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Objective: This study aimed to assess the efficacy of local cold therapy in reducing myalgia pain levels among emergency room patients., Methods: This was a pre-test/post-test randomized controlled study. Standard treatment (non-steroid analgesic anti-inflammatory parenteral medications) was implemented with one group, while the other groups received cold therapy and standard treatment. Before local cold therapy to the painful area, a Patient Description Form including sociodemographic information and a visual analog scale indicating pain level was applied. The VAS was repeated 10 and 30 minutes after cold therapy to the back., Results: Examining the patients' pain, it was seen that there was a significant difference in pain in the patients who received cold therapy compared to the standard group, especially after ten minutes (P < .05), but after 30 minutes, no significant difference was seen (P > .05). After the intervention, the pain level after 10 minutes in the control group was 6.6, while it was 4.4 in the experimental group., Conclusions: The research showed that cold therapy has an effect on the treatment of myalgia and reduces the level of pain, especially quickly. As a result, it is recommended that research on non-pharmacologic pain management in myalgia be increased.

This study assessed whether symptoms of muscle damage could be reduced by a combination of therapeutic ultrasound and electrical stimulations, and whether this could be enhanced by blood flow restriction. Before and 48 h after performing eccentric elbow flexion exercises, individuals completed assessments of muscle damage. A 10-min therapeutic ultrasound and electrical stimulation treatment was then applied with and without blood flow restriction to assess short (5 min) and long-term (24 h) improvements. Twenty-three individuals completed the study (11 females). Data were analysed using Bayesian repeated measures ANOVAs. The damaging exercise increased discomfort (BF 10  = 2.93e14) and relaxed joint angle (BF 10  = 2425.90) while decreasing pain pressure threshold (BF 10  = 289.71). Each of these variables was acutely improved with the combination treatment protocol (all BF 10 ≥ 74) with no added effect of blood flow restriction. A combination of therapeutic ultrasound and interferential electrical stimulations appeared effective at acutely alleviating symptoms of muscle damage with no additive effect of blood flow restriction.

Recent studies have shown that the extramuscular connective tissue (ECT) is thickened and stiffened in delayed onset muscle soreness (DOMS). However, contrarily to the normal population, severe DOMS is rare in athletes or highly trained individuals. The present randomized, controlled trial therefore aimed to investigate pain as well as microcirculation and stiffness of the ECT and the erector spinae muscle following submaximal eccentric trunk extension exercise not causing DOMS. The effect of manual treatment by a therapist (myofascial release; MFR) on these parameters was to be studied. Trained healthy participants (n = 21; 31.3 ± 9.6 years; > 4 h exercise per week) performed submaximal eccentric exercise of the trunk extensors. One group was manually treated (n = 11), while the other group (n = 10) received placebo treatment with sham laser therapy. Stiffness of the ECT and the erector spinae muscle (shear wave elastography), microcirculation (white light and laser Doppler spectroscopy), palpation pain (100 mm visual analogue scale, VAS) and pressure pain threshold (indentometry, PPT) were assessed before (t 0 ), 24 h (t 24 ) and 48 h (t 48 ) after conditions. Erector spinae muscle stiffness increased after eccentric exercise from t 0 to t 24 (0.875 m/s) and from t 0 to t 48 (0.869 m/s). After MFR, erector spinae muscle stiffness decreased in contrast to placebo treatment at t 24 (-0.66 m/s), while ECT stiffness remained unchanged. Oxygen saturation increased (17-20.93%) and relative haemoglobin decreased (-9.1 - -12.76 AU) after eccentric exercise and MFR differed from placebo treatment at t 48 (-3.71 AU). PPT differed after MFR from placebo treatment at t 48 (20.69 N/mm), while VAS remained unchanged. Multiple linear regression showed that ECT stiffness and group membership predicted erector spinae muscle stiffness. MFR could have a positive effect on pain, microcirculation and muscle stiffness after submaximal eccentric exercise, suggesting better recovery, which needs to be confirmed by future work., (© Journal of Sports Science and Medicine.)

Objective: The aim of this study was to conduct a comprehensive evaluation of the rehydration efficacy of QSBYD and elucidate its potential underlying mechanism., Design: 38 participants were randomly assigned to receive either QSBYD or placebo before and after exercise and heat-induced dehydration. Hydration indicators were measured over time. Blood tests assessed cellular anaerobic respiration metabolites, serum inflammatory markers, and coagulation markers. Perceptual measures of thirst, fatigue, and muscular soreness were also taken., Results: QSBYD consumption resulted in lower urine volume (Control vs. QSBYD: 260.83 ± 167.99 ml vs. 187.78 ± 141.34 ml) and smaller decrease in percentage of nude body weight change from baseline (Control vs. QSBYD: -0.52 ± 0.89% vs. -0.07 ± 0.52%). Although no significant differences in urine specific gravity, QSBYD resulted in reduced urine volume at 120 min, suggesting improved fluid retention. Furthermore, QSBYD resulted in lower levels of IL-1β (Control vs. QSBYD: 2.40 ± 0.68 vs. 1.33 ± 0.66 pg/mL), suggesting QSBYD may provide benefits beyond hydration., Conclusion: Further investigation into the underlying mechanisms and long-term effects of QSBYD on hydration is warranted. QSBYD may be an effective alternative to commercial sports drinks in mitigating dehydration effects.

Purpose: To assess the effect of whole-body cryotherapy (WBC) on postmatch recovery in basketball., Methods: Using a crossover design, 17 youth male players (age 16.2 [1.2] y, stature 190.5 [9.4] cm, body mass 79.2 [9.6] kg, experience 9.9 [3.9] y) completed 2 simulated matches, followed by WBC (4 min, -75 to - 85 °C) or a placebo intervention (CON). Countermovement-jump height, change-of-direction performance, 10- and 20-m sprint times, heart-rate variability (log-transformed squared root of the mean sum of the squared differences between R-R intervals [Ln-rMSSD]), muscle soreness, and perceived recovery (Perceived Recovery Status Scale [PRS]) were recorded at prematch, postmatch, postrecovery, and 24 hours postmatch. Additionally, Ln-rMSSD was recorded upon awakening on match day and the following morning., Results: Compared with CON, higher PRS values were reported in WBC at prematch and postrecovery (P ≤ .026), while no significant between-interventions differences were found for any other measure (P > .05). Regarding the effect of time, our findings revealed that 20-m sprint times, Ln-rMSSD, and PRS deteriorated in both interventions from prematch to postmatch (ie, acute changes, P ≤ .045), while muscle soreness worsened in WBC only (P ≤ .003). Conversely, countermovement-jump height, change-of-direction, and 10-m sprint performance were unaffected by match play in the acute phase (P > .05), while none of the investigated measures showed impairments at 24 hours postmatch, compared with prematch (P > .05)., Conclusions: Overall, these findings suggest that WBC was mostly ineffective for improving postexercise recovery in the investigated sample, with benefits observed for perceived recovery being potentially influenced by the participants' status at baseline (ie, higher prematch PRS scores in WBC compared with CON).

Objectives: To investigate the most common concomitant symptoms and the urgent demand of solution in the breast cancer patients undergoing postoperative endocrine treatment, as well as the acceptance and expectation of acupuncture in the patients so as to provide the scientific data for promoting the application of acupuncture in the breast cancer patients., Methods: Breast cancer patients treated in Tianjin Medical University Cancer Institute and Hospital from January 2022 to March 2023 were randomly selected as the subjects. Using "questionnaire star" website, the questionnaire was conducted to investigate the relevant concomitant symptoms of the patients in postoperative endocrine treatment and the questions related to acupuncture treatment., Results: In this study, 229 questionnaires were distributed and 211 valid ones were collected, with the response rate of 92.1%. Among these patients, the first three common symptoms were sleep disorders (157 cases, 74.4%), hot flashes (138 cases, 65.4%) and joint / muscle pain (118 cases, 55.9%)；the top three symptoms to be solved the most urgently were sleep disorders (131 cases, 62.1%), joint / muscle pain (62 cases, 29.4%) and hot flashes (45 cases, 21.3%). 79.1% of the patients (167 cases) were willing to receive acupuncture treatment because of the high expectations on its potential effect (93%). 20.9% of them (44 cases) refused acupuncture because they were worried not to be treated by the experienced physicians of TCM (52%) or afraid of needling feelings (48%). The average expectation value of acupuncture treatment was 4.02 points (5 points for the total score) among patients willing to receive acupuncture treatment. The main purposes of receiring acupuncture for the patients undergoing endocrine treatment were to strengthen the immune function (92%), reduce the adverse reactions (83%), and improve the physical condition (75%), et al., Conclusions: Sleep disorder is one of the most concerned symptoms in endocrine treatment for the patients after breast cancer surgery. The patients highly expect for acupuncture treatment even though some patients dislike the needling sensation. How to provide the acceptable and high-quality acupuncture services for cancer patients will be one of the major directions of acupuncture research in the future.

Among athletes, foam rolling is popular technique of myofascial release aimed to support recovery processes and counteract delayed onset muscle soreness. However, there is no consensus on the optimal parameters of the roller texture used in the procedure. The study aimed to determine whether using rollers with different textures and hardness (smooth/soft, grooved/mid, serrated/hard) in myofascial release affects post-exertional restitution rate and the level of perceived DOMS (Delayed Onset Muscle Soreness) after intense anaerobic exercise. The study involved 60 healthy and physically active men randomly divided into three experimental groups and one control group (passive rest)-each consisting of 15 individuals: STH-rolling with a smooth roller; G-rolling with a grooved roller; TP-rolling with a serrated roller; Pass-passive rest group. After performing a exercise test (one-minute high-intensity squat), blood lactate (LA), creatine kinase (CK) and pain perception (VAS Scale) were monitored. The analysis of the average LA concentration in the blood 30 min post-exercise showed a statistical difference for all rolling groups compared to the passive rest group: STH (p < 0.001), G (p < 0.001), TP (p = 0.035). No statistically significant differences were found between the CK measurement results in individual assessments. Statistically significant differences in VAS values were observed between G (p = 0.013) and TP (p = 0.006) groups and the Pass group at 48 h, as well as between STH (p = 0.003); G (p = 0.001); TP (p < 0.001) groups and the Pass group at 72 h. Based on statistical data, a strong influence (η 2  = 0.578) of time on the quadriceps VAS variable was noted. The research results confirm the effectiveness of rolling in supporting immediate and prolonged recovery. The conducted studies indicate a significantly better pace of post-exertional recovery after a rolling procedure lasting at least 120 s. The texture and hardness of the tool used did not matter with such a duration of the treatment., (© 2024. The Author(s).)

Background: This study investigated a stress management exercise program's effect on mental health, muscle pain, and autonomic nervous system activity in adults exposed to chronic stress., Methods: Thirty mothers between 40 to 59 years old raising children with disabilities were equally allocated into the yoga (YG) or control group (CG). The YG participated in 16 prop-assisted yoga sessions twice weekly for eight weeks, focusing on relaxing and strengthening neck, shoulder, back, and waist stress-related muscles. The Beck Depression Inventory, State-Trait Anxiety Inventory, Parenting Stress Scale, Stress Response Inventory, and Brief Resilience Scale assessed mental health variable changes. Visual Analog Scales (VAS) were used to self-report neck, shoulders, back, and waist pain and assess stress, anxiety, relaxation, and confidence. We also measured pain, psychological VAS, and Heart Rate Variability (HRV) immediately before and after each yoga session., Results: The YG exhibited significant reductions in muscle pain, depression, stress response, fatigue, and frustration, whereas the CG expressed no change. Prop-assisted yoga immediately improved pain and psychological VAS. HRV analyses revealed instantly reduced heart rates and an R-R interval and standard deviation normal to normal (SDNN) increase., Conclusions: Prop-assisted yoga may serve as a viable, safe, and efficient alternative therapeutic modality for managing chronic stress-related conditions.

People with overweight or obesity preferred high-intensity interval training (HIIT) due to the time-efficiency and pleasure. However, HIIT leads to delayed onset muscle soreness (DOMS). The present study aimed to investigate the effects of omega-3 supplementation on DOMS, muscle damage, and acute inflammatory markers induced by cycling HIIT in untrained males with overweight or obesity. A randomized, double-blinded study was used in the present study. Twenty-four males with a sedentary lifestyle were randomly assigned to either receive omega-3 (O3) (4 g fish oil) or placebo (Con). Subjects consumed the capsules for 4 weeks and performed cycling HIIT at the 4 th week. After 4 weeks-intervention, the omega-3 index of O3 group increased by 52.51% compared to the baseline. All subjects performed HIIT at 4 th week. The plasma creatine kinase (CK) level of Con group increased throughout 48h after HIIT. While the CK level of O3 group increased only immediately and 24h after HIIT and decreased at 48h after HIIT. The white blood cell count (WBC) of Con group increased immediately after the HIIT, while O3 group did not show such increase. There was no change of CRP in both groups. O3 group had a higher reduction of calf pain score compared to Con group. O3 group also showed a recovery of leg strength faster than Con group. Omega-3 supplementation for 4 weeks lower increased CK level, reduced calf pain score, and recovery leg strength, DOMS markers after cycling HIIT., (© Journal of Sports Science and Medicine.)

Percussive massage (PM) is an emerging recovery treatment despite the lack of research on its effects post-eccentric exercise (post-EE). This study investigated the effects of PM treatments (immediately, 24, 48, and 72 h post-EE) on the maximal isometric torque (MIT), range of motion (ROM), and an 11-point numerical rating scale (NRS) of soreness of the nondominant arm's biceps brachii from 24-72 h post-EE. Seventeen untrained, college-aged subjects performed 60 eccentric elbow flexion actions with their nondominant arms. Nine received 1 minute of PM, versus eight who rested quietly (control [CON]). In order, NRS, ROM, and MIT (relative to body mass) were collected pre-eccentric exercise (pre-EE) and after treatment (AT) at 24, 48, and 72 h post-EE. NRS was also collected before treatment (BT). Electromyographic (EMG) and mechanomyographic (MMG) amplitudes were collected during the MIT and normalized to pre-EE. There were no interactions for MIT, EMG, or MMG, but there were interactions for ROM and NRS. For ROM, the PM group had higher values than the CON 24-72 h by ~6-8°, a faster return to pre-EE (PM: 48 h, CON: 72 h), and exceeded their pre-EE at 72 h by ~4°. The groups' NRS values did not differ BT 24-72 h; however, the PM group lowered their NRS from BT to AT within every visit by ~1 point per visit, which resulted in them having lower values than the CON from 24-72 h by ~2-3 points. Additionally, the PM group returned their NRS to pre-EE faster than the CON (PM: BT 72 h, CON: never). In conclusion, PM treatments may improve ROM without affecting isometric strength or muscle activation 24-72 h post-EE. Although the PM treatments did not enhance the recovery from delayed onset muscle soreness until 72 h, they consistently provided immediate, temporary relief when used 24-72 h post-EE., (© Journal of Sports Science and Medicine.)

Context: Handheld percussive massage devices (ie, massage guns) are a relatively new and under-researched recovery tool. These tools are intended to increase range of motion and reduce muscle soreness by delivering targeted vibration to soft tissues. Empirical knowledge about the potential influence of these devices on perceptual recovery and the recovery of performance characteristics after exercise is scarce., Objective: To investigate the effect of a 5-minute massage gun application, using a commercially available device, on physical and perceptual recovery after a strenuous bout of lower body exercise., Design: Controlled laboratory study., Setting: Physiology laboratory., Patients or Other Participants: A total of 65 active young adults (age = 21.3 ± 1.4 years; age range = 18-30 years; 34 women: height = 165.8 ± 6.1 cm, mass = 66.0 ± 7.4 kg; 31 men: height = 181.1 ± 6.0 cm, mass = 81.5 ± 11.8 kg)., Intervention(s): Participants applied a massage gun on the calf muscles of 1 leg after strenuous exercise (massage gun recovery group) for 5 minutes and used no recovery intervention on the other leg (control group)., Main Outcome Measure(s): Ankle range of motion, calf circumference, isometric strength, calf endurance, and perceived muscle soreness measures were collected at baseline and at various points after lower body exercise., Results: No significant group × time interactions were recorded for any of the performance or perceptual measures (P values > .05). Effect sizes were mostly unclear, except for a small increase in perceived muscle soreness in the massage gun recovery group compared with the control group immediately (d = -0.35) and 4 hours (d = -0.48) postrecovery., Conclusions: Massage guns appeared to have little effect on physical measures when applied for 5 minutes immediately after strenuous calf exercise. Given the small increase in muscle soreness up to 4 hours after their use, caution is recommended when using massage guns immediately after strenuous lower body exercise., (© by the National Athletic Trainers’ Association, Inc.)

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes., Design: A parallel, single-blinded, randomized controlled trial., Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups., Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750)., Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes.

Abstract: MacLennan, M, Ramirez-Campillo, R, and Byrne, PJ. Self-massage techniques for the management of pain and mobility with application to resistance training: a brief review. J Strength Cond Res 37(11): 2314-2323, 2023-Fascial restrictions that occur in response to myofascial trigger points (MTrP), exercise-induced muscle damage (EIMD), and delayed onset of muscle soreness (DOMS) cause soft tissue to lose extensibility, which contributes to abnormal muscle mechanics, reduced muscle length, and decrements in joint range of motion (ROM) and actively contributes to musculoskeletal pain. Resistance training and in particular, weightlifting movements have unique mobility requirements imperative for movement efficacy and safety with ROM restrictions resulting in ineffective volume and intensity tolerance and dampened force output and power, which may lead to a failed lift or injury. Self-massage (SM) provides an expedient method to promote movement efficiency and reduce injury risk by improving ROM, muscular function, and reducing pain and allows athletes to continue to train at their desired frequency with minimal disruption from MTrPs-associated adverse effects. Thus, the aim of this review was to determine the efficacy of various self-massage tools in managing pain and mobility and to explore the potential benefits of SM on resistance training performance. Many SM devices are available for athletes to manage ROM restrictions and pain, including differing densities of foam rollers, roller massagers, tennis balls, and vibrating devices. To attenuate adverse training effects, a 10-to-20-minute bout consisting of 2-minute bouts of SM on the affected area may be beneficial. When selecting a SM device, athletes should note that foam rollers appear to be more effective than roller massagers, with vibrating foam rollers eliciting an increased reduction to pain perception, and tennis balls and soft massage balls were shown to be efficacious in targeting smaller affected areas., (Copyright © 2023 National Strength and Conditioning Association.)

Purpose: This study aimed to investigate the effect of whole-body cryotherapy (WBC), cold-water immersion (CWI) and passive recovery (PAS) on tennis recovery., Methods: Thirteen competitive male tennis players completed three consecutive match-like tennis protocols, followed by recovery (WBC, CWI, PAS) in a crossover design. Five tennis drills and serves were performed using a ball machine to standardize the fatiguing protocol. Maximal voluntary contraction (MVC) peak torque, creatine kinase activity (CK), muscle soreness, ball accuracy and velocity together with voluntary activation, low- and high-frequency torque and EMG activity were recorded before each protocol and 24 h following the third protocol., Results: MVC peak torque (- 7.7 ± 11.3%; p = 0.001) and the high- to low-frequency torque ratio (- 10.0 ± 25.8%; p < 0.05) decreased on Day 1 but returned to baseline on Day 2, Day 3 and Day 4 (p = 0.052, all p > 0.06). The CK activity slightly increased from 161.0 ± 100.2 to 226.0 ± 106.7 UA L -1 on Day 1 (p = 0.001) and stayed at this level (p = 0.016) across days with no differences between recovery interventions. Muscle soreness increased across days with PAS recovery (p = 0.005), while no main effect of time was neither observed with WBC nor CWI (all p > 0.292). The technical performance was maintained across protocols with WBC and PAS, while it increased for CWI on Day 3 vs Day 1 (p = 0.017)., Conclusion: Our 1.5-h tennis protocol led to mild muscle damage, though neither the neuromuscular function nor the tennis performance was altered due to accumulated workload induced by consecutive tennis protocols. The muscle soreness resulting from tennis protocols was similarly alleviated by both CWI and WBC., Trial Registration: IRB No. 2017-A02255-48, 12/05/2017., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The present study investigated the effects of a far-infrared radiation (FIR) lamp therapy on changes in muscle damage and proprioception markers after maximal eccentric exercise of the elbow flexors (EF: Study 1) and the knee flexors (KF: Study 2) in comparison to a sham treatment condition. In each study, 24 healthy sedentary women were assigned to a FIR or a sham treatment group ( n  = 12/group). They performed 72 maximal EF eccentric contractions (Study 1) or 100 maximal KF eccentric contractions (Study 2) with their non-dominant limbs. They received a 30-min FIR (wavelength: 8-14 µm) or sham treatment at 1, 25, 49, 73 and 97 h post-exercise to the exercised muscles. Maximum voluntary isometric contraction (MVC) torque, muscle soreness, plasma creatine kinase activity, and proprioception assessed by position sense, joint reaction angle, and force match were measured before, and 0.5, 24, 48, 72, 96 and 120 h post-exercise. The outcome measures showed significant changes ( P  < 0.05) at 0.5-hour post-exercise (before treatment) similarly ( P  > 0.05) between the conditions in both studies. However, changes in all measures at 24-120 h post-exercise were smaller ( P  < 0.05) for the FIR than sham condition in both studies. For example, MVC torque returned to the baseline by 72 h post-exercise for the FIR condition in both studies, but was still 19 ± 6% (Study 1) or 17 ± 12% (Study 2) lower than the baseline at 120 h post-exercise for the sham condition. These results suggested that the FIR lamp therapy was effective for accelerating recovery from muscle damage.

Background: This systematic review and meta-analysis examined the effects of foam roller or stick massage performed after exercise-induced muscle damage protocols on indirect markers of muscle damage compared to a non-intervention control group in healthy individuals., Methods: PubMed, Biblioteca Virtual em Saúde, Scopus, Google Scholar, and Cochrane Library database were searched in August 2, 2020, with last update on February 21, 2021. Were included clinical trials involving healthy adult individuals who received foam roller/stick massage versus a non-intervention group and evaluated indirect markers of muscle damage. Risk of bias was assessed by the Cochrane Risk of Bias tools. Standardized mean differences with 95% confidence intervals were used to measure the foam roller/stick massage effect on muscle soreness., Results: The five included studies investigated 151 participants (136 men). Overall, the studies presented a moderate/high risk of bias. A between-groups meta-analysis showed no significant difference between massage and non-intervention control groups on muscle soreness immediately after (0.26 [95%CI: 0.14; 0.65], p = 0.20), 24 h (-0.64 [95%CI: 1.34; 0.07], p = 0.08), 48 h (-0.35 [95%CI: 0.85; 0.15], p = 0.17), 72 h (-0.40 [95%CI: 0.92; 0.12], p = 0.13), and 96 h (0.05 [95%CI: 0.40; 0.50], p = 0.82) after an exercise-induced muscle damage protocol. Moreover, the qualitative synthesis showed that foam roller or stick massage had no significant effect on range of motion, muscle swelling, and maximal voluntary isometric contraction recovery., Conclusion: In conclusion, the current literature appears to not support the advantage of foam roller or stick massage to improve recovery of muscle damage indirect markers (muscle soreness, range of motion, muscle swelling, and maximal voluntary isometric contraction) compared to a non-intervention control group in healthy individuals. Furthermore, due to the heterogeneity of the methodological designs among the included studies, making it difficult to compare the results. In addition, there are not enough high-quality and well-designed studies on foam roller or stick massage to draw any definite conclusions., Review Protocol Number: The study was pre-registered in the International Prospective Register of Systematic Review (PROSPERO) on August 2, 2020, with last update on February 21, 2021. Protocol number: CRD2017058559., Competing Interests: Declaration of competing interest The authors declare no conflict of interest, or financial, or other interest in any product or product distributor., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Both Kinesio Tape (KT) and Compression Sleeves (CS) can relieve Delayed Onset Muscle Soreness (DOMS) to a certain extent, but there is no study report on the difference in the effectiveness of the KT and CS whether the effect is better when used at the same time. The purpose of this study was to compare the effects of KT and CS on the recovery of muscle soreness, isokinetic strength, and body fatigue after DOMS., Methods: In this single-blinded randomized controlled trial, 32 participants aged 18 to 24 years were randomly divided into Control group (CG), Compression Sleeves group (CSG), Kinesio Tape group (KTG), Compression Sleeves and Kinesio Tape group (CSKTG), between October 2021 and January 2022. KTG uses Kinesio Tape, CSG wears Compression Sleeves, and CSKTG uses both Compression Sleeves and Kinesio Tape. Outcomes were performed at five-time points (baseline, 0 h, 24 h, 48 h, 72 h), Primary outcome was pain level Visual Analogue Scale (VAS), and Secondary outcomes were Interleukin 6, Peak Torque/Body Weight, Work Fatigue. Statistical analyses were performed using the repeated measures analysis of variance method., Setting: Laboratory., Results: After the intervention, VAS reached the highest at 24 h after exercise-induced muscle soreness, while the KTG and CSG at each time point were less than CG, and the scores of CSKTG at 24 h and 48 h were less than those of KTG and CSG in the same period (P < 0.05). Interleukin 6, at 24 h, CSKTG is lower than KTG 0.71(95%CI: 0.43 to 1.86) and CG 1.68(95%CI: 0.06 to 3.29). Peak Torque/Body Weight, at 24 h, CG was lower than CSKTG 0.99(95%CI: 0.42 to 1.56), KTG 0.94(95%CI: 0.37 to 1.52), and CSG 0.72(95%CI: 0.14 to 1.29); at 72 h, CG was lower than CSKTG 0.65(95%CI: 0.13 to 1.17) and KTG 0.58(95%CI: 0.06 to 1.10). Work Fatigue, at 24 h, CG was lower than KTG 0.10(95%CI: 0.02 to 1.78) and CSKTG 0.01(95%CI: -0.07 to 0.09). At 48 h, CG was lower than KTG 0.10(95%CI: 0.13 to 1.17) and CSKTG 0.11(95%CI: 0.03 to 0.18)., Conclusions: Kinesio Tape can significantly reduce DOMS pain, and Kinesio Tape has a better recovery effect on Delayed Onset Muscle Soreness than Compression Sleeves. Kinesio Tape combined with Compression Sleeves is helpful to alleviate the Delayed Onset Muscle Soreness pain, speeding up the recovery of muscle strength, and shortening the recovery time after Delayed Onset Muscle Soreness., Trial Registration: Registration number: This study was also registered on 11/10/2021, at the Chinese Clinical Trial Registry (ChiCTR2100051973)., (© 2023. The Author(s).)

Objectives: Exercise-induced hypoalgesia (EIH) is characterized by an increase in pain threshold following acute exercise. EIH is reduced in some individuals with chronic musculoskeletal pain, although the mechanisms are unknown. It has been hypothesized that this may relate to whether exercises are performed in painful or non-painful body regions. The primary aim of this randomized experimental crossover study was to investigate whether the presence of pain per se in the exercising muscles reduced the local EIH response. The secondary aim was to investigate if EIH responses were also reduced in non-exercising remote muscles., Methods: Pain-free women (n=34) participated in three separate sessions. In session 1, the maximal voluntary contraction (MVC) for a single legged isometric knee extension exercise was determined. In sessions 2 and 3, pressure pain thresholds (PPT) were assessed at the thigh and shoulder muscles before and after a 3-min exercise at 30 % of MVC. Exercises were performed with or without thigh muscle pain, which was induced by either a painful injection (hypertonic saline, 5.8 %) or a non-painful injection (isotonic saline, 0.9 %) into the thigh muscle. Muscle pain intensity was assessed with an 11-point numerical rating scale (NRS) at baseline, after injections, during and after exercises., Results: PPTs increased at thigh and shoulder muscles after exercise with painful (14.0-24.9 %) and non-painful (14.3-19.5 %) injections and no significant between-injection EIH differences were observed (p>0.30). Muscle pain intensity was significantly higher following the painful injection compared to the non-painful injection (p<0.001)., Conclusions: Exercising painful muscles did not reduce the local or remote hypoalgesic responses, suggesting that the pain-relieving effects of isometric exercises are not reduced by exercising painful body regions., Ethical Committee Number: S-20210184., Trial Registration Number: NCT05299268., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)

Purpose: Pelvic floor physical therapy (PFPT) is first-line therapy for treatment of pelvic floor tension myalgia (PFTM). Pelvic floor trigger point injections (PFTPI) are added if symptoms are refractive to conservative therapy or if patients experience a flare. The primary objective was to determine if a session of physical therapy with myofascial release immediately following PFTPI provides improved pain relief compared to trigger point injection alone., Methods: This was a retrospective cohort analysis of 87 female patients with PFTM who underwent PFTPI alone or PFTPI immediately followed by PFPT. Visual analog scale (VAS) pain scores were recorded pre-treatment and 2 weeks post-treatment. The primary outcome was the change in VAS between patients who received PFTPI alone and those who received PFTPI followed by myofascial release., Results: Of the 87 patients in this study, 22 received PFTPI alone and 65 patients received PFTPI followed by PFPT. The median pre-treatment VAS score was 8 for both groups. The median post-treatment score was 6 for the PFTPI only group and 4 for the PFTPI followed by PFPT group, showing a median change in VAS score of 2 and 4, respectively (p = 0.042). Seventy-seven percent of patients in the PFTPI followed by PFPT group had a VAS score improvement of 3 or more, while 45% of patients in the PFTPI only group had a VAS score improvement greater than 3 (p = 0.008)., Conclusion: PFTPI immediately followed by PFPT offered more improvement in pain for patients with PFTM. This may be due to greater tolerance of myofascial release immediately following injections., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Theta burst stimulation (TBS) over the primary motor cortex (M1) is an emerging technique that may have utility in the treatment of musculoskeletal pain. However, previous work exploring the analgesic effects of noninvasive brain stimulation has been limited largely to the arm or hand, despite 80% of acute musculoskeletal injuries occurring in the lower limb. This is a pertinent point, given the functional and neurophysiological differences between upper and lower limb musculature, as well as evidence suggesting that reorganization of corticomotor pathways is region-specific. This study investigated the effect of excitatory TBS on pain, function, and corticomotor organization during experimentally induced lower limb pain. Twenty-eight healthy participants attended 2 experimental sessions. On Day 0, participants completed 10 sets of 10 maximal eccentric contractions of the right hamstring muscles to induce delayed onset muscle soreness. Four consecutive blocks of either active or sham TBS were delivered on Day 2. Measures of mechanical sensitivity, pain (muscle soreness, pain intensity, pain area) function (single-leg hop distance, maximum voluntary isometric contraction, lower extremity functional scale), and corticomotor organization were recorded before and after TBS on Day 2. Pain and function were also assessed daily from Days 2 to 10. Active TBS reduced mechanical sensitivity compared to sham stimulation (P = .01). Corticomotor organization did not differ between groups, suggesting that improvements in mechanical sensitivity were not mediated by changes in M1. Subjective reports of pain intensity and function did not change following active TBS, contrasting previous reports in studies of the upper limb. PERSPECTIVE: M1 TBS reduces mechanical sensitivity associated with experimentally induced hamstring pain. Though further work is needed, these findings may hold important implications for those seeking to expedite recovery or reduce muscle sensitivity following hamstring injury., Competing Interests: Disclosures This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. There are no conflicts of interest, additional acknowledgements, or affiliations to report., (Copyright © 2022 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Background: This systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and myofascial pain (MP) in comparison with no treatment or other interventions., Materials and Methods: Based on the inclusion and exclusion criteria of this systematic review, randomized controlled trials were qualified, in which the effectiveness of occlusal splint therapy in the management of muscle pain was examined in comparison with no treatment or other interventions. This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The authors searched three databases (PubMed, CINAHL (The Cumulative Index to Nursing and Allied Health Literature) and Scopus) for English publications published between January 1, 2010, and June 1, 2022. The last database search was carried out on June 4, 2022. Data were extracted from the included studies and assessed for risk of bias using the revised Cochrane risk-of-bias tool for randomized trials., Results: Thirteen studies were identified for inclusion in this review. In total, 589 patients were diagnosed with orofacial muscle pain who underwent education and various forms of therapy including different types of OSs, light emitting diode therapy, acupuncture, low-level laser therapy, device-supported sensorimotor training, Kinesio Taping, myofunctional therapy, and physical therapy. All studies included demonstrated a high risk of bias., Conclusions: There is insufficient evidence regarding whether OS therapy in the treatment of orofacial myalgia and MP offers an advantage over other forms of interventions or no treatment. Further reliable clinical studies in this area are needed to improve the quality of research, which should be performed with larger groups of blinded respondents and controls., Clinical Relevance: Due to the large-scale nature of orofacial muscle pain, it is assumed that each dental clinician will meet patients with orofacial muscle pain repeatedly in daily practice; hence, the review of the effectiveness of OSs in the management of orofacial myalgia and MP is necessary., (© 2023. The Author(s).)

Objective: Our objective was to determine the efficacy of cold-water immersion (CWI) on the management of muscle soreness to identify the impact of immersion time, water temperature, CWI protocol, and type of exercise on this outcome., Design: Intervention systematic review and meta-analysis., Setting: MEDLINE/PubMed, Embase, Central, and SPORTDiscus databases were searched from their earliest record to July 30, 2020. Only randomized controlled trials that assessed muscle soreness comparing CWI and control were included. Studies were pooled in different subgroups regarding the used protocol: water temperature (severe or moderate cold), immersion time (short, medium, or longer time), CWI protocol (intermittent or continuous application), and type of exercise (endurance or resistance exercise). Data were pooled in a meta-analysis and described as weighted mean difference (95% confidence interval, P < 0.05)., Participants: Athletes and nonathletes., Interventions: Cold-water immersion and control condition., Main Outcome Measures: Muscle soreness., Results: Forty-four studies were included. For immediate effects, CWI was superior to control regardless of water temperature and protocol, and for short and medium immersion times and endurance exercises. For delayed effects, CWI was superior to control in all subgroups except longer immersions time., Conclusions: This study suggests that CWI is better than control for the management of muscle soreness and water temperature and CWI protocol do not influence this result, but only short and medium immersions times presented positive effects. Aiming immediate effects, the best results suggest CWI application only after endurance exercises, while delayed effect CWI was superior both after endurance and resistance exercises., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Padoin, S, Zeffa, AC, Molina Corrêa, JC, de Angelis, TR, Moreira, TB, Barazetti, LK, and de Paula Ramos, S. Phototherapy improves muscle recovery and does not impair repeated bout effect in plyometric exercise. J Strength Cond Res 36(12): 3301-3310, 2022-The effects of photobiomodulation with red (630 nm) and near-infrared (940 nm) light wavelengths were investigated on the inhibition of exercise-induced muscle damage (EIMD) and adaptation to the repeated bout effect (RBE). Twenty-eight healthy men were randomized to receive light-emitting diode therapy (LEDT) at 630 nm (4.6 J·cm -2 , 97 J energy), LEDT at 940 nm (4.6 J·cm -2 , 114 J), or placebo. After LEDT or placebo treatment, subjects performed 100 drop-jumps (5 sets of 20 repetitions). Creatine kinase, delayed-onset muscle soreness (DOMS), countermovement jump (CMJ), and squat jump (SJ) were assessed before, immediately after, and 24, 48, and 72 hours after the bout. After 14 days, the subjects were submitted to the same plyometric exercise, without LEDT, and were evaluated again. Creatine kinase levels increased significantly 72 hours after the first bout in the placebo group in relation to the LEDT 940-nm group ( P < 0.01). The LEDT 630-nm group showed a significant increase in SJ at 24 hours ( P < 0.05), whereas, at 48 hours, the LEDT 940 nm showed a significant increase compared with the placebo group ( P < 0.05). The 2-way analysis of variance revealed an effect for treatment in the SJ ( F = 7.12; P = 0.001). No differences were found between groups for DOMS and CMJ after the first bout. After the second bout of exercise, there was no effect of treatment. The results suggest that treatment with LEDT 630 nm and LEDT 940 nm before eccentric exercise attenuates EIMD without impairing RBE., (Copyright © 2022 National Strength and Conditioning Association.)

Background: Delayed onset muscle soreness (DOMS) is caused by unaccustomed exercise, especially eccentric exercise, and is highly likely to cause skeletal muscle injury. It mainly manifests as ultrastructural changes in skeletal muscle, as well as decreased muscle strength, muscle soreness, swelling, and elevated levels of creatine kinase (CK). Vibration training (VT) has been attracting increasing attention as a new type of rehabilitation therapy. It can effectively minimize the occurrence and relieve the symptoms of DOMS, reduce muscle stiffness and soreness, and reduce serum concentrations of CK and lactate dehydrogenase (LDH). This article systematically assessed the impact of VT on the mitigation of DOMS through a meta-analysis to provide updated evidence-based information., Methods: Electronic databases such as China Knowledge Network, VIP Electronics, PubMed, EBSCO, and Web of Science were searched to identify randomized controlled trials of VT on DOMS. Searches were performed from database creation to November 2021. The quality of the literature was assessed using the Cochrane Manual for the Systematic Review of Interventions, and meta-analyses were performed using RevMan 5.4 software., Results: VT intervention in DOMS was shown to effectively reduce subjective pain, improve pain tolerance, and accelerate the reduction of serum CK and LDH concentrations. Subgroup analysis of different test time periods showed that subjective pain decreased more significantly after 48 hours than after the other 2 time periods, and pain tolerance increased more significantly after 72 hours than the other 2 time periods; serum CK was significantly increased after 24 and 48 hours of intervention, but showed no significant change compared with the control group after 72 hours. Serum LDH decreased significantly after 24 hours of intervention, but there was no significant difference compared with the control group after 48 hours or 72 hours., Conclusion: VT effectively reduced the subjective pain sensation after DOMS, increased the pain threshold, reduced serum LDH and CK concentrations, and accelerated muscle damage repair compared with control interventions. However, the effect of improving the range of motion of the joints is not clear and should be studied further., Registration: number: INPLASY2021120115., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The effect of stimulation with different vibration frequencies on delayed muscle soreness (DOMS) has not yet been determined. This study was conducted to investigate the effect of medium- and high-frequency vertical vibration stimulation on DOMS in track and field athletes., Methods: A total of 38 elite men's track and field athletes were recruited during the off-season. Through the digital randomization method, the participants were divided into three groups. Two-knee DOMS modeling was performed on the medium-frequency group (MFG, 25 Hz, n = 13), high-frequency group (HFG, 50 Hz, n = 12) and control group (CG, 0 Hz, n = 13). The three groups were matched in age, height and body mass. Vertical vibration stimulation was performed for 10 min on the MFG and HFG. Visual analog score (VAS); interleukin-6 (IL-6), lactic dehydrogenase (LDH) and creatine kinase (CK) levels and knee extension peak torque (PT) were determined immediately and at 24, 48, and 72 h after vibration., Results: The 48 and 72 h VASs of the HFG were lower than those of the MFG and CG. The immediate and 24 and 48 h IL-6 concentrations in the HFG were lower than those in the CG. The 24 h IL-6 concentration in the HFG was lower than that in the MFG and that in the MFG was lower than that in the CG. LDH concentrations at different time points did not differ amongst groups. Immediate and 24 h CK concentrations were lower in the HFG than in the CG. The immediate and 24, 48, and 72 h knee extensions at 60°/s PT were lower in the HFG than in the CG. The immediate and 24 and 48 h knee extension at 60 °/s PT in the MFG were lower than those in the CG. The 24 h knee extension (240°/s peak torque) value in the HFG was lower than that in the CG., Conclusion: Stimulation with 50 Hz (amplitude of 3 mm) vibration can reduce the muscle pain, IL-6 and CK concentrations and knee extension loss caused by DOMS. However, stimulation with 25 Hz (amplitude of 3 mm) vibration had poor effects. Results suggested that high-frequency vibration training is an effective strategy for relieving DOMS after intensive training., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cheng, Wang, He and Yan.)

Background: Exercise therapy is occasionally considered as an initial treatment for temporomandibular disorders. However, pain can be exacerbated during exercise therapy., Objective: To investigate the immediate curative effects of exercise therapy in patients with masticatory muscle myalgia., Methods: Fifty-nine patients with masticatory muscle myalgia were included. Therapists performed exercise therapy (stretched the painful masseter and/or cervical muscles along the direction of muscle contraction) in 10 rounds of traction, each lasting 10 s. The patient's pain-free maximum mouth opening distance and degree of pain (VAS value) before and immediately after exercise therapy were compared using the Wilcoxon signed-rank test. The Mann-Whitney U test was used for the subgroup comparisons., Results: Mouth opening increased from 41 (IQR 38-43) to 46 (IQR 43-48) mm and pain alleviation from 48 (IQR 31-56) to 21 (IQR 10-56) immediately following exercise therapy (p < .001 for both). None of the patients experienced pain exacerbation or reduction in mouth opening post-exercise. No difference in mouth opening distance changes according to sex, painful side, painful site and therapist were observed (p > .05 for all). Pain reduction was greater in patients with unilateral pain (26, IQR 12-39) than those with bilateral (13, IQR 5-25) (p = .019). There were no differences in the change in the degree of pain according to sex, painful site and therapist (p > .05 for all)., Conclusion: Exercise therapy immediately enlarged the mouth opening distance and reduced myalgia; therefore, it could be helpful in managing masticatory muscle myalgia., (© 2022 John Wiley & Sons Ltd.)

Background: Cupping therapy originated in Eastern Medicine, became renowned in complementary medicine and is utilized as a therapeutic treatment in contemporary medicine for musculoskeletal issues. As with any modality, there is a question of efficacy., Objective: This study investigated the effect of cupping therapy on muscle stiffness (MS), active dorsiflexion (DF) and perceived pain of the medial gastrocnemius muscle following a cupping therapy treatment., Methods: Single cohort design included 20 physically active, healthy participants (10 women, 10 men; age: 22.9 years ± 3.35 years) completed an exercise protocol to induce delayed onset muscle soreness in both lower legs., Intervention: A 5-minute dry cupping treatment was performed on the dominant leg medial gastrocnemius and 5 minutes of rest for the non-dominant control leg., Primary Outcome Measures: Muscle stiffness, active dorsiflexion and perceived pain were measured at baseline, pre-treatment, post-treatment and 5 minutes post-treatment in the medial gastrocnemius muscle. A repeated measures ANOVA was used to analyze the main effect and interaction for condition and time., Results: Active DF was significantly different from baseline to pre-treatment, post-treatment and 5 minutes post-treatment (P < .001, P < .001, P = .01, respectively). Pre-treatment to 5 minutes post-treatment, active DF was also significantly different (P = .05). Active DF was significantly improved post-treatment and 5 minutes post-treatment. Baseline pain was significantly different from pre-treatment, post-treatment and 5 minutes post-treatment measurements (P < .001, P < .001, P < .001, respectively). Pre-treatment pain was significantly different from post-treatment and 5 minutes post-treatment pain (P = .009, P < .001, respectively). Post-treatment pain was also significantly different from 5 minutes post-treatment pain (P = .007). MS was not significant at any of the time points (P = .398) or between conditions (P = .140)., Conclusion: A single cupping treatment significantly improved active DF and decreased pain was observed in the treatment group. No significant difference in MS was observed following the treatment.

Objectives: Previous studies showed that vibration foam rolling (VFR) on damaged muscles improves muscle soreness and range of motion (ROM). VFR intervention can also increase the ROM and pain pressure threshold (PPT) in the non-rolling side, known as a cross-education effect. However, this is not clear for the non-rolling side. Therefore, this study aimed to investigate the cross-education effects of VFR intervention on ROM, muscle soreness, and PPT in eccentrically damaged muscles., Methods: Participants were sedentary healthy male volunteers (n=14, 21.4±0.7 y) who performed eccentric exercise of the knee extensors with the dominant leg and received 90-s VFR intervention of the quadriceps at the nondamaged side 48 h after the eccentric exercise. The dependent variables were measured before the exercise (baseline), before (preintervention), and after VFR intervention (postintervention) 48 h after the eccentric exercise. The Bonferroni post hoc test was used to determine the differences between baseline, preintervention, and postintervention., Results: Results showed that the VFR intervention on the nondamaged side 48 h after the eccentric exercise improved significantly (p<0.05) the knee flexion ROM, muscle soreness at palpation, and PPT compared to baseline., Conclusion: VFR intervention on the nondamaged side can recover ROM and muscle soreness in eccentrically damaged muscles., Competing Interests: The authors have no conflict of interest.

Objectives: To evaluate the efficacy of low-intensity focused ultrasound (LIFU) treatment on rapid relief of delayed-onset muscle soreness (DOMS) triggered by high-intensity exercise., Methods: A total of 16 healthy male college students were randomly divided into two groups: the LIFU group (n = 8) and the Sham group (n = 8). After the exercise protocol, the LIFU group received treatment, which parameters included that the power output was 2.5 W/cm 2 , the frequency was 1 MHz, and the treating time was 20 minutes. The Sham group was treated with LIFU without energy output. Visual analog scale was used to evaluate the level of DOMS in every participant. The activities of plasma creatine kinase, lactate dehydrogenase, and the plasma concentration were measured by spectrophotometry. Tumor necrosis factor-α and interleukin-6 of serum were analyzed by enzyme-linked immunosorbent assay., Results: The visual analog scale of quadriceps femoris and/or calf muscles in the LIFU group decreased significantly at 24 hours (P < 0.01) and 48 hours (P < .01) after the exercise protocol. Both the accumulation of lactic acid (P < .01) in muscle and the activity of lactate dehydrogenase (P < .01) reduced immediately after LIFU treatment. The activities of tumor necrosis factor-α and interleukin-6 24 hours lowered in the LIFU group (P < .01)., Conclusions: LIFU treatment could relieve muscle soreness rapidly and effectively in the early stages of DOMS. The application of LIFU may provide a potential strategy for clinical treatment for DOMS., (© 2021 American Institute of Ultrasound in Medicine.)

Background: Studies investigating the effects of cold-water immersion (CWI) on the recovery of athletic performance, perceptual measures and creatine kinase (CK) have reported mixed results in physically active populations., Objectives: The purpose of this systematic review was to investigate the effects of CWI on recovery of athletic performance, perceptual measures and CK following an acute bout of exercise in physically active populations., Study Design: Systematic review with meta-analysis and meta-regression., Methods: A systematic search was conducted in September 2021 using Medline, SPORTDiscus, Scopus, Web of Science, Cochrane Library, EmCare and Embase databases. Studies were included if they were peer reviewed and published in English, included participants who were involved in sport or deemed physically active, compared CWI with passive recovery methods following an acute bout of strenuous exercise and included athletic performance, athlete perception and CK outcome measures. Studies were divided into two strenuous exercise subgroups: eccentric exercise and high-intensity exercise. Random effects meta-analyses were used to determine standardised mean differences (SMD) with 95% confidence intervals. Meta-regression analyses were completed with water temperature and exposure durations as continuous moderator variables., Results: Fifty-two studies were included in the meta-analyses. CWI improved the recovery of muscular power 24 h after eccentric exercise (SMD 0.34 [95% CI 0.06-0.62]) and after high-intensity exercise (SMD 0.22 [95% CI 0.004-0.43]), and reduced serum CK (SMD - 0.85 [95% CI - 1.61 to - 0.08]) 24 h after high-intensity exercise. CWI also improved muscle soreness (SMD - 0.89 [95% CI - 1.48 to - 0.29]) and perceived feelings of recovery (SMD 0.66 [95% CI 0.29-1.03]) 24 h after high-intensity exercise. There was no significant influence on the recovery of strength performance following either eccentric or high-intensity exercise. Meta-regression indicated that shorter time and lower temperatures were related to the largest beneficial effects on serum CK (duration and temperature dose effects) and endurance performance (duration dose effects only) after high-intensity exercise., Conclusion: CWI was an effective recovery tool after high-intensity exercise, with positive outcomes occurring for muscular power, muscle soreness, CK, and perceived recovery 24 h after exercise. However, after eccentric exercise, CWI was only effective for positively influencing muscular power 24 h after exercise. Dose-response relationships emerged for positively influencing endurance performance and reducing serum CK, indicating that shorter durations and lower temperatures may improve the efficacy of CWI if used after high-intensity exercise., Funding: Emma Moore is supported by a Research Training Program (Domestic) Scholarship from the Australian Commonwealth Department of Education and Training., Protocol Registration: Open Science Framework: 10.17605/OSF.IO/SRB9D., (© 2022. The Author(s).)

The aim of this study was to investigate the effects of a mixed-method recovery intervention (MMR) consisting of active recovery, stretching, cold-water immersion, and massage on physical, technical, physiological, and perceptual recovery during and after a five-day simulated tennis tournament. Nine competitive male tennis players (age, 24.6±4.2 years) with national ranking positions (German Tennis Federation) and Universal Tennis Ratings between approximately 11-13 participated in two singles tennis tournaments, which were separated by a three-month washout period. During the tournaments, participants played five two-and-a-half-hour competitive singles tennis match on five consecutive days. For the assignment to one of two groups, athletes were matched into homogeneous pairs according to their ranking. Then, within each pair, the players were randomly assigned to one of two groups. The first group performed MMR during the first tournament, whereas the other group used passive recovery (PAS). During the second tournament, recovery conditions were interchanged. Measures of physical and technical performance as well as physiological and perceptual responses (heart rate, blood lactate concentration, perceived exertion) were recorded during match-play sessions. Furthermore, muscle soreness, perceived recovery state, blood markers, countermovement jump height (CMJ), and repeated sprint ability (RSA) were determined before, during, and after the five-day tournament periods. Results showed significant changes over time ( P  < 0.05) in muscle soreness, perceived recovery state, creatine kinase, c-reactive protein, insulin-like growth factor 1, and countermovement jump height. However, no significant differences or recovery strategy x time interactions were noted either for tennis-specific performance (e.g. number of total points won) or any other of the measured parameters between MMR and PAS ( P  > 0.05). In conclusion, the repeated use of MMR during and after a five-day tennis tournament did not affect match performance, match load, or recovery from repeated days of tennis match play.

This study aimed to investigate the acute effect of capacitive and resistive electric transfer (CRet) intervention on eccentrically damaged muscle. A total of 28 healthy and sedentary male volunteers were randomly allocated to either CRet intervention or control groups. The participants performed a bout of eccentric exercise of the knee extensors with the dominant leg and received 30 min of CRet intervention of the quadriceps 48 h after the exercise. The dependent variables for the analysis were knee flexion range of motion (ROM), muscle soreness and maximum voluntary isometric (MVC-ISO), and concentric contraction (MVC-CON) torque of the knee extensors. These were measured prior to exercise (baseline) and before and after CRet intervention (48 h after the exercise). The results showed that knee flexion ROM, muscle strength (MVC-ISO and MVC-CON), and muscle soreness significantly improved after CRet intervention. CRet intervention may improve muscle soreness and loss of muscle function in an eccentrically damaged muscle.

Background: Cervicofacial burn (CB) is a unique type of burn, involving the lateral part of the face, neck and chest region with significant skin contractures. Temporomandibular joint (TJ) pain and orofacial myalgia (OM) are the major problems in physiotherapy context to treat. Laser is commonly used as an adjunct therapy in painful conditions. However, clinical studies are lacking in investigating the effects of gallium-arsenide (Ga-As) super pulsed laser therapy on temporomandibular joint pain and orofacial myalgia following healed cervicofacial burn patients., Objective: To investigate the effects of clinical and functional efficacy of Ga-As super pulsed laser therapy on temporomandibular joint pain with orofacial myalgia following healed cervicofacial burn patients., Methods: Through two block random sampling method, the eligible participants were randomized and allocated into active laser (Active-L; n = 18) and placebo laser (Placebo-L; n = 18) groups. The Active-L group received laser treatment and the Placebo-L group received placebo laser effect (inactive laser) with regular physiotherapy care for 3 times in a week for 4 weeks. Primary (pain intensity, pain threshold, pain frequency) and secondary (mouth opening, disability level and quality of life) measures were measured at baseline, after the end 4th week, 8th week and 6 month follow up., Results: Baseline subjective and clinical attributes show homogenous presentation among the study groups (p > 0.05). After four weeks of treatment, and at the end of 6 months follow up, the pain intensity, 2.9 (CI 95% 2.80-3.00), pain threshold 19.2 (CI 95% -30.4 to -7.9), pain frequency 3.4 (CI 95% 3.14-3.65), mouth opening, -16.0 (CI 95%-16.5 to -15.4), disability level 11.3 (CI 95%11.14-11.45), and quality of life -31.7 (CI 95%-37.1 to -26.2) showed more improvement (p < 0.001) in Active-L group than Placebo-L group., Conclusion: The reports of this study proved that, four weeks active laser therapy with regular physiotherapy care has an ideal treatment protocol for temporomandibular joint pain with orofacial myalgia following healed cervicofacial burn. This study also provided a new knowledge for physiotherapists in the field of temporomandibular joint pain rehabilitation., (Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved.)

Purpose: To determine whether a single acute preexercise bout of partial-body cryotherapy (PBC) enhanced maximal-effort shuttle run performance, salivary enzyme concentration, and self-reported performance readiness., Methods: A total of 18 male rugby league players (age = 20.1 [0.5] y; mass = 91.4 [12.4] kg) were exposed to either PBC for 3 minutes at -136°C (1°C) or a control condition prior to a continuous, high-intensity 6 × 40-m shuttle run test. Passive saliva samples were collected to determine salivary alpha amylase (sAA) concentration. Perceived performance readiness and well-being questionnaires were completed using a 1-to-7 Likert scale., Results: The PBC exposure did not elicit a greater improvement in 6 × 40-m shuttle run performance in comparison with the control condition (standardized difference; +0.4 [5.9%]; P = .881; mean ± 90% confidence limits). The increase in sAA concentration was moderately greater 15 minutes after PBC compared with the control group (+67 [32%], P = .012) and remained moderately higher up to 2 hours post-PBC exposure compared with the control condition (+41 [40%], P = .045). There were greater improvements in self-reported perceptions of muscle soreness (+0.6 [0.4%], P = .043; units ±90% confidence limits) and mood (+0.6 [0.7%], P = .038) after PBC compared with control., Conclusions: It appears that a single 3-minute bout of PBC does not augment maximal effort shuttle run performance in elite rugby league players. Beneficial increases in sAA concentration, coupled with improved perceptions of muscle soreness and mood, should be explored further for alternative training or precompetition practices.

Fatigue is a major cause of exercise-induced muscle damage (EIMD). Compression garments (CGs) can aid post-exercise recovery, therefore, this study explored the effects of CGs on muscular efficacy, proprioception, and recovery after exercise-induced muscle fatigue in people who exercise regularly. Twelve healthy participants who exercised regularly were enrolled in this study. Each participant completed an exercise-induced muscle fatigue test while wearing a randomly assigned lower-body CG or sports pants (SP); after at least 7 days, the participant repeated the test while wearing the other garment. The dependent variables were muscle efficacy, proprioception (displacements of center of pressure/COP, and absolute error), and fatigue recovery (muscle oxygen saturation/SmO2, deoxygenation and reoxygenation rate, and subjective muscle soreness). A two-way repeated measure analysis of variance was conducted to determine the effect of garment type. The results indicated that relative to SP use, CG use can promote muscle efficacy, proprioception in ML displacement of COP, and fatigue recovery. Higher deoxygenation and reoxygenation rates were observed with CG use than with SP use. For CG use, SmO2 quickly returned to baseline value after 10 min of rest and was maintained at a high level until after 1 h of rest, whereas for SP use, SmO2 increased with time after fatigue onset. ML displacement of COP quickly returned to baseline value after 10 min of rest and subsequently decreased until after 1 hour of rest. Relative to SP use, CG use was associated with a significantly lower ML displacement after 20 min of rest. In conclusion, proprioception and SmO2 recovery was achieved after 10 min of rest; however, at least 24 h may be required for recovery pertaining to muscle efficacy and soreness regardless of CG or SP use., Competing Interests: The authors have declared that no competing interests exist.

Objective: To comprehensively compare the effectiveness of cold and heat therapies for delayed onset muscle soreness using network meta-analysis., Methods: Eight Chinese and English databases were searched from date of establishment of the database to 31 May 2021. Cochrane risk-of-bias tool was used to analyse the included randomized controlled trials. Potential papers were screened for eligibility, and data were extracted by 2 independent researchers., Results: A total of 59 studies involving 1,367 patients were eligible for this study. Ten interventions were examined: contrast water therapy, phase change material, the novel modality of cryotherapy, cold-water immersion, hot/warm-water immersion, cold pack, hot pack, ice massage, ultrasound, and passive recovery. Network meta-analysis results showed that: (i) within 24 h after exercise, hot pack was the most effective for pain relief, followed by contrast water therapy; (ii) within 48 h, the ranking was hot pack, followed by the novel modality of cryotherapy; and (iii) over 48 h post-exercise, the effect of the novel modality of cryotherapy ranked first., Conclusion: Due to the limited quality of the included studies, further well-designed research is needed to draw firm conclusions about the effectiveness of cold and heat therapies for delayed onset muscle soreness.

Electrotherapy is commonly used for myalgia alleviation. Low-frequency stimulation (LFS) is primarily used for controlling acute and chronic pain and is a non-invasive therapy that can be easily performed with electric stimulation applied on the skin. However, little evidence exists regarding the pain alleviation effects of personal low-frequency stimulation device for home use. Moreover, no studies have compared myalgia alleviation effects between personal low-frequency stimulation (PLS) and physical therapy (PT), which are most commonly used for patients with myalgia in hospitals and clinics. Therefore, we aimed to investigate the pain alleviation effects of PLS in patients with myalgia and compare these effects with those of conventional PT (transcutaneous electrical nerve stimulation + ultrasound). In total, 39 patients with myalgia in the neck, shoulder, back, and waist areas were randomly assigned to the personal low-frequency stimulation group (PLSG: n = 20) and physical therapy group (PTG: n = 19). Both groups were treated for 3 weeks (20 min per session and 5 sessions per week). Patients were assessed for pain intensity by surface electromyography (sEMG), visual analogue scale (VAS) and a short-form McGill pain questionnaire (SF-MPQ) before and after the intervention period. Our results showed that PLSG showed a tendency of muscle relaxation with a significant decrease in sEMG in the neck ( p = 0.0425), shoulder ( p = 0.0425), and back ( p = 0.0046) areas compared to the control group. However, there was no significant difference in waist area. Additionally, VAS scores significantly decreased between pre- and post-treatment in both PTG ( p = 0.0098), and PLSG ( p = 0.0304) groups, but there was no significance difference between the groups. With respect to SF-MPQ, the PLSG showed greater pain alleviation (5.23 ± 0.25) effects than the PTG (6.23 ± 0.25). Accordingly, our results suggest that PLS treatment using a home device might offer positive assistance in pain alleviation for patients with myalgia that is as equally effective as conventional PT treatment. However, further detailed studies are required considering larger samples to fully claim the effectiveness of this device.

Aims: To evaluate the short-term effects of a standardized first-line noninvasive approach (FL-A) including counseling and self-management strategies on pain, masticatory muscle tenderness, and awake bruxism in women with chronic temporomandibular disorder myalgia (mTMD) and to test whether patients' trait anxiety predicted their response to treatment., Methods: FL-A was administered to 14 women with chronic mTMD (mean age ± SD = 33.8 ± 11.1 years; 8 with Graded Chronic Pain Scale [GCPS] grade I and 6 with grade II). Its effects on facial pain, masticatory muscle tenderness, and spontaneous awake bruxism episodes were evaluated using questionnaires, surface electromyography, and quantitative sensory testing. General linear models were used to test FL-A efficacy after 1 (T1) and 2 (T2) months., Results: FL-A reduced pain (from baseline [T0] to T2, P = .010), the frequency of awake bruxism episodes (T0 to T1, P = .024), and their intensity by about 30% (T0 to T1, P < .001). Pressure pain thresholds at the masticatory muscle locations increased significantly from T0 to T2 (P < .001). Patients' trait anxiety decreased significantly from T0 to T2 (P = .030). Trait anxiety measured at baseline was not correlated with relative changes in pain (T0 to T2, P = .248)., Conclusion: In the short term, FL-A reduces facial pain, masticatory muscle tenderness, and awake bruxism in women with chronic mTMD with low disability. A conservative management strategy should be prioritized for the initial management of these patients.

Objective: To evaluate the impact of interventions on pain associated with DOMS., Data Sources: PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to "DOMS" and "intervention therapy"., Eligibility Criteria: Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced., Results: One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I 2  = 60 %), cryotherapy (p = 0,002 I 2  = 100 %), phototherapy (p = 0,0001 I 2  = 95 %), vibration (p = 0,004 I 2  = 96 %), ultrasound (p = 0,02 I 2  = 97 %), massage (p < 0,00001 I 2  = 94 %), active exercise (p = 0,0004 I 2  = 93 %) and compression (p = 0,002 I 2  = 93 %) have a better positive effect than the control in the management of DOMS., Conclusion: Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain., Competing Interests: Declaration of competing interest None declared. The authors declare that the research was conducted with no features that could be construed as a potential conflict of interest., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: To investigate the effects of a single session of either peristaltic pulse dynamic leg compressions (PPDC) or local heat therapy (HT) after prolonged intermittent shuttle running on skeletal muscle glycogen content, muscle function, and the expression of factors involved in skeletal muscle remodeling., Methods: Twenty-six trained individuals were randomly allocated to either a PPDC (n = 13) or a HT (n = 13) group. After completing a 90-min session of intermittent shuttle running, participants consumed 0.3 g·kg-1 protein plus 1.0 g·kg-1 carbohydrate and received either PPDC or HT for 60 min in one randomly selected leg, while the opposite leg served as control. Muscle biopsies from both legs were obtained before and after exposure to the treatments. Muscle function and soreness were also evaluated before, immediately after, and 24 h after the exercise bout., Results: The changes in glycogen content were similar (P > 0.05) between the thigh exposed to PPDC and the control thigh ~90 min (Control: 14.9 ± 34.3 vs PPDC: 29.6 ± 34 mmol·kg-1 wet wt) and ~210 min (Control: 45.8 ± 40.7 vs PPDC: 52 ± 25.3 mmol·kg-1 wet wt) after the treatment. There were also no differences in the change in glycogen content between thighs ~90 min (Control: 35.9 ± 26.1 vs HT: 38.7 ± 21.3 mmol·kg-1 wet wt) and ~210 min (Control: 61.4 ± 50.6 vs HT: 63.4 ± 17.5 mmol·kg-1 wet wt) after local HT. The changes in peak torque and fatigue resistance of the knee extensors, muscle soreness, and the mRNA expression and protein abundance of select factors were also similar (P > 0.05) in both thighs, irrespective of the treatment., Conclusions: A single 1-h session of either PPDC or local HT does not accelerate glycogen resynthesis and the recovery of muscle function after prolonged intermittent shuttle running., (Copyright © 2021 by the American College of Sports Medicine.)

Aims: Chronic widespread musculoskeletal pain (CMP) is a primary condition of Veterans suffering from Gulf War illness. This study evaluated the influence of resistance exercise training (RET) on symptoms, mood, perception of improvement, fitness, and total physical activity in Gulf War Veterans (GWV) with CMP., Main Methods: Fifty-four GWV with CMP were randomly assigned to 16 weeks of RET (n = 28) or wait-list control (n = 26). Supervised exercise was performed twice weekly starting at a low intensity. Outcomes, assessed at baseline, 6, 11 and 17 weeks and 6- and 12-months post-intervention, were: pain, fatigue, mood, sleep quality, perception of improvement, and physical activity via self-report and accelerometry. Muscular strength was assessed at baseline, 8 and 16 weeks. Accelerometer data yielded estimates of time spent in sedentary, light, and moderate-to-vigorous physical activities. Analyses used separate linear mixed models with group and time point as fixed effects. All models, except for perceived improvement, included baseline values as a covariate., Key Findings: Participants assigned to RET completed 87% of training sessions and exhibited strength increases between 16 and 34% for eight lifts tested (Hedges' g range: 0.47-0.78). The treatment by time interaction for perceived improvement (F 1,163  = 16.94, p < 0.001) was characterized by greater perceived improvement since baseline for RET at each time point, until the 12-month follow-up. Effects were not significant for other outcomes (p > 0.05). RET caused no adverse events., Significance: After 16 weeks of RET, GWV with CMP reported improvements in their condition and exhibited increases in muscular strength, without symptom exacerbation or reductions in total physical activity., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to explore the efficiency of massage in the treatment of masseter myalgia compared with biostimulatory laser., Materials and Methods: The instrument Diagnostic Criteria for Temporomandibular Disorders was used to select subjects and monitor treatment outcome. 54 subjects with masseter myalgia of more than 3 months in duration were invited to participated and 42 cases were available at the end and analyzed. Age range was 16-67 years (median 33, interquartile range 25-53), 36% subjects was ≥40 years and there were 62% females in both groups. Both treatment groups (self-massage and laser) had 21 participants and were monitored one months after the start of treatment. Age, gender, distress, somatization, catastrophizing, hypervigilance, health competence and oral parafunctions were also assessed as factors that could influence effectiveness of treatment., Results: Laser and massage are effective in reducing symptoms of chronic myalgia of the masseter in self-reported limitation of jaw function and reducing pain intensities (p<0.001). Increase of mouth opening was present in both groups, but mainly significant in laser group. The differences in the amount of change between groups were not significant. Psychological characteristics and parafunctions, present before the treatment, age and gender did not have major affect the effectiveness of treatment., Conclusion: Both treatment modalities are effective in treatment of chronic myalgia in short-term.

Cryotherapy is utilized as a physical intervention in the treatment of injury and exercise recovery. Traditionally, ice is used in the treatment of musculoskeletal injury while cold water immersion or whole-body cryotherapy is used for recovery from exercise. In humans, the primary benefit of traditional cryotherapy is reduced pain following injury or soreness following exercise. Cryotherapy-induced reductions in metabolism, inflammation, and tissue damage have been demonstrated in animal models of muscle injury; however, comparable evidence in humans is lacking. This absence is likely due to the inadequate duration of application of traditional cryotherapy modalities. Traditional cryotherapy application must be repeated to overcome this limitation. Recently, the novel application of cooling with 15 °C phase change material (PCM), has been administered for 3-6 h with success following exercise. Although evidence suggests that chronic use of cryotherapy during resistance training blunts the anabolic training effect, recovery using PCM does not compromise acute adaptation. Therefore, following exercise, cryotherapy is indicated when rapid recovery is required between exercise bouts, as opposed to after routine training. Ultimately, the effectiveness of cryotherapy as a recovery modality is dependent upon its ability to maintain a reduction in muscle temperature and on the timing of treatment with respect to when the injury occurred, or the exercise ceased. Therefore, to limit the proliferation of secondary tissue damage that occurs in the hours after an injury or a strenuous exercise bout, it is imperative that cryotherapy be applied in abundance within the first few hours of structural damage.

Abstract: Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to minimize the negative effects of training or competition, thus enabling the athlete a quicker return to peak performance. Current evidence demonstrates improved athlete recovery with compression garments, cold water immersion, partial body cryotherapy, hyperbaric oxygen, and vibratory therapies. Other popular modalities, such as compression devices, whole body cryotherapy, percussive gun-assisted therapy, neuromuscular electrical stimulation, and pulsed electromagnetic therapy lack convincing evidence concerning athlete recovery. This article seeks to review the current literature and offer the reader an updated understanding of the mechanisms for each modality and the evidence regarding each modality's potential benefit in an athlete's recovery strategy., (Copyright © 2021 by the American College of Sports Medicine.)

Obese women were more susceptible to myalgia because of their significantly lower vitamin D concentrations; the present study investigated the efficacy of vitamin D in addition to an aerobic interval training in the management of obese women with myalgia. Forty-five obese women with vitamin D deficiency and myalgia (30 to 40 years old) were assigned randomly into three equal groups. Group A received an aerobic interval training with vitamin D supplementation, Group B received vitamin D supplementation only, and Group C received aerobic interval training only; participants in all groups were on calorie deficient diets. The study outcomes were the Visual Analog Scale (VAS) for Pain Evaluation, serum vitamin D level, and Cooper 12-Minute Walk Test for Functional Capacity Evaluation, while the Short-Form Health Survey (SF) was used for assessment of quality of life. We detected a significant improvement in pain intensity level, serum vitamin D level, and quality of life in all groups with significant difference between Group A and groups B and C. We also detected a significant improvement in functional capacity in groups A and C, with no significant change in Group B. Aerobic interval training with vitamin D supplementation was more effective for the management of obese women with perceived myalgia.

To evaluate the effect of photobiomodulation therapy (PBMT) on painful temporomandibular disorders (TMD) patients in a randomized, double-blinded, placebo-controlled manner. Participants were divided into a masseter myalgia group (n = 88) and a temporomandibular joint (TMJ) arthralgia group (n = 87) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Both groups randomly received PBMT or placebo treatment once a day for 7 consecutive days, one session. The PBMT was applied with a gallium-aluminum-arsenide (GaAlAs) laser (wavelength = 810 nm) at pre-determined points in the masseter muscle (6 J/cm 2 , 3 regions, 60 s) or TMJ region (6 J/cm 2 , 5 points, 30 s) according to their most painful site. Pain intensity was rated on a 0-10 numerical rating scale (NRS) and pressure pain thresholds (PPT) and mechanical sensitivity mapping were recorded before and after the treatment on day 1 and day 7. Jaw function was assessed by pain free jaw opening, maximum unassisted jaw opening, maximum assisted jaw opening, maximum protrusion and right and left excursion. Data were analyzed with a mixed model analysis of variance (ANOVA). Pain intensity in arthralgia patients decreased over time (P < 0.001) for both types of interventions, however, PBMT caused greater reduction in pain scores than placebo (P = 0.014). For myalgia patients, pain intensity decreased over time (P < 0.001) but without difference between interventions (P = 0.074). PPTs increased in both myalgia (P < 0.001) and TMJ arthralgia patients over time (P < 0.001) but without difference between interventions (P ≥ 0.614). Overall, PBMT was associated with marginally better improvements in range of motion compared to placebo in both myalgia and arthralgia patients. Pain intensity, sensory function and jaw movements improve after both PBMT and placebo treatments in myalgia and arthralgia patients indicating a substantial non-specific effect of PBMT.