Research article - (2024)23, 581 - 593
DOI:
https://doi.org/10.52082/jssm.2024.581
Effects of a Manual Treatment on Lumbar Microcirculation and Tissue Stiffness Following Submaximal Eccentric Trunk Extensor Exercise: A Randomized Controlled Trial
Andreas Brandl1,2,3,4, Michael Keiner4, Jan Wilke5, Christoph Egner3, Robert Schleip2,3 †, Tobias Schmidt6,7 †
1Faculty for Psychology and Human Movement Science, Institute for Human Movement Science, Department of Sports Medicine, University of Hamburg, Hamburg, Germany
2Department of Sport and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany
3Department for Medical Professions, Diploma Hochschule, Bad Sooden-Allendorf, Germany
4Department of Training and Exercise Science, German University of Health & Sport, Ismaning, Germany
5Department of Neuromotorics and Movement, University of Bayreuth, Bayreuth, Germany
6Osteopathic Research Institute, Hamburg, Germany
7Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
† These authors contributed equally to this work.

Robert Schleip
✉ Department of Sport and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany
Email: robert.schleip@tum.de

Tobias Schmidt
✉ Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
Email: tobias.schmidt@medicalschool-hamburg.de
Received: 09-06-2024 -- Accepted: 08-07-2024
Published (online): 01-09-2024

ABSTRACT

Recent studies have shown that the extramuscular connective tissue (ECT) is thickened and stiffened in delayed onset muscle soreness (DOMS). However, contrarily to the normal population, severe DOMS is rare in athletes or highly trained individuals. The present randomized, controlled trial therefore aimed to investigate pain as well as microcirculation and stiffness of the ECT and the erector spinae muscle following submaximal eccentric trunk extension exercise not causing DOMS. The effect of manual treatment by a therapist (myofascial release; MFR) on these parameters was to be studied. Trained healthy participants (n = 21; 31.3 ± 9.6 years; > 4 h exercise per week) performed submaximal eccentric exercise of the trunk extensors. One group was manually treated (n = 11), while the other group (n = 10) received placebo treatment with sham laser therapy. Stiffness of the ECT and the erector spinae muscle (shear wave elastography), microcirculation (white light and laser Doppler spectroscopy), palpation pain (100 mm visual analogue scale, VAS) and pressure pain threshold (indentometry, PPT) were assessed before (t0), 24 h (t24) and 48 h (t48) after conditions. Erector spinae muscle stiffness increased after eccentric exercise from t0 to t24 (0.875 m/s) and from t0 to t48 (0.869 m/s). After MFR, erector spinae muscle stiffness decreased in contrast to placebo treatment at t24 (-0.66 m/s), while ECT stiffness remained unchanged. Oxygen saturation increased (17-20.93%) and relative haemoglobin decreased (-9.1 - -12.76 AU) after eccentric exercise and MFR differed from placebo treatment at t48 (-3.71 AU). PPT differed after MFR from placebo treatment at t48 (20.69 N/mm), while VAS remained unchanged. Multiple linear regression showed that ECT stiffness and group membership predicted erector spinae muscle stiffness. MFR could have a positive effect on pain, microcirculation and muscle stiffness after submaximal eccentric exercise, suggesting better recovery, which needs to be confirmed by future work.

Key words: Shear wave elastography, connective tissue, eccentric exercise, manual treatment, myofascial release

Key Points
  • Submaximal eccentric exercise of the trunk increases muscle stiffness and oxygen saturation, while relative haemoglobin decreases.
  • Manual myofascial release treatment decreases pressure pain threshold after submaximal exhausting exercise and potentially increases microcirculatory blood flow.
  • Myofascial release treatment could have a positive effect on post-competition recovery.








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