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Ischemic Preconditioning Blunts Muscle Damage Responses Induced by Eccentric Exercise

Franz, Alexander; Behringer, Michael; Harmsen, Jan-Frieder; Mayer, Constantin; Krauspe, Rüdiger; Zilkens, Christoph; Schumann, Moritz
Medicine & Science in Sports & Exercise: Post Acceptance: August 22, 2017
doi: 10.1249/MSS.0000000000001406
Original Investigation: PDF Only


Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion-injury (I/R-Injury) during surgery. Due to similarities between the pathophysiological formation of I/R-injury and eccentric exercise-induced muscle damage (EIMD), as characterized by an intracellular accumulation of Ca2+, an increased production of reactive oxygen species and increased pro-inflammatory signaling, the purpose of the present study was to investigate whether IPC performed prior to eccentric exercise may also protect against EIMD.


Nineteen healthy men were matched to an eccentric only (ECC) (n=9) or eccentric proceeded by IPC group (IPC+ECC) (n=10). The exercise protocol consisted of bilateral biceps curls (3x10 repetitions at 80% of the concentric 1RM). In IPC+ECC, IPC was applied bilaterally at the upper arms by a tourniquet (200 mmHg) immediately prior to the exercise (3x5 minutes of occlusion, separated by 5 minutes of reperfusion). Creatine Kinase (CK), arm circumference, subjective pain (VAS score) and radial displacement (Tensiomyography, Dm) were assessed before IPC, pre-exercise, post-exercise, 20 minutes-, 2 hours-, 24 hours-, 48 hours- and 72 hours post-exercise.


CK differed from baseline only in ECC at 48h (p<0.001) and 72h (p<0.001) post-exercise. After 24h, 48h and 72h, CK was increased in ECC compared to IPC+ECC (between groups: 24h: p=0.004, 48h: p<0.001, 72h: p<0.001). VAS was significantly higher in ECC at 24-72 h post-exercise, when compared to IPC+ECC (between groups: all p<0.001). Dm was decreased on all post-exercise days in ECC (all p<0.001) but remained statistically unchanged in IPC+ECC (between-groups p<0.01).


These findings indicate that IPC performed prior to a bout of eccentric exercise of the elbow flexors blunts EIMD and exercise-induced pain, while maintaining the contractile properties of the muscle.

Corresponding author: Alexander Franz, Department of Orthopedics, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany. E-Mail:

All authors declare that there are no financial and personal relationships with third parties or organizations that could have inappropriately influenced the present work. The authors further state that no funding was received. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation, and the results of the present study do not constitute endorsement by ACSM.

Accepted for Publication: 19 July 2017

© 2017 American College of Sports Medicine