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Muscle function after exercise-induced muscle damage and rapid adaptation
Abstract
This brief review focuses on the time course of changes in muscle function and other correlates of muscle damage following maximal effort eccentric actions of the forearm flexor muscles. Data on 109 subjects are presented to describe an accurate time course of these changes and attempt to establish relationships among the measures. Peak soreness is experienced 2-3 d postexercise while peak swelling occurs 5 d postexercise. Maximal strength and the ability to fully flex the arm show the greatest decrements immediately after exercise with a linear restoration of these functions over the next 10 d. Blood creatine kinase (CK) levels increase precipitously at 2 d after exercise which is also the time when spontaneous muscle shortening is most pronounced. Whether the similarity in the time courses of some of these responses implies that they are caused by similar factors remains to be determined. Performance of one bout of eccentric exercise produces an adaptation such that the muscle is more resistant to damage from a subsequent bout of exercise. The length of the adaptation differs among the measures such that when the exercise regimens are separated by 6 wk, all measures show a reduction in response on the second, compared with the first, bout. After 10 wk, only CK and muscle shortening show a reduction in response. After 6 months only the CK response is reduced. A combination of cellular factors and neurological factors may be involved in the adaptation process.
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“Recall that the greatest declines in muscle function occur immediately following eccentric contraction-induced injury, yet markers of muscle damage are not fully apparent until 1–2 days after injury (34, 47, 52).”
From Phytoecdysteroids Accelerate Recovery of Skeletal Muscle Function Following in vivo Eccentric Contraction-Induced Injury in Adult and Old Mice (2021) · cites this paper as [52]
In the citing paper
“However, there is a dissociation between muscle function and histological markers of muscle damage that disputes the latter causal relationship.”
From Phytoecdysteroids Accelerate Recovery of Skeletal Muscle Function Following in vivo Eccentric Contraction-Induced Injury in Adult and Old Mice (2021) · cites this paper as [52]
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“On the other hand, CK shows large individual variability, and some authors have classified individuals as high, median, or low responders according to their CK activity following eccentric exercise (Chen, 2006; Clarkson et al., 1992).”
BackgroundMuscle alterations induced by electrostimulation are lower at short quadriceps femoris length
Fouré, A., Ogier, A. C. C., Guye, M., Gondin, J., & Bendahan, D. (2019) · European Journal of Applied Physiology · doi:10.1007/s00421-019-04277-5 · Cited by 18
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BackgroundInfluentialMuscle Damage and Overreaching During Wildland Firefighter Critical Training
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Accelerated Muscle Recovery After In Vivo Curcumin Supplementation
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Eccentric contractions of gastrocnemius muscle‐induced nerve damage in rats
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“The associated symptoms are as follows: muscle stiffness, swelling, force production loss, reduced range of motion, and impaired proprioception [2].”
BackgroundPolyphenols and post-exercise muscle damage: a comprehensive review of literature
Zhang, X., Zhong, Y., & Rajabi, S. (2025) · European journal of medical research · doi:10.1186/s40001-025-02506-6 · Cited by 17
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BackgroundAlterations in sarcoplasmic reticulum function in female vastus lateralis with eccentric exercise
Enns, D. L., Green, H., Tupling, A. R., Burnett, M., Grant, S., & Ranney, D. (1999) · Molecular and Cellular Biochemistry · doi:10.1023/a:1007039302381 · Cited by 14
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Eccentric Strength Training Prescription for Older Adults
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“Previous studies have reported that muscle fatigue can be reduced after 2– 4 weeks of E- Stim therapy as a result of muscle adaptation to induced muscle damage (Clarkson et al., 1992; McHugh, 2003).”
BackgroundPressure Pain Mapping of the Wrist Extensors After Repeated Eccentric Exercise at High Intensity
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“The recovery of the muscle from EIMD usually takes a week or even longer (Clarkson et al., 1992; Clarkson and Tremblay, 1988) and can therefore explain the decreased force output and EMG activity for 132 h following the study.”
BackgroundThe Application of DOMS Mechanism and Prevention in Physical Education and Training
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RetractedChanges in torque complexity and maximal torque after a fatiguing exercise protocol
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“…muscle swelling, a rise in passive tension and an increase in the concentration of inflammatory biomarkers in the bloodstream (e.g., creatine kinase, c-reactive protein) (Clarkson & Hubal, 2002; Clarkson et al., 1992; Hedayatpour & Falla, 2015; Howatson & van Someren, 2008; Proske & Allen, 2005).”
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“Eccentric-induced muscle damage may cause muscle shortening without neural activation as a result of calcium leakage from the sarcoplasmic reticulum [1].”
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“The pain intensity was scored on a Likert scale defined as: [0] complete absence of muscle pain; [1] a light soreness in the muscle felt only when touched/a vague ache; [2] a moderate soreness felt only when touched/a slight persistent ache; [3] a light muscle soreness when walking up and down stairs; [4] a light musc…”
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Self-citationPhosphate metabolism of prior eccentrically loaded vastus medialis muscle during exercise in humans
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BackgroundInfluentialElectromyographic activity of the biceps brachii after exercise-induced muscle damage.
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Preventative Strategies for Exercise-Induced Muscle Damage
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Disturbed motor control of rhythmic movement at 2 h and delayed after maximal eccentric actions
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“The 24 and 48 h time points were chosen because the literature indicates that these time points coincide with the biggest change in the ultra structure of the muscle Wbre and pronounced feelings of muscle soreness (Clarkson et al. 1992).”
MethodEffects of the homeopathic remedy arnica on attenuating symptoms of exercise-induced muscle soreness
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“After eccentric exercise, changes in MVC torques, DOMS, muscle swelling, muscle shortening ability and spontaneous muscle shortening followed the expected time course.(9,10) Elevations in the levels of CK, LDH, ASAT, and ALAT activities on the days Figure 4.”
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Evaluation of Human β-Enolase as a Serum Marker for Exercise-induced Muscle Damage
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“The loss of maximal isometric force, perceived muscle soreness, decrease in relaxed knee angle, and increase in thigh circumference is consistent with DOMS as seen in other studies (7, 8, 18, 34).”
ResultCellular, Molecular, and Metabolic Basis of Muscle Fatigue
Fitts, R. H. (1996) · Comprehensive physiology · doi:10.1002/cphy.cp120126 · Cited by 13
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“Recall that the greatest declines in muscle function occur immediately following eccentric contraction-induced injury, yet markers of muscle damage are not fully apparent until 1–2 days after injury (34, 47, 52).”
BackgroundEFFECT OF FLEXIBILITY TRAINING ON SYMPTOMS OF EXERCISE-INDUCED MUSCLE DAMAGE: A PRELIMINARY STUDY
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Membrane Proteins Increase with the Repeated Bout Effect
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“Exhaustive exercise can induce muscle damage [1,2], which, consequently, causes the development of inflammatory responses and the production of reactive oxygen species (ROS) and free radicals inducing oxidative stress in the muscle tissue [2].”
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“The possible positive effects of AR are associated with reduced muscle edema, enhanced muscle fiber regeneration, and decrease in the inflammatory response resulting from high-demanding exercise sessions (9,10,28).”
BackgroundMuanjai, P., Mickevičius, M., Sniečkus, A., Satkunskienė, D., Kamandulis, S., & Jones, D. A. (2019) · PubMed Central · Cited by 11
Marras, W. S., & Radwin, R. G. (2005) · Reviews of Human Factors and Ergonomics · doi:10.1518/155723405783703046 · Cited by 11
Changes in Running Economy following the Repeated Bout of Downhill Running
Chen, T. C., Tu, J.-H., & Clarkson, P. M. (2006) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-200605001-02513 · Cited by 11
Self-citationContraction Induced Muscle Injury: Towards Personalized Training and Recovery Programs
Givli, S. (2014) · Annals of Biomedical Engineering · doi:10.1007/s10439-014-1173-7 · Cited by 11
Mood Profile of an America's Cup Team
Hadała, M., Cebolla, A., Baños, R., et al. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181cd5cb9 · Cited by 11
Vanderthommen, M., Chamayou, R., Demoulin, C., et al. (2014) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12160 · Cited by 11
“Although several studies showed a reduction in the symptoms resulting from the second of two successive maximal eccentric bouts (Clarkson et al., 1992; McHugh, 2003), few authors demonstrated that preconditioning with submaximal and progressive eccentric exercises also constitutes an efficient…”
BackgroundExercise-Induced Muscle Damage and Protein Intake: A Bibliometric and Visual Analysis
Xu, F., Zeng, J., Liu, X., Lai, J., & Xu, J. (2022) · Nutrients · doi:10.3390/nu14204288 · Cited by 11
“The damage process is normally accompanied by a temporary decrease in muscle function (both muscle force and range of motion) [2,3], increased swelling of the involved muscle group [2], increased circulation of muscle-specific proteins [4], and delayed-onset muscle soreness (DOMS) [5].”
BackgroundLangmár, G., Sümegi, T., Fülöp, B., Pozsgai, L., Mocsai, T., Tóth, M., Rácz, L., Kopper, B., Dér, A., Búzás, A., et al. (2025) · Sports · doi:10.3390/sports13080262 · Cited by 10
“The following symptoms are known to be the consequence of DOMS: muscle stiffness, swelling, loss of force-generating capacity, reduced joint range of motion, and, even more importantly, delayed onset of pain sensation and impaired proprioception [3].”
InfluentialShoji, M., Ema, R., Nosaka, K., et al. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2021.775157 · Cited by 10
Self-citationNakamura, M., Sato, S., Kiyono, R., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095723 · Cited by 10
Tsuchiya, Y., Ueda, H., Sugita, N., & Ochi, E. (2020) · Journal of the American College of Nutrition · doi:10.1080/07315724.2020.1752330 · Cited by 10
“Muscle soreness is typically associated with muscle and/or connective tissue damage and/or subsequent inflammatory responses induced by ECCs (2,30,33).”
BackgroundAshida, Y., Himori, K., Tamai, K., Kimura, I., & Yamada, T. (2021) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00463.2021 · Cited by 10
Unilateral eccentric exercise of the knee flexors affects muscle activation during gait
Dover, G. C., Legge, L., & St-Onge, N. (2012) · Gait & Posture · doi:10.1016/j.gaitpost.2012.01.009 · Cited by 10
Vuorimaa, T., Vasankari, T. J., Mattila, K. J., et al. (1999) · European Journal of Applied Physiology and Occupational Physiology · doi:10.1007/s004210050636 · Cited by 10
“Fast and strenuous running exercises induce acute hormone responses (e.g. Kuoppasalmi et al. 1980) and local damage in skeletal muscles, the latter especially if a runner is unaccustomed to fast running (Clarkson et al. 1992; Kuipers 1994).”
BackgroundIngham, S. A., van Someren, K. A., & Howatson, G. (2010) · Journal of Sports Sciences · doi:10.1080/02640414.2010.513398 · Cited by 10
“Thus, overlapping actin and myosin filaments and concomitant cross-bridge cycling can be reduced from such mechanically disruptive stress (Clarkson, Nosaka, & Braun, 1992 ).”
BackgroundPhilippou, Α., Koutsilieris, M., & Maridaki, M. D. (2012) · Journal of Muscle Research and Cell Motility · doi:10.1007/s10974-012-9314-9 · Cited by 10
“subject kept his arm relaxed on the side (Clarkson et al. 1992; Nosaka et al. 2005).”
BackgroundMachado, M., Brown, L. E., Augusto-Silva, P., et al. (2013) · PubMed · Cited by 10
Metadata
- Authors
- CLARKSON, P. M., NOSAKA, K., & BRAUN, B.
- Affiliations
- University of Massachusetts Amherst (US)
- Venue
- Medicine & Science in Sports & Exercise
- Published
- 1992-05
- Volume
- 24
- Issue
- 5
- Pages
- 512???520
- ISSN
- 0195-9131 (ISSN-L)
- OpenAlex
- W2093625864
- Cited by
- 970
- References
- 0
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 25 · 2023: 18 · 2022: 34 · 2021: 35 · 2020: 28 · 2019: 38 · 2018: 32 · 2017: 43 · 2016: 33 · 2015: 41 · 2014: 38 · 2013: 49 · 2012: 45
- FWCI
- 13.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medicine & Science in Sports & Exercise (publishedVersion)
- PubMed (publishedVersion)
- ScholarWorks@UMassAmherst (University of Massachusetts Amherst) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Keywords
- exercise-induced muscle damage, eccentric exercise, forearm flexor muscles, muscle soreness, muscle swelling, maximal strength, creatine kinase, muscle shortening, recovery time course, neuromuscular factors
- MeSH terms
- Adaptation, Physiological, Creatine Kinase, Humans, Movement, Muscle Contraction, Muscles, Tensile Strength, Time Factors, Exercise
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