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1.  A COMPARISON OF TOPICAL MENTHOL TO ICE ON PAIN, EVOKED TETANIC AND VOLUNTARY FORCE DURING DELAYED ONSET MUSCLE SORENESS 
Purpose/Background:
Pain can adversely affect muscle functioning by inhibiting muscle contractions. Delayed onset muscle soreness was used as a tool to ascertain whether a topical menthol-based analgesic or ice was more effective at reducing pain and permitting greater muscular voluntary and evoked force.
Methods:
Sixteen subjects were randomized to receive either a topical gel containing 3.5% menthol or topical application of ice to the non-dominant elbow flexors two days following the performance of an exercise designed to induce muscle soreness. Two days later, DOMS discomfort was treated with a menthol based analgesic or ice. Maximum voluntary contractions and evoked tetanic contractions of the non-dominant elbow flexors were measured at baseline prior to inducing muscle soreness (T1), two days following inducing DOMS after 20 (T2), 25 (T3) and 35 (T4) minutes of either menthol gel or ice therapy. Pain perception using a 10-point visual analog scale was also measured at these four data collection points. Treatment analysis included a 2 way repeated measures ANOVA (2 × 4).
Results:
Delayed onset muscle soreness decreased (p = 0.04) voluntary force 17.1% at T2 with no treatment effect. Tetanic force was 116.9% higher (p<0.05) with the topical analgesic than ice. Pain perception at T2 was significantly (p=0.02) less with the topical analgesic versus ice.
Conclusions:
Compared to ice, the topical menthol-based analgesic decreased perceived discomfort to a greater extent and permitted greater tetanic forces to be produced.
Level of Evidence:
Level 2b
PMCID: PMC3362986  PMID: 22666646
analgesia; cryotherapy; delayed onset muscle soreness; menthol; self-reported pain
2.  EFFECT OF TOPICAL MENTHOL ON IPSILATERAL AND CONTRALATERAL SUPERFICIAL BLOOD FLOW FOLLOWING A BOUT OF MAXIMUM VOLUNTARY MUSCLE CONTRACTION 
Purpose/Background:
Various doses of topical menthol are commonly applied prior to, during, and after exercise to relieve pain although there is limited empirical evidence examining the physiological effects of this treatment. The purpose of this study was to examine the effects of two different doses of menthol (3.5% and 10%) on blood flow and arterial diameter before and after an acute bout of three isokinetic maximum voluntary muscular contraction (MVMC) of the quadriceps and hamstrings.
Methods:
Blood flow and arterial diameter of the right and left popliteal arteries were measured with an ultrasound Doppler prior to and after subjects completed 1 set of 3 MVMC isokinetic knee extension/flexion exercises. Immediately following this exercise one of three different treatment conditions was randomly applied to the right thigh only; 3.5% menthol gel, 10% menthol wipe, or a control condition. Five minutes following the treatment application blood flow through both right and left popliteal arteries was reassessed. This procedure was completed once per week until each of the 16 subjects was exposed to each treatment condition.
Results:
Repeated measures ANOVA with post hoc analysis indicated that both menthol dosages resulted in significant decreases in popliteal blood flow on the right (–19.60 to –8.39%) and left sides (–14.72 to –5.4%) while the control condition demonstrated an increase in blood flow bilaterally (+26.40 to +15.19%) as a result of the MVMC exercise. The right popliteal arterial diameter was also significantly reduced as a result of both menthol dosages (–5.73 to –6.73%) and increased under the control condition (+6.67%).
Conclusion:
These results indicate that topical menthol has a rapid effect on reducing ipsilateral and contralateral arterial blood flow as well as ipsilateral arterial diameter.
Levels of Evidence: 2a
PMCID: PMC3109898  PMID: 21713232

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