Delayed onset muscle soreness following repeated bouts of downhill running

Perceived muscle soreness ratings, serum creatine kinase (CK) activity, and myoglobin levels were assessed in three groups of subjects following two 30-min exercise bouts of downhill running (-10 degrees slope). The two bouts were separated by 3, 6, and 9 wk for groups 1, 2, and 3, respectively. Criterion measures were obtained pre- and 6, 18, and 42 h postexercise. On bout 1 the three groups reported maximal soreness at 42 h postexercise. Also, relative increases in CK for groups 1, 2, and 3 were 340, 272, and 286%, respectively. Corresponding values for myoglobin were 432, 749, and 407%. When the same exercise was repeated, significantly less soreness was reported and smaller increases in CK and myoglobin were found for groups 1 and 2. For example, the percent CK increases on bout 2 for groups 1 and 2 were 63 and 62, respectively. Group 3 demonstrated no significant difference in soreness ratings, CK activities, or myoglobin levels between bouts 1 and 2. It was concluded that performance of a single exercise bout had a prophylactic effect on the generation of muscle soreness and serum protein responses that lasts up to 6 wk.     

Effects of baseline serum levels of Se on markers of eccentric exercise-induced muscle injury

Inflammation and oxidative stress have been implicated in the mechanism of eccentric exercise-induced muscle injury. This study examined whether baseline serum levels of selenium (Se), a trace element that participates in both antioxidant and anti-inflammatory systems, affects the overall response to injury. Thirteen males performed 36 maximal eccentric actions with the elbow flexors of the non-dominant arm on a motorized dynamometer. Venous blood samples were collected immediately before and after exercise at 2, 24, 48, 72 and 96 hours. Established indicators of muscle damage such as maximum isometric torque (MIT), range of motion (ROM), relaxed arm angle (RANG), flexed arm angle (FANG), arm circumference (CIRC), muscle soreness and serum levels of creatine kinase (CK) and lactate dehydrogenase (LDH) were determined at the same time points. Baseline serum levels of Se were also measured. Complementary data regarding assessment of Se status were retrieved by the use of a semi-quantitative food frequency questionnaire. All measures changed significantly (p<0.05) after exercise. The main finding of this study was that baseline Se serum levels were associated inversely with CK, LDH and FANG and positively with MIT and ROM (p<0.05). These data suggest that beyond overt Se deficiency, suboptimal Se status possibly worsens muscle functional decrements subsequent to eccentric muscle contractions.     

Comparison between voluntary and stimulated contractions of the quadriceps femoris for growth hormone response and muscle damage.

This study aimed to compare voluntary and stimulated exercise for changes in muscle strength, growth hormone (GH), blood lactate, and markers of muscle damage. Nine healthy men had two leg press exercise bouts separated by 2 wk. In the first bout, the quadriceps muscles were stimulated by biphasic rectangular pulses (75 Hz, duration 400 mus, on-off ratio 6.25-20 s) with current amplitude being consistently increased throughout 40 contractions at maximal tolerable level. In the second bout, 40 voluntary isometric contractions were performed at the same leg press force output as the first bout. Maximal voluntary isometric strength was measured before and after the bouts, and serum GH and blood lactate concentrations were measured before, during, and after exercise. Serum creatine kinase (CK) activity and muscle soreness were assessed before, immediately after, and 24, 48, and 72 h after exercise. Maximal voluntary strength decreased significantly (P < 0.05) after both bouts, but the magnitude of the decrease was significantly (P < 0.05) greater for the stimulated contractions (-22%) compared with the voluntary contractions (-9%). Increases in serum GH and lactate concentrations were significantly (P < 0.05) larger after the stimulation compared with the voluntary exercise. Increases in serum CK activity and muscle soreness were also significantly (P < 0.05) greater for the stimulation than voluntary exercise. It was concluded that a single bout of electrical stimulation exercise resulted in greater GH response and muscle damage than voluntary exercise.     

Repeated high-force eccentric exercise: effects on muscle pain and damage

Five women and three men (aged 24-43 yr) performed maximal eccentric contractions of the elbow flexors (for 20 min) on three occasions, spaced 2 wk apart. Muscle pain, strength and contractile properties, and plasma creatine kinase (CK) were studied before and after each exercise bout. Muscle tenderness was greatest after the first bout and thereafter progressively decreased. Very high plasma CK levels (1,500-11,000 IU/l) occurred after the first bout, but the second and third bouts did not significantly affect the plasma CK. After each bout the strength was reduced by approximately 50% and after 2 wk had only recovered to 80% of preexercise values. Each exercise bout produced a marked shift of the force-frequency curve to the right which took approximately 2 wk to recover. The recovery rate of both strength and force-frequency characteristics was faster after the second and third bouts. Since the adaptation occurred after the performance of maximal contractions it cannot have been a result of changes in motor unit recruitment. The observed training effect of repeated exercise was not a consequence of the muscle becoming either stronger or more resistant to fatigue.     

Responses of elbow flexors to two strenuous eccentric exercise bouts separated by three days

This study investigated whether the second eccentric exercise performed 3 days after the initial bout would exacerbate muscle damage and retard the recovery. Fifty-one athletes performed 30 eccentric actions of the elbow flexors using a dumbbell weighted 100% of the maximal isometric force (MIF) at the elbow joint angle of 90 degrees (ECC1). Three days after ECC1, all subjects except those in the control group (n = 12) performed the second bout (ECC2) with the same (100%) intensity (n = 12), 90% (n = 13), or 80% (n = 14) of the ECC1. Some subjects, especially in the 100% group, required spotting for ECC2 but made maximal effort to complete the exercise. MIF, range of motion, upper-arm circumference, muscle soreness, muscle proteins in the blood, and ultrasound images were used to assess muscle damage. Changes in these measures for 9 days following ECC1 were compared among groups by 2-way analysis of variance (ANOVA) with repeated measures. All criterion measures changed significantly after ECC1; however, no significant differences between the groups were evident for any of the changes in the measures. These results suggest that it is possible for athletes to complete the second bout if the intensity is reduced 10-20% from the initial bout. No significant differences between the control group and other groups indicate that the second eccentric exercise performed 3 days after the initial bout does not exacerbate muscle damage and retard the recovery regardless of the intensity of the second bout. It is concluded that the elbow flexors can perform high-intensity eccentric exercise in the early stage of recovery from the initial bout and are not damaged further by performing a subsequent bout 3 days after the first.     

Cellular adaptation to repeated eccentric exercise-induced muscle damage.

Eccentrically biased exercise results in skeletal muscle damage and stimulates adaptations in muscle, whereby indexes of damage are attenuated when the exercise is repeated. We hypothesized that changes in ultrastructural damage, inflammatory cell infiltration, and markers of proteolysis in skeletal muscle would come about as a result of repeated eccentric exercise and that gender may affect this adaptive response. Untrained male (n = 8) and female (n = 8) subjects performed two bouts (bout 1 and bout 2), separated by 5.5 wk, of 36 repetitions of unilateral, eccentric leg press and 100 repetitions of unilateral, eccentric knee extension exercises (at 120% of their concentric single repetition maximum), the subjects' contralateral nonexercised leg served as a control (rest). Biopsies were taken from the vastus lateralis from each leg 24 h postexercise. After bout 2, the postexercise force deficit and the rise in serum creatine kinase (CK) activity were attenuated. Women had lower serum CK activity compared with men at all times (P < 0.05), but there were no gender differences in the relative magnitude of the force deficit. Muscle Z-disk streaming, quantified by using light microscopy, was elevated vs. rest only after bout 1 (P < 0.05), with no gender difference. Muscle neutrophil counts were significantly greater in women 24 h after bout 2 vs. rest and bout 1 (P < 0.05) but were unchanged in men. Muscle macrophages were elevated in men and women after bout 1 and bout 2 (P < 0.05). Muscle protein content of the regulatory calpain subunit remained unchanged whereas ubiquitin-conjugated protein content was increased after both bouts (P < 0.05), with a greater increase after bout 2. We conclude that adaptations to eccentric exercise are associated with attenuated serum CK activity and, potentially, an increase in the activity of the ubiquitin proteosome proteolytic pathway.     

Indices of free-radical-mediated damage following maximum voluntary eccentric and concentric muscular work

This study monitored plasma and skeletal muscle markers of free-radical-mediated damage following maximum eccentric and concentric exercise, to examine the potential role of free radicals in exercise-induced muscle damage. Fourteen male volunteers performed either (1) a bout of 70 maximum eccentric and a bout of 70 maximum concentric muscle actions of the forearm flexors (the bouts being separated by 4 weeks; n = 8) or (2) a bout of 80 maximum eccentric and a bout of 80 maximum concentric muscle actions of the knee extensors (the bouts being separated by 1 week; n=6). Plasma markers of lipid peroxidation, thiobarbituric acid-reactive substances (TBARS) and diene-conjugated compounds (DCC) were monitored in the arm protocol and skeletal muscle markers of oxidative lipid and protein damage, malondialdehyde (MDA) and protein carbonyl derivatives (PCD) respectively, were monitored in the leg protocol. In both protocols, the contralateral limb was used for the second bout and the order of the bouts was randomised between limbs. Repeated measures ANOVA indicated significant changes from baseline following eccentric arm work on the measures of serum creatine kinase activity (P < 0.05), maximum voluntary torque production (P < 0.01) and relaxed arm angle (P < 0.01). Subjective muscle soreness peaked 2 days after eccentric arm work (P < 0.05, Wilcoxon test). However, there were no changes in the plasma levels of TBARS or DCC following the eccentric or concentric arm exercise. Immediately after concentric leg exercise, skeletal muscle PCD concentrations was significantly higher than that observed immediately after eccentric work (P < 0.05). However, no significant difference between the eccentric and concentric knee extensor bouts was observed on the measure of skeletal muscle MDA concentration. The results of this study offer no support for the involvement of oxygen free radicals in exercise-induced muscle damage.     

MR measurements of muscle damage and adaptation after eccentric exercise.

The purposes of this study were, first, to clarify the long-term pattern of T2 relaxation times and muscle volume changes in human skeletal muscle after intense eccentric exercise and, second, to determine whether the T2 response exhibits an adaptation to repeated bouts. Six young adult men performed two bouts of eccentric biceps curls (5 sets of 10 at 110% of the 1-repetition concentric maximum) separated by 8 wk. Blood samples, soreness ratings, and T2-weighted axial fast spin-echo magnetic resonance images of the upper arm were obtained immediately before and after each bout; at 1, 2, 4, 7, 14, 21, and 56 days after bout 1; and at 2, 4, 7 and 14 days after bout 2. Resting muscle T2 [27.6 +/- 0.2 (SE) ms] increased immediately postexercise by 8 +/- 1 ms after both bouts. T2 peaked 7 days after bout 1 at 47 +/- 4 ms and remained elevated by 2.5 ms at 56 days. T2 peaked lower (37 +/- 4 ms) and earlier (2-4 days) after bout 2, suggesting an adaptation of the T2 response. Peak serum creatine kinase values, pain ratings, and flexor muscle swelling were also significantly lower after the second bout (P < 0.05). Total volume of the imaged arm region increased transiently after bout 1 but returned to preexercise values within 2 wk. The exercised flexor compartment swelled by over 40%, but after 2 wk it reverted to a volume 10% smaller than that before exercise and maintained this volume loss through 8 wk, consistent with partial or total destruction of a small subpopulation of muscle fibers.     

Protection against muscle damage following fifty drop jumps conferred by ten drop jumps

This study investigated whether 10 drop jumps (DJs) would confer protective effect against muscle damage and soreness in a subsequent bout of 50 DJs. Sixteen men were randomly placed into either a group performing 1 set of 10 DJs followed by 5 sets of 10 DJs (10-50, n = 8) or another group performing 2 bouts of 5 sets of 10 DJs (50-50, n = 8) separated by 2 weeks. The DJs were performed from a box height of 0.6 m, with a 10-second interval between jumps and a 1-minute rest between sets. Jump height, peak vertical ground reaction force, ground contact time, and heart rate during DJs were measured, and blood lactate concentration was assessed before and immediately after DJs. Changes in maximal isometric (ISO) and isokinetic concentric torque (CON), vertical jump, muscle soreness, and plasma creatine kinase activity before, immediately after, and at 1, 24, 48, and 72 hours following exercise were compared between groups for the first and second bouts and between the bouts by a 2-way repeated-measures analysis of variance. Changes in ISO, CON, vertical jump, and muscle soreness were significantly (p < 0.05) smaller for 10 DJs compared with 50 DJs; however, no significant differences in the measures between groups were evident following the second bout. The changes in the measures following 50 DJs in the 10-50 group were significantly (p < 0.05) smaller than those following the first bout of the 50-50 group. These results suggest that 10 DJs and 50 DJs conferred the same magnitude of protective effect against muscle damage by 50 DJs.     

Exercise-induced muscle damage: effects of light exercise on damaged muscle.

The effects of performing light eccentric exercise (LB) during the period of recovery from a heavy eccentric exercise bout (HB) were studied. An experimental and a control group, each consisting of nine college age volunteers (seven women, two men) performed two HB--HB1 and HB2--14 days apart, using the elbow flexor and extensor muscles of one arm. The experimental group performed an additional LB on the day following the first HB. HB1 resulted in muscle soreness, muscle weakness, changes in elbow joint flexibility, and large delayed increases in serum creatine kinase (CK) activity. The HB2 produced smaller changes in all parameters, indicating that adaptation to the effects of eccentric exercise had occurred in the muscle. The LB did not alter muscle soreness, strength or elbow flexibility, but did reduce or delay CK activity increase after HB1. The LB had no apparent effect on adaptation to HB2.     

Benefits of short-term muscular training in reducing the effects of muscular over-exertion

Muscle soreness, serum creatine kinase (CK), and serum and urinary hydroxyproline levels were examined following muscle over-exertion and resistance training. Seven untrained men performed high intensity leg-extension exercises at a resistance at which they could initially accomplish 90% of their 10 repetitions maximum (10 RM), for 30 minutes to induce muscle over-exertion. In Phase 1 a single bout of muscular over-exertion was followed by a week of rest. Phase 2, the training period, was a repeat of the over-exertion workload of Phase 1 for five consecutive days. Phase 3 was a single bout of over-exertion at a higher 10 RM workload. Normo-responsive and hyper-responsive changes in serum CK were exhibited by different subjects in Phase 1. Muscle soreness was perceived by both groups but to a greater extent in the hyper-responsive group. Serum CK and muscle soreness values were lower during Phase 2 and 3 than in Phase 1. Neither serum nor urinary hydroxyproline levels changed significantly post-exercise. These findings show that a single bout of intense exercise and a brief period of muscular training reduces serum CK and muscle soreness responses following a subsequent single bout of exercise at a higher intensity.     

Intensity of eccentric exercise, shift of optimum angle, and the magnitude of repeated-bout effect.

This study compared the effect of four different intensities of initial eccentric exercise (ECC1) on optimum angle shift and extent of muscle damage induced by subsequent maximal eccentric exercise. Fifty-two male students were placed into 100%, 80%, 60%, or 40% groups (n = 13 per group), performing 30 eccentric actions of the elbow flexors of 100%, 80%, 60%, or 40% of maximal isometric strength [maximal voluntary contraction (MVC)] for ECC1, followed 2-3 wk later by a similar exercise (ECC2) that used 100% MVC load. MVC at six elbow joint angles, range of motion, upper arm circumference, serum creatine kinase activity, myoglobin concentration, and muscle soreness were measured before and for 5 days following ECC1 and ECC2. A rightward shift of optimum angle following ECC1 was significantly (P < 0.05) greater for the 100% and 80% than for the 60% and 40% groups, and it decreased significantly (P < 0.05) from immediately to 5 days postexercise. By the time ECC2 was performed, only the 100% group kept a significant shift (4 degrees). Changes in most of the criterion measures following ECC1 were significantly greater for the 100% and 80% groups compared with the 60% and 40% groups. Changes in the criterion measures following ECC2 were significantly (P < 0.05) greater for the 40% group compared with other groups. Although the magnitude of repeated bout effect following ECC2 was significantly (P < 0.05) smaller for the 40% and 60% groups, all groups showed significantly (P < 0.05) reduced changes in criterion measures following ECC2 compared with the ECC1 100% bout. We conclude that the repeated-bout effect was not dependent on the shift of optimum angle.     

Comparison of responses to strenuous eccentric exercise of the elbow flexors between resistance-trained and untrained men

This study compared resistance-trained and untrained men for changes in commonly used indirect markers of muscle damage after maximal voluntary eccentric exercise of the elbow flexors. Fifteen trained men (28.2 +/- 1.9 years, 175.0 +/- 1.6 cm, and 77.6 +/- 1.9 kg) who had resistance trained for at least 3 sessions per week incorporating exercises involving the elbow flexor musculature for an average of 7.7 +/- 1.4 years, and 15 untrained men (30.0 +/- 1.5 years, 169.8 +/- 7.4 cm, and 79.9 +/- 4.4 kg) who had not performed any resistance training for at least 1 year, were recruited for this study. All subjects performed 10 sets of 6 maximal voluntary eccentric actions of the elbow flexors of one arm against the lever arm of an isokinetic dynamometer moving at a constant velocity of 90 degrees .s. Changes in maximal voluntary isometric and isokinetic torque, range of motion, upper arm circumference, plasma creatine kinase activity, and muscle soreness before, immediately after, and for 5 days after exercise were compared between groups. The trained group showed significantly (P < 0.05) smaller changes in all of the measures except for muscle soreness and faster recovery of muscle function compared with the untrained group. For example, muscle strength of the trained group recovered to the baseline by 3 days after exercise, where the untrained group showed approximately 40% lower strength than baseline. These results suggest that resistance-trained men are less susceptible to muscle damage induced by maximal eccentric exercise than untrained subjects.     

The relationship of creatine kinase variability with body composition and muscle damage markers following eccentric muscle contractions

[Purpose]

The purpose of the study was to investigate the relationship between CK variability and body composition and muscle damage markers following eccentric exercise.

[Methods]

Total 119 healthy male subjects were recruited to perform 50 eccentric contractions consisted of 2 sets of 25 contractions. Then, blood creatine kinase (CK) activity was analyzed to divide into three groups based on their CK activity levels. Maximum isometric strength (MIS), muscle soreness (SOR) and body composition data were obtained before and after exercise.

[Results]

The results showed that high CK responders had a significant decrease in MIS (p<0.001) and greater SOR (p<0.01) following eccentric exercise compared to low CK responders. Percent body fat was also higher in high responders compared to low responders (p=0.014). Peak CK activity was significantly correlated with MIS and SOR but no correlation with % body fat, muscle mass, and body mass index.

[Conclusion]

CK variability following eccentric exercise is closely related to MIS and SOR and % body fat may be a potent factor for CK variability.     

Oxidative metabolism and anaerobic glycolysis during repeated exercise

The purpose of the present study was to examine aerobic and muscle anaerobic energy production during supramaximal repeated exercise. Eight subjects performed three 2-min bouts of cycling (EX1-EX3) at an intensity corresponding to about 125 % of VO2 max separated by 15 min of rest. Ventilatory variables were measured breath by breath during the exercise and a muscle biopsy was taken before and after each exercise bout. Blood samples were collected before and after each cycling period and during the recovery periods. Total work in the first 2 min bout of cycling, EX1, [46.3 +/- 2.1 KJ] was greater than in the second, EX2, (p < 0.01) and in the third, EX3, (p < 0.05). The ATP utilization [4.0 +/- 1.4 mmol x (kg dry weight)(-1), EX1] during the three exercise bouts was the same. The decrement in muscle phosphocreatine (PCr) [46.8 +/- 8.5 mmol x (kg dry weight)(-1), EX1] was also similar for the three exercise bouts. Muscle lactate accumulation was greater (p < 0.05) during EX1 compared to EX2 and EX3. The total oxygen consumption was the same for the three exercise bouts, but when it is corrected for the total work performed, oxygen uptake during EX2 (153 +/- 9 ml x KJ(-1)) and EX3 (150 +/- 9 ml x KJ(-1)) was higher (p < 0.01 and p < 0.05, respectively) than during EX1 (139 +/- 8 ml x KJ(-1)). The present data suggest that oxidative metabolism does not compensate for the reduction of anaerobic glycolysis during repeated fatiguing exercise.     

Muscle mechanoreceptor modulation of sweat rate during recovery from moderate exercise.

The objective of this study was to identify whether muscle mechanoreceptor stimulation is capable of modulating sweat rate. Seven healthy subjects performed two 20-min bouts of supine exercise on a tandem cycle ergometer (60 rpm at 65% of maximal heart rate). After one bout, the subject stopped exercising (i.e., no pedaling), whereas, after the other bout, the subject's legs were passively cycled (at 60 rpm) via a second person cycling the tandem ergometer. This allows for mechanical stimulation of muscle with minimal activation of central command. Esophageal temperature (T(es)), mean skin temperature (T(sk)), heart rate, mean arterial blood pressure, oxygen consumption, cutaneous vascular conductance (CVC), and sweat rate were not different during the two exercise bouts. Regardless of the mode of exercise recovery, there were no differences in T(es), T(sk), or CVC. In contrast, early in the recovery period, chest and forearm sweat rate were significantly greater in the passive cycling recovery mode relative to the no-pedaling condition (chest: 0.57 +/- 0.13 vs. 0.39 +/- 0.14, forearm: 0.30 +/- 0.05 vs. 0.12 +/- 0.02 mg.cm(-2).min(-1); both P < 0.05). These results suggested that muscle mechanoreceptor stimulation to the previously activated muscle is capable of modulating sweat rate.     

Difference in the magnitude of muscle damage between maximal and submaximal eccentric loading

This study compared maximal (MAX-ECC) and submaximal (50%-ECC) eccentric exercise of the elbow flexors. Untrained male students (n = 8) performed 3 sets of 10 repetitions of MAX-ECC with one arm and 50%-ECC with the other arm, separated by 4 weeks. In MAX-ECC, the elbow joint was forcibly extended from a flexed (90 degrees ) to a full-extended position (180 degrees ) in 3 seconds while producing maximal force. For 50%-ECC, a dumbbell set at 50% of the maximal isometric strength at 90 degrees of the elbow joint was lowered from the flexed to the extended position in 3 seconds. Changes in indicators of muscle damage were compared between the bouts by a 2-way repeated-measures analysis of variance. Changes in isometric strength, range of motion, upper arm circumference, and plasma creatine kinase activity were significantly smaller and the recovery was significantly faster for 50%-ECC compared with MAX-ECC, although the differences in the changes immediately after exercise were small. It appeared that the magnitude of initial muscle damage was similar between the bouts; however, secondary damage was less after 50%-ECC.     

Acute molecular responses of skeletal muscle to resistance exercise in able-bodied and spinal cord-injured subjects.

Spinal cord injury (SCI) results in muscle atrophy, which contributes to a number of health problems, such as cardiovascular deconditioning, metabolic derangement, and osteoporosis. Electromyostimulation (EMS) holds the promise of ameliorating SCI-related muscle atrophy and, therefore, improving general health. To date, EMS training of long-term SCI subjects has resulted in some muscle hypertrophy but has fallen short of normalizing muscle mass. The aim of this study was to compare the molecular responses of vastus lateralis muscles from able-bodied (AB) and SCI subjects after acute bouts of EMS-induced resistance exercise to determine whether SCI muscles displayed some impairment in response. Analysis included mRNA markers known to be responsive to increased loading in rodent muscles. Muscles of AB and SCI subjects were subjected to EMS-stimulated exercise in two 30-min bouts, separated by a 48-h rest. Needle biopsy samples were obtained 24 h after the second exercise bout. In both the AB and SCI muscles, significant changes were seen in insulin-like growth factor binding proteins 4 and 5, cyclin-dependent kinase inhibitor p21, and myogenin mRNA levels. In AB subjects, the mRNA for mechano-growth factor was also increased. Before exercise, the total RNA concentration of the SCI muscles was less than that of the AB subjects but not different postexercise. The results of this study indicate that acute bouts of resistance exercise stimulate molecular responses in the skeletal muscles of both AB and SCI subjects. The responses seen in the SCI muscles indicate that the systems that regulate these molecular responses are intact, even after extended periods of muscle unloading.     

Serum creatine kinase activity following forearm flexion isometric exercise

The purpose of this study was to compare serum creatine kinase (CK) activity following two forearm flexion isometric exercise regimens differing in work to rest ratio, and examine the CK response to a repeated bout of isometric exercise. Eleven males were tested on two sessions (bouts) spaced 1 week apart. For bout 1, five subjects (group A) performed a forearm flexion isometric exercise consisting of 40 10-s maximal contractions with 20-s inter-trial rests (10:20), while six (group B) performed 40 maximal 10-s contractions with 5-s inter-trial rests (10:5). The increase in serum CK activity following the 10:20 exercise (143%) was significantly greater than that following the 10:5 exercise (52%). The 10:20 exercise was also associated with greater tension generation over trials. One week later, both groups performed a bout of 10:20 exercise. A substantial reduction in the serum CK response was found following this second bout. The data suggest that for bout 1 the isometric exercise associated with the greater overall tension levels resulted in the greater CK response. However, when the 10:20 exercise was repeated 1 week later, a substantial reduction in the CK response was found which was unrelated to the tension generated.