The relationship between stiffness and pain following unaccustomed eccentric exercise: the effects of gentle stretch and repeated bout
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To determine how muscle stiffness and pain which develop after eccentric exercise are affected by gentle stretching and repeated exercise.
Twenty-one healthy female participants undertook eccentric exercise of the elbow flexors and changes in resting elbow flexion angle (REFA; a measure of muscle stiffness), pain on stretch scale, pain elicited by pressure (PPT pain, a measure of mechanoreceptor hypersensitivity), and upper arm girth were followed for 7 days after exercise. The effects of gentle passive stretching on pain and muscle stiffness were investigated 2 and 4 days after exercise. Eleven participants also repeated the exercise with the same arm 6 weeks after the first bout.
There was a significant relationship between the pain on stretch scale and increased REFA (day 4; R2 = 0.65, p < 0.001), whereas there was no relationship between REFA and PPT pain. REFA was reduced by passive stretching and pain on stretch scale was also reduced from 3.0 (1.4, 5.1) to 0.75 (0.0, 2.0) [median (IQR), p = 0.01]. PPT pain was unaffected by the passive stretching, as was muscle swelling. Following the repeated bout, increases in REFA were much reduced, as was pain on stretch scale (p = 0.02). However, PPT pain was not significantly different between the two bouts of exercise.
The results indicate that reductions in pain on stretch scale, either by gentle passive stretching or as the result of repeated exercise, are primarily due to reductions in muscle stiffness which develops after eccentric exercise, whereas mechanoreceptor hypersensitivity is relatively unaffected.
KeywordsEccentric exercise Stretching exercise Damage response Elbow flexor muscle
Delayed onset of muscle soreness
Maximum voluntary isometric contraction
Pressure pain threshold
Resting elbow flexion angle
Visual analog scale
The present study does not constitute any financial funding. We would like to thank all of participants.
PM was responsible the experimental design, data collection, and analysis drafting the manuscript. DAJ and SK were concerned with the design of the study, data analysis and drafting the manuscript. MM and AS assisted with data collection and drafting the manuscript and blood examination. All authors approved the final version of the manuscript. All authors agree to be accountable for all aspects of the work.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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