Share this article on:

Ischemic Preconditioning Blunts Muscle Damage Responses Induced by Eccentric Exercise


Medicine & Science in Sports & Exercise: January 2018 - Volume 50 - Issue 1 - p 109–115
doi: 10.1249/MSS.0000000000001406
Applied Sciences

Purpose Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion injury during surgery. Because of similarities between the pathophysiological formation of ischemia and reperfusion 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 proinflammatory signaling, the purpose of the present study was to investigate whether IPC performed before eccentric exercise may also protect against EIMD.

Methods 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 (3 × 10 repetitions at 80% of the concentric one-repetition maximum). In IPC + ECC, IPC was applied bilaterally at the upper arms by a tourniquet (200 mm Hg) immediately before the exercise (3 × 5 min of occlusion, separated by 5 min of reperfusion). Creatine kinase (CK), arm circumference, subjective pain (visual analog scale score), and radial displacement (tensiomyography, maximal radial displacement) were assessed before IPC, preexercise, postexercise, and 20 min, 2 h, 24 h, 48 h, and 72 h postexercise.

Results CK differed from baseline only in ECC at 48 h (P < 0.001) and 72 h (P < 0.001) postexercise. After 24, 48, and 72 h, CK was increased in ECC compared with IPC + ECC (between groups: 24 h, P = 0.004; 48 h, P < 0.001; 72 h, P < 0.001). The visual analog scale score was significantly higher in ECC at 24–72 h postexercise when compared with IPC + ECC (between groups: all P values < 0.001). The maximal radial displacement was decreased on all postexercise days in ECC (all P values < 0.001) but remained statistically unchanged in IPC + ECC (between groups: P < 0.01).

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

1Department of Orthopedics, University Hospital Duesseldorf, Duesseldorf, GERMANY; 2Faculty of Sport Sciences, Goethe University Frankfurt, Frankfurt, GERMANY; and 3Department of Molecular and Cellular Sport Medicine, German Sport University, Cologne, GERMANY

Address for correspondence: Alexander Franz, B.Sc., Department of Orthopedics, University Hospital Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Germany; E-mail:

Submitted for publication April 2017.

Accepted for publication July 2017.

© 2018 American College of Sports Medicine