Recovery

The effect of protein timing on muscle strength and hypertrophy: a meta-analysis

Brad J. Schöenfeld, Alan A. Aragon, JAMES KRIEGER · Journal of the International Society of Sports Nutrition · 2013 · 193 citations

Consuming protein specifically around your workout (before, during, or immediately after) does not meaningfully increase muscle growth or strength gains compared to eating the same total amount of protein spread across the day — total daily protein intake is what matters most.

Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers: ASCO Guideline Update

Charles L. Loprinzi, Christina Lacchetti, Jonathan Bleeker +13 more · Journal of Clinical Oncology · 2020 · 1,026 citations

After reviewing 45 new studies, this ASCO guideline update confirms that no supplement or drug can prevent chemotherapy-induced peripheral neuropathy (CIPN), and the only treatment with any evidence for established painful CIPN is duloxetine, which provides only modest relief.

Exercise-based rehabilitation for heart failure

Rod S Taylor, Viral A Sagar, Edward J Davies +7 more · Cochrane Database of Systematic Reviews · 2014 · 342 citations

Exercise-based cardiac rehabilitation reduces the risk of hospitalisation for heart failure by roughly 25% over 12 months and improves quality of life, but does not clearly reduce overall mortality — meaning the main benefit is keeping people out of the hospital rather than extending lifespan.

Prehabilitation versus Rehabilitation

Chelsia Gillis, Chao Li, Lawrence Lee +8 more · Anesthesiology · 2014 · 845 citations

A 4-week prehabilitation program (exercise, nutrition, and anxiety reduction before surgery) improved postoperative functional recovery by approximately 20% more than standard rehabilitation starting after surgery, suggesting that preparing the body before a stressor yields better outcomes than waiting to recover afterward.

Effect of Multimodal Prehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer

Francesco Carli, Guillaume Bousquet-Dion, Rashami Awasthi +11 more · JAMA Surgery · 2020 · 544 citations

A multimodal prehabilitation program (exercise, nutrition, and psychological support before surgery) did not reduce 30-day postoperative complications in frail colorectal cancer patients compared to the same program started after surgery, with the Comprehensive Complications Index showing no significant difference (adjusted mean difference, -3.2; 95% CI, -11.8 to 5.3; P = .45).

A.S.P.E.N. Clinical Guidelines: Nutrition Support of the Critically Ill Child

Nilesh M. Mehta, Charlene Compher, A.S.P.E.N. Board of Directors · Journal of Parenteral and Enteral Nutrition · 2009 · 435 citations

This clinical guideline systematically reviewed the available evidence on nutrition support for critically ill children in the pediatric intensive care unit (PICU) and found that most recommendations could only be supported by weak evidence (Grade D or E), highlighting that underfeeding and overfeeding are both common, that enteral nutrition (feeding through the gut) is preferred over intravenous feeding when possible, and that indirect calorimetry (measuring actual energy expenditure) is more accurate than predictive equations—but the overall lack of high-quality pediatric trials means these guidelines are largely based on expert opinion and adult data extrapolation.

THE EFFECTS OF SELF-MYOFASCIAL RELEASE USING A FOAM ROLL OR ROLLER MASSAGER ON JOINT RANGE OF MOTION, MUSCLE RECOVERY, AND PERFORMANCE: A SYSTEMATIC REVIEW.

Scott W. Cheatham, Morey J. Kolber, Matt Cain +1 more · PubMed · 2015 · 315 citations

Foam rolling or using a roller massager for short bouts (30–60 seconds per muscle group) can temporarily increase joint range of motion without hurting muscle performance, and may reduce muscle soreness after hard exercise, but the effects are small and short-lived (lasting minutes to hours, not days), and there is no standardised "best" protocol yet.

Ice-water immersion and delayed-onset muscle soreness: a randomised controlled trial

Kylie Sellwood, Peter Brukner, David A. Williams +2 more · British Journal of Sports Medicine · 2007 · 214 citations

OBJECTIVE: To determine if ice-water immersion after eccentric quadriceps exercise minimises the symptoms of delayed-onset muscle soreness (DOMS). DESIGN: A prospective randomised double-blind controlled trial was undertaken. 40 untrained volunteers performed an eccentric loading protocol with their non-dominant leg. INTERVENTIONS: Participants were randomised to three 1-min immersions in either ice water (5+/-1 degrees C) or tepid water (24 degrees C). MAIN OUTCOME MEASURES: Pain and tenderness (visual analogue scale), swelling (thigh circumference), function (one-legged hop for distance), maximal isometric strength and serum creatine kinase (CK) recorded at baseline, 24, 48 and 72 h after exercise. Changes in outcome measures over time were compared to determine the effect of group allocation using independent t tests or Mann-Whitney U tests. RESULTS: No significant differences were observed between groups with regard to changes in most pain parameters, tenderness, isometric strength, swelling, hop-for-distance or serum CK over time. There was a significant difference in pain on sit-to-stand at 24 h, with the intervention group demonstrating a greater increase in pain than the control group (median change 8.0 vs 2.0 mm, respectively, p = 0.009). CONCLUSIONS: The protocol of ice-water immersion used in this study was ineffectual in minimising markers of DOMS in untrained individuals. This study challenges the wide use of this intervention as a recovery strategy by athletes.

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

Yutan Wang, Hongmei Lü, Sijun Li +7 more · Journal of Rehabilitation Medicine · 2021 · 37 citations

Hot packs provide the best pain relief for delayed onset muscle soreness (DOMS) within the first 48 hours after exercise, while cryotherapy (whole-body or partial-body cold exposure) works best after 48 hours — but the evidence is weak and based on small, low-quality studies, so you should treat these rankings as provisional rather than definitive.

Effect of a Perturbation-Based Balance Training Program on Compensatory Stepping and Grasping Reactions in Older Adults: A Randomized Controlled Trial

Avril Mansfield, Amy Peters, Barbara A. Liu +1 more · Physical Therapy · 2010 · 280 citations

BACKGROUND: Compensatory stepping and grasping reactions are prevalent responses to sudden loss of balance and play a critical role in preventing falls. The ability to execute these reactions effectively is impaired in older adults. OBJECTIVE: The purpose of this study was to evaluate a perturbation-based balance training program designed to target specific age-related impairments in compensatory stepping and grasping balance recovery reactions. DESIGN: This was a double-blind randomized controlled trial. SETTING: The study was conducted at research laboratories in a large urban hospital. PARTICIPANTS: Thirty community-dwelling older adults (aged 64-80 years) with a recent history of falls or self-reported instability participated in the study. INTERVENTION: Participants were randomly assigned to receive either a 6-week perturbation-based (motion platform) balance training program or a 6-week control program involving flexibility and relaxation training. MEASUREMENTS: Features of balance reactions targeted by the perturbation-based program were: (1) multi-step reactions, (2) extra lateral steps following anteroposterior perturbations, (3) foot collisions following lateral perturbations, and (4) time to complete grasping reactions. The reactions were evoked during testing by highly unpredictable surface translation and cable pull perturbations, both of which differed from the perturbations used during training. RESULTS: /b> Compared with the control program, the perturbation-based training led to greater reductions in frequency of multi-step reactions and foot collisions that were statistically significant for surface translations but not cable pulls. The perturbation group also showed significantly greater reduction in handrail contact time compared with the control group for cable pulls and a possible trend in this direction for surface translations. LIMITATIONS: Further work is needed to determine whether a maintenance program is needed to retain the training benefits and to assess whether these benefits reduce fall risk in daily life. CONCLUSION: Perturbation-based training shows promise as an effective intervention to improve the ability of older adults to prevent themselves from falling when they lose their balance.

ESPEN guidelines on nutrition in cancer patients

Jann Arends, Patrick Bachmann, Vickie E. Baracos +19 more · Clinical Nutrition · 2016 · 2,944 citations

ESPEN guideline on clinical nutrition in the intensive care unit

Pierre Singer, Annika Reintam Blaser, Mette M. Berger +12 more · Clinical Nutrition · 2018 · 2,778 citations

ESPEN guideline on clinical nutrition and hydration in geriatrics

Dorothee Volkert, Anne Marie Beck, Tommy Cederholm +11 more · Clinical Nutrition · 2018 · 1,357 citations

ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit

Pierre Singer, Annika Reintam Blaser, Mette M. Berger +10 more · Clinical Nutrition · 2023 · 576 citations

Effect of tart cherry juice on recovery and next day performance in well-trained Water Polo players

Rachel McCormick, Peter Peeling, Martyn J. Binnie +2 more · Journal of the International Society of Sports Nutrition · 2016 · 75 citations

Tart cherry juice supplementation for six days did not improve recovery, reduce inflammation, or enhance next-day performance in well-trained water polo players, likely because the non-weight-bearing, intermittent nature of water polo does not produce enough muscle damage for cherry juice's anti-inflammatory effects to matter.

Curcumin and Piperine Supplementation and Recovery Following Exercise Induced Muscle Damage: A Randomized Controlled Trial.

Barthélémy Delecroix, Abd Elbasset Abaïdia, Cédric Leduc +2 more · PubMed · 2017 · 61 citations

The aim of this study was to analyze the effects of oral consumption of curcumin and piperine in combination on the recovery kinetics after exercise-induced muscle damage. Forty-eight hours before and following exercise-induced muscle damage, ten elite rugby players consumed curcumin and piperine (experimental condition) or placebo. A randomized cross-over design was performed. Concentric and isometric peak torque for the knee extensors, one leg 6 seconds sprint performance on a non-motorized treadmill, counter movement jump performance, blood creatine kinase concentration and muscle soreness were assessed immediately after exercise, then at 24h, 48h and 72h post-exercise. There were moderate to large effects of the exercise on the concentric peak torque for the knee extensors (Effect size (ES) = -1.12; Confidence interval at 90% (CI90%): -2.17 to -0.06), the one leg 6 seconds sprint performance (ES=-1.65; CI90% = -2.51to -0.80) and the counter movement jump performance (ES = -0.56; CI90% = -0.81 to -0.32) in the 48h following the exercise. There was also a large effect of the exercise on the creatine kinase level 72h after the exercise in the control group (ES = 3.61; CI90%: 0.24 to 6.98). This decrease in muscle function and this elevation in creatine kinase indicate that the exercise implemented was efficient to induce muscle damage. Twenty four hours post-exercise, the reduction (from baseline) in sprint mean power output was moderately lower in the experimental condition (-1.77 ± 7.25%; 1277 ± 153W) in comparison with the placebo condition (-13.6 ± 13.0%; 1130 ± 241W) (Effect Size = -1.12; Confidence Interval 90%=-1.86 to -0.86). However, no other effect was found between the two conditions. Curcumin and piperine supplementation before and after exercise can attenuate some, but not all, aspects of muscle damage.

Recovery and Performance in Sport: Consensus Statement

Michael Kellmann, Maurizio Bertollo, Laurent Bosquet +14 more · International Journal of Sports Physiology and Performance · 2018 · 731 citations

The relationship between recovery and fatigue and its impact on performance has attracted the interest of sport science for many years. An adequate balance between stress (training and competition load, other life demands) and recovery is essential for athletes to achieve continuous high-level performance. Research has focused on the examination of physiological and psychological recovery strategies to compensate external and internal training and competition loads. A systematic monitoring of recovery and the subsequent implementation of recovery routines aims at maximizing performance and preventing negative developments such as underrecovery, nonfunctional overreaching, the overtraining syndrome, injuries, or illnesses. Due to the inter- and intraindividual variability of responses to training, competition, and recovery strategies, a diverse set of expertise is required to address the multifaceted phenomena of recovery, performance, and their interactions to transfer knowledge from sport science to sport practice. For this purpose, a symposium on Recovery and Performance was organized at the Technical University Munich Science and Study Center Raitenhaslach (Germany) in September 2016. Various international experts from many disciplines and research areas gathered to discuss and share their knowledge of recovery for performance enhancement in a variety of settings. The results of this meeting are outlined in this consensus statement that provides central definitions, theoretical frameworks, and practical implications as a synopsis of the current knowledge of recovery and performance. While our understanding of the complex relationship between recovery and performance has significantly increased through research, some important issues for future investigations are also elaborated.

Impact of sedentarism due to the COVID‐19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures

Marco Narici, Giuseppe De Vito, Martino V. Franchi +12 more · European Journal of Sport Science · 2020 · 468 citations

Abstract The COVID‐19 pandemic is an unprecedented health crisis as entire populations have been asked to self‐isolate and live in home‐confinement for several weeks to months, which in itself represents a physiological challenge with significant health risks. This paper describes the impact of sedentarism on the human body at the level of the muscular, cardiovascular, metabolic, endocrine and nervous systems and is based on evidence from several models of inactivity, including bed rest, unilateral limb suspension, and step‐reduction. Data form these studies show that muscle wasting occurs rapidly, being detectable within two days of inactivity. This loss of muscle mass is associated with fibre denervation, neuromuscular junction damage and upregulation of protein breakdown, but is mostly explained by the suppression of muscle protein synthesis. Inactivity also affects glucose homeostasis as just few days of step reduction or bed rest, reduce insulin sensitivity, principally in muscle. Additionally, aerobic capacity is impaired at all levels of the O 2 cascade, from the cardiovascular system, including peripheral circulation, to skeletal muscle oxidative function. Positive energy balance during physical inactivity is associated with fat deposition, associated with systemic inflammation and activation of antioxidant defences, exacerbating muscle loss. Importantly, these deleterious effects of inactivity can be diminished by routine exercise practice, but the exercise dose–response relationship is currently unknown. Nevertheless, low to medium‐intensity high volume resistive exercise, easily implementable in home‐settings, will have positive effects, particularly if combined with a 15–25% reduction in daily energy intake. This combined regimen seems ideal for preserving neuromuscular, metabolic and cardiovascular health.

What is the ideal dose and power output of low-level laser therapy (810 nm) on muscle performance and post-exercise recovery? Study protocol for a double-blind, randomized, placebo-controlled trial

Adriano Rodrigues de Oliveira, Adriane Aver Vanin, Thiago De Marchi +9 more · Trials · 2014 · 42 citations

This is a study protocol (not results) for a two-phase, double-blind, randomized, placebo-controlled trial designed to determine the optimal dose and power output of 810 nm low-level laser therapy (LLLT) for improving muscle performance and accelerating post-exercise recovery in high-performance soccer athletes — but since it's a protocol, no actual findings are reported yet.

Low-Load High Volume Resistance Exercise Stimulates Muscle Protein Synthesis More Than High-Load Low Volume Resistance Exercise in Young Men

Nicholas A. Burd, Daniel W. D. West, Aaron W. Staples +8 more · PLoS ONE · 2010 · 518 citations

BACKGROUND: We aimed to determine the effect of resistance exercise intensity (%1 repetition maximum-1RM) and volume on muscle protein synthesis, anabolic signaling, and myogenic gene expression. METHODOLOGY/PRINCIPAL FINDINGS: Fifteen men (21+/-1 years; BMI=24.1+/-0.8 kg/m2) performed 4 sets of unilateral leg extension exercise at different exercise loads and/or volumes: 90% of repetition maximum (1RM) until volitional failure (90FAIL), 30% 1RM work-matched to 90%FAIL (30WM), or 30% 1RM performed until volitional failure (30FAIL). Infusion of [ring-13C6] phenylalanine with biopsies was used to measure rates of mixed (MIX), myofibrillar (MYO), and sarcoplasmic (SARC) protein synthesis at rest, and 4 h and 24 h after exercise. Exercise at 30WM induced a significant increase above rest in MIX (121%) and MYO (87%) protein synthesis at 4 h post-exercise and but at 24 h in the MIX only. The increase in the rate of protein synthesis in MIX and MYO at 4 h post-exercise with 90FAIL and 30FAIL was greater than 30WM, with no difference between these conditions; however, MYO remained elevated (199%) above rest at 24 h only in 30FAIL. There was a significant increase in AktSer473 at 24h in all conditions (P=0.023) and mTORSer2448 phosphorylation at 4 h post-exercise (P=0.025). Phosporylation of Erk1/2Tyr202/204, p70S6KThr389, and 4E-BP1Thr37/46 increased significantly (P<0.05) only in the 30FAIL condition at 4 h post-exercise, whereas, 4E-BP1Thr37/46 phosphorylation was greater 24 h after exercise than at rest in both 90FAIL (237%) and 30FAIL (312%) conditions. Pax7 mRNA expression increased at 24 h post-exercise (P=0.02) regardless of condition. The mRNA expression of MyoD and myogenin were consistently elevated in the 30FAIL condition. CONCLUSIONS/SIGNIFICANCE: These results suggest that low-load high volume resistance exercise is more effective in inducing acute muscle anabolism than high-load low volume or work matched resistance exercise modes.

Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures

Gregory E. P. Pearcey, David Bradbury-Squires, Jon-Erik Kawamoto +3 more · Journal of Athletic Training · 2014 · 336 citations

CONTEXT: After an intense bout of exercise, foam rolling is thought to alleviate muscle fatigue and soreness (ie, delayed-onset muscle soreness [DOMS]) and improve muscular performance. Potentially, foam rolling may be an effective therapeutic modality to reduce DOMS while enhancing the recovery of muscular performance. OBJECTIVE: To examine the effects of foam rolling as a recovery tool after an intense exercise protocol through assessment of pressure-pain threshold, sprint time, change-of-direction speed, power, and dynamic strength-endurance. DESIGN: Controlled laboratory study. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 8 healthy, physically active males (age = 22.1 ± 2.5 years, height = 177.0 ± 7.5 cm, mass = 88.4 ± 11.4 kg) participated. INTERVENTION(S): Participants performed 2 conditions, separated by 4 weeks, involving 10 sets of 10 repetitions of back squats at 60% of their 1-repetition maximum, followed by either no foam rolling or 20 minutes of foam rolling immediately, 24, and 48 hours postexercise. MAIN OUTCOME MEASURE(S): Pressure-pain threshold, sprint speed (30-m sprint time), power (broad-jump distance), change-of-direction speed (T-test), and dynamic strength-endurance. RESULTS: Foam rolling substantially improved quadriceps muscle tenderness by a moderate to large amount in the days after fatigue (Cohen d range, 0.59 to 0.84). Substantial effects ranged from small to large in sprint time (Cohen d range, 0.68 to 0.77), power (Cohen d range, 0.48 to 0.87), and dynamic strength-endurance (Cohen d = 0.54). CONCLUSIONS: Foam rolling effectively reduced DOMS and associated decrements in most dynamic performance measures.

The low-temperature effect on sports regeneration

Robert Trybulski, Andriy Vovkanych, Olha Bas +1 more · Fisioterapia em Movimento · 2023 · 6 citations

Cold therapy (ice baths, cold water immersion, cryotherapy) reliably reduces pain and inflammation after intense exercise and helps restore sprint performance within 24 hours, but it does little to improve muscle strength, endurance, or lactate clearance — so it's useful for recovery between explosive efforts, not for building strength or stamina.

Effect of a Therapeutic Intervention for the Hemiplegic Upper Limb in the Acute Phase After Stroke

Hilde Feys, Willy J. De Weerdt, Beat Selz +5 more · Stroke · 1998 · 462 citations

BACKGROUND AND PURPOSE: Arm function recovery is notoriously poor in stroke patients. The effect of treatment modalities, particularly those directed at improving upper limb function, has been studied primarily in chronic stroke patients. The purpose of this study was to investigate the effect of a specific therapeutic intervention on arm function in the acute phase after stroke. METHODS: In a single-blind, randomized, controlled multicenter trial, 100 consecutive patients were allocated to either an experimental group that received an additional treatment of sensorimotor stimulation or to a control group. The intervention was applied for 6 weeks. Patients were evaluated for level of impairment (Brunnström-Fugl-Meyer test) and disability (Action Research Arm test, Barthel Index) before, midway, and after the intervention period and at follow-up 6 and 12 months after stroke. RESULTS: Patients in the experimental group performed better on the Brunnström-Fugl-Meyer test than those in the control group throughout the study period, but differences were significant only at follow-up. Results on the Action Research Arm test and Barthel Index revealed no effect at the level of disability. The effect of the therapy was attributed to the repetitive stimulation of muscle activity. The treatment was most effective in patients with a severe motor deficit and hemianopia or hemi-inattention. No adverse effects due to the intervention were found. CONCLUSIONS: Adding a specific intervention during the acute phase after stroke improved motor recovery, which was apparent 1 year later. These results emphasize the potential beneficial effect of therapeutic interventions for the arm.

Optimizing recovery strategies for winter athletes: insights for Milano-Cortina 2026 Olympic Games

Peter Edholm, Niels Ørtenblad, Hans‐Christer Holmberg +1 more · Sport Sciences for Health · 2024 · 5 citations

This narrative umbrella review of 21 meta-analyses and systematic reviews found that sleep and nutrition are the only recovery strategies with consistent, high-quality evidence for improving recovery in winter athletes, while physical methods like cold-water immersion and massage show context-specific benefits for pain relief but not performance restoration, and stretching, sauna, and contrast therapy lack robust evidence.

Effects of Whole-Body Cryotherapy vs. Far-Infrared vs. Passive Modalities on Recovery from Exercise-Induced Muscle Damage in Highly-Trained Runners

Christophe Hausswirth, Julien Louis, François Bieuzen +4 more · PLoS ONE · 2011 · 234 citations

Enhanced recovery following physical activity and exercise-induced muscle damage (EIMD) has become a priority for athletes. Consequently, a number of post-exercise recovery strategies are used, often without scientific evidence of their benefits. Within this framework, the purpose of this study was to test the efficacy of whole body cryotherapy (WBC), far infrared (FIR) or passive (PAS) modalities in hastening muscular recovery within the 48 hours after a simulated trail running race. In 3 non-adjoining weeks, 9 well-trained runners performed 3 repetitions of a simulated trail run on a motorized treadmill, designed to induce muscle damage. Immediately (post), post 24 h, and post 48 h after exercise, all participants tested three different recovery modalities (WBC, FIR, PAS) in a random order over the three separate weeks. Markers of muscle damage (maximal isometric muscle strength, plasma creatine kinase [CK] activity and perceived sensations [i.e. pain, tiredness, well-being]) were recorded before, immediately after (post), post 1 h, post 24 h, and post 48 h after exercise. In all testing sessions, the simulated 48 min trail run induced a similar, significant amount of muscle damage. Maximal muscle strength and perceived sensations were recovered after the first WBC session (post 1 h), while recovery took 24 h with FIR, and was not attained through the PAS recovery modality. No differences in plasma CK activity were recorded between conditions. Three WBC sessions performed within the 48 hours after a damaging running exercise accelerate recovery from EIMD to a greater extent than FIR or PAS modalities.

Time-Course of Changes in Inflammatory Response after Whole-Body Cryotherapy Multi Exposures following Severe Exercise

Hervé Pournot, François Bieuzen, Julien Louis +3 more · PLoS ONE · 2011 · 184 citations

The objectives of the present investigation was to analyze the effect of two different recovery modalities on classical markers of exercise-induced muscle damage (EIMD) and inflammation obtained after a simulated trail running race. Endurance trained males (n = 11) completed two experimental trials separated by 1 month in a randomized crossover design; one trial involved passive recovery (PAS), the other a specific whole body cryotherapy (WBC) for 96 h post-exercise (repeated each day). For each trial, subjects performed a 48 min running treadmill exercise followed by PAS or WBC. The Interleukin (IL) -1 (IL-1), IL-6, IL-10, tumor necrosis factor alpha (TNF-α), protein C-reactive (CRP) and white blood cells count were measured at rest, immediately post-exercise, and at 24, 48, 72, 96 h in post-exercise recovery. A significant time effect was observed to characterize an inflammatory state (Pre vs. Post) following the exercise bout in all conditions (p<0.05). Indeed, IL-1β (Post 1 h) and CRP (Post 24 h) levels decreased and IL-1ra (Post 1 h) increased following WBC when compared to PAS. In WBC condition (p<0.05), TNF-α, IL-10 and IL-6 remain unchanged compared to PAS condition. Overall, the results indicated that the WBC was effective in reducing the inflammatory process. These results may be explained by vasoconstriction at muscular level, and both the decrease in cytokines activity pro-inflammatory, and increase in cytokines anti-inflammatory.

Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise

Chris Bleakley, Suzanne McDonough, Evie Gardner +3 more · Cochrane Database of Systematic Reviews · 2012 · 183 citations

BACKGROUND: Many strategies are in use with the intention of preventing or minimising delayed onset muscle soreness and fatigue after exercise. Cold-water immersion, in water temperatures of less than 15°C, is currently one of the most popular interventional strategies used after exercise. OBJECTIVES: To determine the effects of cold-water immersion in the management of muscle soreness after exercise. SEARCH METHODS: In February 2010, we searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library (2010, Issue 1), MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health (CINAHL), British Nursing Index and archive (BNI), and the Physiotherapy Evidence Database (PEDro). We also searched the reference lists of articles, handsearched journals and conference proceedings and contacted experts.In November 2011, we updated the searches of CENTRAL (2011, Issue 4), MEDLINE (up to November Week 3 2011), EMBASE (to 2011 Week 46) and CINAHL (to 28 November 2011) to check for more recent publications. SELECTION CRITERIA: Randomised and quasi-randomised trials comparing the effect of using cold-water immersion after exercise with: passive intervention (rest/no intervention), contrast immersion, warm-water immersion, active recovery, compression, or a different duration/dosage of cold-water immersion. Primary outcomes were pain (muscle soreness) or tenderness (pain on palpation), and subjective recovery (return to previous activities without signs or symptoms). DATA COLLECTION AND ANALYSIS: Three authors independently evaluated study quality and extracted data. Some of the data were obtained following author correspondence or extracted from graphs in the trial reports. Where possible, data were pooled using the fixed-effect model. MAIN RESULTS: Seventeen small trials were included, involving a total of 366 participants. Study quality was low. The temperature, duration and frequency of cold-water immersion varied between the different trials as did the exercises and settings. The majority of studies failed to report active surveillance of pre-defined adverse events.Fourteen studies compared cold-water immersion with passive intervention. Pooled results for muscle soreness showed statistically significant effects in favour of cold-water immersion after exercise at 24 hour (standardised mean difference (SMD) -0.55, 95% CI -0.84 to -0.27; 10 trials), 48 hour (SMD -0.66, 95% CI -0.97 to -0.35; 8 trials), 72 hour (SMD -0.93; 95% CI -1.36 to -0.51; 4 trials) and 96 hour (SMD -0.58; 95% CI -1.00 to -0.16; 5 trials) follow-ups. These results were heterogeneous. Exploratory subgroup analyses showed that studies using cross-over designs or running based exercises showed significantly larger effects in favour of cold-water immersion. Pooled results from two studies found cold-water immersion groups had significantly lower ratings of fatigue (MD -1.70; 95% CI -2.49 to -0.90; 10 units scale, best to worst), and potentially improved ratings of physical recovery (MD 0.97; 95% CI -0.10 to 2.05; 10 units scale, worst to best) immediately after the end of cold-water immersion.Five studies compared cold-water with contrast immersion. Pooled data for pain showed no evidence of differences between the two groups at four follow-up times (immediately, 24, 48 and 72 hours after treatment). Similar findings for pooled analyses at 24, 48 and 72 hour follow-ups applied to the four studies comparing cold-water with warm-water immersion. Single trials only compared cold-water immersion with respectively active recovery, compression and a second dose of cold-water immersion at 24 hours. AUTHORS' CONCLUSIONS: There was some evidence that cold-water immersion reduces delayed onset muscle soreness after exercise compared with passive interventions involving rest or no intervention. There was insufficient evidence to conclude on other outcomes or for other comparisons. The majority of trials did not undertake active surveillance of pre-defined adverse events. High quality, well reported research in this area is required.

An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing

Corey A. Peacock, Darren D. Krein, Tobin Silver +2 more · International journal of exercise science · 2014 · 156 citations

Recent developments in the strength and conditioning field have shown the incorporation of foam rolling self-myofascial release in adjunct with a dynamic warm-up. This is thought to improve overall training performance; however, minimal research exists supporting this theory. Therefore, determining if an acute bout of foam rolling self-myofascial release in addition to a dynamic warm-up could influence performance is of importance. In order to do so, eleven athletically trained male subjects participated in a two condition, counterbalanced, crossover within-subjects study comparing two particular warm-up routines. The two warm-up routines compared were a total-body dynamic warm-up (DYN) and a total-body dynamic warm-up in adjunct with a self-myofascial release, total-body foam rolling session (SMR). Following each warm-up condition, subjects performed tests of flexibility, power, agility, strength, and speed. Paired samples T-tests were utilized to determine if there were any significant differences in test results between conditions (DYN vs. SMR). The data indicated that SMR was effective at improving power, agility, strength, and speed when compared to DYN (P ≤ 0.024). A warm-up routine consisting of both a dynamic warm-up and a self-myofascial release, total-body foam rolling session resulted in overall improvements in athletic performance testing.

Effect of New Zealand blueberry consumption on recovery from eccentric exercise-induced muscle damage

Yanita McLeay, Matthew J. Barnes, Toby Mündel +3 more · Journal of the International Society of Sports Nutrition · 2012 · 154 citations

BACKGROUND: Exercise-induced muscle damage (EIMD) is accompanied by localized oxidative stress / inflammation which, in the short-term at least, is associated with impaired muscular performance. Dietary antioxidants have been shown to reduce excessive oxidative stress; however, their effectiveness in facilitating recovery following EIMD is not clear. Blueberries demonstrate antioxidant and anti-inflammatory properties. In this study we examine the effect of New Zealand blueberries on EIMD after strenuous eccentric exercise. METHODS: In a randomized cross-over design, 10 females consumed a blueberry smoothie or placebo of a similar antioxidant capacity 5 and 10 hours prior to and then immediately, 12 and 36 hours after EIMD induced by 300 strenuous eccentric contractions of the quadriceps. Absolute peak and average peak torque across the knee, during concentric, isometric, and eccentric actions were measured. Blood biomarkers of oxidative stress, antioxidant capacity, and inflammation were assessed at 12, 36 and 60 hours post exercise. Data were analyzed using a two-way ANOVA. RESULTS: A significant (p < 0.001) decrease in isometric, concentric and eccentric torque was observed 12 hours following exercise in both treatment groups. During the 60 hour recovery period, a significant (p = 0.047) interaction effect was seen for peak isometric tension suggesting a faster rate of recovery in the blueberry intervention group. A similar trend was observed for concentric and eccentric strength. An increase in oxidative stress and inflammatory biomarkers was also observed in both treatment groups following EIMD. Although a faster rate of decrease in oxidative stress was observed in the blueberry group, it was not significant (p < 0.05) until 36 hours post-exercise and interestingly coincided with a gradual increase in plasma antioxidant capacity, whereas biomarkers for inflammation were still elevated after 60 hours recovery. CONCLUSIONS: This study demonstrates that the ingestion of a blueberry smoothie prior to and after EIMD accelerates recovery of muscle peak isometric strength. This effect, although independent of the beverage's inherent antioxidant capacity, appears to involve an up-regulation of adaptive processes, i.e. endogenous antioxidant processes, activated by the combined actions of the eccentric exercise and blueberry consumption. These findings may benefit the sporting community who should consider dietary interventions that specifically target health and performance adaptation.

Connecting the Dots: Exploring the Interplay of Calcium, Delayed Onset Muscle Soreness, and the Myofascial System

Charles J. Middleton, Gerardo Rivera-Colón, Joseph E. Fares +2 more · Journal of Surgery Care · 2024 · 1 citations

This narrative review synthesises evidence that deep fascia damage—not muscle fibre damage—is the primary driver of delayed onset muscle soreness (DOMS), and that calcium signalling plays a central role in both the inflammatory cascade and the fibroblastic remodelling required for recovery, suggesting that recovery strategies targeting fascial health (massage, compression) may be more effective than those targeting muscle tissue alone.

Intake of a Ketone Ester Drink during Recovery from Exercise Promotes mTORC1 Signaling but Not Glycogen Resynthesis in Human Muscle

Tijs Vandoorne, Stefan De Smet, Monique Ramaekers +4 more · Frontiers in Physiology · 2017 · 107 citations

, we confirmed that ketone bodies potentiate the increase in mTORC1 activation and protein synthesis in leucine-stimulated myotubes. Whether, chronic oral KE intake during recovery from exercise can facilitate training-induced muscular adaptation and remodeling need to be further investigated.

Aquatic Therapy Versus Conventional Land-Based Therapy for Parkinson's Disease: An Open-Label Pilot Study

Jamile Vivas Costa, Pablo Arias, Javier Cudeiro · Archives of Physical Medicine and Rehabilitation · 2011 · 136 citations

Effects of Vibration and Non-Vibration Foam Rolling on Recovery after Exercise with Induced Muscle Damage.

Blanca Romero‐Moraleda, Jaime González‐García, Ángel Cuéllar-Rayo +3 more · PubMed · 2019 · 72 citations

We aimed to compare the effects between non-vibration foam rolling (NVFR) and vibration foam rolling (VFR) on visual analogic scale (VAS), pressure pain threshold (PPT), oxygen saturation (SmO2), countermovement jump (CMJ) and hip and knee range of movement (ROM) after eliciting muscle damage through eccentric acute exercise using an inertial flywheel. Thirty-eight healthy volunteers (32 men, 6 women; aged 22.2±3.2 years) were randomly assigned in a counter-balanced fashion to either a VFR or NVFR protocol group. All participants performed a 10x10 (sets x repetitions) eccentric squat protocol to induce muscle damage. The protocols were administered 48-h post-exercise, measuring VAS, PPT, SmO2, CMJ and ROM, before and immediately post-treatment. The treatment technique was repeated on both legs for 1 minute for a total of five sets, with a 30-s rest between sets. The VFR group showed substantially greater improvements (likely to very likely) in the passive VAS (VFR -30.2%, 90% CI -66.2 to -12.8) with chances for lower, similar or greater VAS compared with the NVFR group of 82%, 14% and 4%, respectively and passive extension hip joint ROM (VFR 9.3%, 90% CI 0.2-19.2) with chances for lower, similar or greater ROM compared with the NVFR group of 78%, 21% and 1%, respectively. For intragroup changes, we observed substantial improvements in VAS (p=.05), lateral vastus, rectus femoris and medial vastus PPT. The results suggest that the VFR group achieved greater short-term benefits in pain perception and passive extension hip joint ROM. Both protocols were effective in improving PPT, SmO2, CMJ and knee joint ROM. The enhanced improvement in VAS and hip ROM measures could have significant implications for VFR treatment.

The effect of an acute sleep hygiene strategy following a late-night soccer match on recovery of players

Hugh H.K. Fullagar, Sabrina Skorski, Rob Duffield +1 more · Chronobiology International · 2016 · 126 citations

Elite soccer players are at risk of reduced recovery following periods of sleep disruption, particularly following late-night matches. It remains unknown whether improving sleep quality or quantity in such scenarios can improve post-match recovery. Therefore, the aim of this study was to investigate the effect of an acute sleep hygiene strategy (SHS) on physical and perceptual recovery of players following a late-night soccer match. In a randomised cross-over design, two highly-trained amateur teams (20 players) played two late-night (20:45) friendly matches against each other seven days apart. Players completed an SHS after the match or proceeded with their normal post-game routine (NSHS). Over the ensuing 48 h, objective sleep parameters (sleep duration, onset latency, efficiency, wake episodes), countermovement jump (CMJ; height, force production), YoYo Intermittent Recovery test (YYIR2; distance, maximum heart rate, lactate), venous blood (creatine kinase, urea and c-reactive protein) and perceived recovery and stress markers were collected. Sleep duration was significantly greater in SHS compared to NSHS on match night (P = 0.002, d = 1.50), with NSHS significantly less than baseline (P < 0.001, d = 1.95). Significant greater wake episodes occurred on match night for SHS (P = 0.04, d = 1.01), without significant differences between- or within-conditions for sleep onset latency (P = 0.12), efficiency (P = 0.39) or wake episode duration (P = 0.07). No significant differences were observed between conditions for any physical performance or venous blood marker (all P > 0.05); although maximum heart rate during the YYIR2 was significantly higher in NSHS than SHS at 36 h post-match (P = 0.01; d = 0.81). There were no significant differences between conditions for perceptual "overall recovery" (P = 0.47) or "overall stress" (P = 0.17). Overall, an acute SHS improved sleep quantity following a late-night soccer match; albeit without any improvement in physical performance, perceptual recovery or blood-borne markers of muscle damage and inflammation.

EFFECT OF SINGLE AND MULTIPLE SESSIONS OF SELF-MYOFASCIAL RELEASE: SYSTEMATIC REVIEW

Raphael Ferreira de Oliveira, Gustavo Ribeiro da Mota, Wellington Roberto Gomes de Carvalho +2 more · Revista Brasileira de Medicina do Esporte · 2022 · 2 citations

Foam rolling after exercise can speed recovery of some performance measures, but the effects are modest and depend on whether you roll once or repeatedly — multiple sessions help power and speed recovery better, while a single session is better for strength recovery, and neither consistently improves agility, pain, flexibility, or blood lactate clearance beyond what happens naturally.

Winning the war against ICU-acquired weakness: new innovations in nutrition and exercise physiology

Paul E. Wischmeyer, Iñigo San-Millán · Critical Care · 2015 · 148 citations

Abstract Over the last 10 years we have significantly reduced hospital mortality from sepsis and critical illness. However, the evidence reveals that over the same period we have tripled the number of patients being sent to rehabilitation settings. Further, given that as many as half of the deaths in the first year following ICU admission occur post ICU discharge, it is unclear how many of these patients ever returned home. For those who do survive, the latest data indicate that 50-70% of ICU "survivors" will suffer cognitive impairment and 60-80% of "survivors" will suffer functional impairment or ICU-acquired weakness (ICU-AW). These observations demand that we as intensive care providers ask the following questions: "Are we creating survivors ... or are we creating victims?" and "Do we accomplish 'Pyrrhic Victories' in the ICU?" Interventions to address ICU-AW must have a renewed focus on optimal nutrition, anabolic/anticatabolic strategies, and in the future employ the personalized muscle and exercise evaluation techniques utilized by elite athletes to optimize performance. Specifically, strategies must include optimal protein delivery (1.2-2.0 g/kg/day), as an athlete would routinely employ. However, as is clear in elite sports performance, optimal nutrition is fundamental but alone is often not enough. We know burn patients can remain catabolic for 2 years post burn; thus, anticatabolic agents (i.e., beta-blockers) and anabolic agents (i.e., oxandrolone) will probably also be essential. In the near future, evaluation techniques such as assessing lean body mass at the bedside using ultrasound to determine nutritional status and ultrasound-measured muscle glycogen as a marker of muscle injury and recovery could be utilized to help find the transition from the acute phase of critical illness to the recovery phase. Finally, exercise physiology testing that evaluates muscle substrate utilization during exercise can be used to diagnose muscle mitochondrial dysfunction and to guide a personalized ideal heart rate, assisting in recovery of muscle mitochondrial function and functional endurance post ICU. In the end, future ICU-AW research must focus on using a combination of modern performance-enhancing nutrition, anticatabolic/anabolic interventions, and muscle/exercise testing so we can begin to create more "survivors" and fewer victims post ICU care.

Nutrition, sleep and recovery

Shona L. Halson · European Journal of Sport Science · 2008 · 218 citations

Abstract Ensuring athletes achieve an appropriate quality and/or quantity of sleep may have significant implications for performance and recovery and reduce the risk of developing overreaching or overtraining. Indeed, sleep is often anecdotally suggested to be the single best recovery strategy available to elite athletes. A number of nutritional factors have been suggested to improve sleep, including valerian, melatonin, tryptophan, a high glycaemic index diet before bedtime, and maintenance of a balanced and healthy diet. Conversely, consumption of alcohol and caffeine and hyper‐hydration may disturb sleep. Strategies such as warming the skin, hydrotherapy, and adoption of appropriate sleep hygiene (maintenance of good sleep habits and routines) are other tools to aid in sleep promotion. Ensuring athletes gain an appropriate quality and quantity of sleep may be important for optimal athletic performance.

Effect of Branched-Chain Amino Acid Supplementation on Recovery Following Acute Eccentric Exercise

Trisha A. VanDusseldorp, Kurt A. Escobar, Kelly E. Johnson +9 more · Nutrients · 2018 · 79 citations

This study investigated the effect of branched-chain amino acid (BCAA) supplementation on recovery from eccentric exercise. Twenty males ingested either a BCAA supplement or placebo (PLCB) prior to and following eccentric exercise. Creatine kinase (CK), vertical jump (VJ), maximal voluntary isometric contraction (MVIC), jump squat (JS) and perceived soreness were assessed. No significant (p &gt; 0.05) group by time interaction effects were observed for CK, soreness, MVIC, VJ, or JS. CK concentrations were elevated above baseline (p &lt; 0.001) in both groups at 4, 24, 48 and 72 hr, while CK was lower (p = 0.02) in the BCAA group at 48 hr compared to PLCB. Soreness increased significantly from baseline (p &lt; 0.01) in both groups at all time-points; however, BCAA supplemented individuals reported less soreness (p &lt; 0.01) at the 48 and 72 hr time-points. MVIC force output returned to baseline levels (p &gt; 0.05) at 24, 48 and 72 hr for BCAA individuals. No significant difference between groups (p &gt; 0.05) was detected for VJ or JS. BCAA supplementation may mitigate muscle soreness following muscle-damaging exercise. However, when consumed with a diet consisting of ~1.2 g/kg/day protein, the attenuation of muscular performance decrements or corresponding plasma CK levels are likely negligible.

Low muscle glycogen concentration does not suppress the anabolic response to resistance exercise

Donny M. Camera, Daniel W. D. West, Nicholas A. Burd +4 more · Journal of Applied Physiology · 2012 · 74 citations

We determined the effect of muscle glycogen concentration and postexercise nutrition on anabolic signaling and rates of myofibrillar protein synthesis after resistance exercise (REX). Sixteen young, healthy men matched for age, body mass, peak oxygen uptake (Vo(2peak)) and strength (one repetition maximum; 1RM) were randomly assigned to either a nutrient or placebo group. After 48 h diet and exercise control, subjects undertook a glycogen-depletion protocol consisting of one-leg cycling to fatigue (LOW), whereas the other leg rested (NORM). The next morning following an overnight fast, a primed, constant infusion of l-[ring-(13)C(6)] phenylalanine was commenced and subjects completed 8 sets of 5 unilateral leg press repetitions at 80% 1RM. Immediately after REX and 2 h later, subjects consumed a 500 ml bolus of a protein/CHO (20 g whey + 40 g maltodextrin) or placebo beverage. Muscle biopsies from the vastus lateralis of both legs were taken at rest and 1 and 4 h after REX. Muscle glycogen concentration was higher in the NORM than LOW at all time points in both nutrient and placebo groups (P < 0.05). Postexercise Akt-p70S6K-rpS6 phosphorylation increased in both groups with no differences between legs (P < 0.05). mTOR(Ser2448) phosphorylation in placebo increased 1 h after exercise in NORM (P < 0.05), whereas mTOR increased ~4-fold in LOW (P < 0.01) and ~11 fold in NORM with nutrient (P < 0.01; different between legs P < 0.05). Post-exercise rates of MPS were not different between NORM and LOW in nutrient (0.070 ± 0.022 vs. 0.068 ± 0.018 %/h) or placebo (0.045 ± 0.021 vs. 0.049 ± 0.017 %/h). We conclude that commencing high-intensity REX with low muscle glycogen availability does not compromise the anabolic signal and subsequent rates of MPS, at least during the early (4 h) postexercise recovery period.

Comparison between cold water immersion therapy (CWIT) and light emitting diode therapy (LEDT) in short-term skeletal muscle recovery after high-intensity exercise in athletes—preliminary results

Ernesto César Pinto Leal‐Junior, Vanessa de Godoi, José Luis Mancalossi +10 more · Lasers in Medical Science · 2010 · 109 citations

In the last years, phototherapy has becoming a promising tool to improve skeletal muscle recovery after exercise, however, it was not compared with other modalities commonly used with this aim. In the present study we compared the short-term effects of cold water immersion therapy (CWIT) and light emitting diode therapy (LEDT) with placebo LEDT on biochemical markers related to skeletal muscle recovery after high-intensity exercise. A randomized double-blind placebo-controlled crossover trial was performed with six male young futsal athletes. They were treated with CWIT (5°C of temperature [SD ±1°]), active LEDT (69 LEDs with wavelengths 660/850 nm, 10/30 mW of output power, 30 s of irradiation time per point, and 41.7 J of total energy irradiated per point, total of ten points irradiated) or an identical placebo LEDT 5 min after each of three Wingate cycle tests. Pre-exercise, post-exercise, and post-treatment measurements were taken of blood lactate levels, creatine kinase (CK) activity, and C-reactive protein (CRP) levels. There were no significant differences in the work performed during the three Wingate tests (p > 0.05). All biochemical parameters increased from baseline values (p < 0.05) after the three exercise tests, but only active LEDT decreased blood lactate levels (p = 0.0065) and CK activity (p = 0.0044) significantly after treatment. There were no significant differences in CRP values after treatments. We concluded that treating the leg muscles with LEDT 5 min after the Wingate cycle test seemed to inhibit the expected post-exercise increase in blood lactate levels and CK activity. This suggests that LEDT has better potential than 5 min of CWIT for improving short-term post-exercise recovery.

Effects of different recovery strategies following a half-marathon on fatigue markers in recreational runners

Thimo Wiewelhove, Christoph Schneider, Alexander Döweling +6 more · PLoS ONE · 2018 · 69 citations

PURPOSE: To investigate the effects of different recovery strategies on fatigue markers following a prolonged running exercise. METHODS: 46 recreational male runners completed a half-marathon, followed by active recovery (ACT), cold water immersion (CWI), massage (MAS) or passive recovery (PAS). Countermovement jump height, muscle soreness and perceived recovery and stress were measured 24h before the half-marathon (pre), immediately after the recovery intervention (postrec) and 24h after the race (post24). In addition, muscle contractile properties and blood markers of fatigue were determined at pre and post24. RESULTS: Magnitude-based inferences revealed substantial differences in the changes between the groups. At postrec, ACT was harmful to perceived recovery (ACT vs. PAS: effect size [ES] = -1.81) and serum concentration of creatine kinase (ACT vs. PAS: ES = 0.42), with CWI being harmful to jump performance (CWI vs. PAS: ES = -0.98). It was also beneficial for reducing muscle soreness (CWI vs. PAS: ES = -0.88) and improving perceived stress (CWI vs. PAS: ES = -0.64), with MAS being beneficial for reducing muscle soreness (MAS vs. PAS: ES = -0.52) and improving perceived recovery (MAS vs. PAS: ES = 1.00). At post24, both CWI and MAS were still beneficial for reducing muscle soreness (CWI vs. PAS: ES = 1.49; MAS vs. PAS: ES = 1.12), with ACT being harmful to perceived recovery (ACT vs. PAS: ES = -0.68), serum concentration of creatine kinase (ACT vs. PAS: ES = 0.84) and free-testosterone (ACT vs. PAS: ES = -0.91). CONCLUSIONS: In recreational runners, a half-marathon results in fatigue symptoms lasting at least 24h. To restore subjective fatigue measures, the authors recommend CWI and MAS, as these recovery strategies are more effective than PAS, with ACT being even disadvantageous. However, runners must be aware that neither the use of ACT nor CWI or MAS had any beneficial effect on objective fatigue markers.

Sleep and Sport Performance

Hugh H.K. Fullagar, Grace E. Vincent, Michael E. McCullough +2 more · Journal of Clinical Neurophysiology · 2023 · 36 citations

SUMMARY: Elite athletes and coaches believe sleep is the most important recovery strategy and widely consider it critical to optimal performance. Despite this perceived importance, there are numerous circumstances that can reduce sleep quantity and quality in athletic populations. Because of the effects of sleep loss on various physical, neurophysiological, and cognitive parameters, such perturbations can have consequences for performance and recovery outcomes. Although peer-reviewed literature examining the interaction between sleep, performance, and recovery in athletes is increasing, understanding of these issues remains equivocal. Perhaps most pertinently, the effect of sleep on sport performance does not align with a one-size-fits-all approach and rather depends on numerous factors such as type of sport, scheduling, time of the season, and the intraindividual requirements for sleep. The relationship between brain plasticity and memory, which in turn can influence learning processes and long-term memory consolidation, suggests that sleep may play an important role in learning new skills and tactics for both elite and developing athletes. The aim of this special issue review was to analyze the evidence of sleep loss on sport performance and recovery, with a specific focus on elite athletes. An assessment of these sleep-compromising situations that elite athletes may face during a typical season and practical considerations for alleviating these issues is also provided to further the understanding for medical professionals, scientists, and applied sporting practitioners alike.

Effect of an acute dose of omega-3 fish oil following exercise-induced muscle damage

John Jakeman, Danielle Lambrick, Beverly K. Wooley +2 more · European Journal of Applied Physiology · 2017 · 64 citations

Comparison of Interventional Strategies to Improve Recovery after Eccentric Exercise-Induced Muscle Fatigue

Manuel García-Sillero, Javier Benítez‐Porres, Jerónimo García-Romero +3 more · International Journal of Environmental Research and Public Health · 2021 · 45 citations

The aim of this study was to compare the effects of various recovery techniques on muscle tissue after eccentric exercise-induced muscle fatigue (EIMF). Forty subjects (24.3 ± 2.6 years; 77.45 ± 8.3 kg; 177.0 ± 6.4 cm; 24.66 ± 1.6 kg∙m−2) were randomly assigned to one of the following groups: manual therapy (n =10, MT), mechanical vibration (n = 10, MV), percussion therapy (n = 10, PT) or foam roller (n = 10, FR). The contraction time (Tc) and the radial displacement (Dm) of the gastrocnemius was evaluated through tensiomyography (TMG). The application of the different techniques had positive effects for Tc and Dm in the treated leg compared to the untreated leg (F = 50.01, p &lt; 0.01, η2p = 0.58 and F = 27.58, p &lt; 0.01, η2p = 0.43, respectively) and for the interaction of the factors (Time x Leg x Therapy: F = 5.76, p &lt; 0.01, η2p = 0.32 and F = 5.93, p &lt; 0.01, η2p = 0.33, respectively). The results of the various methods used were similar: Tc (F = 0.17, p = 0.917; η2p = 0.01) and Dm (F = 3.30, p = 0.031, η2p = 0.22). PT interventions show potential for restoring muscle compliance and reducing stiffness, similar to MT and possibly more effective (cost-time relationship) compared to MV or FR.

Effect of vitamin C supplementation on post-exercise recovery: A systematic review and meta-analysis of randomized double-blind placebo trials.

Candeloro BM, Miranda ESF, Hizuka LA +9 more · Clin Nutr ESPEN · 2026 · 0 citations

Effects of cold-water immersion at different body regions on post-exercise muscle damage recovery: a systematic review and meta-analysis.

Zhu Y, Yang L, Liu T +3 more · Front Sports Act Living · 2026 · 0 citations

Cold-water immersion (CWI) reduces muscle soreness and blood markers of muscle damage by a small-to-moderate amount, but does not improve strength or power recovery — and partially immersing only the legs immediately impairs explosive power — yet whole-body and partial immersion work equally well for soreness and biochemical recovery, making partial immersion the safer, equally effective choice for next-day recovery.

Attenuating Muscle Damage Biomarkers and Muscle Soreness After an Exercise-Induced Muscle Damage with Branched-Chain Amino Acid (BCAA) Supplementation: A Systematic Review and Meta-analysis with Meta-regression.

Salem A, Ben Maaoui K, Jahrami H +10 more · Sports Med Open · 2024 · 34 citations

This meta-analysis of 32 randomised controlled trials found that BCAA supplementation consistently reduces markers of muscle damage (creatine kinase by ~30–40% and lactate dehydrogenase by ~15–25%) and subjective muscle soreness by about 1–2 points on a 10-point scale in the 24–72 hours after intense exercise, but the effect is modest and likely matters most for people doing unaccustomed or very high-volume training.

Heart Rate Variability, Risk-Taking Behavior and Resilience in Firefighters During a Simulated Extinguish-Fire Task

Rebecca Prell, Oliver Opatz, Giampiero Merati +3 more · Frontiers in Physiology · 2020 · 33 citations

Firefighters face a high-risk potential, thus their psychological ability to cope with critical or traumatic events is a crucial characteristic. This study examines correlations between cardiac autonomic modulation, risk-taking behavior, and resilience in professional firefighters. Twenty male professional firefighters underwent a 20 min beat-to-beat heart rate (HR) monitoring at baseline at morning upon awakening, then before, during and after a realistic deployment in a container, systematically set on fire. Risk-taking behavior, resilience and subjective stress were assessed by specific validated tools after deployment: the Risk-taking scale (R-1), the Resilience Scale (RS-13), and the multi-dimensional NASA-Task Load Index. The cardiac autonomic modulation at rest and in response to stress was assessed by classic indexes of heart rate variability (HRV) as RMSSD and LF/HF ratio. Results showed that: (i) risk-taking behavior correlated with a withdrawal in vagal indices, shifted the baseline sympathovagal balance toward sympathetic predominance (LF/HF ratio r(8)=0.522, p=.01), and increased HR mean both in baseline and during physical exercise (r(8)=0.526, p=.01 and r(8)=0.445, p=.05 respectively); (ii) resilience was associated with higher vagal indices (RMSSD r(18)=0.288, p=.04), and with a baseline sympathovagal balance shifted toward parasympathetic predominance (LF/HF ratio r(18)=-0.289, p=.04); (iii) the physical workload of firefighting led to a significantly increased mean HR (p=.002; +22 bpm, 95% CI [9.70, 35.82]) in comparison to the firefighters who did not exercise, which lasted in the recovery phase (p=.005 +24 bpm; 95% CI [8.62, 41.16]). Associations of risk-taking behavior and resilience with cardiac autonomic modulation could be demonstrated, showing that HRV may be a valuable monitoring tool in this specific population; however further studies are warranted for validation.

Non-invasive Assessments of Subjective and Objective Recovery Characteristics Following an Exhaustive Jump Protocol

Erich Hohenauer, Peter Clarys, Jean‐Pierre Baeyens +1 more · Journal of Visualized Experiments · 2017 · 4 citations

Fast recovery after strenuous exercise is important in sports and is often studied via cryotherapy applications. Cryotherapy has a significant vasoconstrictive effect, which seems to be the leading factor in its effectiveness. The resulting enhanced recovery can be measured by using both objective and subjective parameters. Two commonly measured subjective characteristics of recovery are delayed-onset muscle soreness (DOMS) and ratings of perceived exertion (RPE). Two important objective recovery characteristics are countermovement jump (CMJ) performance and peak power output (PPO). Here, we provide a detailed protocol to induce muscular exhaustion of the frontal thighs with a self-paced, 3 x 30 countermovement jump protocol (30-s rest between each set). This randomized controlled trial protocol explains how to perform local cryotherapy cuff application (+ 8 °C for 20 min) and thermoneutral cuff application (+ 32 °C for 20 min) on both thighs as two possible post-exercise recovery modalities. Finally, we provide a non-invasive protocol to measure the effects of these two recovery modalities on subjective (i.e., DOMS of both frontal thighs and RPE) and objective recovery (i.e., CMJ and PPO) characteristics 24, 48, and 72 h post-application. The advantage of this method is that it provides a tool for researchers or coaches to induce muscular exhaustion, without using any expensive devices; to implement local cooling strategies; and to measure both subjective and objective recovery, without using invasive methods. Limitations of this protocol are that the 30 s rest period between sets is very short, and the cardiovascular demand is very high. Future studies may find the assessment of maximum voluntary contractions to be a more sensitive assessment of muscular exhaustion compared to CMJs.

The Effect of Consuming Carbohydrate With and Without Protein on the Rate of Muscle Glycogen Re-synthesis During Short-Term Post-exercise Recovery: a Systematic Review and Meta-analysis.

Craven J, Desbrow B, Sabapathy S +3 more · Sports Med Open · 2021 · 21 citations

Eating carbohydrate after exercise speeds up muscle glycogen replenishment by about 23.5 mmol·kg dm⁻¹·h⁻¹ compared to eating nothing, but adding protein to carbohydrate does not further accelerate glycogen restoration — so if you have limited recovery time between workouts, prioritise carbohydrate intake and don't worry about adding protein for glycogen purposes.