentage of unsuccessful trials only increased at POST during TTDPM_FLEX and TTDPM_EXT. The 20%-MVIC decrease was associated with significant decreases in voluntary activation level (- 12.7%, p < 0.01) and potentiated doublet torque at 100 Hz (- 18.1%, p < 0.001). At POST24, despite persistent reductions of maximal voluntary and electrically evoked torques associated with increased perceived muscle soreness, TTDPM values and the percentage of unsuccessful trials returned to baseline values. Consequently, movement sense alterations were only observed in the presence of voluntary activation deficits, suggesting that some exercise-induced central alterations may affect the somatosensory function.

Peripheral Alterations Affect the Loss in Force after a Treadmill Downhill Run

Downhill running has an important effect on performance in trail running competitions, but it is less studied than uphill running. The purpose of this study was to investigate the cardiorespiratory response during 15 min of downhill running (DR) and to evaluate the neuromuscular consequences in a group of trail runners. Before and after a 15-min DR trial (slope: −25%) at ~60% of maximal oxygen consumption (V̇O₂max), we evaluated maximal voluntary contraction torque (MVCt) and muscle contractility in a group of seventeen trail running athletes. Additionally, during the DR trial, we measured V̇O₂ and heart rate (HR). V̇O₂ and HR increased as a function of time, reaching +19.8 ± 15.9% (p < 0.001; ES: 0.49, medium) and +15.3 ± 9.9% (p < 0.001; ES: 0.55, large), respectively, in the last minute of DR. Post-exercise, the MVCt decreased (−22.2 ± 12.0%; p < 0.001; ES = 0.55, large) with respect to the pre-exercise value. All the parameters related to muscle contractility were impaired after DR: the torque evoked by a potentiated high frequency doublet decreased (−28.5 ± 12.7%; p < 0.001; ES: 0.61, large), as did the torque response from the single-pulse stimulation (St, −41.6 ± 13.6%; p < 0.001; ES: 0.70, large) and the M-wave (−11.8 ± 12.1%; p < 0.001; ES: 0.22, small). We found that after 15 min of DR, athletes had a decreased MVCt, which was ascribed mainly to peripheral rather than central alterations. Additionally, during low-intensity DR exercise, muscle fatigue and exercise-induced muscle damage may contribute to the development of O₂ and HR drift.

Resistance Training to Failure vs. Not to Failure: Acute and Delayed Markers of Mechanical, Neuromuscular, and Biochemical Fatigue

ABSTRACT

González-Hernández, JM, García-Ramos, A, Colomer-Poveda, D, Tvarijonaviciute, A, Cerón, J, Jiménez-Reyes, P, and Márquez, G. Resistance training to failure vs. not to failure: acute and delayed markers of mechanical, neuromuscular, and biochemical fatigue. J Strength Cond Res 35(4): 886-893, 2021-This study aimed to compare acute and delayed markers of mechanical, neuromuscular, and biochemical fatigue between resistance training sessions leading to or not to failure. Twelve resistance-trained men completed 2 sessions that consisted of 6 sets of the full-squat exercise performed against the 10 repetitions maximum load. In a randomized order, in one session the sets were performed to failure and in the other session the sets were not performed to failure (5 repetitions per set). Mechanical fatigue was quantified through the recording of the mean velocity during all repetitions. The neuromuscular function of the knee extensors was assessed through a maximal voluntary contraction and the twitch interpolation technique before training, immediately after each set, and 1, 24, and 48 hours post-training. Serum creatine kinase (CK) and aspartate aminotransferase (AST) were measured before training and 1, 24, and 48 hours post-training to infer muscle damage. Alpha was set at a level of 0.05. A higher velocity loss between sets was observed during the failure protocol (-21.7%) compared with the nonfailure protocol (-3.5%). The markers of peripheral fatigue were generally higher and long lasting for the failure protocol. However, the central fatigue assessed by the voluntary activation was comparable for both protocols and remained depressed up to 48 hours post-training. The concentrations of CK and AST were higher after the failure protocol revealing higher muscle damage compared with the nonfailure protocol. These results support the nonfailure protocol to reduce peripheral fatigue and muscle damage, whereas the central fatigue does not seem to be affected by the set configuration.

Inflammation, muscle damage and postrace physical activity following a mountain ultramarathon

BACKGROUND

The study aimed at exploring whether muscle membrane disruption, as a surrogate for muscle damage, and inflammation recovery following a mountain ultramarathon (MUM) was related with race performance and postrace physical activity.

METHODS

Blood samples were obtained from thirty-four athletes (29 men and 5 women) before a 118-km MUM, immediately after and three- and seven-days postrace. Creatine kinase (CK), lactate dehydrogenase (LDH) and C-reactive protein (CRP) were compared between faster (FR) and slower (SR) runners. Physical activity performed during the week following the MUM was objectively analyzed using accelerometers and compared between FR and SR.

RESULTS

CK was significantly higher in FR at 3 days postrace (P<0.012, d=1.17) and LDH was significantly higher in FR at 3- and 7-days postrace (P=0.005, d=1.01; P<0.015, d=1.05 respectively), as compared to SR. No significant differences were identified in postrace physical activity levels between FR and SR. Significant relationships were found between race time and CK and LDH concentrations at 3 days postrace (r<inf>s</inf>=-0.41, P=0.017; r<inf>s</inf>=-0.52, P=0.002 respectively) and 7 days postrace (r<inf>s</inf>=-0.36, P=0.039; r<inf>s</inf>=-0.46. P=0.007 respectively). However, postrace physical activity was not associated with muscle damage and inflammation recovery, except for light intensity and CRP at 3 days postrace (r<inf>s</inf>=-0.40, P=0.025).

CONCLUSIONS

Race time appeared to have a higher influence on muscle damage recovery than the intensity of physical activities performed in the week after running a MUM. Inflammatory activity takes longer to normalize than muscle damage following a MUM, it is not related with race time and lightly related with postrace physical activity.

Epidemiology of Injury and Illness Among Trail Runners: A Systematic Review

BACKGROUND

Trail running is characterised by large elevation gains/losses and uneven varying running surfaces. Limited information is available on injury and illness among trail runners to help guide injury and illness prevention strategies.

OBJECTIVE

The primary aim of this review was to describe the epidemiology of injury and illness among trail runners.

METHODS

Eight electronic databases were systematically searched (MEDLINE Ovid, PubMed, Scopus, SportsDiscus, CINAHL, Health Source: Nursing/Academic, Health Source: Consumer Ed., and Cochrane) from inception to November 2020. The search was conducted according to the PRISMA statement and the study was registered on PROSPERO international prospective register of systematic reviews (CRD42019135933). Full-text English and French studies that investigated injury and/or illness among trail runners participating in training/racing were included. The main outcome measurements included: trail running injury (incidence, prevalence, anatomical site, tissue type, pathology-type/specific diagnosis, severity), and illness (incidence, prevalence, symptoms, specific diagnosis, organ system, severity). The methodological quality of the included studies was assessed using an adapted Downs and Black assessment tool.

RESULTS

Sixteen studies with 8644 participants were included. Thirteen studies investigated race-related injury and/or illness and three studies included training-related injuries. The overall incidence range was 1.6-4285.0 injuries per 1000 h of running and 65.0-6676.6 illnesses per 1000 h of running. The foot was the most common anatomical site of trail running injury followed by the knee, lower leg, thigh, and ankle. Skin lacerations/abrasions were the most common injury diagnoses followed by skin blisters, muscle strains, muscle cramping, and ligament sprains. The most common trail running illnesses reported related to the gastro-intestinal tract (GIT), followed by the metabolic, and cardiovascular systems. Symptoms of nausea and vomiting related to GIT distress and dehydration were commonly reported.

CONCLUSION

Current trail running literature consists mainly of injury and illness outcomes specifically in relation to single-day race participation events. Limited evidence is available on training-related injury and illness in trail running. Our review showed that injury and illness are common among trail runners, but certain studies included in this review only focused on dermatological injuries (e.g. large number of feet blisters) and GIT symptoms. Specific areas for future research were identified that could improve the management of trail running injury and illness.

Altered Position Sense after Submaximal Eccentric Exercise-inducing Central Fatigue

PURPOSE

The purpose of this study was to concomitantly investigate the acute and delayed effects of a submaximal eccentric-induced muscle fatigue on the position sense and the neuromuscular function of the right knee extensor muscles.

METHODS

Thirteen young and physically active participants performed a unilateral isokinetic eccentric exercise of their right lower limb until a decrease in maximal voluntary isometric contraction (MVIC) of 20% was reached. Neuromuscular (i.e., MVIC, voluntary activation (VA) level, and evoked contractile properties [DB100 and DB10]) and psychophysical evaluations (i.e., bilateral position-matching task, perceived muscle soreness, and perceived fatigue) were performed at four time points: before (PRE), immediately after (POST), 24 (POST24), and 48 (POST48) the exercise.

RESULTS

The acute 20% MVIC reduction (P < 0.001) was associated with both central (i.e., -13% VA decrease, P < 0.01) and peripheral (i.e., -18% and -42% reduction of DB100 and DB10, respectively, P < 0.001) fatigue. In the following days (POST24 and POST48), VA levels had recovered despite the presence of a persisting peripheral fatigue and delayed-onset muscle soreness. Knee position sense, as revealed by position errors, was significantly altered only at POST (P < 0.05) with participants overestimating the length of their knee extensor. Position errors and VA deficits were significantly correlated at POST (r = -0.60, P = 0.03). Position errors returned to nonsignificant control values in the following days.

CONCLUSION

The acute central fatigue induced by the eccentric exercise contributes to the position sense disturbances. Central fatigue might lead to alterations in the sensory structures responsible for the integration and the processing of position-related sensory inputs.

Downhill Running: What Are The Effects and How Can We Adapt? A Narrative Review

Downhill running (DR) is a whole-body exercise model that is used to investigate the physiological consequences of eccentric muscle actions and/or exercise-induced muscle damage (EIMD). In a sporting context, DR sections can be part of running disciplines (off-road and road running) and can accentuate EIMD, leading to a reduction in performance. The purpose of this narrative review is to: (1) better inform on the acute and delayed physiological effects of DR; (2) identify and discuss, using a comprehensive approach, the DR characteristics that affect the physiological responses to DR and their potential interactions; (3) provide the current state of evidence on preventive and in-situ strategies to better adapt to DR. Key findings of this review show that DR may have an impact on exercise performance by altering muscle structure and function due to EIMD. In the majority of studies, EIMD are assessed through isometric maximal voluntary contraction, blood creatine kinase and delayed onset muscle soreness, with DR characteristics (slope, exercise duration, and running speed) acting as the main influencing factors. In previous studies, the median (25th percentile, Q1; 75th percentile, Q3) slope, exercise duration, and running speed were - 12% (- 15%; - 10%), 40 min (30 min; 45 min) and 11.3 km h-1 (9.8 km h-1; 12.9 km h-1), respectively. Regardless of DR characteristics, people the least accustomed to DR generally experienced the most EIMD. There is growing evidence to suggest that preventive strategies that consist of prior exposure to DR are the most effective to better tolerate DR. The effectiveness of in-situ strategies such as lower limb compression garments and specific footwear remains to be confirmed. Our review finally highlights important discrepancies between studies in the assessment of EIMD, DR protocols and populations, which prevent drawing firm conclusions on factors that most influence the response to DR, and adaptive strategies to DR.

High-intensity downhill running exacerbates heart rate and muscular fatigue in trail runners

This study explores the cardiorespiratory and muscular fatigue responses to downhill (DR) vs uphill running (UR) at similar running speed or similar oxygen uptake (⩒O₂). Eight well-trained, male, trail runners completed a maximal level incremental test and three 15-min treadmill running trials at ±15% slope: i) DR at ~6 km·h^-1 and ~19% ⩒O_2max (LDR); ii) UR at ~6 km·h^-1 and ~70% ⩒O_2max (HUR); iii) DR at ~19 km·h^-1 and ~70% ⩒O_2max (HDR). Cardiorespiratory responses and spatiotemporal gait parameters were measured continuously. Maximal isometric torque was assessed before and after each trial for hip and knee extensors and plantar flexor muscles. At similar speed (~6 km·h^-1), cardiorespiratory responses were attenuated in LDR vs HUR with altered running kinematics (all p < 0.05). At similar ⩒O₂ (~3 l·min^-1), heart rate, pulmonary ventilation and breathing frequency were exacerbated in HDR vs HUR (p < 0.01), with reduced torque in knee (-15%) and hip (-11%) extensors and altered spatiotemporal gait parameters (all p < 0.01). Despite submaximal metabolic intensity (70% ⩒O_2max), heart rate and respiratory frequency reached maximal values in HDR. These results further our understanding of the particular cardiorespiratory and muscular fatigue responses to DR and provide the bases for future DR training programs for trail runners.

Inspiratory and Lower-Limb Strength Importance in Mountain Ultramarathon Running. Sex Differences and Relationship with Performance

The study was aimed at comparing lower-limb strength and respiratory parameters between male and female athletes and their interaction with performance in a 107 km mountain ultramarathon. Forty seven runners (29 males and 18 females; mean ± SD age: 41 ± 5 years) were enrolled. Lower-limb strength assessment comprised a squat jump test, an ankle rebound test, and an isometric strength test. Respiratory assessment included pulmonary function testing and the measurement of maximal inspiratory pressure. Male athletes performed largely better in the squat jump (26 ± 4 vs. 21 ± 3 cm; p < 0.001; d = 1.48), while no sex differences were found in the other two lower-limb tests. Concerning the respiratory parameters, male athletes showed largely greater values in pulmonary expiratory variables: forced vital capacity (5.19 ± 0.68 vs. 3.65 ± 0.52 L; p < 0.001; d = 2.53), forced expiratory volume in 1 s (4.24 ± 0.54 vs. 2.97 ± 0.39 L; p < 0.001; d = 2.69), peak expiratory flow (9.9 ± 1.56 vs. 5.89 ± 1.39 L/min; p < 0.001; d = 2.77) and maximum voluntary ventilation in 12 s (171 ± 39 vs. 108 ± 23 L/min; p < 0.001; d = 1.93); while no sex differences were identified in maximal inspiratory pressure. Race time was associated with ankle rebound test performance (r = −0.390; p = 0.027), isometric strength test performance (r = −0.349; p = 0.049) and maximal inspiratory pressure (r = −0.544; p < 0.001). Consequently, it seems that athletes competing in mountain ultramarathons may benefit from improving lower-limb isometric strength, ankle reactive strength and inspiratory muscle strength. Nevertheless, further interventional studies are required to confirm these exploratory results. In addition, the fact that the magnitude of the sex difference for isometric strength was minor, as compared with the other strength tests, could represent one of the factors explaining why the performance gap between males and females is reduced in ultramarathons.

Ultra Trail Performance is Differently Predicted by Endurance Variables in Men and Women

The study aimed to assess the relationship between peak oxygen uptake, ventilatory thresholds and maximal fat oxidation with ultra trail male and female performance. 47 athletes (29 men and 18 women) completed a cardiopulmonary exercise test between 2 to 4 weeks before a 107-km ultra trail. Body composition was also analyzed using a bioelectrical impedance weight scale. Exploratory correlation analyses showed that peak oxygen uptake (men: r=-0.63, p=0.004; women: r=-0.85, p < 0.001), peak speed (men: r=-0.74, p < 0.001; women: r=-0.69, p=0.009), speed at first (men: r=-0.49, p=0.035; women: r=-0.76, p=0.003) and second (men: r=-0.73, p < 0.001; women: r=-0.76, p=0.003) ventilatory threshold, and maximal fat oxidation (men: r=-0.53, p=0.019; women: r=-0.59, p=0.033) were linked to race time in male and female athletes. Percentage of fat mass (men: r=0.58, p=0.010; women: r=0.62, p= 0.024) and lean body mass (men: r=-0.61, p=0.006; women: r=-0.61, p=0.026) were also associated with performance in both sexes. Subsequent multiple regression analyses revealed that peak speed and maximal fat oxidation together were able to predict 66% of male performance; while peak oxygen uptake was the only statistically significant variable explaining 69% of the variation in women's race time. These results, although exploratory in nature, suggest that ultra trail performance is differently predicted by endurance variables in men and women.

Changes in Skeletal Muscle Oxidative Capacity After a Trail-Running Race

Purpose: To evaluate the effects of a trail-running race on muscle oxidative function by measuring pulmonary gas exchange variables and muscle fractional O2 extraction. Methods: Eighteen athletes were evaluated before (PRE) and after (POST) a trail-running competition of 32 or 50 km with 2000 or 3500 m of elevation gain, respectively. During the week before the race, runners performed an incremental uphill running test and an incremental exercise by utilizing a 1-leg knee extension ergometer. The knee extension exercise was repeated after the end of the race. During the knee extension test, the authors measured oxygen uptake () and micromolar changes in deoxygenated hemoglobin (Hb)+myoglobin (Mb) concentrations (Δ[deoxy(Hb+Mb)]) on vastus lateralis with a portable near-infrared spectroscopy. Results: was lower at POST versus PRE (−23.9% [9.0%]; P < .001). at POST was lower than at the same workload at PRE (−8.4% [15.6%]; P < .050). Peak power output and time to exhaustion decreased at POST by −23.7% (14.3%) and −18.3% (11.3%), respectively (P < .005). At POST, the increase of Δ[deoxy(Hb+Mb)] as a function of work rate, from unloaded to peak, was less pronounced (from 20.2% [10.1%] to 64.5% [21.1%] of limb ischemia at PRE to 16.9% [12.7%] to 44.0% [18.9%] at POST). Peak Δ[deoxy(Hb+Mb)] values were lower at POST (by −31.2% [20.5%]; P < .001). Conclusions: Trail running leads to impairment in skeletal muscle oxidative metabolism, possibly related to muscle damage from repeated eccentric contractions. In association with other mechanisms, the impairment of skeletal muscle oxidative metabolism is likely responsible for the reduced exercise capacity and tolerance during and following these races.

Predicting Competition Performance in Short Trail Running Races with Lactate Thresholds

Trail running is a popular sport, yet factors related to performance are still not fully understood. Lactate thresholds have been thoroughly investigated in road running and correlate strongly with race performance, but to date few data are available about the value in trail running performance prediction. We examined 25 trail runners (age 31.2 ± 5.1 years, BMI 22.2 ± 1.82 kg/m²) with an initial graded exercise test for measurement of VO_2max (59.5 ± 5.2 ml.kg^‐1.min^{‐ 1}) and lactate thresholds (LT): LTAET (LT aerobic) 1.03 ± 0.59 mmol/l; 11.2 ± 1.1 km/h), IAT (individual lactate threshold) (2.53 ± 0.59 mmol/l; 15.4 ± 1.6 km/h) and LT4 (lactate threshold at 4 mmol/l) (16.2 ± 1.9 km/h). All runners subsequently participated in a 31.1 km XS trail race and 9 runners in a 21 km XXS trail race. Race performance times correlated negatively with the XS trail run (LTAET: r = ‐0.65, p < 0.01; LT4: r = ‐0.87, p < 0.01; IAT: r = ‐0.84, p < 0.01) and regression analysis showed that race performance could be predicted by: LT4: ‐324.15×LT4+13195.23 (R² = .753, F_1,23 = 70.02, p < 0.01). A subgroup analysis showed higher correlations with race performance for slower than faster runners. No correlations were found with the XXS race. Lactate thresholds can be of value in predicting trail race performance and help in designing training plans.

Regular changes in foot strike pattern during prolonged downhill running do not influence neuromuscular, energetics, or biomechanical parameters

Research has suggested that a high variability in foot strike pattern during downhill running is associated with lower neuromuscular fatigue of the plantar flexors (PF). Given the popularity of trail running, we designed an intervention study to investigate whether a strategy with regular changes in foot strike pattern during downhill running could reduce the extent of fatigue on neuromuscular, energetics and biomechanical parameters as well as increase an uphill time-to-exhaustion trial (TTE) performance. Fourteen experienced trail runners completed two interventional conditions (separated by 15 days) in a pseudo-randomised and counter-balanced order that consisted of 2.5-h of treadmill graded running with (switch condition) or without (control condition) a change between fore- and rear-foot strike pattern every 30 s during the downhill sections. Pre and Post, neuromuscular tests were performed to assess PF central and peripheral fatigue. Energy cost of running was assessed using an indirect calorimetry system and biomechanical gait parameters were acquired with an instrumented treadmill. TTE was performed after both the graded running conditions. There were not significant condition × time interactions (p ≥ .085) for any of the variables considered, and TTE was not different between the two conditions (p = .755). A deliberate strategy to alternate between foot strike patterns did not reduce the extent of fatigue during prolonged graded running. We suggest that it is not the ability to switch between foot strike patterns that minimises fatigue; rather the ability to adapt foot strike pattern to the terrain and therefore a better running technique.

Cadence impact on cardiopulmonary, metabolic and biomechanical loading during downhill running

BACKGROUND

Distance runners can approach long descents with slow cadence and long steps, or a fast cadence with shorter steps. These approaches differentially affect mechanical loading and energy demand.

RESEARCH QUESTION

This study determined the cadence range in which biomechanical loads, caloric unit cost and energy cost were simultaneously minimized during downhill running (DR).

METHODS

Trained runners (N = 40; 25.6 ± 7.2 yr; 42.5% female) participated in this experimental study. Participants ran on an instrumented treadmill while wearing a portable gas analyzer during six conditions: control normal level running (LR) at 0 deg inclination (CON-0); control DR -6 deg inclinaton (CON-6); DR at cadences +/-5% and +/-10% different from CON-6. A motion analysis system was used to capture running motion, and an instrumented treadmill captured force data. Cardiopulmonary measures, rating of perceived exertion (RPE), and biomechanical measures (temporal spatial parameters, peak ground reaction forces [GRF], vertical average loading rate [VALR], impulses) were calculated. Caloric unit cost and energy costs were standardized per unit distance.

RESULTS

Running at -10% cadence increased HR by 10 bpm compared to CON-6 (p < 0.0001). Vertical excursion of the center of mass and step length were greatest in the cadence -10% and least in the cadence +10% conditions (both p < 0.0001). RPEs were higher among all cadence conditions compared to CON-0 (p < 0.0001). Caloric unit costs were lowest in CON-6, and +/5% cadence conditions compared to the CON-0 and +/-10% conditions (-2.1% to -12.3%, respectively; p < 0.05). Peak GRF and VALR were not different among conditions; vertical impulses were greatest in the -10% condition compared to CON-0, CON-6 and +5% and +10% by 11.3-14.5% (p < .001).

SIGNIFICANCE

Changing cadence across level and downhill stretches is likely not necessary and may actually increase perceived effort of running. Running downhill at cadences that range +/-5% of preferred simultaneously minimize caloric unit cost and impulse loading.

Short Trail Running Race: Beyond the Classic Model for Endurance Running Performance

PURPOSE

This study aimed to examine the extent to which the classical physiological variables of endurance running performance (maximal oxygen uptake (V˙O2max), %V˙O2max at ventilatory threshold (VT), and running economy (RE)) but also muscle strength factors contribute to short trail running (TR) performance.

METHODS

A homogeneous group of nine highly trained trail runners performed an official TR race (27 km) and laboratory-based sessions to determine V˙O2max, %V˙O2max at VT, level RE (RE0%) and RE on a +10% slope, maximal voluntary concentric and eccentric knee extension torques, local endurance assessed by a fatigue index (FI), and a time to exhaustion at 87.5% of the velocity associated with V˙O2max. A simple regression method and commonality analysis identifying unique and common coefficients of each independent variable were used to determine the best predictors for the TR race time (dependent variable).

RESULTS

Pearson correlations showed that FI and V˙O2max had the highest correlations (r = 0.91 and r = -0.76, respectively) with TR performance. The other selected variables were not significantly correlated with TR performance. The analysis of unique and common coefficients of relative V˙O2max, %V˙O2max at VT, and RE0% provides a low prediction of TR performance (R = 0.48). However, adding FI and RE on a +10% slope (instead of RE0%) markedly improved the predictive power of the model (R = 0.98). FI and V˙O2max showed the highest unique (49.8% and 20.4% of total effect, respectively) and common (26.9% of total effect) contributions to the regression equation.

CONCLUSIONS

The classic endurance running model does not allow for meaningful prediction of short TR performance. Incorporating more specific factors into TR such as local endurance and gradient-specific RE testing procedures should be considered to better characterize short TR performance.

Acute and Delayed Neuromuscular Alterations Induced by Downhill Running in Trained Trail Runners: Beneficial Effects of High-Pressure Compression Garments

Introduction: The aim of this study was to examine, from a crossover experimental design, whether wearing high-pressure compression garments (CGs) during downhill treadmill running affects soft-tissue vibrations, acute and delayed responses in running economy (RE), neuromuscular function, countermovement jump, and perceived muscle soreness. Methods: Thirteen male trail runners habituated to regular eccentric training performed two separate 40-min downhill running (DHR, -8.5°) sessions while wearing either CGs (15-20 mmHg for quadriceps and calves) or control garments (CON) at a velocity associated with ∼55% of VO2max , with a set of measurements before (Pre-), after (Post-DHR), and 1 day after (Post-1D). No CGs was used within the recovery phase. Perceived muscle soreness, countermovement jump, and neuromuscular function (central and peripheral components) of knee extensors (KE) and plantar flexors (PF) were assessed. Cardiorespiratory responses (e.g., heart rate, ventilation) and RE, as well as soft-tissue vibrations (root mean square of the resultant acceleration, RMS Ar ) for vastus lateralis and gastrocnemius medialis were evaluated during DHR and in Post-1D. Results: During DHR, mean values in RMS Ar significantly increased over time for the vastus lateralis only for the CON condition (+11.6%). RE and cardiorespiratory responses significantly increased (i.e., alteration) over time in both conditions. Post, small to very large central and peripheral alterations were found for KE and PF in both conditions. However, the deficit in voluntary activation (VA) was significantly lower for KE following CGs (-2.4%), compared to CON (-7.9%) conditions. No significant differences in perceived muscle soreness and countermovement jump were observed between conditions whatever the time period. Additionally, in Post-1D, the CGs condition showed reductions in neuromuscular peripheral alterations only for KE (from -4.4 to -7.7%) and perceived muscle soreness scores (-8.3%). No significant differences in cardiorespiratory and RE responses as well as countermovement jump were identified between conditions in Post-1D. Discussion: Wearing high-pressure CGs (notably on KE) during DHR was associated with beneficial effects on soft-tissue vibrations, acute and delayed neuromuscular function, and perceived muscle soreness. The use of CGs during DHR might contribute to the enhanced muscle recovery by exerting an exercise-induced "mechanical protective effect."

Localization of damage in the human leg muscles induced by downhill running

We investigated localization of damage within the knee extensors (KEs) and plantar flexors (PFs) induced by downhill running (DR) by using transverse relaxation time (T₂)-weighted magnetic resonance imaging (MRI). Fourteen young adults performed 45-min DR (-15% slope) at their maximal tolerable velocity. At pre- and 24, 48, and 72 h post-exercise, T₂-MRI was scanned and T₂ values for each muscle composing KEs and PFs at proximal, middle, and distal sites were calculated. Maximal isometric torque and rate of torque development (RTD: 0-30, 0-50, 0-100, 0-200 ms) were also measured. Maximal torque significantly decreased in KEs (14-17%) and PFs (6-8%) at 24-48 h post-exercise, with greater reductions for KEs. RTD in all phases, except for 0-200 ms in PFs, significantly decreased in KEs (11-42%) and PFs (13-23%) at least at one time point post-exercise. T₂ significantly increased at several sites (3-5%) in both muscle groups at 24 and/or 48 h post-exercise. Among the T₂-increased sites, the peak effect size (Cohen's d) regarding T₂ change was pronounced at proximal (1.05) and middle (1.64) vastus intermedius compared to the other sites (0.72-0.77). These results suggest that DR induces damage in both KEs and PFs, and especially affects proximal-middle sites of the vastus intermedius.

Fatigue associated with prolonged graded running

Scientific experiments on running mainly consider level running. However, the magnitude and etiology of fatigue depend on the exercise under consideration, particularly the predominant type of contraction, which differs between level, uphill, and downhill running. The purpose of this review is to comprehensively summarize the neurophysiological and biomechanical changes due to fatigue in graded running. When comparing prolonged hilly running (i.e., a combination of uphill and downhill running) to level running, it is found that (1) the general shape of the neuromuscular fatigue-exercise duration curve as well as the etiology of fatigue in knee extensor and plantar flexor muscles are similar and (2) the biomechanical consequences are also relatively comparable, suggesting that duration rather than elevation changes affects neuromuscular function and running patterns. However, 'pure' uphill or downhill running has several fatigue-related intrinsic features compared with the level running. Downhill running induces severe lower limb tissue damage, indirectly evidenced by massive increases in plasma creatine kinase/myoglobin concentration or inflammatory markers. In addition, low-frequency fatigue (i.e., excitation-contraction coupling failure) is systematically observed after downhill running, although it has also been found in high-intensity uphill running for different reasons. Indeed, low-frequency fatigue in downhill running is attributed to mechanical stress at the interface sarcoplasmic reticulum/T-tubule, while the inorganic phosphate accumulation probably plays a central role in intense uphill running. Other fatigue-related specificities of graded running such as strategies to minimize the deleterious effects of downhill running on muscle function, the difference of energy cost versus heat storage or muscle activity changes in downhill, level, and uphill running are also discussed.

Effects of the foot strike pattern on muscle activity and neuromuscular fatigue in downhill trail running

Minimizing musculo-skeletal damage and fatigue is considered paramount for performance in trail running. Our purposes were to investigate the effects of the foot strike pattern and its variability on (a) muscle activity during a downhill trail run and (b) immediate and delayed neuromuscular fatigue. Twenty-three runners performed a 6.5-km run (1264 m of negative elevation change). Electromyographic activity of lower-limb muscles was recorded continuously. Heel and metatarsal accelerations were recorded to identify the running technique. Peripheral and central fatigue was assessed in knee extensors (KE) and plantar flexors (PF) at Pre-, Post-, and 2 days post downhill run (Post2d). Anterior patterns were associated with (a) higher gastrocnemius lateralis activity and lower tibialis anterior and vastus lateralis activity during the run and (b) larger decreases in KE high-frequency stimulus-evoked torque Post and larger decrements in KE MVC Post2d. High patterns variability during the run was associated with (a) smaller decreases in KE Db100 Post and MVC Post2d and (b) smaller decreases in PF MVC Post and Post2d. Anterior patterns increase the severity of KE peripheral fatigue. However, high foot strike pattern variability during the run reduced acute and delayed neuromuscular fatigue in KE and PF.