A noninvasive, immediate, and convenient method for assessing muscle tissue status during exercise-induced muscle damage (EIMD) has not been established. This study was designed to assess and determine parameters suitable for measuring EIMD after eccentric exercise, using multi-frequency bioimpedance analysis (BIA). Thirty-five young male participants performed dumbbell exercises with their left arm, and their BIA parameters were measured at various time points up to 168 h post exercise using a multi-frequency BIA device. At all-time points, intra and extracellular water content was greater in the left arm than in the right arm, whereas the impedance, reactance, resistance, and phase angle were lower in the left arm than in the right arm. Established EIMD indices, such as maximal isometric voluntary contraction, were measured and used in correlational analyses. Only reactance was correlated with biomarkers, indicating muscle damage (r =  - 0.56 to - 0.49). Furthermore, reactance was found to correlate well with indirect indicators of EIMD, suggesting that it may be a suitable marker for evaluating EIMD. However, the relationship with the limited evaluation indices employed in this study is constrained. Future studies should investigate the correlation between reactance and direct damage indicators, such as structural damage, observed in biopsies.

Eccentric upper-body exercise performed 24 h prior to high-altitude decompression has previously been shown to aggravate venous gas emboli (VGE) load. Yet, it is unclear whether increasing the muscle mass recruited (i.e., upper vs. whole-body) during eccentric exercise would exacerbate the decompression strain. Accordingly, this study aimed to investigate whether the total muscle mass recruited during eccentric exercise influences the decompression strain. Eleven male participants were exposed to a simulated altitude of 24,000 ft for 90 min on three separate occasions. Twenty-four hours before each exposure, participants performed one of the following protocols: (i) eccentric whole-body exercise (ECCw; squats and arm-cycling exercise), (ii) eccentric upper-body exercise (ECCu; arm-cycling), or (iii) no exercise (control). Delayed onset muscle soreness (DOMS) and isometric strength were evaluated before and after each exercise intervention. VGE load was evaluated at rest and after knee- and arm-flex provocations using the 6-graded Eftedal-Brubakk scale. Knee extensor (-20 ± 14%, P = 0.001) but not elbow flexor (-12 ± 18%, P = 0.152) isometric strength was reduced 24 h after ECCw. ECCu reduced elbow flexor isometric strength at 24 h post-exercise (-18 ± 10%, P < 0.001). Elbow flexor DOMS was higher in the ECCu (median 6) compared with ECCw (5, P = 0.035). VGE scores were higher following arm-flex provocations in the ECCu (median (range), 3 (0-4)) compared with ECCw (2 (0-3), P = 0.039) and control (0 (0-2), P = 0.011), and in ECCw compared with control (P = 0.023). VGE were detected earlier in ECCu (13 ± 20 min) compared with control (60 ± 38 min, P = 0.021), while no differences were noted between ECCw (18 ± 30 min) and control or ECCu. Eccentric exercise increased the decompression strain compared with control. The VGE load varied depending on the body region but not the total muscle mass recruited. HIGHLIGHTS: What is the central question of this study? Does exercise-induced muscle damage (EIMD) resulting from eccentric exercise influence the presence of venous gas emboli (VGE) during a 90 min continuous exposure at 24,000 ft? What is the main finding and its importance? EIMD led to an earlier manifestation and greater VGE load compared with control. However, the decompression strain was dependent on the body region but not the total muscle mass recruited.

This study examined the effect of repeated bouts of level and downhill running on physiological markers of effort and exercise-induced muscle soreness in trained female distance runners. Ten participants (Age: 24.4 ± 2.0 years; V̇O2peak: 52.9 ± 1.1 mL·kg-1·min-1), naïve to downhill running, completed six alternate 5 min trials of level and downhill running (-15%) at a 70% velocity at V̇O2peak on two occasions, three weeks apart. Perceived muscle soreness was measured upon completion and in the 72 h post exercise. V̇O2, Heart Rate (HR), Blood Lactate (BLa), and Respiratory Exchange Ratio (RER) were lower running downhill (p < 0.016, ηp2 > 0.541). For the first downhill run, Rating of Perceived Exertion (RPE) was higher compared to that for level running (p = 0.051; d = 0.447), but for the remaining trials, RPE was lower when running downhill (p < 0.004; d > 0.745). V̇O2, HR, and RER were not different in the second bout (p > 0.070, ηp2 < 0.318); however, V̇O2 was lower in each downhill trial (Δ = 1.6-2.2 mL·kg-1·min-1; d = 0.382-0.426). In the second bout, BLa was lower (p = 0.005, ηp2 = 0.602), RPE in the first trial was lower (p = 0.002; d = 0.923), and post exercise perceived soreness of the gastrocnemius, quadriceps, and hamstrings was attenuated (p < 0.002; ηp2 > 0.693). Perceived soreness of the gluteal muscles was lower in the second bout immediately post exercise, 24 h, and 48 h post exercise (p < 0.025; d > 0.922). A repeated bout of downhill running attenuated perceived muscle soreness and may modulate the physiological and perceived physical demand of a second bout of level and downhill running.

OBJECTIVE: Nordic Hamstring Exercise (NHE) is one of the best exercises proposed for injury prevention of hamstring muscles. However, its effects on lower extremity proprioception are unclear. The aim of this study was to investigate the immediate effects of a single bout of NHE on hip and knee joints\' proprioception.
METHODS: Forty collegiate male soccer players participated in this study with a mean age of 22.85 ± 1.82 years and were randomized into either control (n = 20) or experimental (n = 20) groups. Each subject participated in pre-test measurements in which hip and knee active joints position sense (JPS) were assessed in standing and lying tasks using the image-capturing method. The experimental group then performed three sets of NHE with 10 repetitions in each set, while the control group rested for 10 min. Paired and independent t-tests were used for calculating the differences within and between groups on SPSS software, respectively. The level of significance was P ≤ 0.05.
RESULTS: Hip JPS in the lying task and knee JPS in both of the standing and lying tasks were impaired significantly after performing a single bout of NHE (P ≤ 0.05). However, the effects of this exercise on hip JPS in the standing task were not significant (P ≥ 0.05).
CONCLUSIONS: NHE performing with three sets of 10 repetitions can significantly impair hip and knee JPS immediately after exercise and reduce the proprioception acuity of the lower limbs. It is recommended to perform this exercise at a time rather than before training or match sessions.

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

(1) Background: This study compared the effects of mouth rinsing with a carbohydrate trial (CMR) and a placebo trial (PL) on concentric and eccentric contraction strength in multi-joint resistance exercise performance. (2) Methods: Twenty healthy adult men (age: 22.4 ± 3.7 years, body mass index: 26 ± 3.8, peak power: 378.3 ± 138.7 W) were recruited in this study. Participants were employed in a double-blind, randomized crossover design to divide participants into carbohydrate mouth rinsing trial (CMR) and placebo trial (PL). After warming up, participants used 6.6% maltodextrin (CMR) or mineral water (PL) to rinse their mouth for 20 s. Next, the participants underwent tests of maximum inertial Romanian deadlift resistance exercise comprising five sets of six reps, with 3 min rests between sets. After deducting the first repetition of each set, the mean values from the five sets were analyzed. (3) Results: The concentric peak power of the CMR trial was significantly higher than that of the PL trial (p = 0.001, Cohen\'s d = 0.46), the eccentric peak power of the CMR trial was significantly higher than that of the PL trial (p = 0.008, Cohen\'s d = 0.56), and the total work of the CMR trial was significantly higher than that of PL trial (p = 0.002, Cohen\'s d = 0.51). (4) Conclusions: These findings demonstrate that mouth rinsing with carbohydrates before exercise can improve concentric and eccentric contraction strength in multi-joint resistance exercise performance.

OBJECTIVE: Eccentric strength training is an innovative and promising approach to improve exercise performance. However, most eccentric training studies in the past were performed with a focus on the lower extremities. The present study aimed to test the feasibility and effects on strength and power adaptations of a structured upper-body eccentric training program.
METHODS: Fourteen (median age (Q1-Q3) 29 years (27-32); 9 females, 5 males) healthy, regularly exercising individuals performed 20 progressive training sessions (2-3 sessions/week at 20-50% peak power for 8-14 min) on a symmetric eccentric arm-crank ergometer. Before and after the intervention, anaerobic peak power (PP) and maximal concentric aerobic power output (POmax) on an arm-crank ergometer as well as the one repetition maximum (1RM) for bench press were determined as main outcome parameters. A p-value ≤ 0.05 was considered statistically significant.
RESULTS: Significant improvements in PP (+ 4% (1-8), p = 0.007), POmax (+ 6% (0-8); p = 0.01), and 1RM (+ 12% (10-17); p < 0.001) were found. Exercise intensity was relatively low at 64% (55-70) of maximum heart rate.
CONCLUSIONS: Twenty progressive training sessions on a symmetric arm-crank ergometer are effective in inducing significant aerobic and anaerobic performance and strength improvements in the upper body. This intervention is safe and feasible, and can be performed at relatively low cardiovascular intensities. Therefore, this training method offers an interesting approach from elite sports to rehabilitation.

OBJECTIVE: Exercise-induced muscle damage (EIMD) results in the generation of reactive oxygen species (ROS), but little is known about the temporal profile of change in ROS post-EIMD and how ROS levels relate to the onset of and recovery from EIMD. Our primary aim was to examine the effect of EIMD on the pattern of change in the blood level of thiol-oxidised albumin, a marker of oxidative stress.
METHODS: Seven male participants were subjected on separate days to eccentric muscle contraction to cause EIMD or a no-exercise condition. After each session, the participants collected daily dried blood spots to measure thiol-oxidised albumin and returned to the laboratory every 2 days for the assessment of indirect markers of EIMD, namely maximal voluntary contraction (MVC), delayed onset muscle soreness (DOMS), creatine kinase (CK), and myoglobin.
RESULTS: Eccentric exercise resulted in a significant decrease in MVC and increase in DOMS, CK, myoglobin, and thiol-oxidised albumin with the latter reaching above baseline level within 24-48 h post-exercise. All the markers of EIMD returned to baseline level within 6 days post-exercise, but not the level of thiol-oxidised albumin which remained elevated for 10 days after exercise. There was a moderate correlation between changes in thiol-oxidised albumin and DOMS, but no significant relationship between any other markers of muscle damage.
CONCLUSIONS: The levels of thiol-oxidised albumin increase in response to EIMD and remain elevated for several days post-exercise. The temporal pattern of change in the level of thiol-oxidised albumin suggests that this may be a useful biomarker of muscle repair post-EIMD.

OBJECTIVE: Recent advancements in elastography techniques, specifically supersonic shearwave elastography (SWE), have enabled non-invasive assessment of muscle stiffness. However, there is limited research on the immediate and short-term effects of eccentric exercise-induced muscle damage (EIMD) in well-trained individuals. This study aimed to follow up on the effects of eccentric training on the biceps brachialis stiffness by supersonic shearwave imaging (SSI) as well as the soreness and elbow flexion maximal voluntary isometric contraction (MVIC), immediately post-intervention, at 10 min, 48 h, and 96 h in well-trained men.
METHODS: Thirteen well-trained males participated in the study. Baseline measurements of elastography images, MVIC of the elbow flexors, and muscle soreness were obtained. The participants performed an eccentric exercise protocol (4 sets X 10 repetitions) on the dynamometer isokinetic and elastography measurements were repeated immediately post-exercise, at 10 min, 48 h, and 96 h.
RESULTS: Significant reductions in stiffness (measured by shear modulus (µ)) were observed immediately and at 10 min post-exercise. MVIC exhibited significant reductions immediately after, 10 min, and 48 h compared to baseline measurements. Muscle soreness peaked at 48 h, persisting until 96 h.
CONCLUSIONS: The BB stiffness and MVIC reduction immediately post-eccentric exercise in well-trained men, suggest the potential involvement of mechanical stress and sarcomere rupture. Trained individuals may exhibit a distinct response to EIMD compared to untrained individuals, highlighting the applicability of elastography in monitoring acute biomechanical changes following high-intensity exercise.

Despite the known beneficial effects of creatine in treating exercise-induced muscle damage (EIMD), its effectiveness remains unclear. This study investigates the recovery effect of creatine monohydrate (CrM) on EIMD. Twenty healthy men (21-36 years) were subjected to stratified, randomized, double-blind assignments. The creatine (CRE) and placebo (PLA) groups ingested creatine and crystalline cellulose, respectively, for 28 days. They subsequently performed dumbbell exercises while emphasizing eccentric contraction of the elbow flexors. The EIMD was evaluated before and after exercise. The range of motion was significantly higher in the CRE group than in the PLA group 24 h (h) post exercise. A similar difference was detected in maximum voluntary contraction at 0, 48, 96, and 168 h post exercise (p = 0.017-0.047). The upper arm circumference was significantly lower in the CRE group than in the PLA group at 48, 72, 96, and 168 h post exercise (p = 0.002-0.030). Similar variation was observed in the shear modulus of the biceps brachii muscle at 96 and 168 h post exercise (p = 0.003-0.021) and in muscle fatigue at 0 and 168 h post exercise (p = 0.012-0.032). These findings demonstrate CrM-mediated accelerated recovery from EIMD, suggesting that CrM is an effective supplement for EIMD recovery.