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Exercise-Induced Muscle Damage in Humans

Clarkson, Priscilla M., PhD; Hubal, Monica J., MS

American Journal of Physical Medicine & Rehabilitation: November 2002 - Volume 81 - Issue 11 - p S52-S69
Literature Review: Contraction-Induced Muscle Injury

Clarkson PM, Hubal MJ: Exercise-induced muscle damage in humans. Am J Phys Med Rehabil 2002;81(Suppl):S52–S69.

Exercise-induced muscle injury in humans frequently occurs after unaccustomed exercise, particularly if the exercise involves a large amount of eccentric (muscle lengthening) contractions. Direct measures of exercise-induced muscle damage include cellular and subcellular disturbances, particularly Z-line streaming. Several indirectly assessed markers of muscle damage after exercise include increases in T2 signal intensity via magnetic resonance imaging techniques, prolonged decreases in force production measured during both voluntary and electrically stimulated contractions (particularly at low stimulation frequencies), increases in inflammatory markers both within the injured muscle and in the blood, increased appearance of muscle proteins in the blood, and muscular soreness. Although the exact mechanisms to explain these changes have not been delineated, the initial injury is ascribed to mechanical disruption of the fiber, and subsequent damage is linked to inflammatory processes and to changes in excitation-contraction coupling within the muscle. Performance of one bout of eccentric exercise induces an adaptation such that the muscle is less vulnerable to a subsequent bout of eccentric exercise. Although several theories have been proposed to explain this “repeated bout effect,” including altered motor unit recruitment, an increase in sarcomeres in series, a blunted inflammatory response, and a reduction in stress-susceptible fibers, there is no general agreement as to its cause. In addition, there is controversy concerning the presence of sex differences in the response of muscle to damage-inducing exercise. In contrast to the animal literature, which clearly shows that females experience less damage than males, research using human studies suggests that there is either no difference between men and women or that women are more prone to exercise-induced muscle damage than are men.

From the Department of Exercise Science, University of Massachusetts, Amherst, Massachusetts.

Presented at the State of the Science Roundtable 2001: Role of Physical Activity and Exercise Training in Neuromuscular Diseases, San Diego, California, September 30 through October 3, 2001, a conference sponsored by the National Institute on Disability and Rehabilitation Research and Training Center in Neuromuscular Diseases at the University of California–Davis, University of California–Davis Exercise Biology Program, and the Muscular Dystrophy Association.

All correspondence and requests for reprints should be addressed to Priscilla M. Clarkson, PhD, Department of Exercise Science, Totman Building, University of Massachusetts, Amherst, MA 01003.

© 2002 Lippincott Williams & Wilkins, Inc.