Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes

The effects of hydrotherapy and cryotherapy on recovery from acute post-exercise induced muscle damage-a network meta-analysis

BACKGROUND

This systematic review and network meta-analysis assessed via direct and indirect comparisons the recovery effects of hydrotherapy and cold therapy at different temperatures on exercise induced muscle damage.

METHODS

Five databases were searched in English and Chinese. The included studies included exercise interventions such as resistance training, high-intensity interval training, and ball games, which the authors were able to define as activities that induce the appearance of EIMD. The included RCTs were analyzed using the Cochrane Risk of Bias tool. Eligible studies were included and and two independent review authors extracted data. Frequentist network meta-analytical approaches were calculated based on standardized mean difference (SMD) using random effects models. The effectiveness of each intervention was ranked and the optimal intervention was determined using the surface under the cumulative ranking curve (SUCRA) indicator.

RESULTS

57 studies with 1220 healthy participants were included, and four interventions were examined: Cold Water Immersion (CWI), Contrast Water Therapy (CWT), Thermoneutral or Hot Water Immersion (TWI/HWI), and Cryotherapy(CRYO). According to network meta-analysis, Contrast Water Immersion (SUCRA: 79.9% )is most effective in recovering the biochemical marker Creatine Kinase. Cryotherapy (SUCRA: 88.3%) works best to relieve Delayed Onset Muscle Soreness. In the recovery of Jump Ability, cryotherapy (SUCRA: 83.7%) still ranks the highest.

CONCLUSION

We found that CWT was the best for recovering biochemical markers CK, and CRYO was best for muscle soreness and neuromuscular recovery. In clinical practice, we recommend the use of CWI and CRYO for reducing EIMD.

SYSTEMATIC REVIEW REGISTRATION

[PROSPERO], identifier [CRD42023396067].

A evidence-based approach to selecting post-exercise cryostimulation techniques for improving exercise performance and fatigue recovery: A systematic review and meta-analysis

Rationale

Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast water therapy), and WBC (whole-body cryostimulation). Previous systematic reviews focused on the effect of cryostimulation on muscle fatigue and sports performance. However, studies on the selection of different cryostimulation methods and their intervention effects present inconsistent results.

Introduction

To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that the effects of various cryostimulation methods, including CWI, CWT, and WBC, on exercise performance and fatigue recovery.

Methods

Following PRISMA guidelines, we conducted searches in PubMed, Embase, The Cochrane Library, Web of Science, and EBSCO databases to gather randomized controlled trials or self-controlled trials involving CWI/CWT/WBC and their effects on exercise performance or fatigue recovery. The search period ranged from November 2013 to November 2, 2023. Literature screening was performed using EndNote X9.1, and the quality of included studies was assessed using the Cochrane risk of bias assessment tool. Meta-analysis was conducted using RevMan 5.3 software.

Results

This study included a total of 18 articles, included a total of 499 healthy participants, comprising 479 males and 20 females. Among them, participants underwent cryostimulation, including 102 using CWT, using CWI, and 58 using WBC. Compared to the control group, cryostimulation can significantly alleviate muscle pain intensity (SMD -0.45, 95% CL -0.82 to 0.09, P = 0.01). Specifically, CWI significantly reduced muscle pain intensity (SMD = -0.45, 95% CI: 0.820.09, P = 0.01), WBC significantly decreased C-reactive protein levels (SMD = -1.36, 95% CI: 2.350.36, P = 0.008). While, CWT showed no significant differences from the control group in exercise performance and fatigue recovery indicators (P > 0.05).

Conclusion

Cryostimulation can significantly reduce muscle pain intensity and perceived fatigue. Specifically, CWI significantly alleviates muscle pain intensity, WBC significantly lowers markers of inflammation caused by fatigue after exercise, in contrast, CWT does not significantly improve exercise performance and fatigue recovery. After exercise, compared with rest, using cryostimulation may have more noticeable benefits for muscle fatigue and muscle pain, with recommendations prioritizing WBC and CWI particularly for addressing inflammation and muscle pain. However, all cryostimulation may have no significant influence on exercise performance.

Effect of Alpha-1 Antitrypsin and Irisin on Post-Exercise Inflammatory Response: A Narrative Review

Physical activity has a positive effect on human health and emotional well-being. However, in both amateur and professional athletes, training poses a risk of acute or chronic injury through repetitive overloading of bones, joints, and muscles. Inflammation can be an adverse effect of intense exercise caused by several factors including oxidative stress. The present narrative review summarizes current knowledge on inflammatory markers induced by physical exercise. Post-exercise recovery may reduce inflammatory responses and is key to effective training and adaptation of muscle tissues to sustained physical exertion.

Effect of repeatedly applied cold water immersion on subclinical atherosclerosis, inflammation, fat accumulation and lipid profile parameters of volunteers

Significant acute cardiovascular, metabolic, and endocrine changes have been traced to short-lasting cold water immersion (CWI); however, the long-term impact of recurrent CWI on atherogenesis, lipid parameters, and fat distribution has not yet been studied. The goal of this study was to investigate the alleged protective effect. A total of 35 healthy volunteers were monitored for a period of 5 months during which the CWI was performed under standardized conditions (three times per week for 7-10 min, without neoprene equipment). Volunteers with measured weight or muscle mass increases of more than 5% were ineligible. An analogous control group (N = 30) was included. At the onset and completion of the study, blood samples were obtained, and clinical assessments took place. PCSK9 and hsCRP levels were measured together with other lipid-related and non-lipid-related indicators. Carotid intima-media thickness test (cIMT) and echo-tracking for the identification of arterial stiffness (PWV, AI, and β) were used to identify early vascular alterations. Hepatorenal index (HRI) calculations served to quantify liver steatosis, while changes in subcutaneous and visceral fat thickness were used to quantify fat distribution. The given protocol was successfully completed by 28 volunteers. Long-term repeated CWI resulted in a significant decline in cIMT (p = 0.0001), AI (p = 0.0002), Beta (p = 0.0001), and PWV (p = 0.0001). PCSK9 (p = 0.01) and hsCRP (p = 0.01) showed a significant decrease when compared to initial values. In comparison to the starting values, liver fat accumulation decreased by 11% on average (HRI p = 0.001). LDL, TC, TG, and VLDL levels all significantly decreased as well. We suggest that repeated CWI may have beneficial impact on lipid, non-lipid, and lipid-related indices, as well as atherogenesis and liver fat storage.

Cold water immersion in recovery following a single bout resistance exercise suppresses mechanisms of miRNA nuclear export and maturation

Cold water immersion (CWI) following intense exercise is a common athletic recovery practice. However, CWI impacts muscle adaptations to exercise training, with attenuated muscle hypertrophy and increased angiogenesis. Tissue temperature modulates the abundance of specific miRNA species and thus CWI may affect muscle adaptations via modulating miRNA expression following a bout of exercise. The current study focused on the regulatory mechanisms involved in cleavage and nuclear export of mature miRNA, including DROSHA, EXPORTIN-5, and DICER. Muscle biopsies were obtained from the vastus lateralis of young males (n = 9) at rest and at 2, 4, and 48 h of recovery from an acute bout of resistance exercise, followed by either 10 min of active recovery (ACT) at ambient temperature or CWI at 10°C. The abundance of key miRNA species in the regulation of intracellular anabolic signaling (miR-1 and miR-133a) and angiogenesis (miR-15a and miR-126) were measured, along with several gene targets implicated in satellite cell dynamics (NCAM and PAX7) and angiogenesis (VEGF and SPRED-1). When compared to ACT, CWI suppressed mRNA expression of DROSHA (24 h p = 0.025 and 48 h p = 0.017), EXPORTIN-5 (24 h p = 0.008), and DICER (24 h p = 0.0034). Of the analyzed miRNA species, miR-133a (24 h p < 0.001 and 48 h p = 0.007) and miR-126 (24 h p < 0.001 and 48 h p < 0.001) remained elevated at 24 h post-exercise in the CWI trial only. Potential gene targets of these miRNA, however, did not differ between trials. CWI may therefore impact miRNA abundance in skeletal muscle, although the precise physiological relevance needs further investigation.

Effect of Kinesio tape and Compression sleeves on delayed onset of muscle soreness: a single-blinded randomized controlled trial

BACKGROUND

Both Kinesio Tape (KT) and Compression Sleeves (CS) can relieve Delayed Onset Muscle Soreness (DOMS) to a certain extent, but there is no study report on the difference in the effectiveness of the KT and CS whether the effect is better when used at the same time. The purpose of this study was to compare the effects of KT and CS on the recovery of muscle soreness, isokinetic strength, and body fatigue after DOMS.

METHODS

In this single-blinded randomized controlled trial, 32 participants aged 18 to 24 years were randomly divided into Control group (CG), Compression Sleeves group (CSG), Kinesio Tape group (KTG), Compression Sleeves and Kinesio Tape group (CSKTG), between October 2021 and January 2022. KTG uses Kinesio Tape, CSG wears Compression Sleeves, and CSKTG uses both Compression Sleeves and Kinesio Tape. Outcomes were performed at five-time points (baseline, 0 h, 24 h, 48 h, 72 h), Primary outcome was pain level Visual Analogue Scale (VAS), and Secondary outcomes were Interleukin 6, Peak Torque/Body Weight, Work Fatigue. Statistical analyses were performed using the repeated measures analysis of variance method.

SETTING

Laboratory.

RESULTS

After the intervention, VAS reached the highest at 24 h after exercise-induced muscle soreness, while the KTG and CSG at each time point were less than CG, and the scores of CSKTG at 24 h and 48 h were less than those of KTG and CSG in the same period (P < 0.05). Interleukin 6, at 24 h, CSKTG is lower than KTG 0.71(95%CI: 0.43 to 1.86) and CG 1.68(95%CI: 0.06 to 3.29). Peak Torque/Body Weight, at 24 h, CG was lower than CSKTG 0.99(95%CI: 0.42 to 1.56), KTG 0.94(95%CI: 0.37 to 1.52), and CSG 0.72(95%CI: 0.14 to 1.29); at 72 h, CG was lower than CSKTG 0.65(95%CI: 0.13 to 1.17) and KTG 0.58(95%CI: 0.06 to 1.10). Work Fatigue, at 24 h, CG was lower than KTG 0.10(95%CI: 0.02 to 1.78) and CSKTG 0.01(95%CI: -0.07 to 0.09). At 48 h, CG was lower than KTG 0.10(95%CI: 0.13 to 1.17) and CSKTG 0.11(95%CI: 0.03 to 0.18).

CONCLUSIONS

Kinesio Tape can significantly reduce DOMS pain, and Kinesio Tape has a better recovery effect on Delayed Onset Muscle Soreness than Compression Sleeves. Kinesio Tape combined with Compression Sleeves is helpful to alleviate the Delayed Onset Muscle Soreness pain, speeding up the recovery of muscle strength, and shortening the recovery time after Delayed Onset Muscle Soreness.

TRIAL REGISTRATION

Registration number: This study was also registered on 11/10/2021, at the Chinese Clinical Trial Registry (ChiCTR2100051973).

The effect of cold water immersion on the recovery of physical performance revisited: A systematic review with meta-analysis

This review evaluated the effect of CWI on the temporal recovery profile of physical performance, accounting for environmental conditions and prior exercise modality. Sixty-eight studies met the inclusion criteria. Standardised mean differences were calculated for parameters assessed at <1, 1-6, 24, 48, 72 and ≥96 h post-immersion. CWI improved short-term recovery of endurance performance (p = 0.01, 1 h), but impaired sprint (p = 0.03, 1 h) and jump performance (p = 0.04, 6h). CWI improved longer-term recovery of jump performance (p < 0.01-0.02, 24 h and 96 h) and strength (p < 0.01, 24 h), which coincided with decreased creatine kinase (p < 0.01-0.04, 24-72 h), improved muscle soreness (p < 0.01-0.02, 1-72 h) and perceived recovery (p < 0.01, 72 h). CWI improved the recovery of endurance performance following exercise in warm (p < 0.01) and but not in temperate conditions (p = 0.06). CWI improved strength recovery following endurance exercise performed at cool-to-temperate conditions (p = 0.04) and enhanced recovery of sprint performance following resistance exercise (p = 0.04). CWI seems to benefit the acute recovery of endurance performance, and longer-term recovery of muscle strength and power, coinciding with changes in muscle damage markers. This, however, depends on the nature of the preceding exercise.

Effects of cold water immersion after exercise on fatigue recovery and exercise performance--meta analysis

Cold water immersion (CWI) is very popular as a method reducing post-exercise muscle stiffness, eliminating fatigue, decreasing exercise-induced muscle damage (EIMD), and recovering sports performance. However, there are conflicting opinions as to whether CWI functions positively or negatively. The mechanisms of CWI are still not clear. In this systematic review, we used meta-analysis aims to examine the effect of CWI on fatigue recovery after high-intensity exercise and exercise performance. A total of 20 studies were retrieved and included from PubMed, PEDro and Elsevier databases in this review. Publication years of articles ranged from 2002 to 2022. In selected studies including randomized controlled trials (RCTs) and Crossover design (COD). Analyses of subjective indicators such as delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE), and objective indicators such as countermovement jump (CMJ) and blood plasma markers including creatine kinase(CK), lactate/lactate dehydrogenase(LDH), C-reactive protein(CRP), and IL-6 were performed. Pooled data showed as follows: CWI resulted in a significant decline in subjective characteristics (delayed-onset muscle soreness and perceived exertion at 0 h); CWI reduced countermovement jump(CMJ) significantly at 0 h, creatine kinase(CK) was lowered at 24 h, and lactate at 24 and 48 h. There was no evidence that CWI affects C-reactive protein(CRP) and IL-6 during a 48-h recovery period. Subgroup analysis revealed that different CWI sites and water temperatures have no effect on post-exercise fatigue recovery. Recommended athletes immersed in cold water immediately after exercise, which can effectively reduce muscle soreness and accelerate fatigue recovery.

The Influence of Ambient Temperature Changes on the Indicators of Inflammation and Oxidative Damage in Blood after Submaximal Exercise

Physical activity has a positive effect on human health and well-being, but intense exercise can cause adverse changes in the organism, leading to the development of oxidative stress and inflammation. The aim of the study was to determine the effect of short-term cold water immersion (CWI) and a sauna bath as methods of postexercise regeneration on the indicators of inflammation and oxidative damage in the blood of healthy recreational athletes. Forty-five male volunteers divided into two groups: 'winter swimmers' who regularly use winter baths (n = 22, average age 43.2 ± 5.9 years) and 'novices' who had not used winter baths regularly before (n = 23, mean age 25 ± 4.8 years) participated in the study. The research was divided into two experiments, differing in the method of postexercise regeneration used, CWI (Experiment I) and a sauna bath (Experiment II). During Experiment I, the volunteers were subjected to a 30-min aerobic exercise, combined with a 20-min rest at room temperature (RT-REST) or a 20-min rest at room temperature with an initial 3-min 8 °C water bath (CWI-REST). During the Experiment II, the volunteers were subjected to the same aerobic exercise, followed by a RT-REST or a sauna bath (SAUNA-REST). The blood samples were taken before physical exercise (control), immediately after exercise and 20 min after completion of regeneration. The concentrations of selected indicators of inflammation, including interleukin 1β (IL-1β), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 8 (IL-8), interleukin 10 (IL-10), transforming growth factor β1 (TGF-β1) and tumor necrosis factor α (TNF-α), as well as the activity of indicators of oxidative damage: α1-antitrypsin (AAT) and lysosomal enzymes, including arylsulfatase A (ASA), acid phosphatase (AcP) and cathepsin D (CTS D), were determined. CWI seems to be a more effective post-exercise regeneration method to reduce the inflammatory response compared to a sauna bath. A single sauna bath is associated with the risk of proteolytic tissue damage, but disturbances of cellular homeostasis are less pronounced in people who regularly use cold water baths than in those who are not adapted to thermal stress.

The effect of local cold application on intradialytic cramp: A quasi-experimental study

Aims:

An intradialytic cramp, which frequently occurs in hemodialysis patients, is a disturbing condition. This study was conducted to evaluate the effect of local cold applications on the severity and duration of intradialytic cramps in patients with chronic kidney disease.

Materials and Methods:

This quasi-experimental study sample comprised of 74 patients who were aged >18 years, conscious, and reported experiencing intradialytic cramps in a dialysis center. In this study, the application group had the local cold treatment as well as the treatment recommended by the physician whereas the control group was only given the treatment recommended by the physician. The cramp severity was assessed using a visual analog scale as soon as the cramp started (T1) and 10 min after the onset of the cramp (T2). The cramp duration was determined by a chronometer. The Independent Sample T-test, One-Way ANOVA test, Paired Samples T-test and the Two-Way ANOVA test were used to analyze the data.

Results:

In the study, the duration of the cramp (sd) was 9.49 (0.86) minutes in the application group and 7.51 (0.69) minutes in the control group ( t = 1791, p = 0.078). It was determined that the pain severity scores of the application and control group patients were significantly decreased at the T2 time point compared to T1 ( p = 0.001), and the effect of the group and evaluation time points on the cramp severity score was not statistically different ( p = 0.548).

Conclusion:

In this study, the mean duration of the intradialytic cramp was below 10 min for both groups. The local cold application had no effect on cramp severity or duration.

Potential Application of Low-Intensity Focused Ultrasound in Rapidly Relieving Delayed-Onset Muscle Soreness Induced by High-Intensity Exercise

OBJECTIVES

To evaluate the efficacy of low-intensity focused ultrasound (LIFU) treatment on rapid relief of delayed-onset muscle soreness (DOMS) triggered by high-intensity exercise.

METHODS

A total of 16 healthy male college students were randomly divided into two groups: the LIFU group (n = 8) and the Sham group (n = 8). After the exercise protocol, the LIFU group received treatment, which parameters included that the power output was 2.5 W/cm² , the frequency was 1 MHz, and the treating time was 20 minutes. The Sham group was treated with LIFU without energy output. Visual analog scale was used to evaluate the level of DOMS in every participant. The activities of plasma creatine kinase, lactate dehydrogenase, and the plasma concentration were measured by spectrophotometry. Tumor necrosis factor-α and interleukin-6 of serum were analyzed by enzyme-linked immunosorbent assay.

RESULTS

The visual analog scale of quadriceps femoris and/or calf muscles in the LIFU group decreased significantly at 24 hours (P < 0.01) and 48 hours (P < .01) after the exercise protocol. Both the accumulation of lactic acid (P < .01) in muscle and the activity of lactate dehydrogenase (P < .01) reduced immediately after LIFU treatment. The activities of tumor necrosis factor-α and interleukin-6 24 hours lowered in the LIFU group (P < .01).

CONCLUSIONS

LIFU treatment could relieve muscle soreness rapidly and effectively in the early stages of DOMS. The application of LIFU may provide a potential strategy for clinical treatment for DOMS.

Cold Water Immersion Improves the Recovery of Both Central and Peripheral Fatigue Following Simulated Soccer Match-Play

The present study aimed to investigate the effect of cold water immersion (CWI) on the recovery of neuromuscular fatigue following simulated soccer match-play. In a randomized design, twelve soccer players completed a 90-min simulated soccer match followed by either CWI or thermoneutral water immersion (TWI, sham condition). Before and after match (immediately after CWI/TWI through 72 h recovery), neuromuscular and performance assessments were performed. Maximal voluntary contraction (MVC) and twitch responses, delivered through electrical femoral nerve stimulation, were used to assess peripheral fatigue (quadriceps resting twitch force, Q_tw,pot) and central fatigue (voluntary activation, VA). Performance was assessed via squat jump (SJ), countermovement jump (CMJ), and 20 m sprint tests. Biomarkers of muscle damages (creatine kinase, CK; Lactate dehydrogenase, LDH) were also collected. Smaller reductions in CWI than TWI were found in MVC (-9.9 ± 3%vs-23.7 ± 14.7%), VA (-3.7 ± 4.9%vs-15.4 ± 5.6%) and Q_tw,pot (-15.7 ± 5.9% vs. -24.8 ± 9.5%) following post-match intervention (p < 0.05). On the other hand, smaller reductions in CWI than TWI were found only in Q_tw,pot (-0.2 ± 7.7% vs. -8.8 ± 9.6%) at 72 h post-match. Afterwards, these parameters remained lower compared to baseline up to 48–72 h in TWI while they all recovered within 24 h in CWI. The 20 m sprint performance was less impaired in CWI than TWI (+11.1 ± 3.2% vs. +18 ± 3.6%, p < 0.05) while SJ and CMJ were not affected by the recovery strategy. Plasma LDH, yet no CK, were less increased during recovery in CWI compared to TWI. This study showed that CWI reduced both central and peripheral components of fatigue, which in turn led to earlier full recovery of the neuromuscular function and performance indices. Therefore, CWI might be an interesting recovery strategy for soccer players.

RELATIONSHIP BETWEEN COMPETITION SIMULATION AND TRAINING ON STRENGTH AND DAMAGE INDICATORS IN JIU-JITSU

ABSTRACT Background: The relationship between training and competition is very important and aims at a more specific and adequate preparation in Jiu-Jitsu. Problem and objective: To evaluate the relationship between training and competition through indications of injury and muscle strength. Methods: The study sample included nine subjects (22.54 ± 2.77 years of age) who were submitted to the following two conditions: 1) training simulation and 2) competition simulation. Results: There were no significant differences in the countermovement jump (CMJ) test. However, 48 hours after training there was an indication of values higher than the post-competition ones. Creatine kinase (CK) indicated significant differences in muscle damage after competition in relation to the other conditions and moments (p <0.01) with a high effect. Lactate dehydrogenase (LDH) showed differences in the moments before, during, and after both competition and training conditions (p <0.05) with a high effect. The power of the upper limbs (PUL) showed a medium correlation at 24h (> 0.55) and 48h (0.47) after the intervention. There was high correlation (> 0.70) for all conditions in the squat jump (SJ). LDH showed a high correlation (> 0.70) at 48 hours. Conclusion: There was a good correlation between training and competition simulation, which tends to indicate that the training model used in the study properly prepare Jiu-Jitsu athletes for the demands of competition. Level of evidence I; High-quality randomized clinical trial with or without a statistically significant difference, but with narrow confidence intervals.

Efficacy of Different Cold-Water Immersion Temperatures on Neuromotor Performance in Young Athletes

Cold-Water-Immersion (CWI) has been frequently used to accelerate muscle recovery and to improve performance after fatigue onset. In the present study, the aim was to investigate the effects of different CWI temperatures on neuromuscular activity on quadriceps after acute fatigue protocol. Thirty-six young athletes (16.9 ± 1.4 years-old; 72.1 ± 13.8 kg; 178.4 ± 7.2 cm) were divided into three groups: passive recovery group (PRG); CWI at 5 °C group (5G); and CWI at 10 °C group (10G). All participants performed a fatigue exercise protocol; afterwards, PRG performed a passive recovery (rest), while 5G and 10G were submitted to CWI by means of 5 °C and 10 °C temperatures during 10 min, respectively. Fatigue protocol was performed by knee extension at 40% of isometric peak force from maximal isometric voluntary contraction. Electromyography was used to evaluate neuromuscular performance. The passive recovery and CWI at 5 °C were associated with normalized isometric force and quadriceps activation amplitude from 15 until 120 min after exercise-induced fatigue (F = 7.169, p < 0.001). CWI at 5 °C and 10 °C showed higher muscle activation (F = 6.850, p < 0.001) and lower median frequency (MF) than passive recovery after 15 and 30 min of fatigue (F = 5.386, p < 0.001). For neuromuscular efficiency (NME) recovery, while PRG normalized NME values after 15 min, 5G and 10G exhibited these responses after 60 and 30 min (F = 4.330, p < 0.01), respectively. Passive recovery and CWI at 5 °C and 10 °C revealed similar effects in terms of recovery of muscle strength and NME, but ice interventions resulted in higher quadriceps activation recovery.

Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression

Background

Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations.

Objectives

The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations.

Study Design

Systematic review with meta-analysis and meta-regression.

Methods

A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables.

Results

Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06–0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004–0.43]), and reduced serum CK (SMD − 0.85 [95% CI − 1.61 to − 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD − 0.89 [95% CI − 1.48 to − 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29–1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise.

Conclusion

CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose–response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise.

Funding

Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training.

Protocol registration

Open Science Framework: 10.17605/OSF.IO/SRB9D.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01644-9.

Effect of cold and heat therapies on pain relief in patients with delayed onset muscle soreness: A network meta-analysis

OBJECTIVE

To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis.

METHODS

Eight Chinese and English databases were searched from date of establishment of the database to 31 May 2021. Cochrane risk-of-bias tool was used to analyse the included randomized controlled trials. Potential papers were screened for eligibility, and data were extracted by 2 independent researchers.

RESULTS

A total of 59 studies involving 1,367 patients were eligible for this study. Ten interventions were examined: contrast water therapy, phase change material, the novel modality of cryotherapy, cold-water immersion, hot/warm-water immersion, cold pack, hot pack, ice massage, ultrasound, and passive recovery. Network meta-analysis results showed that: (i) within 24 h after exercise, hot pack was the most effective for pain relief, followed by contrast water therapy; (ii) within 48 h, the ranking was hot pack, followed by the novel modality of cryotherapy; and (iii) over 48 h post-exercise, the effect of the novel modality of cryotherapy ranked first.

CONCLUSION

Due to the limited quality of the included studies, further well-designed research is needed to draw firm conclusions about the effectiveness of cold and heat therapies for delayed onset muscle soreness.

Analysis of the Effect of Acupuncture and Pressing of Traditional Chinese Medicine on Recovery of Delayed Muscle Soreness in Athletes

In this study, we have analyzed numerous effects of the acupuncture and pressing of traditional Chinese medicine on recovery of delayed muscle soreness in athletes. To implement this idea, a total of 84 athletes with delayed muscle soreness treated in our hospital from January 2018 to June 2020 were included. According to the random number table method, they were divided into the experimental group and the control group: among them, 42 cases were in the experimental group and were treated by TCM acupuncture. In the control group, 42 athletes used rehabilitation training. Compared with serum CK levels in the control group, serum CK levels in the experimental group decreased after training, and there was a significant difference (P < 0.05). After intensive training in the control group (P < 0.05), it indicated that acupuncture and pressing of traditional Chinese medicine was effective in the recovery of fatigue after exercise, which was significantly better than that in the control group. The serum testosterone value of the experimental group before intensive training had no significant difference, but the serum testosterone value of the moxibustion group of male athletes after intensive training was significantly higher than that of the control group (P < 0.05). Female athletes have a low blood testosterone base and are less affected by the gonad axis. There was no statistically significant difference in RPE scores before treatment. After treatment, the RPE score of the experimental group decreased rapidly (P < 0.05), which was statistically significant compared with the control group (P < 0.05). There was no significant difference in VAS scores before treatment. After treatment, the VAS score in the experimental group decreased rapidly (P < 0.05) compared with the control group (P < 0.05). After treatment, compared with the control group, the experimental group had a decrease in calf circumference, an increase in muscle strength, and an increase in the range of motion (P < 0.05). Acupuncture and pressing of traditional Chinese medicine have obvious clinical application value in the treatment of delayed muscle soreness in athletes, and they have great clinical application value. Muscle injury is a common disease of athletes.

The effect of Liquid ice after high-intensity exercise on muscle function compared to Block ice

Cryotherapy is used to recover muscle damage after exercise and to treat acute sports injuries. Liquid ice (LI) can keep cold for a long time, and is assumed more effective than block ice (BI). From this, the aim of this study was to investigate the effects of LI on the change of passive stiffness (PS) as muscle function and to validate the effectiveness of LI compared to BI. We performed the experiment as part of a case series of verification of the effects of cryotherapy. 22 healthy men (target area: right leg) were randomized to two groups: LI group and BI group. PS was measured three times during experiment protocol, pre: before exercise; post; after treating each cryotherapy after exercise; 48h: 48 hours after pre. Statistical analysis compared the PS, the amount of change in PS, and the rate of change in PS between the two groups. The rate of change between pre and 48h in LI was significantly lower compared to that in BI (p = 0.03). There was no significant difference regarding other results between groups. It revealed that the difference of effect between LI and BI for PS of muscles after high-intensity exercises. These results could be helpful for the choice of intervention for reducing muscle stiffness after exercise and at sports field.

Physical therapy interventions for the treatment of delayed onset muscle soreness (DOMS): Systematic review and meta-analysis

OBJECTIVE

To evaluate the impact of interventions on pain associated with DOMS.

DATA SOURCES

PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to "DOMS" and "intervention therapy".

ELIGIBILITY CRITERIA

Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced.

RESULTS

One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I² = 60 %), cryotherapy (p = 0,002 I² = 100 %), phototherapy (p = 0,0001 I² = 95 %), vibration (p = 0,004 I² = 96 %), ultrasound (p = 0,02 I² = 97 %), massage (p < 0,00001 I² = 94 %), active exercise (p = 0,0004 I² = 93 %) and compression (p = 0,002 I² = 93 %) have a better positive effect than the control in the management of DOMS.

CONCLUSION

Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain.

Different Training Methods Cause Similar Muscle Damage in Youth Judo Athletes

It is well known that different factors can contribute to muscle damage in judo matches or training. Previous research analyzed only the effects of simulated judo combat or judo training on biochemical markers of muscle damage without determining its specific causes. Our objective was to identify possible differences in biochemical markers of muscular damage in response to different training methods in youth judo athletes. Twelve high-level male judo athletes were randomly assigned to a standing (SP, n = 6, age = 16.6 ± 1.1 years) or a groundwork (GP, n = 6, age = 17.8 ± 0.8 years) position combat practice group. Both groups had the same protocol of four 4-minute combat practice bouts separated by 1-minute rest intervals. Before and immediately after combat practice blood samples were taken to assess muscle damage markers: creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT). There were significant increases in AST, LDH, and CK after the standing and groundwork training sessions compared with resting values in both groups. Additionally, no significant differences in the enzyme's activity between SP and GP groups were found. These results showed that standing and groundwork randori training (free sparring or free practice) causes similar muscle damage in adolescent judo athletes. Future research should assess the effects of the same damage mechanisms over a longer period of time.

Intramuscular Temperature Changes in the Quadriceps Femoris Muscle After Post-Exercise Cold-Water Immersion (10°C for 10 min): A Systematic Review With Meta-Analysis

Post-exercise cold-water immersion (CWI) is a widely accepted recovery strategy for maintaining physical performance output. However, existing review articles about the effects of CWI commonly pool data from very heterogenous study designs and thus, do rarely differentiate between different muscles, different CWI-protocols (duration, temperature, etc.), different forms of activating the muscles before CWI, and different thickness of the subcutaneous adipose tissue. This systematic review therefore aimed to investigate the effects of one particular post-exercise CWI protocol (10°C for 10 min) on intramuscular temperature changes in the quadriceps femoris muscle while accounting for skinfold thickness. An electronic search was conducted on PubMed, LIVIVO, Cochrane Library, and PEDro databases. Pooled data on intramuscular temperature changes were plotted with respect to intramuscular depth to visualize the influence of skinfold thickness. Spearman's rho (r_s) was used to assess a possible linear association between skinfold thickness and intramuscular temperature changes. A meta-analysis was performed to investigate the effect of CWI on pre-post intramuscular temperature for each measurement depth. A total of six articles met the inclusion criteria. Maximum intramuscular temperature reduction was 6.40°C with skinfold thickness of 6.50 mm at a depth of 1 cm, 4.50°C with skinfold thickness of 11.00 mm at a depth of 2 cm, and only 1.61°C with skinfold thickness of 10.79 mm at a depth of 3 cm. However, no significant correlations between skinfold thickness and intramuscular temperature reductions were observed at a depth of 1 cm (r _s = 0.0), at 2 cm (r _s = -0.8) and at 3 cm (r _s = -0.5; all p > 0.05). The CWI protocol resulted in significant temperature reductions in the muscle tissue layers at 1 cm (d = -1.92 [95% CI: -3.01 to -0.83] and 2 cm (d = -1.63 [95% CI: -2.20 to -1.06]) but not at 3 cm (p < 0.05). Skinfold thickness and thus, subcutaneous adipose tissue, seems to influence temperature reductions in the muscle tissue only to a small degree. These findings might be useful for practitioners as they demonstrate different intramuscular temperature reductions after a specific post-exercise CWI protocol (10°C for 10 min) in the quadriceps femoris muscle.

The impact of cold-water-immersion on athletes' muscle function and aerobic capacity: studies from thin to thick

Studies treating the impact of cold-water-immersion (CWI) on athletes' performance are very interesting and should be encouraged. The CWI is currently attracting the attention of the sports world as a recovery technique and it is often recommended in sports where contact is repeated throughout training and competitions. However, if some studies reported the efficacy of CWI as an analgesic against traumatic or immune aspects, currently there is not consistent unanimity of its use as a method of improving performance. The researchers set out to observe the effects of CWI on the restoration of numerous performance indicators, characterizing both the aerobic and anaerobic energy pathways, but also the different modalities of muscle contraction. However, few data appear to be available on the effects of CWI on performance and recovery capacity and very few studies have observed results in the same direction. Results regarding the impact of CWI on performance are conflicting, with a few studies suggesting beneficial effects and others indicating negligible effects. The two main aims of the present paper are to briefly expose the literature data related to the effects of CWI on muscle function and aerobic capacity of athletes, and to clarify the origin of discrepancies between studies' findings.

Experience of cold-water immersion on recovery efficiency after soccer match

BACKGROUND

immersion in cold-water is one of the most common recovery and rehabilitation techniques among athletes. However, several factors such as shocking induced by cold water can affect the effectiveness of this technique.

AIM

The aim of this study was to investigate the effect of 4 weeks cold water habituation on the effectiveness of CWI recovery technique on muscle damage and function indices of young soccer players.

METHODS

Twenty young men with no previous experience of CWI participated in this study. Output power and RSADec of subjects were measured. The subjects then performed a simulated soccer test and, after collecting blood samples, were immediately immersed in 15 ° C water for 15 minutes. Twenty-four hours later blood sampling and functional tests were repeated. Subjects then were divided randomly into two groups of exercise with CWI recovery and exercise with passive recovery. After four weeks, the blood sampling and performance tests repeated like the pre-test.

RESULTS

The CWI had no significant effect on serum levels of AST and LDH before and after 4 weeks of CWI (P> 0.05). Also, there was no significant difference in power output and RSADec after CWI before and after cold water habituation (P> 0.05).

CONCLUSIONS

It seems that the experience of recovering by immersion in cold-water has no effect on the effectiveness of this method. Therefore, soccer coaches and athletes should think more about using this recovery method.

Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials

OBJECTIVE

The aim of this review and meta-analysis was to evaluate the effect of heat and cold therapy on the treatment of delayed onset muscle soreness (DOMS).

METHODS

We followed our protocol that was registered in PROSPERO with ID CRD42020170632. A systematic review and meta-analysis of randomized controlled trials (RCT) was conducted. Nine databases were searched up to December 2020. Data was extracted from the retained studies and underwent methodological quality assessment and meta-analysis.

RESULTS

A total of 32 RCTs involving 1098 patients were included. Meta-analysis showed that, the application of cold therapy within 1 h after exercise could reduce the pain of DOMS patients within 24 h (≤24 h) after exercise (SMD -0.57,95%CI -0.89 to -0.25, P = 0.0005) and had no obvious effect within more than 24 h (>24 h) (P = 0.05). In cold therapies, cold water immersion (SMD -0.48, 95%CI -0.84 to -0.13, P = 0.008) and other cold therapies (SMD -0.68, 95%CI -1.28 to -0.08, P = 0.03) had the significant effects within 24 h. Heat treatment could reduce the pain of patients. It had obvious effects on the pain within 24 h (SMD -1.17, 95%CI -2.62 to -0.09, P = 0.03) and over 24 h (SMD -0.82, 95%CI -1.38 to -0.26, P = 0.004). Hot pack effect was the most obvious, which reduced the pain within 24 h (SMD -2.31, 95%CI -4.33 to -0.29, P = 0.03) and over 24 h (SMD -1.78, 95%CI -2.97 to -0.59, P = 0.003). Other thermal therapies were not statistically significant (P > 0.05). Both cold and heat showed effect in reducing pain of patients, however there was no significant difference between cold and heat group (P = 0.16).

CONCLUSIONS

The current evidence indicated that the application of cold and heat therapy within 1 h after exercise could effectively reduce the pain degree of DOMS patients for 24 h cold water immersion and hot pack therapy, which had the best effect, could promote the recovery of DOMS patients. But more high-quality studies are needed to confirm whether cold or heat therapy work better.

Caffeine improves biochemical and specific performance after judo training: a double-blind crossover study in a real judo training situation

Background

Nutritional ergogenic aids are foods or nutrients that can improve physical performance. Among these foods with ergogenic properties, caffeine has shown that it can increase the fat catabolism, strength, and improve the cognition and time reaction of an athlete, therefore, it is hoped that it can improve the performance of judokas. This study through a double-blind crossover (supplement X placebo) protocol, investigated the effects caffeine supplementation (single capsule containing 5 mg/kg body mass intake 60 min before the session) on biochemical, anthropometrical, physical, subjective and hemodynamic variables measured before, during and after two typical judo trainingcxs sessions (120-min: 40-min of gymnastics; 40-min of specific technics and; 40-min of judo combat).

Methods

8 high-level athletes (21.4 ± 2.0 years; 83.6 ± 15.2 kg; 1.8 ± 0.1 m; 17.9 ± 7.0 Fat%) were evaluated before and after each training for body mass, hydration, upper and lower limb power, performance in the special judo fitness test (SJFT), free fatty acids (FFA) in plasma, uric acid, glucose, lactate, heart rate, and pain. In addition, heart rate, FFA in plasma, uric acid, glucose, lactate, rating of perceived exertion and pain were assessed during the training.

Results

At 120 min, supplementation resulted in a higher concentration of plasma FFA (1.5 ± 0.5 vs. 1.0 ± 0.3 mmol/L; p = 0.047) and lactate (4.9 ± 1.8 vs. 3.0 ± 1.2 mmol/L; p = 0.047), and a lower concentration of uric acid (5.4 ± 0.9 vs. 7.0 ± 1.5 mg/dL; p = 0.04). Supplementation also resulted in performance maintenance (fatigue index) in the SJFT (Δ0.3 ± 2.0 vs Δ1.7 ± 2.5, for caffeine and placebo respectively, p = 0.046). No adverse effects were observed.

Conclusion

Based on the applied dose, intake time, and sample of this study, we can conclude that caffeine produces an ergogenic biochemical effect, and improves performance in judo athletes.

Effects of 2 Intersection Strategies for Physical Recovery in Jiu-Jitsu Athletes

PURPOSE

To compare the effect of static stretching (SS) and cold-water immersion (CWI) on strength performance and blood lactate levels of jiu-jitsu athletes.

METHODS

A total of 21 male Brazilian jiu-jitsu fighters were randomly assigned to SS (9 × 30-s carpal extension), CWI (3 × 3 min at 10°C), or a control group (CG); their maximal handgrip strength, handgrip muscle endurance, dynamic kimono grip strength test, and blood lactate concentration were assessed before and after a simulated Brazilian jiu-jitsu fight and after one of the recovery interventions.

RESULTS

There was an interaction (F = 9.075; P = .002) and a time effect (F = 11.792; P = .003) for dynamic kimono grip strength test, showing a decrease in performance for the CG (P = .0001; effect size [ES] = 0.52, moderate) and after SS (P = .006; ES = 0.43, small). There was an interaction (F = 3.592; P = .015) and a time effect (F = 122.631; P = .0001) for blood lactate concentration, showing lower levels after CWI versus CG (P = .028; ES = 0.93, moderate) and after CWI versus SS (P = .042; ES = 0.82, moderate). There was an interaction (F = 9.617; P = .001) for handgrip strength, showing an impairment in performance after SS (P = .001; ES = 0.67, moderate).

CONCLUSION

CWI promoted restoration of muscle strength and endurance and reduction in blood lactate levels after the simulated fight and can thus be used by jiu-jitsu athletes as a recovery strategy between fights.

Effect of cold water immersion on muscle damage indexes after simulated soccer training in young soccer players

Study aim: To investigate the effect of cold water immersion (CWI) on muscle damage indexes after simulated soccer activity in young soccer players.

Material and methods: Eighteen professional male soccer players were randomly divided into two groups: CWI (n = 10, age 19.3 ± 0.5, body mass index 22.2 ± 1.3) and control (n = 8, age 19.4 ± 0.8, body mass index 21.7 ± 1.5). Both groups performed a simulated 90-minute soccer-specific aerobic field test (SAFT90). Then, the CWI group subjects immersed themselves for 10 minutes in 8°C water, while the control group subjects sat passively for the same time period. Blood samples were taken before, immediately after, 10 minutes, 24 hours and 48 hours after the training session in a fasted state. Blood lactate, creatine kinase (CK) and lactate dehydrogenase (LDH) enzyme levels were measured.

Results: Lactate, CK and LDH levels increased significantly after training (p < 0.001). There were significant interactions between groups and subsequent measurements for CK (p = 0.0012) and LDH (p = 0.0471). There was no significant difference in lactate level between the two groups at any aforementioned time.

Conclusion: It seems that CWI after simulated 90-minute soccer training can reduce the values of muscle damage indexes in soccer players.

Evidence-based post exercise recovery in combat sports: a narrative review

INTRODUCTION

Some methods such as ergo nutritional aids, cooling or massage among others could improve recovery in combat sports (CS). The effects, doses, duration, and timing of these methods remains unknown. Nowadays, there is no clear consensus regarding the recovery strategies and it is necessary to understand the type of fatigue induced in CS and its underlying mechanisms. The main aim of this article is to review the update literature related to recovery strategies in CS.

EVIDENCE ACQUISITION

A literature search was conducted following preferred reporting items for review statement on the topic of: "combat sports," "recovery," "nutrition," "fatigue," "ergogenic aids," "weight cutting" and "hydration."

EVIDENCE SYNTHESIS

The initial search of the literature detected 369 articles about CS. Later, 307 were excluded after being determined unrelated to recovery or after failure to fulfill the inclusion criteria. Of the 80 included articles, 19 satisfied the final inclusion criteria.

CONCLUSIONS

To optimize CS performance, adequate recovery is required during training and competition processes. Traditional ergo nutritional supplementation of carbohydrates and proteins combined. Besides, the consumption of evidence supported supplementation (green tea, beetroot gels, creatine or alkaline water) improve recovery processes. Further methods of recovery including physical (cold water immersion, massage or photobiomodulation) and physiological (types of active recovery, sleep and rest) therapies have also been shown useful. This narrative review elucidates the important role of recovery techniques in CS.

Cold-Water Immersion Does Not Accelerate Performance Recovery After 10-km Street Run: Randomized Controlled Clinical Trial

The use of strategies to assure better post-effort recovery is frequent in sports settings. There are several interventions available for exercise induced muscle damage recovery, but cold-water immersion (CWI) stands out among them. The effects of CWI are unclear in the literature and, although the number of street runners has been growing, there is a gap in the scientific evidence regarding the use of CWI to recover runners' performance after a 10-km street run. Purpose: The goal of our study was to analyze the effects of CWI on the recovery of muscle damage markers after a 10-km street run. Method: We randomly assigned thirty male recreational street runners, immediately after a 10-km street run, into three recovery groups: control (rest for 10 minutes), immersion (10 min immersed in water without ice at room temperature) and CWI (10 min immersed in water with ice at 10ºC). We assessed pain, triple hop distance, extensor peak torque and blood creatine kinase levels pre- and post-run, post-intervention and 24 hours after the run. Results: The 10-km run was enough to decrease triple hop distance and extensor peak torque, and increase levels of creatine kinase (p < 0.05); however, we found no time/group interactions in any of the assessed variables after we applied the appropriate interventions (p > 0.05). Conclusion: 10-min CWI at 10°C was no more effective than water immersion and rest in recovering muscle damage markers after 10-km runs.

Cryotherapy Models and Timing-Sequence Recovery of Exercise-Induced Muscle Damage in Middle- and Long-Distance Runners

CONTEXT

Among sports-recovery methods, cold-water immersion (CWI), contrast-water therapy (CWT), and whole-body cryotherapy (WBC) have been applied widely to enhance recovery after strenuous exercise. However, the different timing effects in exercise-induced muscle damage (EIMD) after these recovery protocols remain unknown.

OBJECTIVE

To compare the effects of CWI, CWT, and WBC on the timing-sequence recovery of EIMD through different indicator responses.

DESIGN

Crossover study.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twelve male middle- and long-distance runners from the Beijing Sport University (age = 21.00 ± 0.95 years).

INTERVENTION(S)

Participants were treated with different recovery methods (control [CON], CWI, CWT, WBC) immediately postexercise and at 24, 48, and 72 hours postexercise.

MAIN OUTCOME MEASURE(S)

We measured perceived sensation using a visual analog scale (VAS), plasma creatine kinase (CK) activity, plasma C-reactive protein (CRP) activity, and vertical-jump height (VJH) pre-exercise, immediately postexercise, and at 1, 24, 48, 72, and 96 hours postexercise.

RESULTS

For the VAS score and CK activity, WBC exhibited better timing-sequence recovery effects than CON and CWI (P < .05), but the CWT demonstrated better effects than CON (P < .05). The CRP activity was lower after WBC than after the other interventions (P < .05). The VJH was lower after WBC than after CON and CWI (P < .05).

CONCLUSIONS

The WBC positively affected VAS, CK, CRP, and VJH associated with EIMD. The CWT and CWI also showed positive effects. However, for the activity and timing-sequence effect, CWT had weaker effects than WBC.

Prolonged cooling with phase change material enhances recovery and does not affect the subsequent repeated bout effect following exercise

PURPOSE

The aim of this investigation was twofold: (1) to examine the effect of prolonged phase change material (PCM) cooling following eccentric exercise of the quadriceps on indices of muscle damage, and (2) to elucidate whether application of PCM cooling blunted the acute adaptive response to eccentric exercise, known as the repeated bout effect (RBE).

METHODS

Twenty-six males (25 ± 6 years) performed an initial bout (B1) of 120 eccentric quadriceps contractions on each leg at 90% of their isometric strength and were then randomized to receive PCM packs frozen at 15 °C (treatment) or melted packs (control) worn directly on the skin under shorts for 6 h. The protocol was repeated 14 days later (B2) with all participants receiving the control condition.

RESULTS

PCM cooling provided protection against strength loss in B1 (P = 0.005) with no difference in strength between treatment groups in B2 (P = 0.172; bout by treatment by time P = 0.008). PCM cooling reduced soreness in B1 (P = 0.009) with no difference between treatment groups in B2 (P = 0.061). Soreness was overall lower following B2 than B1 (P < 0.001). CK was elevated in B1 (P < 0.0001) and reduced in B2 (P < 0.001) with no difference between treatments. The damage protocol did not elevate hsCRP in B1, with no difference between treatments or between bouts.

CONCLUSIONS

This work provides further evidence that PCM cooling enhances recovery of strength and reduces soreness following eccentric exercise. Importantly, these data show for the first time that prolonged PCM cooling does not compromise the adaptive response associated with the RBE.

Kinetics of Muscle Damage Biomarkers at Moments Subsequent to a Fight in Brazilian Jiu-Jitsu Practice by Disabled Athletes

Purpose: Evidence indicates that muscle injury caused by exercise can lead to functional, biochemical, and clinical damage. These outcomes encompass an intrinsic potential to understand the real magnitude of interpretation of classic signs in sport environments and to monitor athletes, contributing to specific actions. However, little or no research has explored the general behavior of the variables presented in response to paradesportivo Brazilian jiu-jitsu. The objective of this study was to investigate the physiological behavior through clinical, functional, and metabolic outcomes in the moments following a simulated fight. Methods: Six disabled athletes, male Brazilian jiu-jitsu practitioners (34-44 years old), were included. The participants had their outcomes analyzed individually and the variables studied were correlated. It is noteworthy that participants I and II are professional athletes with world titles. The ethics committee involving human beings of the Federal University of Mato Grosso (register no. 2.997.241) accepted the study. The participants attended the collection site four times, with a 24-h interval between sessions, characterizing the following moments: pre-exertion, and post-exertion, 24, 48, and 72 h after the simulated fight. Data collected were muscle pain, perception of recovery, muscle strength, and blood samples for creatine kinase (CK) and lactate dehydrogenase (LDH) analysis. The variables described were measured at all collection moments. The data were presented in individual raw values of each participant, with Spearman correlation analysis to verify the relationship between variables and moments. Results: The outcomes demonstrated that the CK and LDH activity was higher of high-performance parathletes (I and II) and the reported muscle pain was lower. The fight did not influence maximal isometric strength levels in either participant. In addition, regarding delayed effects, the participants reported peak pain, CK, LDH, and decreased perception of recovery within 24 h. However, it was found that, at 72 h, all values had recovered, close to baseline levels. Conclusion: The presented outcomes provide parameters and suggest a safe scenario based on the intensity and volume commonly adopted in this sports parade modality where the level of effort recommended during combat does not seem to cause deleterious damage.

EFEITO DA IMERSÃO EM ÁGUA FRIA SOBRE A RECUPERAÇÃO PÓS-ESFORÇO EM ATLETAS DE JIU-JITSU

RESUMO Introdução: A imersão em água fria (IAF) tem sido usada habitualmente para a recuperação muscular, mesmo com evidências limitadas sobre sua eficácia. Objetivo: O objetivo deste estudo foi investigar os efeitos da IAF depois de uma sessão de treinamento de atletas de jiu-jitsu, sobre creatina quinase (CQ), testes funcionais de força e parâmetros isocinéticos. Métodos: Doze atletas de jiu-jitsu (idade 21,75 ± 3,10 anos; IMC 24,65 ± 3,81 kg/m2; tempo de treinamento 3,41 ± 0,51 anos) foram recrutados. Considerando que o estudo é cruzado, cada grupo teve a participação dos 12 atletas com wash-out de 30 dias. Os participantes foram divididos em dois grupos experimentais: (I) Grupo controle (CON), no qual os atletas não foram submetidos à IAF e (II) Grupo IAF, no qual os atletas foram submetidos à IAF (~12º C) durante seis minutos. O esforço físico foi realizado em uma sessão de treino com simulação de lutas de jiu-jitsu, com quatro lutas de cinco minutos cada e intervalo de três minutos entre elas. As variáveis CQ plasmática, protocolo estático e dinâmico do Kimono Grip Strength Test e parâmetros isocinéticos (pico de torque, trabalho e potência) foram avaliadas antes e depois dos procedimentos experimentais de recuperação. Para a análise estatística foi usada a análise de variância de dois fatores (tempo e tratamento). O nível de significância foi de 5%. Resultados: Observou-se o efeito do tempo ao comparar CQ plasmática (incremento de 174,39 ± 99,95 UI/l para o CON e incremento de 187,91 ± 113,02 UI/l para o IAF) e teste estático do KGST (delta de -5,83 ± 9,35 s para o CON e delta de -2,83 ± 13,94 s para o IAF) antes e depois dos procedimentos experimentais de recuperação, porém, sem efeito do tratamento (P > 0,05). Os parâmetros isocinéticos não foram influenciados. Conclusão: Conclui-se que a IAF não promoveu recuperação pós-esforço em atletas de jiu-jitsu. Nível de Evidência II; ECRC de menor qualidade.

Effect of compression garments on delayed-onset muscle soreness and blood inflammatory markers after eccentric exercise: a randomized controlled trial

The purpose of this study was to investigate how compression garments, applied after eccentric exercise, can affect delayed onset muscle soreness (DOMS) and inflammatory markers. Sixteen healthy male university students enrolled in this study and were randomly assigned to either the compression garment group (CG, n=8) or control group (CON, n=8). All participants performed two sets of eccentric exercise using elbow flexor with 25 repetitions per set on a modified preacher curl machine. Maximal isometric strength was measured before exercise and immediately, 24, 48, 72, and 96 hr after eccentric exercise. Muscle soreness was measured before exercise and 24, 48, 72, and 96 hr after eccentric exercise. Creatine kinase (CK) activity and tumor necrosis factor-alpha (TNF-α) levels were also measured before exercise and 3, 6, 24, and 48 hr after exercise. A repeated measures analysis of variance was used for statistical analysis. The CG group reported faster recovery of maximal isometric strength following exercise (P<0.001) and lower muscle soreness during the recovery period than the control group (P<0.05). However, there were no significant differences in either CK activity or TNF-α levels between the two groups (P>0.05). In conclusion, wearing compression garments during the postexercise period can be an effective way to reduce DOMS and accelerate the recovery of muscle function.