To assess the effect of beetroot juice (BET) on recovery kinetics of physical performance, muscle damage and perceived muscle soreness after simulated soccer match play in soccer players.In a randomized, double-blind, crossover design, thirteen soccer players completed the Loughborough Intermittent Shuttle Test LIST. Players received either BET or placebo (PLA) (2*150) for 7 days (3 days pre-exercise, on the day trial, and 3 days post-exercise). Physical performance (Squat jump: SJ, countermovement jump: CMJ, maximal voluntary contraction: MVC, and 20 meters sprint: SP), blood markers of muscle damage (creatine kinase: CK, Lactate dehydrogenase: LDH), inflammatory parameter (C-reactive protein: CRP) and perceived muscle soreness (DOMS) were assessed at baseline, 0 h, 24 h, 48 h and 72 h following the exercise.Following the LIST, a decrease was observed in CMJ, MVC and SP at 0 h, 24 h, 48 h in both conditions (p < 0.05). However, compared to PLA session, this decrease was significantly attenuated with BET for CMJ at 24 h and at 48 h and for MVC at 0 h, 24 h, 48 h and for SP at 48 h after the LIST (p < 0.05). Likewise, DOMS values were significantly lower with BET compared to PLA condition immediately and at 24 h after exercise.CK, LDH and CRP levels increased at 0 h and at 24 h post exercise in both conditions (p < 0.05), but without any significant difference between the two condition (p > 0.05).The results of the present study suggest that chronic beetroot juice supplementation reduces post exercise perceived muscle soreness and maintain better performance during the recovery period in soccer players.

OBJECTIVE: This study was done to investigate the effects of a standardized acupuncture treatment on symptoms and muscle function in exercise-induced delayed-onset muscle soreness (DOMS). METHODS: A prospective, randomized, controlled, observer and subject-blinded trial was undertaken. Twenty-two (22) healthy subjects (22-30 years; 10 males and 12 females) were randomly assigned to three treatment groups: real acupuncture (deep needling at classic acupuncture points and tender points; n = 7), sham-acupuncture (superficial needling at nonacupuncture points; n = 8), and control (no needling; n = 7). DOMS of the nondominant elbow-flexors was experimentally induced through eccentric contractions until exhaustion. The outcome measures were pain perception (visual analogue scale; VAS; range: 0-10 cm), mechanical pain threshold (MPT; pressure algometer), and maximum isometric voluntary force (MIVF; force transducer). Treatment was applied immediately, 24 and 48 hours after DOMS induction. Measurements of MPT and MIVF were made prior to DOMS induction as well as before and after every treatment session. VAS data were acquired after DOMS induction as well as pre- and post-treatment. Final pain, MPT, and MIVF measurements were performed 72 hours after DOMS induction. RESULTS: Following nonparametric testing, there were no significant differences between groups in outcome measures at baseline. After 72 hours, pain perception (VAS) was significantly lower in the acupuncture group compared to the sham acupuncture and control subjects. However, the mean MPT and MIVF scores were not significantly different between groups. CONCLUSIONS: Although acupuncture seemed to have no effects on mechanical pain threshold and muscle function, it proved to reduce perceived pain arising from exercise-induced muscle soreness.

OBJECTIVE: This study was done to investigate the effects of a standardized acupuncture treatment on symptoms and muscle function in exercise-induced delayed-onset muscle soreness (DOMS). METHODS: A prospective, randomized, controlled, observer and subject-blinded trial was undertaken. Twenty-two (22) healthy subjects (22-30 years; 10 males and 12 females) were randomly assigned to three treatment groups: real acupuncture (deep needling at classic acupuncture points and tender points; n = 7), sham-acupuncture (superficial needling at nonacupuncture points; n = 8), and control (no needling; n = 7). DOMS of the nondominant elbow-flexors was experimentally induced through eccentric contractions until exhaustion. The outcome measures were pain perception (visual analogue scale; VAS; range: 0-10 cm), mechanical pain threshold (MPT; pressure algometer), and maximum isometric voluntary force (MIVF; force transducer). Treatment was applied immediately, 24 and 48 hours after DOMS induction. Measurements of MPT and MIVF were made prior to DOMS induction as well as before and after every treatment session. VAS data were acquired after DOMS induction as well as pre- and post-treatment. Final pain, MPT, and MIVF measurements were performed 72 hours after DOMS induction. RESULTS: Following nonparametric testing, there were no significant differences between groups in outcome measures at baseline. After 72 hours, pain perception (VAS) was significantly lower in the acupuncture group compared to the sham acupuncture and control subjects. However, the mean MPT and MIVF scores were not significantly different between groups. CONCLUSIONS: Although acupuncture seemed to have no effects on mechanical pain threshold and muscle function, it proved to reduce perceived pain arising from exercise-induced muscle soreness.

Developing effective methods for helping athletes recover from muscle fatigue is deemed essential, particularly on the eves' important competitions. This study aimed to investigate the effects of acupuncture stimulation on athletes' recovery abilities. Subjects were selected from 30 male elite university basketball players who were randomly assigned to 3 groups: acupuncture group, sham group, and normal (control) group, each containing 10 subjects. Acupuncture was carried out on each athlete in acupuncture group at the Neiguan (PC6) and Zusanli (ST36) acupoints, beginning at 15 min prior to exercise and continuing until exhaustion of the subject. Similar acupuncture was also carried out on each athlete in the sham group but the positions were 1 cm away from the PC6 and ST36 acupoints. No acupuncture was conducted on the athletes in the normal group. During the experiments, each subject performed separate runs on the treadmill. The data of heart rate (HR(max)), oxygen consumption (VO(2max)), and blood lactic acid were measured during the rest period and at 3 recovery points of time (5th, 30th and 60th min) post-exercise. The results showed that the acupuncture group (PC6 and ST36) has significantly lower HR(max), VO(2max) and blood lactic acid than both the sham and normal groups at the 30th min post-exercise. Blood lactic acid of the acupuncture group was also significantly lower than that of the other two groups in the 60th min post-exercise. Our findings have shed some light on the development of effective acupuncture schemes to enhance the recovery ability for elite basketball athletes.

Developing effective methods for helping athletes recover from muscle fatigue is deemed essential, particularly on the eves' important competitions. This study aimed to investigate the effects of acupuncture stimulation on athletes' recovery abilities. Subjects were selected from 30 male elite university basketball players who were randomly assigned to 3 groups: acupuncture group, sham group, and normal (control) group, each containing 10 subjects. Acupuncture was carried out on each athlete in acupuncture group at the Neiguan (PC6) and Zusanli (ST36) acupoints, beginning at 15 min prior to exercise and continuing until exhaustion of the subject. Similar acupuncture was also carried out on each athlete in the sham group but the positions were 1 cm away from the PC6 and ST36 acupoints. No acupuncture was conducted on the athletes in the normal group. During the experiments, each subject performed separate runs on the treadmill. The data of heart rate (HR(max)), oxygen consumption (VO(2max)), and blood lactic acid were measured during the rest period and at 3 recovery points of time (5th, 30th and 60th min) post-exercise. The results showed that the acupuncture group (PC6 and ST36) has significantly lower HR(max), VO(2max) and blood lactic acid than both the sham and normal groups at the 30th min post-exercise. Blood lactic acid of the acupuncture group was also significantly lower than that of the other two groups in the 60th min post-exercise. Our findings have shed some light on the development of effective acupuncture schemes to enhance the recovery ability for elite basketball athletes.

CONTEXT: Delayed-onset muscle soreness (DOMS) describes muscle pain and tenderness that typically develop several hours postexercise and consist of predominantly eccentric muscle actions, especially if the exercise is unfamiliar. Although DOMS is likely a symptom of eccentric-exercise-induced muscle damage, it does not necessarily reflect muscle damage. Some prophylactic or therapeutic modalities may be effective only for alleviating DOMS, whereas others may enhance recovery of muscle function without affecting DOMS. OBJECTIVE: To test the hypothesis that massage applied after eccentric exercise would effectively alleviate DOMS without affecting muscle function. DESIGN: We used an arm-to-arm comparison model with 2 independent variables (control and massage) and 6 dependent variables (maximal isometric and isokinetic voluntary strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness). A 2-way repeated-measures analysis of variance and paired t tests were used to examine differences in changes of the dependent variable over time (before, immediately and 30 minutes after exercise, and 1, 2, 3, 4, 7, 10, and 14 days postexercise) between control and massage conditions. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: Ten healthy subjects (5 men and 5 women) with no history of upper arm injury and no experience in resistance training. INTERVENTION(S): Subjects performed 10 sets of 6 maximal isokinetic (90 degrees x s(-1)) eccentric actions of the elbow flexors with each arm on a dynamometer, separated by 2 weeks. One arm received 10 minutes of massage 3 hours after eccentric exercise; the contralateral arm received no treatment. MAIN OUTCOME MEASURE(S): Maximal voluntary isometric and isokinetic elbow flexor strength, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness. RESULTS: Delayed-onset muscle soreness was significantly less for the massage condition for peak soreness in extending the elbow joint and palpating the brachioradialis muscle (P<.05). Soreness while flexing the elbow joint (P = .07) and palpating the brachialis muscle (P = .06) was also less with massage. Massage treatment had significant effects on plasma creatine kinase activity, with a significantly lower peak value at 4 days postexercise (P<.05), and upper arm circumference, with a significantly smaller increase than the control at 3 and 4 days postexercise (P<.05). However, no significant effects of massage on recovery of muscle strength and ROM were evident. CONCLUSIONS: Massage was effective in alleviating DOMS by approximately 30% and reducing swelling, but it had no effects on muscle function.

The omega-3 fatty acid docosahexaenoic acid (DHA) has anti-inflammatory and anti-nociceptive (pain inhibiting) effects. Because strenuous exercise often results in local inflammation and pain, we hypothesized that DHA supplementation attenuates the rise in markers of local muscle inflammation and delayed onset muscle soreness (DOMS) that occur after eccentric strength exercise. Twenty-seven, healthy women (33± 2 y, BMI 23.1±1.0 kg·m(-2)) were randomized to receive 9d of 3000 mg/d DHA or placebo in a double-blind fashion. On day 7 of the supplementation period, the participants performed 4 sets of maximal-effort eccentric biceps curl exercise. Before and 48h after the eccentric exercise, markers of inflammation were measured including measures of muscle soreness (10-point visual analog pain scale, VAS), swelling (arm circumference), muscle stiffness (active and passive elbow extension), skin temperature, and salivary C-reactive protein (CRP) concentrations. As expected, muscle soreness and arm circumference increased while active and passive elbow extension decreased. The increase in soreness was 23% less in the DHA group (48h increase in VAS soreness ratings: 4.380.4 vs. 5.600.5, p=0.02). Furthermore, the number of subjects who were able to achieve full active elbow extension 48h after eccentric exercise was greater in the DHA group (71% vs. 15%, p = 0.006), indicating significantly less muscle stiffness. No between-group differences were observed for passive elbow extension (p = 0.78) or arm swelling (p = 0.75). Skin temperature and salivary CRP concentrations did not change from baseline to 48h after exercise in either group. These findings indicate that short-term DHA supplementation reduces exercise-induced muscle soreness and stiffness. Therefore, in addition to other health benefits that n-3 fatty acids have been associated with, DHA supplementation could be beneficial for improving tolerance to new and/or strenuous exercise programs and thereby might facilitate better training adaptations and exercise adherence. Key pointsSeven days of 3000 mg/day supplementation with algae-derived docosahexaenoic acid (DHA) attenuates the delayed onset muscle soreness and stiffness, and protects against the loss of joint range of motion that is caused by strenuous eccentric exercise.This benefit was observed in women, and supports the findings from other studies that were conducted on men or a combination of men and womenThe benefits from algae-derived DHA appear to be similar to those reported in other studies that used a combination of DHA and eicosapentaenoic acid (EPA) derived from fish oilThe findings of better recovery from strenuous exercise with DHA supplementation, paired with other research which demonstrated that DHA and EPA protect against chronic diseasessuggest that DHA is an attractive optionThese findings have relevance to athletic populations, in that DHA would be expected to facilitate recovery and allow for better performance during training and competition. However, DHA supplementation might also benefit non-athletic populations, such as individuals starting new exercise programs and patient populations that are prone to muscle soreness (e.g. physical therapy patients).

OBJECTIVES: The purpose of this pilot study was to determine whether there are markers that can be used to study the effects of grounding on delayed-onset muscle soreness (DOMS). DESIGN AND SUBJECTS: Eight (8) healthy subjects were exposed to an eccentric exercise that caused DOMS in gastrocnemius muscles of both legs. Four (4) subjects were grounded with electrode patches and patented conductive sheets connected to the earth. Four (4) control subjects were treated identically, except that the grounding systems were not connected to the earth. OUTCOME MEASURES: Complete blood counts, blood chemistry, enzyme chemistry, serum and saliva cortisols, magnetic resonance imaging and spectroscopy and pain levels were taken at the same time of day before the eccentric exercise and 24, 48, and 72 hours afterwards. Parameters consistently differing by 10% or more, normalized to baseline, were considered worthy of further study. RESULTS: Parameters that differed by these criteria included white blood cell counts, bilirubin, creatine kinase, phosphocreatine/inorganic phosphate ratios, glycerolphosphorylcholine, phosphorylcholine, the visual analogue pain scale, and pressure measurements on the right gastrocnemius. CONCLUSIONS: In a pilot study, grounding the body to the earth alters measures of immune system activity and pain. Since this is the first intervention that appears to speed recovery from DOMS, the pilot provides a basis for a larger study.

PURPOSE:The aim of this study was to investigate the effect of natural Pomegranate juice supplementation on performance and acute and delayed responses of muscle soreness and biomarkers of muscle damage after a weightlifting training session.

METHODS:Nine elite weightlifters (21±0.5 years) performed two Olympic-Weightlifting-sessions after either placebo (PLA) or natural pomegranate juice (POMj) supplementations. Heart rate, blood pressure and blood samples (hematological parameters, muscle damage and C-reactive protein (CRP)) were collected at rest, 3min and 48h after each session. Weightlifting performance, RPE, and DOMS were also assessed after each training session.

RESULTS:T-test showed higher performance (+8.30%) and lower RPE values (-4.37%) using POMj supplementation (p<0.05) in comparison with PLA. For the DOMS values, a significant improvement (13.4%) was shown only for the knee extensors (p<0.01) using the POMj. Compared to PLA condition, POMj attenuated the acute (i.e., 3min) increase of systolic blood pressure (SBP), HR, CK and LDH (p<0.05; -4.46%, -1.81%, -8.75%, -1.64%, respectively) and blunted the significant increase of ASAT, PAL and CRP (p>0.05). Additionally, during the 48h following the training session, POMj improved the recovery kinetic of SBP (p<0.01, 7.97%), CK (p<0.001, 11.34%), LDH (p<0.05, 7.30%) and ASAT (p<0.05, 6.77%). Indeed, the present study showed that 48h of recovery associated to natural POMj supplementation was sufficient to reach the resting values of the selected muscle damage markers after intensive training session.

CONCLUSION:Natural POMj seems to ameliorate the capacity to adhere to an intensive training program. Therefore, elite weightlifters are advised to use natural POMj during intensive training program and competition to accelerate muscle recovery.

TRIAL REGISTRATION:ClinicalTrials.gov NCT02697903.