Although the aforementioned studies found no clear benefit of acute ginger supplementation on exercise-induced muscle pain, additional studies from Black et al. (12) found that 11 days of ginger supplementation (2 g·d−1) reduced pain stemming from eccentric actions of the elbow flexors. To induce muscle soreness, untrained participants completed 3 sets of 6 repetitions of elbow flexor exercises using a weight equal to 120% of concentric 1 repetition maximum (1RM). The article presented the results of 2 separate studies, one of which compared ground raw ginger with placebo while the other compared heat-treated ginger with placebo. In both studies, participants consumed ginger or placebo capsules for 7 days before, the day of, and for 3 days after the elbow flexor protocol. Raw ginger reduced muscle soreness by 25% (p = 0.041) relative to placebo, while heat-treated ginger reduced soreness by 23% (p = 0.049) relative to placebo. The duration of supplementation was the major difference between these and previous investigations, suggesting that the analgesic properties of ginger may require several days to take full effect.
Overall, the available research indicates no clear ergogenic benefit of ginger on oxygen use, heart rate, metabolic rate, body composition, isometric force generation, or perceived exertion. A single investigation suggests relatively high-dose ginger supplementation (4 g·d−1) may accelerate recovery of upper body strength after eccentric resistance exercise. In addition, chronic ginger supplementation may reduce the inflammatory response to cardiorespiratory exercise. More research is needed to determine whether ginger supplementation affects other performance outcomes such as the functional adaptations to chronic resistance and cardiorespiratory training.
Warnings regarding the potential for ginger to increase the risk of bleeding and to interact with anticoagulant medications are present in the literature (64,82). Suggestions that ginger may increase bleeding time are primarily based on in vitro research showing that ginger inhibits thromboxane synthesis and platelet aggregation (69,88). Ginger supplementation trials in humans, however, have been equivocal; several studies have found no significant effects on thromboxane production (42,54) or bleeding time (54), with others showing significant decreases in platelet aggregation (15,106) and thromboxane production (89).
It is yet to be determined whether ginger, like NSAIDs, influences hyponatremia risk and connective and bone tissue remodeling. Human studies examining the effects of ginger on renal physiology and function are needed to establish whether ginger is a potentially nephrotoxic agent that should be avoided during prolonged endurance exercise. Likewise, additional research is needed to determine whether ginger supplementation modifies the connective and bone tissue remodeling process that normally occurs with weight-bearing exercise.
Finally, the effects of ginger on muscle protein synthesis and adaptations to endurance and resistance training require examination. It has been hypothesized that COX enzymes regulate muscle protein synthesis and that COX inhibition may blunt the rise in muscle protein synthesis that normally accompanies exercise (112). Given ginger's inhibition of COX enzymes, it is possible that chronic ginger consumption may modify the functional and morphological responses to resistance and endurance training.
A common limitation of the human research on ginger is a lack of reporting and/or standardization of bioactive compounds in treatments (70,91). Ginger contains many bioactive compounds, such as gingerols and shogaols, which are known to have varying effects on physiological pathways, including COX enzymes (1,102). Variations in the concentrations of these bioactive compounds make between-study comparisons and clinical application challenging. Additionally, the myriad of ways ginger can be prepared (e.g., powder, oil, extract, ground, heat-treated) further complicates between-study comparisons.
The pungent flavor and aroma of ginger are substantial obstacles to designing placebo-controlled double-blind trials. This may be particularly problematic for studies supplementing ginger before prolonged endurance exercise, given the relatively frequent incidence of reflux experienced during endurance exercise and with ginger supplementation. Although all of the articles identified from this review's PubMed search reported double-blinding, only 2 collected information on the success of blinding (12,116). While the utility of formally assessing the success of blinding has been questioned (81), ascertaining reasons why a participant believes they were consuming ginger or placebo (e.g., ginger smell or taste) may provide insight as to whether the sensory characteristics of the treatment and placebo were well-matched. Interestingly, ginger may be easier to blind if it is administered in blister packs as opposed to bottles, due to the odor arising from the storage of numerous ginger capsules in a single container (104,119).
Notably, several of the studies included in this review recruited untrained participants (12–14,60), including one that found ginger reduced soreness (12) and another that showed ginger accelerated recovery of strength (60). While it is common for muscle damage studies to use untrained individuals (presumably because it is easier to induce muscle soreness), this practice limits generalizability of the findings. Consequently, studies including trained individuals will be needed to further elucidate the analgesic properties of ginger in athletic populations.
Despite shortcomings in the research, tentative and circumstantial evidence suggests that ginger may offer a favorable combination of analgesic, GI, and respiratory effects, and thus, it seems reasonable to conduct additional research evaluating ginger as an analgesic and ergogenic aid for exercise training and sport. Future research should directly compare the analgesic properties and side effects of ginger with NSAIDs in athletes and individuals undergoing exercise training. These future trials should include trained individuals and pay particular attention to blinding effectiveness and reporting of adverse events, as these details have been lacking in the research to date.
The author discloses no conflicts of interest. The entirety of this article was conceived and drafted by P. B. Wilson.
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