A Change-Point Method to Detect Meaningful Change in Return-to-Sport Progression in Athletes.

PURPOSE: To explore how the change-point method can be used to analyze complex longitudinal data and detect when meaningful changes (change points) have occurred during rehabilitation. METHOD: This design is a prospective single-case observational study of a football player in a professional club who sustained an acute lower-limb muscle injury during high-speed running in training. The rehabilitation program was entirely completed in the football club under the supervision of the club's medical team. Four wellness metrics and 5 running-performance metrics were collected before the injury and until the player returned to play. RESULTS: Data were collected over 130 days. In the univariate analysis, the change points for stress, sleep, mood, and soreness were located on days 30, 47, 50, and 50, respectively. The change points for total distance, acceleration, maximum speed, deceleration, and high-speed running were located on days 32, 34, 37, 41, and 41, respectively. The multivariate analysis resulted in a single change point for the wellness metrics and running-performance metrics, on days 50 and 67, respectively. CONCLUSIONS: The univariate approach provided information regarding the sequence and time point of the change points. The multivariate approach provided a common change point for multiple metrics, information that would benefit clinicians to have a broad overview of the changes in the rehabilitation process. Clinicians may consider the change-point method to integrate and visualize data from multiple sources to evaluate athletes' progression along the return-to-sport continuum.

Analysis of the Effect of Acupuncture and Pressing of Traditional Chinese Medicine on Recovery of Delayed Muscle Soreness in Athletes.

In this study, we have analyzed numerous effects of the acupuncture and pressing of traditional Chinese medicine on recovery of delayed muscle soreness in athletes. To implement this idea, a total of 84 athletes with delayed muscle soreness treated in our hospital from January 2018 to June 2020 were included. According to the random number table method, they were divided into the experimental group and the control group: among them, 42 cases were in the experimental group and were treated by TCM acupuncture. In the control group, 42 athletes used rehabilitation training. Compared with serum CK levels in the control group, serum CK levels in the experimental group decreased after training, and there was a significant difference (P < 0.05). After intensive training in the control group (P < 0.05), it indicated that acupuncture and pressing of traditional Chinese medicine was effective in the recovery of fatigue after exercise, which was significantly better than that in the control group. The serum testosterone value of the experimental group before intensive training had no significant difference, but the serum testosterone value of the moxibustion group of male athletes after intensive training was significantly higher than that of the control group (P < 0.05). Female athletes have a low blood testosterone base and are less affected by the gonad axis. There was no statistically significant difference in RPE scores before treatment. After treatment, the RPE score of the experimental group decreased rapidly (P < 0.05), which was statistically significant compared with the control group (P < 0.05). There was no significant difference in VAS scores before treatment. After treatment, the VAS score in the experimental group decreased rapidly (P < 0.05) compared with the control group (P < 0.05). After treatment, compared with the control group, the experimental group had a decrease in calf circumference, an increase in muscle strength, and an increase in the range of motion (P < 0.05). Acupuncture and pressing of traditional Chinese medicine have obvious clinical application value in the treatment of delayed muscle soreness in athletes, and they have great clinical application value. Muscle injury is a common disease of athletes.

Exploring the Underlying Mechanisms of Action of Dry Needling: What Is the Immediate Effect on Muscle Electrophysiology? An Experimental Randomized Controlled Trial.

OBJECTIVE: Dry needling is a commonly used treatment technique for myofascial pain syndromes, such as trapezius myalgia. Despite the shown positive clinical effects on pain, the underlying mechanisms of action, such as the effect on muscle electrophysiology, remain unclear. The aim of this study was to investigate the effect of dry needling, compared with sham needling, in the upper trapezius muscle on surface electromyography activity and the relation with pain in office workers with trapezius myalgia. DESIGN: For this experimental randomized controlled trial, 43 office workers with work-related trapezius myalgia were included. Surface electromyography activity was measured before and after a pain-provoking computer task and immediately after, 15, and 30 mins after treatment with dry or sham needling. Pain scores were evaluated at the same time points as well as 1, 2, and 7 days after treatment. RESULTS: No significant differences in surface electromyography activity between dry needling and sham needling were found. Significant positive low to moderate Spearman correlations were found between surface electromyography activity and pain levels after dry needling treatment. CONCLUSIONS: This study shows no immediate effects of dry needling on the electrophysiology of the upper trapezius muscle, compared with sham needling.

Moderate intensity cycling is better than running on recovery of eccentric exercise-induced muscle damage.

OBJECTIVE: To compare the effects of moderate intensity running and cycling on markers of exercise-induced muscle damage in men. STUDY DESIGN: Randomized controlled trial. SETTING: Laboratory. PARTICIPANTS: Thirty volunteers were randomized in three groups [running (RG; n = 10), cycling (CG; n = 10) and control (CON; n = 10)] and were evaluated at baseline, post 24, 48 and 72 h of knee extensors' muscle damage protocol. CON performed passive recovery, while RG and CG performed active recovery immediately after the protocol, as well as 24 h and 48 h afterwards. MAIN OUTCOMES: (i) maximal voluntary isometric contraction (MVIC); (ii) delayed-onset muscle soreness (DOMS); (iii) plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels. RESULTS: No group-by-time interaction was found in any outcome evaluated (p > 0.05). All groups presented decreases in MVIC and increases in DOMS (p < 0.001), without differences in CK and LDH. Compared with CON, exercise groups presented likely beneficial effects for LDH, while only CG had a likely beneficial effect for DOMS. Lastly, CG presented likely/very likely beneficial effects for MVIC and DOMS compared to RG. CONCLUSION: Although the null hypothesis analysis did not find differences, the magnitude-based inference analysis suggested that moderate intensity cycling have likely beneficial effects on knee extensor muscle recovery after eccentric exercise protocol.

Effect of kinesio taping on calf pain after a half marathon: A pilot study / Efecto del vendaje neuromuscular sobre el dolor en las pantorrillas después de una media maratón: Un estudio piloto / Efeito da bandagem neuromuscular na dor na panturrilha após meia maratona: um estudo piloto

OBJECTIVE: The purpose of the present study was to examine the effect of kinesio taping on calf pain in healthy runners immediately after a half marathon. METHOD: A sample of 13 runner volunteers was recruited in a half marathon. Calf pain measurements were taken at baseline and 10-15 minutes after competition. Kinesio tape was applied to the calf of runners the evening before the competition, only on one leg, with the contralateral leg acting as a control. RESULTS: The results of the repeated measures ANOVA in the leg differences on pain values did not show statistically significant differences (p = 0.515). However, the effect size after the race could be an indication that kinesio tape might be useful (g = - 0.37) and that studies with the sample calculated would be necessary (n = 61). CONCLUSIONS: When kinesio tape was applied to healthy half marathon runners, the data did not disclose whether the tape could lead to control calf pain produced by the competition

OBJETIVO: El propósito del presente estudio fue examinar el efecto del vendaje neuromuscular sobre el dolor de la pantorrilla en corredores sanos inmediatamente después de una media maratón. MÉTODO: Una muestra de 13 corredores voluntarios fue reclutada en una media maratón. Las mediciones de dolor de las pantorrillas se tomaron al inicio y 10-15 minutos después de la competición. El vendaje neuromuscular se aplicó en la pantorrilla de los corredores la noche anterior a la competencia, sólo en una pierna, con la pierna contralateral actuando como control. RESULTADOS: Los resultados del ANOVA de medidas repetidas sobre las diferencias en los valores de dolor en las piernas no mostraron diferencias estadísticamente significativas (p = 0.515). Sin embargo, el tamaño del efecto después de la carrera podría ser un indicio de la utilidad del vendaje (g = - 0.37) y de que estudios con la muestra calculada son necesarios (n = 61). CONCLUSIONES: Cuando el vendaje neuromuscular se aplicó a los corredores de medio maratón sanos, los datos no revelaron si podría controlar el dolor de las pantorrillas producido por la competición

OBJETIVO: O objetivo do presente estudo foi examinar o efeito da bandagem neuromuscular na dor na panturrilha em corredores saudáveis ​​imediatamente após uma meia maratona. MÉTODO: Uma amostra de 13 corredores voluntários foi recrutada para uma meia maratona. As medições da dor na panturrilha foram feitas no início e 10-15 minutos após a competição. A bandagem neuromuscular foi aplicada na panturrilha dos corredores na noite anterior à competição, apenas em uma perna, com a perna contralateral atuando como controle. RESULTADOS: Os resultados da ANOVA de medidas repetidas sobre as diferenças nos valores de dor nas pernas não mostraram diferenças estatisticamente significativas (p = 0,515). Porém, o tamanho do efeito após a corrida pode ser um indicativo da utilidade da bandagem (g = - 0,37) e que estudos com a amostra calculada são necessários (n = 61). CONCLUSÕES: Quando a bandagem neuromuscular foi aplicada em corredores saudáveis ​​de meia maratona, os dados não revelaram se ela poderia controlar a dor na panturrilha produzida pela competição

Does the type of foam roller influence the recovery rate, thermal response and DOMS prevention?

PURPOSE: Supporting post-exercise recovery requires choosing not only the right treatment but also the equipment, in which the impact is not always clear. The study aimed to determine the effect of foam rolling on the rate of lactate removal and DOMS prevention and whether the type of foam roller is effective in the context of post-exercise recovery. METHODS: This randomized trial enrolled 33 active healthy males divided into three groups of eleven individuals: foam rolling with a smooth (STH) or grid roller (GRID) or passive recovery (PAS). All the participants performed full squat jumps for one minute. Examination took place at rest (thermal imaging of skin temperature-[Tsk] and blood lactate-[LA]), immediately following exercise (Tsk & LA), immediately after recovery treatment (Tsk) and after 30 minutes of rest (Tsk & LA). Their pain levels were assessed using the Visual Analog Scale (VAS) 24, 48, 72, and 96 hours after exercise. RESULTS: The magnitude of lactate decrease depended on the type of recovery used. In the PAS group, the decrease in lactate concentration by 2.65 mmol/L following a half-hour rest was significantly lower than that in the other groups (STH vs. PAS p = 0.042 / GRID vs. PAS p = 0.025). For thermal responses, significant differences between both experimental groups were noted only 30 minutes after exercise. A significant decrease in pain in the STH group occurred between 48 and 96 hours, while the GRID group showed a systematic significant decrease in VAS values in subsequent measurements. Changes in VAS values in subsequent measurements in the PAS group were not statistically significant (p>0.05). CONCLUSIONS: Foam rolling seems to be effective for enhancing lactate clearance and counteracting DOMS, but the type of foam roller does not seem to influence the recovery rate.

The Feasibility and Effects of Acupuncture on Muscle Soreness and Sense of Well-being in an Adolescent Football Population.

OBJECTIVE: The aims of the study were to assess the feasibility of performing acupuncture on multiple adolescent athletes in a warm weather, high-intensity training environment and to measure perceived effects of acupuncture on delayed-onset muscle soreness and sense of well-being. DESIGN: This is a prospective feasibility study (registered clinical trial NCT03478800). Forty-two healthy male participants, aged 13-18 yrs, were involved in at least 1 of 5 treatment days for a total of 147 individual treatment sessions. Fifteen-minute treatments of traditional needle acupuncture were administered at the football field. Time, cost, adverse effects, and participant/provider ratio were observed. Effect on delayed-onset muscle soreness and sense of well-being were measured via pretreatment and posttreatment visual analog scale (0-10) rating analyses. RESULTS: The results are as follows: time required by research staff on treatment days, 75 mins; total cost, US $700; temperature range, 21°C-28°C; and largest participant to acupuncturist ratio, 7-10:1. No major adverse effects occurred; 55% reported minimal adverse effects, such as mild focal numbness or tingling. Overall pretreatment to posttreatment effect on delayed-onset muscle soreness (average over 5 days) demonstrated significantly improved posttreatment scores (pre 4.6 ± 2.0; post 2.9 ± 2.2, P < 0.001). There was no significant effect on sense of well-being (P = 0.12). CONCLUSIONS: Effectively providing acupuncture to multiple adolescent football players in their training environment is feasible with appropriate staff and resources. Despite mild adverse effects, treatment was well tolerated. This study provides guidance on acupuncture delivery to other athletes in their training environments.

Influence of Foam Rolling on Recovery From Exercise-Induced Muscle Damage.

D'Amico, AP and Gillis, J. Influence of foam rolling on recovery from exercise-induced muscle damage. J Strength Cond Res 33(9): 2443-2452, 2019-The purpose of this study was to examine the impact of foam rolling (FR) on recovery from exercise-induced muscle damage (EIMD). Thirty-seven male individuals performed 40 × 15-m sprints, inducing muscle damage. Immediately after sprinting and in the 4 days following, perceived muscle soreness, hip abduction range of motion (ROM), hamstring muscle length, vertical jump (VJ), and agility measures were recorded. Eighteen subjects (mean ± SD; age 22.4 ± 2.0 years; BMI [body mass index] 26.9 ± 4.2 kg·m) foam rolled before testing each day, whereas 19 (mean ± SD; age 23.2 ± 3.2 years; BMI 26.3 ± 4.0 kg·m) served as a non-FR control (CON). Measurements recorded during the 5 days of recovery from the repeated sprint protocol were compared with week 1 baseline measurements. The area under the curve (AUC) was calculated by summing all 5 scores as they changed from baseline measurement, and these data were compared by condition using a 2-tailed Mann-Whitney U-test (alpha level = 0.05). Perceived soreness, hip abduction ROM, hamstring muscle length, and VJ were not significantly different between groups (p ≥ 0.25). Agility was less impaired in the FR condition (p = 0.0049) as AUC was higher in CON (2.88 ± 2.45 seconds) than in FR (0.33 ± 2.16 seconds). Based on these data, FR appears to expedite recovery of agility after EIMD instigated by a repeated sprint protocol. Foam rolling may be useful for athletes requiring adequate agility who need to recover quickly from demanding bouts of exercise.

Faster physical performance recovery with cold water immersion is not related to lower muscle damage level in professional soccer players.

The aim of the present study was to assess the effects of cold water immersion (CWI) after an intermittent test on the recovery kinetic of physical performance, muscle damage and perceived muscle soreness in professionals soccer players. In a randomized design, eight soccer players completed the Loughborough Intermittent Shuttle Test followed by 10 min of either CWI (10C°) or thermoneutral water immersion (TWI) (28C°). Physical performance (Squat jump: SJ, countermovement jump: CMJ, maximal voluntary contraction: MVC, and 20 m sprint: SP), muscle damage parameter (creatine kinase: CK) and perceived muscle soreness were assessed at baseline, 0 h, 24 h, 48 h and 72 h after the intermittent test. After the test, a decrease was observed in SJ and in CMJ at 0 h, 24 h, 48 h and 72 h with TWI (p < 0.05) and only at 0 h for SJ with CWI (p < 0.05). SP decreased at 24 h and 48 h after the test with TWI (p < 0.05) and only at 24 h with CWI (p < 0.05). MVC, CK activity and perceived muscle soreness increased in both condition after the test and returned to baseline levels 72 h after the test with TWI (p < 0.05) and at 48 h with CWI (p < 0.05). For the correlation between physical performance and muscle damage parameters in CWI session, the statistical analysis didn't reveal any significant link between CK and SJ, CMJ, MVC or SP values (p > 0.05). The results suggest that CWI immediately after an intermittent test reduces muscle damage and perceived muscle soreness, and accelerate recovery of physical performance in professional soccer players. However, the faster recovery of physical performance seems not be related to the lower level of muscle damage induced by CWI.

Preconditioning Contractions Suppress Muscle Pain Markers after Damaging Eccentric Contractions.

Inexperienced vigorous exercise, including eccentric contraction (ECC), causes muscle pain and damage. Similar prior light exercise suppresses the development of muscle pain (repeated-bout effect), but the molecular mechanisms behind this are not sufficiently understood. In this study, the influence of a nondamaging preconditioning ECC load (Precon) on muscle pain-related molecules and satellite cell-activating factors was investigated at the mRNA expression level. Nine-week-old male Wistar rats (n=36) were divided into 2 groups: a group receiving only a damaging ECC (100 contractions) load (non-Precon) and a group receiving a nondamaging ECC (10 contractions) load 2 days before receiving the damaging ECC load (Precon). ECC was loaded on the left leg, and the right leg was regarded as the intact control (CTL). The medial head of the gastrocnemius muscle from all rats was excised 2 or 4 days after the damaging ECC loading, and the relative mRNA expression levels of muscle pain- and satellite cell-related molecules were quantitated using real-time RT PCR. Precon suppressed increases in MHC-embryonic and MHC-neonatal mRNA expressions. Enhancement of HGF, Pax7, MyoD, and myogenin mRNA expression was also suppressed, suggesting that Precon decreased the degree of muscle damage and no muscle regeneration or satellite cell activation occurred. Similarly, increases in mRNA expression of muscle pain-related molecules (BKB2 receptor, COX-2, and mPGEC-1) were also suppressed. This study clearly demonstrated that at the mRNA level, prior light ECC suppressed muscle damage induced by later damaging ECC and promoted recovery from muscle pain.

Experimental muscle hyperalgesia modulates sensorimotor cortical excitability, which is partially altered by unaccustomed exercise.

Impaired corticomotor function is reported in patients with lateral epicondylalgia, but the causal link to pain or musculotendinous overloading is unclear. In this study, sensorimotor cortical changes were investigated using a model of persistent pain combined with an overloading condition. In 24 healthy subjects, the effect of nerve growth factor (NGF)-induced pain, combined with delayed-onset muscle soreness (DOMS), was examined on pain perception, pressure pain sensitivity, maximal force, and sensorimotor cortical excitability. Two groups (NGF alone and NGF + DOMS) received injections of NGF into the extensor carpi radialis brevis (ECRB) muscle at day 0, day 2, and day 4. At day 4, the NGF + DOMS group undertook wrist eccentric exercise to induce DOMS in the ECRB muscle. Muscle soreness scores, pressure pain thresholds over the ECRB muscle, maximal grip force, transcranial magnetic stimulation mapping of the cortical ECRB muscle representation, and somatosensory-evoked potentials from radial nerve stimulation were recorded at day 0, day 4, and day 6. Compared with day 0, day 4 showed in both groups: (1) increased muscle soreness (P < 0.01); (2) reduced pressure pain thresholds (P < 0.01); (3) increased motor map volume (P < 0.01); and (4) decreased frontal N30 somatosensory-evoked potential. At day 6, compared with day 4, only the DOMS + NGF group showed: (1) increased muscle soreness score (P < 0.01); (2) decreased grip force (P < 0.01); and (3) decreased motor map volume (P < 0.05). The NGF group did not show any difference on the remaining outcomes from day 4 to day 6. These data suggest that sustained muscle pain modulates sensorimotor cortical excitability and that exercise-induced DOMS alters pain-related corticomotor adaptation.

Recovery following a marathon: a comparison of cold water immersion, whole body cryotherapy and a placebo control.

PURPOSE: Cryotherapy is an increasingly popular recovery strategy used in an attempt to attenuate the negative impact of strenuous physical activity on subsequent exercise. Therefore, this study aimed to assess the effects of whole body cryotherapy (WBC) and cold water immersion (CWI) on markers of recovery following a marathon. METHODS: Thirty-one endurance trained males completed a marathon. Participants were randomly assigned to a CWI, WBC or placebo group. Perceptions of muscle soreness, training stress and markers of muscle function were recorded before the marathon and at 24 and 48 h post exercise. Blood samples were taken at baseline, post intervention and 24 and 48 h post intervention to assess inflammation and muscle damage. RESULTS: WBC had a harmful effect on muscle function compared to CWI post marathon. WBC positively influenced perceptions of training stress compared to CWI. With the exception of C-reactive protein (CRP) at 24 and 48 h, neither cryotherapy intervention positively influenced blood borne markers of inflammation or structural damage compared to placebo. CONCLUSION: The findings show WBC has a negative impact on muscle function, perceptions of soreness and a number of blood parameters compared to CWI, contradicting the suggestion that WBC may be a superior recovery strategy. Further, cryotherapy is no more effective than a placebo intervention at improving functional recovery or perceptions of training stress following a marathon. These findings lend further evidence to suggest that treatment belief and the placebo effect may be largely responsible for the beneficial effects of cryotherapy on recovery following a marathon.

Acute Radial Neuropathy at the Spiral Groove Following Massage: A Case Presentation.

Massage-related nerve injury is an uncommon, rarely reported complication. We report an unusual case of radial nerve neuropathy at the spiral groove in a 58-year-old woman that resulted from a single episode of deep tissue massage. Although the spiral groove is known as the most common site implicated in radial nerve neuropathy, to our knowledge, there have not previously been any reports of massage-related spiral groove radial nerve neuropathy. Electrodiagnostic and ultrasound examinations were used to localize the nerve lesion at the spiral groove and also to provide prognostic evaluation. Serial follow-ups demonstrated concomitant improvement in clinical symptoms and electrodiagnostic parameters. A near-total recovery was achieved after 6 months. This case presentation aims to increase awareness and early recognition of massage-related nerve injuries. LEVEL OF EVIDENCE: V.

Comparison of the recovery response from high-intensity and high-volume resistance exercise in trained men.

PURPOSE: The purpose of this study was to compare the physiological responses of a high-volume (HV; 8 sets of 10 repetitions) versus high-intensity (HI; 8 sets of 3 repetitions) exercise protocol in resistance-trained men. METHODS: Twelve men (24.5 ± 4.2 years; 82.3 ± 8.4 kg; 175.2 ± 5.5 cm) with 6.3 ± 3.4 years of resistance training experience performed each protocol in a counterbalanced, randomized order. Performance [counter movement jump peak power (CMJP), isokinetic (ISOK) and isometric leg extension (MVIC), isometric mid-thigh pull (IMTP), and isometric squat (ISQ)] and muscle morphological [cross-sectional area (CSA) of vastus lateralis] assessments were performed at baseline (BL), 30-min (P-30 min), 24-h (P-24 h), 48-h (P-48 h), and 72-h (P-72 h) post-exercise for each testing session. In addition, endocrine (testosterone and cortisol), inflammatory [interleukin-6 (IL-6) and C-reactive protein (CRP)], and markers of muscle damage [creatine kinase (CK), lactate dehydrogenase (LDH), and myoglobin (Mb)] were assessed at the same time points. RESULTS: Significantly greater reductions in CMJP (p < 0.001), and peak torque during both ISOK (p = 0.003) and MVIC (p = 0.008) at P-30 min were detected in HV compared to HI protocol. MVIC was still impaired at P-72 h following the HV protocol, while no differences were noted following HI. Markers of muscle damage (LDH, CK, and Mb) were significantly elevated following both HV and HI (p < 0.05), while cortisol and IL-6 concentrations were significantly elevated at P-30 min following HV only (p < 0.001 and p < 0.05, respectively). CONCLUSIONS: Results indicate that high-volume resistance exercise results in greater performance deficits, and a greater extent of muscle damage, than a bout of high-intensity resistance exercise.

The effect of intermittent lower limb occlusion on recovery following exercise-induced muscle damage: A randomized controlled trial.

OBJECTIVES: The purpose of this investigation was to examine the effectiveness of intermittent lower limb occlusion in augmenting recovery from exercise induced muscle damage (EIMD) in physically active males. DESIGN: Randomized controlled trial, double blind. METHODS: Sixteen healthy recreationally active male participants were randomly assigned to an intermittent occlusion (OCC; n=8) or control (SHAM; n=8) group. The EIMD protocol comprised of 100 drop-jumps, from a 0.6m box. Indices of muscle damage were creatine kinase (CK), thigh-circumference (TC), muscle soreness (DOMS), counter-movement jump (CMJ) and maximal isometric voluntary contraction (MIVC). Measurements were assessed pre, 24h, 48h and 72h following exercise. RESULTS: There was a significant time effect for all indices of muscle damage suggesting EIMD was present following the exercise protocol. The decrease in MIVC was significantly attenuated in the OCC group compared to the SHAM group at 24 (90.4±10.7 vs. 81.5±6.7%), 48 (96.2±6.1 vs. 84.5±7.1%) and 72h (101.1±4.2 vs. 89.7±7.5%). The CK response was reduced in the OCC group at 24 (335±87 vs. 636±300 IU) and 48h (244±70 vs. 393±248 IU), compared to the SHAM group. DOMS was significantly lower in the OCC compared to the SHAM group at 24, 48 and 72h post EIMD. There was no effect of OCC on CMJ or TC. CONCLUSIONS: This investigation shows that intermittent lower limb occlusion administered after a damaging bout of exercise reduces indices of muscle damage and accelerates the recovery in physically active males.

Cold-Water Immersion and Contrast Water Therapy: No Improvement of Short-Term Recovery After Resistance Training.

CONTEXT: An athlete's ability to recover quickly is important when there is limited time between training and competition. As such, recovery strategies are commonly used to expedite the recovery process. PURPOSE: To determine the effectiveness of both cold-water immersion (CWI) and contrast water therapy (CWT) compared with control on short-term recovery (<4 h) after a single full-body resistance-training session. METHODS: Thirteen men (age 26 ± 5 y, weight 79 ± 7 kg, height 177 ± 5 cm) were assessed for perceptual (fatigue and soreness) and performance measures (maximal voluntary isometric contraction [MVC] of the knee extensors, weighted and unweighted countermovement jumps) before and immediately after the training session. Subjects then completed 1 of three 14-min recovery strategies (CWI, CWT, or passive sitting [CON]), with the perceptual and performance measures reassessed immediately, 2 h, and 4 h postrecovery. RESULTS: Peak torque during MVC and jump performance were significantly decreased (P < .05) after the resistance-training session and remained depressed for at least 4 h postrecovery in all conditions. Neither CWI nor CWT had any effect on perceptual or performance measures over the 4-h recovery period. CONCLUSIONS: CWI and CWT did not improve short-term (<4-h) recovery after a conventional resistance-training session.

The Feasibility and Effects of Acupuncture in an Adolescent Nordic Ski Population.

BACKGROUND: Studies investigating the use and effectiveness of acupuncture in adults after exercise have been well documented. Fewer studies involving acupuncture have been completed in the adolescent athlete population. To our knowledge, there are no published studies that investigate the use of acupuncture in adolescent athletes within their field of play. OBJECTIVE: To primarily assess the feasibility of performing acupuncture in adolescent Nordic skiers within their athletic environment, and secondarily to measure the effect of acupuncture on muscle soreness and sense of well-being. DESIGN: Prospective feasibility study. SETTING: Local outdoor cross country ski trails and indoor lodge. PARTICIPANTS: Fifteen healthy participants (80% female, 20% male; age 14-17 years) were involved on at least 1 of 5 treatment days. INTERVENTION: Fifteen-minute treatments were administered using traditional needle acupuncture following the first 5 consecutive Nordic Ski Team practices of the season in an attempt to capture the effect of acupuncture on delayed-onset muscle soreness (DOMS). Acupuncture points specific to muscle groups in the lower limbs that are commonly reported as painful during Nordic skiing were chosen. Pre- and posttreatment surveys included visual analogue scales (VAS) to track participant responses. OUTCOME MEASURES: Time, cost, side effects, and participant to provider ratio was observed to determine feasibility. Effect on muscle soreness and sense of well-being was measured via pre- and posttreatment VAS (0-10) rating analyses. RESULTS: Total time required by research staff on treatment days was 90 minutes; total cost, $1500; temperature range, -13.9°C to -2.8°C, and largest participant to acupuncturist ratio, 7:1. No major side effects occurred. The majority (73%) of participants reported minimal side effects; most common was treatment site pain. The overall pre- to posttreatment effect on muscle soreness (average over 5 days) demonstrated significantly improved posttreatment scores (P = .04). The effect of the day (average over pre- and posttreatment values) demonstrated significantly higher muscle soreness scores on day 3 versus day 1 (P = .03). At study completion, all participants indicated that they would consider acupuncture in the future and would recommend treatments to friends or teammates. CONCLUSION: Providing acupuncture to adolescent Nordic ski athletes in the practice field under extreme temperatures is feasible with the appropriate resources. Despite mild side effects, acupuncture was well received by the athletes. Lessons learned from this trial can provide a framework for delivering acupuncture to other athletes in their training environment. LEVEL OF EVIDENCE: IV.

Effect of a Single Administration of Focused Extracorporeal Shock Wave in the Relief of Delayed-Onset Muscle Soreness: Results of a Partially Blinded Randomized Controlled Trial.

OBJECTIVE: To examine the effects of a single administration of focused extracorporeal shock wave therapy on eccentric exercise-induced delayed-onset muscle soreness (DOMS). DESIGN: Three-arm randomized controlled study. SETTING: University research center. PARTICIPANTS: Participants (N=46; 23 women) had a mean age of 29.0±3.0 years and a mean body mass index of 23.8±2.8kg/m2. INTERVENTIONS: Participants were randomly allocated to verum- (energy flux density, .06-.09mJ/mm2; pulse ratio per point, 200) or sham-focused extracorporeal shock wave therapy (no energy) at 7 equidistant points along the biceps muscle or no intervention. MAIN OUTCOME MEASURES: The primary outcome was the difference in pain intensity. Secondary outcomes included maximum isometric voluntary force (MIVF), pressure pain threshold (PPT), and impairment in daily life. RESULTS: Despite descriptive clinically meaningful differences, mixed-effects analysis (group × time) of changes to baseline did not reveal significant differences in the reduction of pain intensity between groups (F2,42=2.5, P=.094). MIVF was not significantly different between groups (F2,43=1.9, P=.159). PTT (F2,43=0.2, P=.854) and daily life impairment (F2,42=1.4, P=.248) were not significantly decreased over time, and there were no differences between groups in the post hoc analysis. CONCLUSIONS: DOMS is a common symptom in people participating in exercise, sports, or recreational physical activities. A single treatment with focused extracorporeal shock wave therapy causes clinically relevant effects in the relief of pain, increase in force, and improvement of pain-associated impairments of daily living. Still, results need to be cautiously interpreted because of the pilot character of this study. Focused extracorporeal shock wave therapy might present an option in the midterm recovery from DOMS (72h) and be an approach to enhance the return to play in athletes.

La vibración como terapia preventiva y tratamiento del dolor muscular tardío. Una revisión sistemática / The vibration as preventive therapy and treatment of delayed onset muscle soreness. A systematic review

En años recientes la terapia vibratoria ha recibido gran importancia en el tratamiento del dolor muscular tardío. Dolor que se presenta entre 12 y 24 horas después de haber realizado un ejercicio desacostumbrado. Por lo que el presente estudio tuvo como objetivo determinar el efecto preventivo y terapéutico de las vibraciones sobre el dolor muscular tardío. Se llevó a cabo una búsqueda en las bases de datos Pubmed, Web of Science, Scopus, SportDiscus, PEDro y Cochrane Library, para lo cual se usaron las palabras clave; delayed onset muscular soreness y vibration. De 403 artículos identificados en las diferentes bases de datos se seleccionaron 10 que cumplieron con los criterios establecidos para la revisión. Además de los anteriores, se incluyeron otros 6 artículos que se identificaron por medio del buscador Google Académico, en todos los casos se recuperó en artículo en texto completo. El 75 % de los artículos tiene menos de 5 años de haber sido publicados. El índice de Burton Kleber, medido con la mediana, fue de 2,5 años. El promedio de la frecuencia aplicada a los sujetos de los estudios fue de 37,4 ± 15 Hz, con un desplazamiento de la plataforma de 3,7 ± 2,3 mm y una duración de 9,4 ± 8,8 min. Mientras que el promedio de la calidad metodológica de los estudios fue de 4,9 ± 1,1 Después de analizar los estudios seleccionados se concluyó que el tema es actual y que las vibraciones son efectivas tanto en la prevención como en el tratamiento del dolor muscular tardío

In recent years the vibration therapy has received great importance in the treatment of delayed onset muscle soreness. Pain that occurs between 12 and 24 hours after an unaccustomed exercise. So the aim of the present study was to determine the preventive and therapeutic effect of vibrations on delayed onset muscle soreness. Conducted a searching in PubMed, Web of Science, Scopus, SportDiscus, PEDro and Cochrane Library databases, for which keywords were used; delayed onset muscle soreness and vibration. 403 articles were identified in the different databases, 10 were selected that met the criteria for review. Besides before, 6 other items that were identified by the search engine Google Scholar were included, in all cases retrieved in full text. 75% of the articles have less than 5 years of have being published. Kleber Burton index, measured by the median, was 2,5 years. The average frequency applied to the participants was 37,4 ± 15 Hz, with a displacement of the platform 3,7 ± 2,3 mm and a length of 9,4 ± 8,8 min. While the average methodological quality of the studies was 4,9 ± 1,1 After analyzing the selected studies it was concluded that the topic is present and that the vibrations are effective both in the prevention and treatment of delayed onset muscle soreness

Current concepts of inguinal-related and adductor-related groin pain.

Groin pain encompasses a number of conditions from the lower abdomen, inguinal region, proximal adductors, hip joint, upper anterior thigh and perineum. The complexity of the anatomy, the heterogeneous terminology and the overlapping symptoms of different conditions that may co-exist epitomise the challenges in diagnosis and treatment. Inguinal-related and adductor-related pain is the most common cause of groin pain and will be discussed in this article.