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7 Scientific basis for information on eliminating muscle pain

Thursday, June 10, 2021

Muscle pain

Scientific basis for information on eliminating muscle pain

Cryotherapy for Muscle Pain

Research details

Four laboratory-based randomized controlled trials were included.

They reported the physical activity results of 64 people, mostly young adults (mean age 23). All but four participants were male. Two trials were parallel-group trials (44 participants), and two were crossover trials (20 participants).

The trials were heterogeneous, including type of WBC, temperature, duration, frequency, and type of preceding exercise. All four trials had design features with a high risk of bias, potentially limiting the reliability of the results.

All results evidence was classified as "very low" quality based on the grading criteria.

Two comparisons were tested.

WBC versus control (rest or no WBC) tested in four studies.

WBC versus far infrared therapy also tested in one study.

No studies compared WBC with other active interventions such as cold water immersion, or with different types or applications of WBC. In all four studies, WBC was compared to rest or no WBC. There was low-quality evidence of lower self-reported muscle pain (rest pain) scores after WBC at 1 hour. Notably, the 95% CI also contained no between-group differences or benefits in favor of the control group. One small crossover study (9 participants) found no difference in fatigue after WBC 24 hours after exercise, but better well-being.

One small crossover trial involving 9 well-trained runners provided very low quality evidence of lower muscle pain levels after WBC when compared to infrared therapy at 1 hour follow-up, but not at 24 or 48 hours. In the same study, there was no difference in health status after WBC at 24 hours post-exercise, but fatigue was reduced. There were no adverse events reported.

Conclusion.

There is insufficient evidence to determine whether whole-body cryotherapy (WBC) reduces post-exercise self-reported muscle soreness or improves subjective recovery compared with passive rest or no WBC in physically active young adult men after exercise. There is no evidence on the use of this intervention in women or elite athletes. The lack of evidence on adverse events is significant because of the potential risks associated with exposure to extreme temperatures. There is a need for more high-quality, well-reported studies in this area that provide detailed reporting of adverse events.

Costello JT, Baker PRA, Minett GM, Bieuzen F, Stewart IB, Bleakley C. Whole-body cryotherapy (extreme cold air exposure) to prevent and treat post-exercise muscle pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 9. art. No.: CD010789. doi: 10.1002 / 14651858.CD010789.pub2. 

Oxygen therapy for muscle pain and soft tissue injuries

What are the studies?

From a Cochrane review in 2005.

It included 9 small trials with 219 participants. Two trials compared HBOT therapy with sham therapy for acute closed soft tissue injuries (ankle sprains and medial collateral knee ligament injuries, respectively). The other seven trials examined the effect of HBOT on *DOM after eccentric exercise in unconditioned volunteers.

*Delayed onset muscle soreness.

All 32 participants in the ankle sprain study returned to normal activity.

There were no significant differences in time to recovery, functional outcome, pain, or swelling between the two groups. In the second acute injury trial, there was no difference in knee function scores between the two groups.

However, an intent-to-treat analysis was not possible in this trial.

The pooled data from the seven DOMS trials showed significantly and consistently higher pain at 48 and 72 hours in the HBOT group. (Mean difference in pain score at 48 hours [0 to 10 worst pain] 0.88, 95% CI 0.09 to 1.67, P = .03)

In trials where HBOT was initiated immediately There was no difference between the two groups in either long-term pain score or any measure of swelling or muscle strength. No trials reported complications of HBOT, but careful selection of participants was evident in most trials.

Conclusions.

There was insufficient evidence from comparisons tested in randomized controlled trials to establish the effect of HBOT for ankle sprains or acute knee ligament injuries or experimentally induced DOMS. there was some evidence that HBOT may increase the provisional pain of DOMS. Any future use of HBOT for these injuries would need to be preceded by a carefully conducted randomized controlled trial that showed efficacy.

Bennett MH, Best TM, Babul-Wellar S, Taunton JE. Hyperbaric oxygen therapy for delayed onset muscle pain and closed soft tissue injuries Cochrane Database of Systematic Reviews 2005, No. 4. Number: CD004713. doi: 10.1002 / 14651858.CD004713.pub2.

Massage for delayed onset muscle pain

There was a paper that evaluated the efficacy of manual therapy given to delayed onset muscle pain. The evidence is not very strong!

Because the subjects chosen were 12 healthy male students.

What was the research?

Pain was assessed using the Visual Analog Scale (VAS), tenderness (finger-head tendinometer), and muscle hardness. The intervention method was 3 sets of 10 centrifugal contractions (angular velocity: 60deg/sec) of the same muscle (interval: 30 seconds) at 100% load of the maximum muscle strength of the elbow flexor muscle group. 

Arm 1: Manual therapy group: 6 subjects (1 minute of light rubbing on the elbow flexor group → 10 minutes of rubbing → 1 minute of light rubbing)

Arm 2: Control group (no treatment) 6 subjects

Results

The VAS values for pain were 19.5 to 13.0 for the control group from day 3 to day 6. The VAS values of the control group increased from 19.5 to 13.7, 8.2, and 2.8, respectively, from day 3 to day 6, while the VAS values of the manual therapy group increased from 54.5 to 54.8, respectively. The pressure pain threshold of the manual therapy group increased from 54.2 to 44.8 to 27.3 to 12.5.

The mean pressure pain threshold of the manual therapy group was lower than that of the control group after the third day, and the mean muscle hardness was slightly higher. Muscle hardness was slightly higher.

T. Ikeuchi, A. Kimura, K. Kakutani, et al. Effect of manual therapy on delayed onset myalgia. Journal of the Eastern Medical Association of Japan. Journal of the Japan Eastern Medical Association. 2008; 25: 46. Medical Journal web ID 2008255553

Anti-oxidation and muscle pain

What does the study involve?

Fifty randomized placebo-controlled trials were included, 12 of which used a crossover design. Of the 1089 participants, 961 were men and 128 were women.

Participants ranged in age from 16 to 55 years, and in exercise frequency from sedentary to moderate training. Intervention methods were measured as timing (pre- or post-exercise), frequency, dose, duration, and type of antioxidant supplementation. All studies used higher than recommended daily doses of antioxidants. There were no studies comparing high and low doses.

Results　

Results for muscle soreness showed a small difference in support for antioxidant supplementation after DOMS-induced exercise in all major follow-up studies. DOMS = delayed onset muscle soreness.

After 6 hours

(Standardized mean difference (SMD) -0.30, 95% confidence interval (CI) -0.56 to -0.04; 525 participants, 21 studies, low quality evidence)

After 24 hours

(SMD -0.13, 95% CI -0.27 to 0.00; 936 participants, 41 studies, moderate quality evidence)

After 48 hours

(SMD -0.24, 95% CI -0.42 to -0.07, 1047 participants, 45 studies, low quality evidence)

72 hours

(SMD -0.19, 95% CI -0.38 to -0.00; 657 participants, 28 studies; moderate evidence)

Little difference at 96 hours.

(SMD -0.05, 95% CI -0.29 to 0.19; 436 participants), 17 studies; low quality evidence)

Therefore, the effect size suggesting less muscle pain with antioxidant supplementation was not considered to actually amount to a meaningful or important difference.

Ranchordas MK, Rogerson D, Soltani H, Costello JT. Antioxidants for the prevention and reduction of post-exercise muscle soreness. Cochrane Database of Systematic Reviews 2017, No. 12. Number: CD009789. doi: 10.1002 / 14651858.CD009789.pub2.

Massage and Exercise for Muscle Pain Relief

Are you experiencing muscle pain?

I'm not sure if it's because I've never been to a gym or because I've never been to a gym before. Do you suffer from muscle pain in your daily life? But since there is such a boom in exercise, here is a study that might be useful. Here is a study that might help.

The study

This study examines the effects of vigorous exercise or immediate post-massage treatment for the relief of muscle pain. It is a randomized controlled trial, single blind study.

Twenty participants, healthy women, were randomly assigned to

Massage group

Active exercise group

Control group

The upper trapezius fibers were subjected to centrifugal contraction, and delayed onset muscle soreness occurred after 48 hours of intervention. For massage, the upper trapezius fibers were subjected to compression, kneading, and rubbing for 10 minutes. For exercise, only one side of the upper trapezius fibers was moved for 10 minutes. (Shoulder shrugs, using Theraband)

As for the evaluation items, the degree of muscle pain was assessed by NRS and the threshold of tenderness was examined. The results show changes in the degree of muscle pain and the threshold of tenderness in the massage group and with active exercise. Both groups showed significant changes compared to the control group, with the threshold of tenderness reaching its peak after 20 minutes of implementation. There is no significant difference between the two groups in this regard, but the decrease in muscle pain is lower in the active exercise group intervention in comparison. And for the intervention of the massage group, the result is that the threshold of tenderness was higher immediately after.

Comment.

This study focused on the immediate effects of active exercise and massage treatment on the relief of delayed onset muscle soreness. It is interesting to note that the authors created delayed onset muscle soreness in the upper trapezius fibers on both sides, intervened only on one side, and compared the conditions on the right and left sides. the immediate effect on muscle soreness in both the massage and active exercise groups was shown, but the observation was limited to within one hour after the intervention. Extending the observation time and examining the differences between the massage group and the active exercise group would be a very useful study in the field of sports. 

Andersen LL, Jay K, Andersen CH, Jakobsen MD, Sundstrup E, Topp R, Behm DG. Acute effects of massage or active exercise in relieving muscle soreness: Journal of strength and conditioning research. 2013;27(12):3352-9. MEDLINE ID: 23524365

Muscle Pain and Roller Massage

How do you deal with muscle pain?

If you are not exercising until you get sore muscles in the first place, you may be training at the ideal load, or you may not be training at all. There are many popular ways to deal with muscle soreness, and perhaps it is the sports industry that often sees trendy = good. In this study, we investigate whether roller massage, one of the popular methods, is beneficial for muscle pain. This is a study that investigates whether roller massage, one of the popular methods, is beneficial for muscle pain.

The study

Roller massage has become a popular intervention in sports settings to treat muscle pain and stiffness and improve post-exercise recovery. However, evidence for this method has been limited. The purpose of this study was to evaluate the effect of a single session of roller massage applied with controlled force after an exercise-induced muscle injury protocol on muscle recovery. A randomized controlled trial was conducted using a repeated measures design. Thirty-six young men completed four sets of six eccentric movements of the elbow flexors at 90°/s, with a rest interval of 90 seconds between sets.

The participants performed
1. roller massage
2. placebo
3. control group
and were randomly assigned to one of the three groups.
Maximal isometric voluntary contraction (MIVC), delayed onset muscle soreness (DOMS), range of motion (ROM), and muscle thickness were measured at baseline and at 24, 48, and 72 hours post-exercise.

There was no significant group by time interaction between MIVC and ROM.
There was also a significant group due to the time interaction of muscle thickness, but the post-test did not find any significant differences between the groups. DOMS was seen to recover in 72 hours with the roller massage and control groups, while the placebo group showed no recovery from DOMS over 72 hours.

Medeiros FVA, Bottaro M, Martins WR, et al. The effects of one session of roller massage on recovery from exercise-induced muscle damage: A randomized controlled trial. J Exerc Sci Fit. 2020;18(3):148-154. doi:10.1016/j.jesf.2020.05.002

Muscle soreness after exercise and compression wear

In this article, we will discuss the effects of exercise on muscle soreness. In this article, I would like to share with you a few tips on how to avoid muscle pain after exercise. One of the features of these garments is that they claim to have the effect of supporting bodily functions by applying appropriate pressure to the body, don't you think?

I don't know how many people actually feel this effect while exercising in these clothes, but I would like to introduce a study that examines the aspect of muscle pain.

Contents of the study

This study is investigating the effects of compression wear and complex massage interventions on post-exercise muscle damage in the lower extremities. The research model used is a randomized controlled trial. The subjects are 32 women who exercise at least three times a week. They were divided into three groups: a passive recovery group, a compression wear group, and a compression wear and massage group. The passive recovery group was given 10 sets of 10 plyometric jumps. The compression group is made to wear the same post-exercise commercial wear as the passive recovery group for 12 hours.

The compression and massage group is given 30 minutes of massage by a qualified person after the same exercise as the passive recovery group, and the same intervention as the compression group. The assessment items are subjective pain, blood creatine kinase, isokinetic motor function, counter movement jump and squat jump.

Results

For subjective pain, the passive recovery group tended to be significantly stronger than the other intervention groups at 24, 48, and 72 hours after exercise. There was no significant difference between the compression group and the compression and massage group. For counter movement jumps, the passive recovery group showed a decrease compared to the other interventions, and there were no significant differences between the other intervention groups.

For squat jump and isokinetic motor function, there was a significant difference between the two intervention groups when compared to the control group. In blood creatine kinase, there was no significant difference between any of the interventions. Thus, for pain, the interventions in both groups worked to reduce it, and the addition of massage resulted in less pain immediately afterwards.

Comment.

This paper examines the effects of compression tights and massage on pain and performance after damaging muscles with plyometrics exercise loading. It is commendable that the study was well designed and had practical outcomes with a 4-day post-exercise follow-up. On the other hand, the placebo effect could not be ruled out for any of the interventions. Considering that the number of athletes using compression wear in athletics and triathlon has been increasing for several years, and that this is based on the results of this study and other studies, we believe that this is a highly valuable paper that contributes to clinical sports.

Jakeman JR, Byrne C, Eston RG. Efficacy of lower limb compression and combined treatment of manual massage and lower limb compression on symptoms of Efficacy of lower limb compression and combined treatment of manual massage and lower limb compression on symptoms of exercise-induced muscle damage in women. Journal of strength and conditioning research. 2010; 24(11): 3157-65. MEDLINE ID: 20940646 

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