PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jathtrainLink to Publisher's site
 
J Athl Train. 1995 March; 30(1): 29–34.
PMCID: PMC1317825

Pathophysiology of Acute Exercise-Induced Muscular Injury: Clinical Implications

Phillip Page, MS, ATC, PT, LAT

Abstract

Acute muscular injury is the most common injury affecting athletes and those participating in exercise. Nearly everyone has experienced soreness after unaccustomed or intense exercise. Clinically, acute strains and delayed-onset muscle soreness are very similar. The purpose of this paper is to review the predisposing factors, mechanisms of injury, structural changes, and biochemical changes associated with these injuries. Laboratory and clinical findings are discussed to help athletic trainers differentiate between the two conditions and to provide a background knowledge for evaluation, prevention, and treatment of exercise-induced muscular injury.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Armstrong RB. Initial events in exercise-induced muscular injury. Med Sci Sports Exerc. 1990 Aug;22(4):429–435. [PubMed]
  • Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc. 1984 Dec;16(6):529–538. [PubMed]
  • Armstrong RB, Ogilvie RW, Schwane JA. Eccentric exercise-induced injury to rat skeletal muscle. J Appl Physiol Respir Environ Exerc Physiol. 1983 Jan;54(1):80–93. [PubMed]
  • Bach BR, Jr, Warren RF, Wickiewicz TL. Triceps rupture. A case report and literature review. Am J Sports Med. 1987 May-Jun;15(3):285–289. [PubMed]
  • Bennett JG, Stauber WT. Evaluation and treatment of anterior knee pain using eccentric exercise. Med Sci Sports Exerc. 1986 Oct;18(5):526–530. [PubMed]
  • Bohannon RW. Effect of repeated eight-minute muscle loading on the angle of straight-leg raising. Phys Ther. 1984 Apr;64(4):491–497. [PubMed]
  • Byrd SK. Alterations in the sarcoplasmic reticulum: a possible link to exercise-induced muscle damage. Med Sci Sports Exerc. 1992 May;24(5):531–536. [PubMed]
  • Byrd SK, McCutcheon LJ, Hodgson DR, Gollnick PD. Altered sarcoplasmic reticulum function after high-intensity exercise. J Appl Physiol (1985) 1989 Nov;67(5):2072–2077. [PubMed]
  • Byrnes WC, Clarkson PM. Delayed onset muscle soreness and training. Clin Sports Med. 1986 Jul;5(3):605–614. [PubMed]
  • Byrnes WC, Clarkson PM, White JS, Hsieh SS, Frykman PN, Maughan RJ. Delayed onset muscle soreness following repeated bouts of downhill running. J Appl Physiol (1985) 1985 Sep;59(3):710–715. [PubMed]
  • Ciccone CD, Leggin BG, Callamaro JJ. Effects of ultrasound and trolamine salicylate phonophoresis on delayed-onset muscle soreness. Phys Ther. 1991 Sep;71(9):666–678. [PubMed]
  • Clarkson PM, Byrnes WC, McCormick KM, Turcotte LP, White JS. Muscle soreness and serum creatine kinase activity following isometric, eccentric, and concentric exercise. Int J Sports Med. 1986 Jun;7(3):152–155. [PubMed]
  • Clarkson PM, Nosaka K, Braun B. Muscle function after exercise-induced muscle damage and rapid adaptation. Med Sci Sports Exerc. 1992 May;24(5):512–520. [PubMed]
  • Clarkson PM, Tremblay I. Exercise-induced muscle damage, repair, and adaptation in humans. J Appl Physiol (1985) 1988 Jul;65(1):1–6. [PubMed]
  • Davies GJ, Wallace LA, Malone T. Mechanisms of selected knee injuries. Phys Ther. 1980 Dec;60(12):1590–1595. [PubMed]
  • De Vries HA. Quantitative electromyographic investigation of the spasm theory of muscle pain. Am J Phys Med. 1966 Jun;45(3):119–134. [PubMed]
  • Ekstrand J, Gillquist J. The frequency of muscle tightness and injuries in soccer players. Am J Sports Med. 1982 Mar-Apr;10(2):75–78. [PubMed]
  • Evans WJ, Cannon JG. The metabolic effects of exercise-induced muscle damage. Exerc Sport Sci Rev. 1991;19:99–125. [PubMed]
  • Fridén J, Lieber RL. Structural and mechanical basis of exercise-induced muscle injury. Med Sci Sports Exerc. 1992 May;24(5):521–530. [PubMed]
  • Fridén J, Sjöström M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. Int J Sports Med. 1983 Aug;4(3):170–176. [PubMed]
  • Fritz VK, Stauber WT. Characterization of muscles injured by forced lengthening. II. Proteoglycans. Med Sci Sports Exerc. 1988 Aug;20(4):354–361. [PubMed]
  • Garrett WE., Jr Muscle strain injuries: clinical and basic aspects. Med Sci Sports Exerc. 1990 Aug;22(4):436–443. [PubMed]
  • Garrett WE., Jr Injuries to the muscle-tendon unit. Instr Course Lect. 1988;37:275–282. [PubMed]
  • Garrett WE, Jr, Rich FR, Nikolaou PK, Vogler JB., 3rd Computed tomography of hamstring muscle strains. Med Sci Sports Exerc. 1989 Oct;21(5):506–514. [PubMed]
  • Hasson SM, Daniels JC, Divine JG, Niebuhr BR, Richmond S, Stein PG, Williams JH. Effect of ibuprofen use on muscle soreness, damage, and performance: a preliminary investigation. Med Sci Sports Exerc. 1993 Jan;25(1):9–17. [PubMed]
  • Hasson SM, Wible CL, Reich M, Barnes WS, Williams JH. Dexamethasone iontophoresis: effect on delayed muscle soreness and muscle function. Can J Sport Sci. 1992 Mar;17(1):8–13. [PubMed]
  • Heiser TM, Weber J, Sullivan G, Clare P, Jacobs RR. Prophylaxis and management of hamstring muscle injuries in intercollegiate football players. Am J Sports Med. 1984 Sep-Oct;12(5):368–370. [PubMed]
  • Jönhagen S, Németh G, Eriksson E. Hamstring injuries in sprinters. The role of concentric and eccentric hamstring muscle strength and flexibility. Am J Sports Med. 1994 Mar-Apr;22(2):262–266. [PubMed]
  • Knapik JJ, Bauman CL, Jones BH, Harris JM, Vaughan L. Preseason strength and flexibility imbalances associated with athletic injuries in female collegiate athletes. Am J Sports Med. 1991 Jan-Feb;19(1):76–81. [PubMed]
  • McCully KK, Faulkner JA. Characteristics of lengthening contractions associated with injury to skeletal muscle fibers. J Appl Physiol (1985) 1986 Jul;61(1):293–299. [PubMed]
  • McGlynn GH, Laughlin NT, Rowe V. Effect of electromyographic feedback and static stretching on artificially induced muscle soreness. Am J Phys Med. 1979 Jun;58(3):139–148. [PubMed]
  • Newham DJ, Jones DA, Clarkson PM. Repeated high-force eccentric exercise: effects on muscle pain and damage. J Appl Physiol (1985) 1987 Oct;63(4):1381–1386. [PubMed]
  • Newham DJ, McPhail G, Mills KR, Edwards RH. Ultrastructural changes after concentric and eccentric contractions of human muscle. J Neurol Sci. 1983 Sep;61(1):109–122. [PubMed]
  • Nikolaou PK, Macdonald BL, Glisson RR, Seaber AV, Garrett WE., Jr Biomechanical and histological evaluation of muscle after controlled strain injury. Am J Sports Med. 1987 Jan-Feb;15(1):9–14. [PubMed]
  • Noonan TJ, Best TM, Seaber AV, Garrett WE., Jr Thermal effects on skeletal muscle tensile behavior. Am J Sports Med. 1993 Jul-Aug;21(4):517–522. [PubMed]
  • Safran MR, Garrett WE, Jr, Seaber AV, Glisson RR, Ribbeck BM. The role of warmup in muscular injury prevention. Am J Sports Med. 1988 Mar-Apr;16(2):123–129. [PubMed]
  • Schwane JA, Johnson SR, Vandenakker CB, Armstrong RB. Delayed-onset muscular soreness and plasma CPK and LDH activities after downhill running. Med Sci Sports Exerc. 1983;15(1):51–56. [PubMed]
  • Smith CA. The warm-up procedure: to stretch or not to stretch. A brief review. J Orthop Sports Phys Ther. 1994 Jan;19(1):12–17. [PubMed]
  • Smith LL. Acute inflammation: the underlying mechanism in delayed onset muscle soreness? Med Sci Sports Exerc. 1991 May;23(5):542–551. [PubMed]
  • Stauber WT. Eccentric action of muscles: physiology, injury, and adaptation. Exerc Sport Sci Rev. 1989;17:157–185. [PubMed]
  • Stauber WT, Clarkson PM, Fritz VK, Evans WJ. Extracellular matrix disruption and pain after eccentric muscle action. J Appl Physiol (1985) 1990 Sep;69(3):868–874. [PubMed]
  • Strickler T, Malone T, Garrett WE. The effects of passive warming on muscle injury. Am J Sports Med. 1990 Mar-Apr;18(2):141–145. [PubMed]
  • Taylor DC, Dalton JD, Jr, Seaber AV, Garrett WE., Jr Experimental muscle strain injury. Early functional and structural deficits and the increased risk for reinjury. Am J Sports Med. 1993 Mar-Apr;21(2):190–194. [PubMed]
  • Taylor DC, Dalton JD, Jr, Seaber AV, Garrett WE., Jr Viscoelastic properties of muscle-tendon units. The biomechanical effects of stretching. Am J Sports Med. 1990 May-Jun;18(3):300–309. [PubMed]
  • Tiidus PM, Ianuzzo CD. Effects of intensity and duration of muscular exercise on delayed soreness and serum enzyme activities. Med Sci Sports Exerc. 1983;15(6):461–465. [PubMed]
  • Wiktorsson-Möller M, Oberg B, Ekstrand J, Gillquist J. Effects of warming up, massage, and stretching on range of motion and muscle strength in the lower extremity. Am J Sports Med. 1983 Jul-Aug;11(4):249–252. [PubMed]
  • Yackzan L, Adams C, Francis KT. The effects of ice massage on delayed muscle soreness. Am J Sports Med. 1984 Mar-Apr;12(2):159–165. [PubMed]
  • Zarins B, Ciullo JV. ACute muscle and tendon injuries in athletes. Clin Sports Med. 1983 Mar;2(1):167–182. [PubMed]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association