Pressure Pain Mapping of the Wrist Extensors After Repeated Eccentric Exercise at High Intensity

Abstract Delfa de la Morena, JM, Samani, A, Fernández-Carnero, J, Hansen, EA, and Madeleine, P. Pressure pain mapping of the wrist extensors after repeated eccentric exercise at high intensity. J Strength Cond Res 27(11): 3045–3052, 2013—The purpose of this study was to investigate adaptation mechanisms after 2 test rounds consisting of eccentric exercise using pressure pain imaging of the wrist extensors. Pressure pain thresholds (PPTs) were assessed over 12 points forming a 3 × 4 matrix over the dominant elbow in 12 participants. From the PPT assessments, pressure pain maps were computed. Delayed onset muscle soreness was induced in an initial test round of high-intensity eccentric exercise. The second test round performed 7 days later aimed at resulting in adaptation. The PPTs were assessed before, immediately after, and 24 hours after the 2 test rounds of eccentric exercise. For the first test round, the mean PPT was significantly lower 24 hours after exercise compared with before exercise (389.5 ± 64.1 vs. 500.5 ± 66.4 kPa, respectively; p = 0.02). For the second test round, the PPT was similar before and 24 hours after (447.7 ± 51.3 vs. 458.0 ± 73.1 kPa, respectively; p = 1.0). This study demonstrated adaptive effects of the wrist extensors monitored by pain imaging technique in healthy untrained humans. A lack of hyperalgesia, i.e., no decrease in PPT underlined adaptation after the second test round of eccentric exercise performed 7 days after the initial test round. The present findings showed for the first time that repeated eccentric exercise performed twice over 2 weeks protects the wrist extensor muscles from developing exacerbated pressure pain sensitivity. Thus, the addition of eccentric components to training regimens should be considered to induce protective adaptation.

[1]  Patrick Dattalo,et al.  Statistical Power Analysis , 2008 .

[2]  Eira Viikari-Juntura,et al.  Prevalence and determinants of lateral and medial epicondylitis: a population study. , 2006, American journal of epidemiology.

[3]  M. McHugh,et al.  Recent advances in the understanding of the repeated bout effect: the protective effect against muscle damage from a single bout of eccentric exercise , 2003, Scandinavian journal of medicine & science in sports.

[4]  L. Arendt-Nielsen,et al.  Topographical pressure and thermal pain sensitivity mapping in patients with unilateral lateral epicondylalgia. , 2011, The journal of pain : official journal of the American Pain Society.

[5]  F Goubel,et al.  Changes in elastic characteristics of human muscle induced by eccentric exercise. , 1990, Journal of biomechanics.

[6]  Julius Sim,et al.  Interrater Reliability of Algometry in Measuring Pressure Pain Thresholds in Healthy Humans, Using Multiple Raters , 2007, The Clinical journal of pain.

[7]  K. Nosaka,et al.  Changes in fluctuation of isometric force following eccentric and concentric exercise of the elbow flexors , 2006, European Journal of Applied Physiology.

[8]  L. Arendt-Nielsen,et al.  Delayed onset muscle soreness in neck/shoulder muscles , 2005, European journal of pain.

[9]  J. Fridén,et al.  Wrist Extensor Muscle Pathology in Lateral Epicondylitis , 1999, Journal of hand surgery.

[10]  Lars Arendt-Nielsen,et al.  Sensory and motor effects of experimental muscle pain in patients with lateral epicondylalgia and controls with delayed onset muscle soreness , 2005, Pain.

[11]  P. Clarkson,et al.  Muscle function after exercise-induced muscle damage and rapid adaptation. , 1992, Medicine and science in sports and exercise.

[12]  D. Newham,et al.  Repeated high-force eccentric exercise: effects on muscle pain and damage. , 1987, Journal of applied physiology.

[13]  H. Langberg,et al.  Myofibre damage in human skeletal muscle: effects of electrical stimulation versus voluntary contraction , 2007, The Journal of physiology.

[14]  Pascal Madeleine,et al.  Sensory Mapping of the Upper Trapezius Muscle in Relation to Consecutive Sessions of Eccentric Exercise , 2012, Journal of strength and conditioning research.

[15]  L. Arendt-Nielsen,et al.  Experimental deep tissue pain in wrist extensors—a model of lateral epicondylalgia , 2003, European journal of pain.

[16]  P Madeleine,et al.  Mechanomyography and electromyography during and after fatiguing shoulder eccentric contractions in males and females , 2006, Scandinavian journal of medicine & science in sports.

[17]  P. Clarkson,et al.  Muscle damage following repeated bouts of high force eccentric exercise. , 1995, Medicine and science in sports and exercise.

[18]  B. Vicenzino,et al.  Exploration of the extent of somato-sensory impairment in patients with unilateral lateral epicondylalgia. , 2009, The journal of pain : official journal of the American Pain Society.

[19]  Pascal Madeleine,et al.  Pressure pain sensitivity maps, self-reported musculoskeletal disorders and sickness absence among cleaners , 2011, International archives of occupational and environmental health.

[20]  J. Mitchell,et al.  Adaptation to eccentric exercise: effect on CD64 and CD11b/CD18 expression. , 1995, Journal of applied physiology.

[21]  J. Fridén,et al.  Sarcomere length in wrist extensor muscles. Changes may provide insights into the etiology of chronic lateral epicondylitis. , 1997, Acta orthopaedica Scandinavica.

[22]  H. Slater,et al.  Exercise-induced mechanical hypoalgesia in musculotendinous tissues of the lateral elbow. , 2010, Manual therapy.

[23]  D. Walsh,et al.  Delayed onset muscle soreness: effect of an ischaemic block upon mechanical allodynia in humans , 2000, Pain.

[24]  R. Conatser,et al.  Muscle stiffness, strength loss, swelling and soreness following exercise‐induced injury in humans. , 1993, The Journal of physiology.

[25]  Pascal Madeleine,et al.  Pressure pain threshold mapping of the trapezius muscle reveals heterogeneity in the distribution of muscular hyperalgesia after eccentric exercise , 2010, European journal of pain.

[26]  E. Dannecker,et al.  EFFECT OF ECCENTRIC STRENGTH TESTING ON DELAYED‐ONSET MUSCLE PAIN , 2005, Journal of strength and conditioning research.

[27]  L. Bisset,et al.  A New Integrative Model of Lateral Epicondylalgia a Proposed Pathophysiological Model of Lateral Epicondylalgia Evidence of Local Tendon Pathology , 2022 .

[28]  L. Arendt-Nielsen,et al.  Pressure pain sensitivity mapping in experimentally induced lateral epicondylalgia. , 2010, Medicine and science in sports and exercise.

[29]  M. Muthalib,et al.  The effects of a repeated bout of eccentric exercise on indices of muscle damage and delayed onset muscle soreness. , 2000, Journal of science and medicine in sport.

[30]  L. Arendt-Nielsen,et al.  Anatomical association between wrist extensor musculature and topographical pain sensitivity maps of the elbow area. , 2012, Journal of manipulative and physiological therapeutics.

[31]  Kazunori Nosaka,et al.  Time course of muscle adaptation after high force eccentric exercise , 2004, European Journal of Applied Physiology and Occupational Physiology.

[32]  J. Cleland,et al.  Specific mechanical pain hypersensitivity over peripheral nerve trunks in women with either unilateral epicondylalgia or carpal tunnel syndrome. , 2010, The Journal of orthopaedic and sports physical therapy.

[33]  C. Cooper,et al.  Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. , 2004, Arthritis and rheumatism.