Blood Flow After Exercise-Induced Muscle Damage

Abstract

Context:The most common modality used to address acute inflammation is cryotherapy. Whereas pain decreases with cryotherapy, evidence that changes occur in perfusion of skeletal muscle is limited. We do not know whether ice attenuates the increases in perfusion associated with acute inflammation.Objective: To examine the effects of repeated applications of ice bags on perfusion of the gastrocnemius muscle after an eccentric exercise protocol.Design: Controlled laboratory study. Setting: Laboratory.Patients or Other Participants: Eighteen healthy participants (3 men, 15 women; age ¼ 22.2 6 2.2 years, height ¼ 166.0 6 11.9 cm, mass ¼ 69.4 6 25.0 kg).Intervention(s): To induce eccentric muscle damage, participants performed 100 unilateral heel-lowering exercises off a step to the beat of a metronome. A randomized intervention (cryotherapy, sham, control) was applied to the exercised lower extremity immediately after the protocol and again at 10, 24, and 34 hours after the protocol.Main Outcome Measure(s): Baseline perfusion measurements (blood volume, blood flow, and blood flow velocity) were taken using contrast-enhanced ultrasound of the exercised leg.Perfusion was reassessed after the first intervention and 48 hours after the protocol as percentage change scores. Pain was measured with a visual analog scale at baseline and at 10, 24, 34, and 48 hours after the protocol. Separate repeatedmeasures analyses of variance were used to assess each dependent variable.Results: We found no interactions among interventions for microvascular perfusion. Blood volume and blood flow, however, increased in all conditions at 48 hours after exercise (P , .001), and blood flow velocity decreased postintervention from baseline (P ¼ .041). We found a time-by-intervention interaction for pain (P ¼ .009). Visual analog scale scores were lower for the cryotherapy group than for the control group at 34 and 48 hours after exercise.Conclusions: Whereas eccentric muscle damage resulted in increased blood flow, ice did not decrease muscle perfusion 48 hours after exercise. Therefore, ice does not seem to decrease muscle perfusion when blood flow is elevated, as it would be during inflammation.

Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes

“…We studied highly trained athletes; however, the effects of CWI can last longer in athletes who train at lower levels. In healthy individuals, Selkow et al 12 observed less perceived pain 48 hours after CWI. Given that our results provided evidence of a positive effect of CWI on serum LDH levels, muscle soreness, and upper and lower body performance until 24 hours, this approach can be useful when athletes are submitted to periods of intensified training.…”

“…These peripheral changes from the low temperature of the liquid medium result in less muscle soreness signaling. 31 Whereas the analgesic effect of CWI has not been fully explained, 12 investigators 32 believe that the smaller nerve conduction decreases the firing rate of the muscle spindle and afferent responses, thereby decreasing pain and spasm. Yanagisawa et al 33 observed that cryotherapy increases intracellular pH, delaying the onset of muscle edema, but other physiologic effects, such as the release of interleukin-6, can occur in the muscles.…”

“…Among these methods, cold-water immersion (CWI) has been used widely. It causes peripheral vasoconstriction, which reduces the metabolic outflow resulting from exercise, and decreases nerve conduction in the exercised muscle, resulting in decreased muscle soreness 12,13 ; however, little evidence is available to support its effectiveness in improving physical performance. 13,14 In addition, Rupp et al 15 reported that CWI decreased muscle temperature faster than an ice pack, so this approach seems to be relevant to athletes conducting successive training sessions.…”

The Effectiveness of Photobiomodulation Therapy Versus Cryotherapy for Skeletal Muscle Recovery: A Critically Appraised Topic

“…There continues to be widespread use of cryotherapy techniques postexercise despite inconsistencies in the literature validating its effectiveness. Cryotherapy decreases the tissue metabolic rate, 14 promotes superficial vasoconstriction, 15 decreases vascular permeability, 16 and leads to less edema formation. 12,17 A form of cryotherapy, cold-water immersion therapy has an additional effect, due to hydrostatic pressure, at encouraging reabsorption of interstitial fluids found in the muscle after exercise.…”

Cooling of Lower Extremity Muscles According to Subcutaneous Tissue Thickness

“…One text 11 even went so far as to recommend treatment times. A number of researchers [13][14][15][16][17][18][19][20][21][22][23][24] have incorporated cooling recommendations based on subcutaneous tissue thickness into their study designs or accounted for subcutaneous tissue thickness in different results across patients. Textbooks and scholarly articles suggested translating these recommendations to patient care, but many clinicians were complacent and relied on a ''cookbook approach'' to patient care.…”