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Exercise-Induced Muscle Damage and Potential Mechanisms for the Repeated Bout Effect

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Abstract

Unfamiliar, predominantly eccentric exercise, frequently results in muscle damage. A repeated bout of similar eccentric exercise results in less damage and is referred to as the ‘repeated bout effect’. Despite numerous studies that have clearly demonstrated the repeated bout effect, there is little consensus as to the actual mechanism. In general, the adaptation has been attributed to neural, connective tissue or cellular adaptations. Other possible mechanisms include, adaptation in excitation-contraction coupling or adaptation in the inflammatory response.

The ‘neural theory’ predicts that the initial damage is a result of high stress on a relatively small number of active fast-twitch fibres. For the repeated bout, an increase in motor unit activation and/or a shift to slow-twitch fibre activation distributes the contractile stress over a larger number of active fibres. Although eccentric training results in marked increases in motor unit activation, specific adaptations to a single bout of eccentric exercise have not been examined.

The ‘connective tissue theory’ predicts that muscle damage occurs when the noncontractile connective tissue elements are disrupted and myofibrillar integrity is lost. Indirect evidence suggests that remodelling of the intermediate filaments and/or increased intramuscular connective tissue are responsible for the repeated bout effect.

The ‘cellular theory’ predicts that muscle damage is the result of irreversible sarcomere strain during eccentric contractions. Sarcomere lengths are thought to be highly non-uniform during eccentric contractions, with some sarcomeres stretched beyond myofilament overlap. Loss of contractile integrity results in sarcomere strain and is seen as the initial stage of damage. Some data suggest that an increase in the number of sarcomeres connected in series, following an initial bout, reduces sarcomere strain during a repeated bout and limits the subsequent damage.

It is unlikely that one theory can explain all of the various observations of the repeated bout effect found in the literature. That the phenomenon occurs in electrically stimulated contractions in an animal model precludes an exclusive neural adaptation. Connective tissue and cellular adaptations are unlikely explanations when the repeated bout effect is demonstrated prior to full recovery, and when the fact that the initial bout does not have to cause appreciable damage in order to provide a protective effect is considered. It is possible that the repeated bout effect occurs through the interaction of various neural, connective tissue and cellular factors that are dependent on the particulars of the eccentric exercise bout and the specific muscle groups involved.

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References

  1. Nosaka K, Clarkson PM. Muscle damage following repeated bouts of high force eccentric exercise. Med Sci Sports Exerc 1995; 27 (9): 1263–9

    PubMed  CAS  Google Scholar 

  2. Highman B, Altland PD. Effects of exercise and training on serum enzyme and tissue changes in rats. Am J Physiol 1963; 205: 162–6

    PubMed  CAS  Google Scholar 

  3. Schwane JA, Armstrong RB. Effects of training on skeletal muscle injury from downhill running in rats. J Appl Physiol 1983; 55 (3): 969–75

    PubMed  CAS  Google Scholar 

  4. Balnave CD, Thompson MW. Effect of training on eccentricinduced muscle damage. J Appl Physiol 1993; 75 (4): 1545–51

    PubMed  CAS  Google Scholar 

  5. Brown SJ, Child RB, Day SH, et al. Exercise-induced skeletal muscle damage and adaptation following repeated bouts of eccentric muscle contractions. J Sports Sci 1997; 15: 215–22

    Article  PubMed  CAS  Google Scholar 

  6. Byrnes WC, Clarkson PM, White JS, et al. Delayed onset muscle soreness following repeated bouts of downhill running. J Appl Physiol 1985; 59 (3): 710–5

    PubMed  CAS  Google Scholar 

  7. Clarkson PM, Tremblay I. Exercise-induced muscle damage, repair, and adaptation in humans. J Appl Physiol 1988; 65 (1): 1–6

    PubMed  CAS  Google Scholar 

  8. Ebbeling CB, Clarkson PM. Muscle adaptation prior to recovery following eccentric exercise. Eur J Appl Physiol 1990; 60: 26–31

    Article  CAS  Google Scholar 

  9. Eston RG, Finney S, Baker S, et al. Muscle soreness and strength loss changes after downhill running following a prior bout of isokinetic eccentric exercise. J Sports Sci 1996; 14: 291–9

    Article  PubMed  CAS  Google Scholar 

  10. Fridén J, Seger J, Sjöström M, et al. Adaptive response in human skeletal muscle subjected to prolonged eccentric training. Int J Sports Med 1983; 4 (3): 177–83

    Article  PubMed  Google Scholar 

  11. Fridén J. Changes in human skeletal muscle induced by longterm eccentric exercise. Cell Tissue Res 1984; 236: 365–72

    Article  PubMed  Google Scholar 

  12. Golden CL, Dudley GA. Strength after bout of eccentric or concentric actions. Med Sci Sports Exerc 1992; 24 (8): 926–33

    PubMed  CAS  Google Scholar 

  13. Lynn R, Morgan DL. Decline running produces more sarcomeres in rat vastus intermedius muscle fibers than does incline running. J Appl Physiol 1994; 77 (3): 1439–44

    PubMed  CAS  Google Scholar 

  14. Mair J, Mayr M, Müller E, et al. Rapid adaptation to eccentric exercise-induced muscle damage. Int J Sports Med 1994; 16 (6): 352–6

    Article  Google Scholar 

  15. Newham DJ, Jones DA, Clarkson PM. Repeated high-force eccentric exercise: effects on muscle pain and damage. J Appl Physiol 1987; 63 (4): 1381–6

    PubMed  CAS  Google Scholar 

  16. Pizza FX, Davis BH, Hendrickson SD, et al. Adaptation to eccentric exercise: effect on CD64 and CD11b/CD18 expression. J Appl Physiol 1996; 80 (1): 47–55

    PubMed  CAS  Google Scholar 

  17. Pierrynowski MR, Tüdus PM, Plyley MJ. Effects of downhill or uphill training prior to a downhill run. Eur J Appl Physiol 1987; 56: 668–72

    Article  CAS  Google Scholar 

  18. Sacco P, Jones DA. The protective effect of damaging eccentric exercise against repeated bouts of exercise in the mouse tibialis anterior. Exp Physiol 1992; 77: 757–60

    PubMed  CAS  Google Scholar 

  19. Westerlind KC, Byrnes WC, Harris C, et al. Alterations in oxygen consumption during and between bouts of level and downhill running. Med Sci Sports Exerc 1994; 26 (9): 1144–52

    PubMed  CAS  Google Scholar 

  20. Westerlind KC, Byrnes WC, Mazzeo RS. A comparison of oxygen drift in downhill vs. level running. J Appl Physiol 1992; 72 (2): 796–800

    PubMed  CAS  Google Scholar 

  21. Balnave CD, Allen DG. Intracellular calcium and force in single muscle fibers following repeated contractions with stretch. J Physiol (Lond) 1995; 488 (1): 25–36

    CAS  Google Scholar 

  22. Warren GL, Lowe DA, Hayes DA, et al. Excitation failure in eccentric contraction-induced injury of mouse soleus muscle. J Physiol (Lond) 1993; 468: 487–99

    CAS  Google Scholar 

  23. Raven PB. ýContraction,ý a definition of muscle action [editorial]. Med Sci Sports Exerc 1991 Jul: 23: 777–8

    PubMed  CAS  Google Scholar 

  24. Armstrong RB, Warren GL, Warren JA. Mechanisms of exerciseinduced muscle fiber injury. Sports Med 1991; 12 (3): 184–207

    Article  PubMed  CAS  Google Scholar 

  25. Cleak MJ, Eston RG. Delayed onset muscle soreness: mechanisms and management. J Sports Sci 1992; 10: 325–41

    Article  PubMed  CAS  Google Scholar 

  26. Faulkner JA, Brooks SV, Opiteck JA. Injury to skeletal muscle fibers during contractions: conditions of occurrence and prevention. Phys Ther 1993; 73: 911–21

    PubMed  CAS  Google Scholar 

  27. Moritani T, Muramatsu S, Muro M. Activity of motor units during concentric and eccentric contractions. Am J Phys Med 1988; 66 (6): 338–50

    Article  Google Scholar 

  28. Adams GR, Duvoisin MR, Dudley GA. Magnetic resonance imaging and electromyography as indexes of muscle function. J Appl Physiol 1992; 73 (4): 1578–83

    PubMed  CAS  Google Scholar 

  29. Bigland B, Lippold OCJ. The relation between force velocity and integrated electrical activity in human muscles. J Physiol 1954; 123: 214–24

    PubMed  CAS  Google Scholar 

  30. Komi PV, Kaneko M, Aura O. EMG activity of the leg extensors muscles with special reference to mechanical efficiency in concentric and eccentric exercise. Int J Sports Med 1987; 8: 22–9

    Article  PubMed  Google Scholar 

  31. Potvin JR. Effects of muscle kinematics on surface EMG amplitude and frequency during fatiguing dynamic contractions. J Appl Physiol 1997; 82 (1): 144–51

    PubMed  CAS  Google Scholar 

  32. Enoka RM. Eccentric contractions require unique activation strategies by the nervous system. J Appl Physiol 1996; 81 (6): 2339–46

    PubMed  CAS  Google Scholar 

  33. Nardone A, Romano C, Schieppati M. Selective recruitment of high-threshold human motor units during voluntary isotonic lengthening of active muscles. J Physiol 1989; 409: 451–71

    PubMed  CAS  Google Scholar 

  34. Nardone A, Schieppati M. Shift of activity from slow to fast muscle during voluntary lengthening contractions of the triceps surae muscles in humans. J Physiol 1988; 395: 363–81

    PubMed  CAS  Google Scholar 

  35. Tesch PA, Dudley DA, Duvoisin MR, et al. Force and EMG signal patterns during repeated bouts of eccentric muscle actions. Acta Physiol Scand 1990; 138: 263–71

    Article  PubMed  CAS  Google Scholar 

  36. Nakazawa K, Kawakami Y, Fukunaga T, et al. Differences in activation patterns in elbow flexor muscles during isometric, concentric and eccentric contractions. Eur J Appl Physiol 1993; 66: 214–20

    Article  CAS  Google Scholar 

  37. Hortobágyi T, Tracy J, Hamilton G, et al. Fatigue effects on muscle excitability. Int J Sports Med 1996; 17 (6): 409–14

    Article  PubMed  Google Scholar 

  38. Fridén J, Sjöström M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. Int J Sports Med 1983; 4 (3): 170–6

    Article  PubMed  Google Scholar 

  39. Lieber RL, Fridén J. Muscle damage induced by eccentric contractions of 25% strain. J Appl Physiol 1991; 70 (6): 2498–507

    PubMed  CAS  Google Scholar 

  40. MacPherson CD, Schork AM, Faulkner JA. Contraction-induced injury to single permeabilized muscle fibers from fast and slow muscles of the rat following single stretches. Am J Physiol 1996; 271: C1438–46

    Google Scholar 

  41. Hortobágyi T, Barrier J, Beard D, et al. Greater initial adaptations to submaximal muscle lengthening than maximal shortening. J Appl Physiol 1996; 81 (4): 1677–82

    PubMed  Google Scholar 

  42. Hortobágyi T, Hill JP, Houmard JA, et al. Adaptive responses to muscle lengthening and shortening in man. J Appl Physiol 1996; 80 (3): 765–72

    PubMed  Google Scholar 

  43. Komi PV, Buskirk ER. Effect of eccentric and concentric muscle conditioning on tension and electrical activity of human muscle. Ergonomics 1972; 15 (4): 417–34

    Article  PubMed  CAS  Google Scholar 

  44. Hortobágyi T, Hill JP, Lambert NJ. Greater cross education following training with muscle lengthening than shortening. Med Sci Sports Exerc 1997; 29 (1): 107–12

    Article  PubMed  Google Scholar 

  45. Weir JP, Housh DJ, Housh TJ, et al. The effect of unilateral eccentric weight training and detraining on joint angle specificity, cross-training, and the bilateral deficit. J Orthop Sport Phys Ther 1995; 22: 207–15

    CAS  Google Scholar 

  46. Warren GL, Hayes DA, Lowe DA, et al. Materials fatigue initiates eccentric contraction-induced injury in rat soleus muscle. J Physiol 1993; 464: 477–89

    PubMed  CAS  Google Scholar 

  47. Brooks SV, Zerba E, Faulkner JA. Injury to muscle fibers after single stretches of passive and maximally stimulated muscles in mice. J Physiol 1995; 488 (2): 459–69

    PubMed  CAS  Google Scholar 

  48. Hunter KD, Faulkner JA. Pliometric contraction-induced injury of mouse skeletal muscle: effect of initial length. J Appl Physiol 1997; 82 (1): 278–83

    PubMed  CAS  Google Scholar 

  49. Lieber RL, Fridén J. Muscle damage is not a function of muscle force but active strain. J Appl Physiol 1993; 74 (2): 520–6

    PubMed  CAS  Google Scholar 

  50. Newham DJ, Jones DA, Ghosh G, et al. Muscle fatigue and pain after eccentric contractions at long and short length. Clin Sci 1988; 74: 553–7

    PubMed  CAS  Google Scholar 

  51. Gordon AM, Huxley AF, Julian FJ. The variation in isometric tension with sarcomere length in vertebrate muscle fibres. J Physiol 1966; 184: 170–92

    PubMed  CAS  Google Scholar 

  52. Huxley AF. The origin of force in skeletal muscle. Ciba Found Symp 1975; 31: 271–90

    PubMed  CAS  Google Scholar 

  53. Flitney FW, Hirst DG. Cross-bridge detachment and sarcomere ýgiveý during stretch of active frogýs muscle. J Physiol 1978; 276: 449–65

    PubMed  CAS  Google Scholar 

  54. Huxley AF, Peachey LD. The maximum length for contraction in vertebrate striated muscle. J Physiol 1961; 156: 150–65

    PubMed  CAS  Google Scholar 

  55. Morgan DL. New insights into the behavior of muscle during active lengthening. Biophys J 1990; 57: 209–21

    Article  PubMed  CAS  Google Scholar 

  56. Fridén J, Lieber RL. Structural and mechanical basis of exerciseinduced injury. Med Sci Sports Exerc 1992; 24 (5): 521–30

    PubMed  Google Scholar 

  57. Waterman-Storer CM. The cytoskeleton of skeletal muscle: is it affected by exercise? A brief review. Med Sci Sports Exerc 1991; 23 (11): 1240–9

    PubMed  CAS  Google Scholar 

  58. Patel TJ, Lieber RL. Force transmission in skeletal muscle: from actomyosin to external tendons. Exerc Sports Sci Rev 1997; 25: 321–63

    Article  CAS  Google Scholar 

  59. Street SF. Lateral transmission of tension in frog myofibers: a myofibrillar network and transverse cytoskeletal connections are possible transmitters. J Cell Physiol 1983; 114: 346–64

    Article  PubMed  CAS  Google Scholar 

  60. Lapier TK, Burton HW, Almon R, et al. Alterations in intramuscular connective tissue after limb casting affect contractioninduced muscle injury. J Appl Physiol 1995; 78 (3): 1065–9

    PubMed  CAS  Google Scholar 

  61. Kovanen V, Suominen H, Heikkinen E. Mechanical properties of fast and slow skeletal muscle with special reference to collagen and training. J Biomech 1984; 17 (10): 725–35

    Article  PubMed  CAS  Google Scholar 

  62. Klinge K, Magnusson SP, Simonsen EB, et al. The effect of strength and flexibility training on skeletal muscle electromyographic activity, stiffness, and viscoelastic stress relaxation response. Am J Sports Med 1997; 25 (5): 710–6

    Article  PubMed  CAS  Google Scholar 

  63. Chelboun GS, Howell JN, Baker HL, et al. Intermittent pneumatic compression effect on eccentric exercise-induced swelling, stiffness and strength loss. Arch Phys Med Rehabil 1995; 76: 744–9

    Article  Google Scholar 

  64. Howell JN, Chelboun G, Conaster R. Muscle stiffness, strength loss, swelling and soreness following exercise-induced injury in humans. J Physiol 1993; 464: 183–96

    PubMed  CAS  Google Scholar 

  65. Howell JN, Chila AG, Ford G, et al. An electromyographic study of elbow motion during postexercise muscle soreness. J Appl Physiol 1985; 58 (5): 1713–8

    PubMed  CAS  Google Scholar 

  66. Nosaka K, Clarkson PM. Influence of previous concentric exercise on eccentric exercise-induced muscle damage. J Sport Sci 1997 15: 477–83

    Article  CAS  Google Scholar 

  67. Magnusson SP, Simonsen EB, Aagaard P, et al. Contraction specific changes in passive torque in human skeletal muscle. Acta Physiol Scand 1995 155: 377–86

    Article  PubMed  CAS  Google Scholar 

  68. Wood SA, Morgan DL, Proske U. Effects of repeated eccentric contractions on structure and mechanical properties of toad sartorius muscle. Am J Physiol 1993 265: C792–800

    Google Scholar 

  69. Saxton JM, Donnelly AE. Length-specific impairment of skeletal muscle contractile function after eccentric muscle actions in man. Clin Sci 1996; 90: 119–25

    PubMed  CAS  Google Scholar 

  70. Armstrong RB, Ogilvie RW, Schwane JA. Eccentric exerciseinduced injury to rat skeletal muscle. J Appl Physiol 1983; 54 (1): 80–93

    PubMed  CAS  Google Scholar 

  71. Jones C, Allen T, Talbot J, et al. Changes in the mechanical properties of human and amphibian muscle after eccentric exercise. Eur J Appl Physiol 1997 76: 21–31

    Article  CAS  Google Scholar 

  72. Enoka RM, Stuart DG. Neurobiology of muscle fatigue. J Appl Physiol 1992; 72 (5): 1631–48

    PubMed  CAS  Google Scholar 

  73. Ford LE, Huxley AF, Simmons RM. The relation between stiffness and filament overlap in stimulated frog muscle fibres. J Physiol 1981; 311: 219–49

    PubMed  CAS  Google Scholar 

  74. Hill AV. The series elastic component of muscle. Proc R Soc B 1950; 136: 273–80

    Article  Google Scholar 

  75. Morgan DL. Separation of active and passive components of short-range stiffness of muscle. Am J Physiol 1977; 232 (1): C45–9

    Google Scholar 

  76. Poussen M, Van Hoecke J, Goubel F. Changes in elastic characteristics of human muscle induced by eccentric exercise. J Biomech 1990 23 (4): 343–8

    Article  Google Scholar 

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Authors and Affiliations

  1. School of Sport, Health and Physical Education Sciences, University of Wales, Bangor, Gwynedd Wales, UK

    Malachy P. McHugh & Roger G. Eston

  2. Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, New York, USA

    Malachy P. McHugh & Gilbert W. Gleim

  3. Department of Physical Education, University of Vermont, Burlington, Vermont, USA

    Declan A. J. Connolly

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  1. Malachy P. McHugh
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  2. Declan A. J. Connolly
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McHugh, M.P., Connolly, D.A.J., Eston, R.G. et al. Exercise-Induced Muscle Damage and Potential Mechanisms for the Repeated Bout Effect. Sports Med 27, 157–170 (1999). https://doi.org/10.2165/00007256-199927030-00002

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