ASSESSMENT OF FATIGUE AND RECOVERY IN MALE AND

FEMALE ATHLETES AFTER 6 DAYS OF INTENSIFIED

STRENGTH TRAINING
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CHRISTIAN RAEDER,1 THIMO WIEWELHOVE,1 RAUNO ÁLVARO DE PAULA SIMOLA,1

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MICHAEL KELLMANN,2,3 TIM MEYER,4 MARK PFEIFFER,5 AND ALEXANDER FERRAUTI1

1
Department of Training and Exercise Science, Faculty of Sport Science, Ruhr-University Bochum, Bochum, Germany;
2
Department of Sport Psychology, Faculty of Sport Science, Ruhr-University Bochum, Bochum, Germany; 3School of Human
Movement Studies and School of Psychology, The University of Queensland, Brisbane, Australia; 4Institute of Sports and
Preventive Medicine, Saarland University, Saarbru¨cken, Germany; and 5Institute of Sport Science, Johannes-Gutenberg
University, Mainz, Germany

ABSTRACT MRJ (210.5 6 3.3, ES = 20.66), and RSI (211.2 6 3.8,

Raeder, C, Wiewelhove, T, Simola, RÁDP, Kellmann, M, Meyer, ES = 20.73), as well as significantly reduced muscle contractile
T, Pfeiffer, M, and Ferrauti, A. Assessment of fatigue and recov- properties (Dm, 214.5 6 5.3, ES = 20.60; V90, 215.5 6 4.9,
ery in male and female athletes after 6 days of intensified ES = 20.62). After days of recovery, a significant return to base-
strength training. J Strength Cond Res 30(12): 3412–3427, line values could be observed in 1RMest (4.3 6 2.8, ES = 0.12),
2016—This study aimed to analyze changes of neuromuscular, CMJ (5.2 6 2.2, ES = 0.28), and MRJ (4.9 6 3.8, ES = 0.32),
physiological, and perceptual markers for routine assessment whereas RSI (27.9 6 4.5, ES = 20.50), Dm (214.7 6 4.8,
of fatigue and recovery in high-resistance strength training. ES = 20.61), and V90 (215.3 6 4.7, ES = 20.66) remained
Fourteen male and 9 female athletes participated in a 6-day significantly reduced. The STM also induced significant changes
intensified strength training microcycle (STM) designed to pur- of large practical relevance in CK, DOMS, PPC, and MS before
posefully overreach. Maximal dynamic strength (estimated 1 to after training and after the recovery period. The markers Td
repetition maximum [1RMest]; criterion measure of fatigue and and Tc remained unaffected throughout the STM. Moreover, the
recovery); maximal voluntary isometric strength (MVIC); coun- accuracy of selected markers for assessment of fatigue and
termovement jump (CMJ) height; multiple rebound jump (MRJ) recovery in relation to 1RMest derived from a contingency table
height; jump efficiency (reactive strength index, RSI); muscle was inadequate. Correlational analyses also revealed no signifi-
contractile properties using tensiomyography including muscle cant relationships between changes in 1RMest and all analyzed
displacement (Dm), delay time (Td), contraction time (Tc), and markers. In conclusion, mean changes of performance markers
contraction velocity (V90); serum concentration of creatine and CK, DOMS, PPC, and MS may be attributed to STM-
kinase (CK); perceived muscle soreness (delayed-onset mus- induced fatigue and subsequent recovery. However, given the
cle soreness, DOMS) and perceived recovery (physical perfor- insufficient accuracy of markers for differentiation between
mance capability, PPC); and stress (MS) were measured fatigue and recovery, their potential applicability needs to be
before and after the STM and after 3 days of recovery. After confirmed at the individual level.
completing the STM, there were significant (p # 0.05) perfor-
mance decreases in 1RMest (%Δ 6 90% confidence limits, KEY WORDS overreaching, mechanical overloading, muscle
ES = effect size; 27.5 6 3.5, ES = 20.21), MVIC (28.2 6 damage, jump performance, neuromuscular function
4.9, ES = 20.24), CMJ (26.4 6 2.1, ES = 20.34),
INTRODUCTION

H
The present study was initiated and funded by the German Federal igh-resistance strength training represents a com-
Institute of Sport Science. The research was realized within RegMan mon strategy for athletes participating in com-
—Optimization of Training and Competition: Management of
Regeneration in Elite Sports (IIA1-081901/12-16). The authors bat sports (e.g., boxing, karate) and intermittent
would like to thank the coaches and athletes for their participation. sports (e.g., American football, handball, soc-
Address correspondence to Christian Raeder, [Link]@[Link]. cer), where improvements in muscle hypertrophy, strength,
30(12)/3412–3427 and power are considered important (1). Regarding this,
Journal of Strength and Conditioning Research maximal strength and power of the lower limbs have been
Ó 2016 National Strength and Conditioning Association strongly correlated to jump height, acceleration, and sprint
the TM

3412 Journal of Strength and Conditioning Research

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 the TM

Journal of Strength and Conditioning Research | [Link]

performance (44). Therefore, maximal strength and power (32). Thus, there is a need to identify useful surrogate markers
are decisive factors in the complex demands of intermittent that give an early indication of exercise-related changes in
sports, among other relevant physical capabilities as well as fatigue and recovery. Ideally, those markers can be deter-
technical and tactical skills. mined at rest or during low metabolic and neuromuscular
A single bout of high-intensity muscle action results in demands causing minimal additional fatigue and could be
decreased neuromuscular performance in addition to routinely used, without disturbing the training process, to
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increased muscle damage and discomfort lasting for many evaluate performance and readiness (21,32,42).
days, especially when eccentric overload strategies are used A couple of measures fulfilling these requirements have
been proposed, including markers of neuromuscular function
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(3,5,10,11). This exercise-induced fatigue is an integral com-

ponent of effective strength training programs and can be (e.g., jump tests) or skeletal muscle contractile properties
considered as an intended stimulus (i.e., acute overload) for (e.g., tensiomyography [TMG]) as well as routine blood
muscle adaptation and performance improvement. How- parameters (e.g., creatine kinase [CK]), and perceptual
ever, long-term intensified strength training followed by measures (e.g., delayed-onset muscle soreness [DOMS])
inadequate recovery periods (i.e., imbalance between load (9,10,21,26,33,34,36). However, an evaluation of these poten-
and recovery) could induce conditions of severe fatigue tial surrogate markers regarding their usefulness for routine
and underperformance, which could result in overreaching assessment of fatigue and recovery in high-resistance
or overtraining (15,16,22,32). According to studies, almost strength training seems to be necessary (32,34,42). More-
30% of Swiss elite athletes from a variety of competitive over, it has been reported that female athletes are less fati-
sports experience such issues during their entire career (6), gable than male athletes in response to training because of
and 15% of British elite athletes from different Olympic differences in strength levels, muscle mass, and muscle contrac-
sports developed a state of overtraining over a 12-month tile properties (27). Therefore, the present study aimed to inves-
training season (22). These conditions may have serious im- tigate the effectiveness of neuromuscular, physiological, and
plications on the health and well-being of athletes (6). perceptual markers to represent changes in fatigue and recov-
Therefore, regular assessment of an athlete’s fatigue and ery after a 6-day intensified strength training microcycle (STM)
recovery status using practical or nondemanding surrogate in male and female athletes. We hypothesized that the short
markers may provide important practical insights with period of dense overreaching induces fatigue in maximal
respect to training progress and prescription, readiness, dynamic strength (1RMest) associated with meaningful changes
and injury prevention (21,32). in potential surrogate markers of fatigue and recovery.
Logically, the most relevant marker for the evaluation of
fatigue in strength training represents a specific maximal METHODS
performance test (e.g., estimated one-repetition maximum Experimental Approach to the Problem
[1RMest] performance) that can be considered a gold stan- A repeated-measures study design was used to evaluate
dard (21,32,42). However, 1RMest testing is certainly practi- surrogate markers for fatigue and recovery (Figure 1).
cal but also associated with intense efforts using heavy Regarding this, an STM was carried out to purposely induce
weights, which could induce additional fatigue, if used fre- fatigue in maximal dynamic strength (1RMest) to compare
quently in the applied field (21). Furthermore, 1RMest pro- surrogate markers with changes in 1RMest. The entire study
vides little information about the potential mechanism of covered a period of 19 days comprising a 9-day run-in
fatigue, and frequent testing of maximal strength would also period, a 6-day STM, and a 4-day posttesting period. One
require the athlete to repeatedly perform maximal efforts for week before beginning the STM, the subjects underwent
noncompetitive purposes that may cause lack of motivation, a health examination to preclude any cardiovascular, pulmo-
particularly when fatigued (21,42). Consequently, this nary, or orthopedic contraindications to participate in this
approach seems to be a rather suboptimal strategy for rou- study. In the subsequent 2 days, there were 2 separate labo-
tine assessment of fatigue and recovery. ratory familiarization visits to introduce and practice the
The underlying mechanisms pertaining to the emergence testing and training procedures and to ensure that any learn-
of exercise-induced fatigue are very complex and driven by ing effect was minimal for the upcoming performance tests.
various central and peripheral regulatory pathways (32,38). After this habituation process, the subjects were instructed to
Therefore, a great number of diagnostic tools have been sug- rest for the next 4 days, during which no training or fatiguing
gested as surrogate markers of fatigue and recovery including exercise was allowed.
performance, cardiovascular, neuromuscular, physiological, Maximal dynamic strength, which was defined as the
and perceptual markers (16,21,32,42). Certainly, a series of criterion measure of fatigue in strength training (i.e., gold
these markers seem to be impractical (e.g., heart rate variabil- standard) (21,32,42), was tested at baseline (Pre) and 1 day
ity), too invasive, and costly in the long term (e.g., venipunc- after the STM (Post1) and after 3 days of recovery (Post4), in
ture hormone testing) (33), or inappropriate (e.g., maximal which the subjects were asked to rest (no training or fatigu-
performance tests) for closely assessing fatigue and recovery ing exercise). Before the 1RMest test, potential surrogate
in a typical combative or intermittent sports environment markers of fatigue and recovery were determined in the

VOLUME 30 | NUMBER 12 | DECEMBER 2016 | 3413

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Figure 1. Schematic representation of the study design. 1RMest = estimated 1 repetition maximum; MVIC = maximal voluntary isometric contraction; CMJ =
countermovement jump; MRJ = multiple rebound jumps; TMG = tensiomyography measurements including maximal radial displacement of the muscle belly
(Dm), delay time (Td), contraction time (Tc), and muscle contraction velocity (V90); CK = serum creatine kinase; DOMS = delayed-onset muscle soreness;
SRSS = short recovery and stress scale; Ts = training session; *session-RPE determined 30 minutes after training session.

specified order including perceived muscle soreness, per- disease. This was confirmed in a preliminary health exami-
ceived recovery and stress, a blood parameter, skeletal mus- nation (including resting and exercise electrocardiogram) to
cle contractile properties, jump performance, and maximal check the aptitude for intensified training. The study was
isometric strength. In addition, the perceptual measures were approved by the local Ethics Committee of the Ruhr-
measured daily within the STM and the subsequent recovery University Bochum. Before any participation, the experi-
period, whereas the other surrogate markers (except isomet- mental procedures and potential risks were explained fully
ric strength) were determined once during the STM (Mid) to the subjects in accordance with the Declaration of Hel-
and on the second (Post2) and third (Post3) recovery day sinki. The subjects were free to withdraw from this study
after the completion of the STM. For a given subject, each without penalty at any time, and they all provided written
measurement and test was performed at the same time of the informed consent.
day to minimize diurnal variations. During testing and train-
Training Program and Training Protocols
ing, the subjects were allowed to drink water ad libitum.
The STM was conceived to purposefully overreach from
There was 30 minutes rest between jump tests and the iso-
intensified strength training in close density. Therefore, the
metric strength test and 60 minutes rest between the iso-
subjects trained twice a day, morning (;9 AM) and afternoon
metric and dynamic strength test. Before all performance
(;3 PM), on 6 consecutive days, resulting in a total of 11
tests, a standardized dynamic warm-up was conducted.
training sessions (the morning of training day 4, there were
Within the length of this study, the subjects were instructed
Mid-tests). Overall, the training program consisted of basic
to maintain their normal dietary intake and habitual lifestyle
multijoint high-resistance combined with maximal eccentric
and also to abstain from alcohol drinking. Additionally, the
strength exercises, primarily focusing on lower limb training
subjects had to keep a nutrition log to control energy intake
(i.e., parallel squat). Four different alternating training proto-
throughout the study period.
cols were used, including traditional multiple sets (TD), drop
Subjects sets (DS), an eccentric overload (EO), and a flywheel YoYo
Twenty-three strength-trained athletes participating in com- squat protocol (FW), which has been previously described in
bat sports (e.g., boxing, karate) and intermittent game sports detail (39). A general description of the training program and
(e.g., American football, handball, soccer) volunteered to protocols is shown in Table 1. The parallel squat depth was
participate in this study (mean 6 SD; male, n = 14, age 24.1 determined when the knees are flexed until the inguinal fold
6 2.0 years, mass 78.9 6 6.9 kg; female, n = 9, age 25.4 6 1.9 is in a straight horizontal line with the top of the knee mus-
years, mass 60.8 6 6.9 kg). Before any involvement, the culature (23) and was thoroughly controlled by experienced
subjects had to meet the following inclusion criteria: (a) supervisors. At the end of each training session, the subjects
estimated 1RMest in parallel squat of at least 120% of male additionally performed upper-body exercises (4 sets of 6
body mass and 80% of female body mass (20), (b) experience maximal repetitions of alternating incline and flat bench
in strength training for the lower limbs of at least 3 years press), several exercises for the hamstrings and back (4 sets
with a minimum of 2 strength training sessions per week, (3) of 6 to 8 repetitions of Nordic hamstrings, and 4 sets of
and absence of any cardiovascular, pulmonary, or orthopedic 8 to 12 maximal repetitions of alternating lat pull-down or
the TM

3414 Journal of Strength and Conditioning Research

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TABLE 1. Training program and protocols used during the STM.

Day 1 Day 2 Day 3 Day 4 Day 5 Day 6

Morning
FW: squats FW: squats FW: squats Mid-test FW: squats FW: squats
TD: bench press DS: bench press DS: bench press DS: bench press DS: bench press
Hamstrings, back and core Hamstrings, back and core Hamstrings, back and core Hamstrings, back Hamstrings, back
and core and core
s-RPE, M: 6.5 6 1.9; s-RPE, M: 7.0 6 1.2; s-RPE, M: 7.1 6 1.2; s-RPE, M: 7.1 6 1.3; s-RPE, M: 7.6 6 1.2;
F: 5.0 6 0.9 F: 6.2 6 1.2 F: 6.4 6 1.1 F: 7.0 6 1.2 F: 7.0 6 0.8
Afternoon
EO: squats TD: squats EO: squats TD: squats EO: squats TD: squats
TD: squats FW: squats TD: squats FW: squats TD: squats FW: squats
EO: bench press TD: bench press EO: bench press TD: bench press EO: bench press TD: bench press
Hamstrings, back Hamstrings, back and core Hamstrings, back and core Hamstrings, back Hamstrings, back Hamstrings, back
and core and core and core and core
s-RPE, M: 6.8 6 1.4; s-RPE, M: 6.9 6 1.7; s-RPE, M: 6.8 6 1.0; s-RPE, M: 7.2 6 0.9; s-RPE, M: 7.3 6 1.1; s-RPE, M: 7.2 6 1.3;

Journal of Strength and Conditioning Research

F: 5.7 6 1.3 F: 6.5 6 0.9 F: 6.7 6 1.4 F: 6.9 6 1.6 F: 7.4 6 1.5 F: 7.0 6 1.6

the
Protocol Volume (sets 3 reps) Intensity (% 1 RMest) Cadence (s) Rest (s)

TD 436 85 2 ECC–x CON 180

VOLUME 30 | NUMBER 12 | DECEMBER 2016 |

DS 1 3 6 (+3 drop sets) 85 (70–55–40) 4 ECC–2 CON 30

EO 436 100 ECC–70 CON 2 ECC–1 ISO–x CON 180
FW 4 3 6 (+2 acc reps) Maximum effort Maximum–explosive 180

FW = flywheel YoYo squat; TD = traditional multiple sets; DS = drop sets; s-RPE = session-RPE; M = male; F = female; EO = eccentric overload; 1RMest = estimated 1 repetition
maximum; ECC = eccentric; x = intended explosive; CON = concentric; ISO = isometric; acc reps = acceleration repetitions; TUT = time under tension.

TM
| [Link]
3415

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 Assessment of Fatigue in Heavy Strength Training

cable rowing), and accessory core exercises (4 sets, by each between warm-up sets and 3 minutes rest between testing
40–60 seconds time under tension, of plank, side plank, sets. A 1RM strength was estimated (1RMest) using the for-
bridging, and various derivatives), to enhance compliance mula proposed by Brzycki (31). This formula has been
and motivation as well as to reduce risk of injury. At the shown to be valid in accurately predicting 1RM performance
start of each training session, the subjects performed a stan- (14). In addition, 1RMest was used to calculate the subjects’
dardized dynamic warm-up finishing with some basic core individual training loads in parallel squat exercise throughout
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exercises. Each training exercise was also preceded by 5 to 3 the STM. The intraclass correlation coefficient (ICC) and
specific warm-up repetitions corresponding to 50 and 70% of the typical error (TE) were previously calculated in our
subjects’ maximum performance. Every training session own laboratory and considered highly reliable in 1RM
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 11/09/2024

lasted approximately 90 minutes, including warm-up and (kg), n = 38, ICC = 0.959, TE = 5.2.
additional exercises performed.
Neuromuscular Function. Maximal voluntary isometric con-
Procedures traction (MVIC) force in the squat was determined at Pre,
Anthropometry. Within the first laboratory visit, anthropometric Post1, and Post4. The MVIC was measured by recording the
data were collected, including body mass, using a customary maximal isometric force output, in Newton (N), using the
weighing scale (Soehnle Professional, Backnang, Germany), Multitrainer 7812-000 testing device similar to a Smith
and body height, using a customary height measure system machine (Kettler Profiline, Ense-Parsit, Germany) and
(Seca Leicester, Birmingham, United Kingdom). analogous user software (DigiMax, version 7.X). The subjects
were directed to position under the shoulder pads of the bar
Maximal Strength. Maximal dynamic strength (estimated into a shoulder bride stand with an external foot rotation of
1RM, 1RMest) in the squat was determined at Pre, Post1, 5–108. Perpendicular to the middle of the shoulder pads,
and Post4 using a Smith rack machine (Technogym, Cesena, a floor marker functioned as a point of reference to stand
Italy). The subjects were instructed to position into a shoul- parallel to and to standardize the adjustment of the axis
der bride stand with an external foot rotation of 5–108 under of the ankle joint. Subsequently, the bar was lowered and
the barbell of the Smith rack machine. The barbell was posi- mechanically locked into a testing position corresponding to
tioned for a high-bar back squat. Perpendicular to the middle a knee joint angle of 908 using a customary goniometer. This
of the barbell, a colored floor marker functioned as a point of testing position was previously determined for each subject
reference to stand parallel to and to standardize the adjust- and kept constant throughout the study. Before completing
ment of the axis of the ankle joint. The squat depth was the MVIC test, the subjects conducted 2 submaximal prac-
determined at the parallel squat position. An integrated lin- tice trials corresponding to approximately 50 and 70% of
ear transducer served as an acoustic stimulus to standardize maximum MVIC force interspersed with 1-minute rest.
the range of motion of approximately 110–1208. The subjects Without moving explosively but with a slow force develop-
were instructed to lower the barbell consistently throughout ment, they were then asked to produce an MVIC over
the full range of motion, whereas stopping the barbell at any a 3-second interval (7). At all measurement points, the sub-
point during the lift was prohibited. Generally, 1RMest jects performed 2 maximal MVIC trials interspersed with
testing comprised the determination of 5 to 10 maximal 2 minutes of recovery. The mean MVIC force of both
repetitions until concentric failure, following the recommen- attempts was used for later analysis.
dations described elsewhere (8,31). After the general warm- The countermovement jump (CMJ) test were performed
up and before 1RMest testing, the subjects performed a spe- at Pre, Mid, Post1, Post2, Post3, and Post4 using a contact
cific warm-up consisting of 5 and 3 repetitions correspond- platform (Haynl Elektronik, Schönebeck, Germany). During
ing to approximately 50 and 70% of subjects’ estimated 5–10 the CMJ, the subjects were asked to place the hands on the
RM. Then, a near maximal (;90%) 5–10 RM load was cho- hips and to drop down to a self-selected level before jumping
sen that allowed the subjects to complete 5 to ,10 repeti- for maximal height. The flight time was used to calculate the
tions. In the subject’s and supervisors’ estimation, a maximal jump height. At all measurement points, the subjects per-
5–10 RM load was then selected to start a first maximal formed 2 CMJs, and the mean jump height (cm) was taken
attempt. If the subjects tended to exceed the limit of 10 for later analysis. The multiple rebound jumps (MRJ) were
repetitions, then the supervisors stopped the test immedi- performed at Pre, Mid, Post1, Post2, Post3, and Post4 using
ately and the load was gradually increased. The test was also a contact platform (Haynl Elektronik). At all measurement
stopped when the subjects were unable to raise the barbell point, the subjects performed MRJs for maximal jump height
with a proper technique or when the help of the supervisors with minimal ground contact time (GCT) for a total of 15
was needed. The 1RMest test involves a procedure of pro- seconds. During the MRJs, the subjects were instructed to
gressively increasing and decreasing the load and was com- place the hands on the hips and to keep their legs as straight
pleted until the heaviest successful 5–10 RM lift was as possible, enabling powerful rebounds with mostly the
determined (8). The subjects’ final loads were all collected ankle joint. The GCTs and flight times of the 5 best jumps
within a maximum of 3 testing sets. There was 1-minute rest based on the jump efficiency score ([flight time, s]2 3
the TM

3416 Journal of Strength and Conditioning Research

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TABLE 2. Markers of fatigue and recovery at baseline (Pre), after 6 days of intensified strength training (Post1), and after 3 days of recovery (Post4), as well as
mean and standardized changes with qualitative inferences of all markers between measurement points.*†

Pre Post1 Post4 Post1–Pre Post4–Post1 Post4–Pre

Mean 6 SD Mean 6 SD Mean 6 SD %Δ 6 ES 6 90% %Δ 6 ES 6 90% %Δ 6 90% ES 6 90%

Variable (95% CI) (95% CI) (95% CI) 90% CL CL 90% CL CL CL CL
Maximal
dynamic
strength
1RMest (kg) 103.8 6 35.1 (88.6–119.0) 95.4 6 31.1z (82.0–108.8) 99.7 6 31.2§ (86.2–113.2) 27.5 6 3.5 20.21 6 0.10P 4.3 6 2.8 0.12 6 0.07T 23.2 6 4.0 20.09 6 0.11T
Neuromuscular
function
MVIC (N) 1,524 6 562 (1,281–1,767) 1,404 6 503z (1,161–1,647) 1,427 6 509 (1,207–1,647) 28.2 6 4.9 20.24 6 0.15P 1.8 6 4.0 0.06 6 0.11T 26.4 6 4.3 20.18 6 0.13T
CMJ (cm) 40.8 6 7.3 (37.6–44.0) 38.1 6 5.6z (35.7–40.5) 40.3 6 6.7§ (37.4–43.2) 26.4 6 2.1 20.34 6 0.13L 5.2 6 2.2 0.28 6 0.11L 21.2 6 2.7 20.06 6 0.14T
MRJ (cm) 30.1 6 4.6 (28.1–32.1) 27.1 6 4.9z (25.0–29.2) 28.5 6 4.9§ (26.4–30.6) 210.5 6 3.3 20.66 6 0.15ML 4.9 6 3.8 0.32 6 0.21L 25.6 6 4.6 20.34 6 0.29L
RSI (index) 1.87 6 0.27 (1.75–1.99) 1.67 6 0.31z (1.54–1.80) 1.72 6 0.28z (1.60–1.84) 211.2 6 3.8 20.73 6 0.26ML 3.3 6 3.8 0.23 6 0.22P 27.9 6 4.5 20.50 6 0.30VL
Skeletal muscle
contractile
properties
Dm (mm) 9.0 6 2.1 (8.1–9.9) 7.7 6 1.6z (7.0–8.4) 7.7 6 1.7z (7.0–8.4) 214.5 6 5.3 20.60 6 0.23ML 20.2 6 5.2 0.01 6 0.20T 214.7 6 4.8 20.61 6 0.22ML
Td (ms) 21.3 6 1.4 (20.7–21.9) 21.5 6 1.8 (20.7–22.3) 21.4 6 1.8 (20.6–22.2) 0.6 6 2.0 0.09 6 0.31U 20.5 6 1.8 20.08 6 0.28T 0.1 6 2.5 0.01 6 0.39U
Tc (ms) 23.9 6 2.9 (22.6–25.2) 23.6 6 3.0 (22.3–24.9) 24.1 6 3.3 (22.7–25.5) 20.2 6 5.6 20.01 6 0.31U 1.8 6 3.3 0.10 6 0.18T 1.6 6 5.5 0.09 6 0.30U
V90 (mm$s21) 180.6 6 40.1 (163.3–197.9) 153.9 6 33.4z (139.5–168.3) 152.9 6 32.7z (138.8–167.0) 214.5 6 4.9 20.62 6 0.23ML 20.8 6 4.1 20.04 6 0.16T 215.3 6 4.7 20.66 6 0.22ML

Δ 6 90% Δ 6 90% Δ 6 90%

CL CL CL
Muscle damage
and soreness

Journal of Strength and Conditioning Research

the
CK (U$L21) 307 6 454 (111–503) 889 6 510z (668–1,110) 271 6 126§ (217–325) 582 6 233 1.24 6 0.49ML 2618 6 150 21.32 6 0.32ML 236 6 154 20.08 6 0.33U
DOMS (cm) 0.2 6 0.1 (0.2–0.2) 2.3 6 1.8z (1.5–3.1) 0.3 6 0.5§ (0.1–0.5) 2.1 6 0.6 17.06 6 5.14ML 22.0 6 0.6 216.51 6 5.23ML 0.1 6 0.2 0.55 6 1.56U
Perceived
recovery and
stress
PPC (0–6) 4.0 6 1.0 (3.6–4.4) 2.4 6 1.2z (1.9–2.9) 4.0 6 1.3§ (3.4–4.6) 21.6 6 0.5 21.50 6 0.44ML 1.6 6 0.4 1.55 6 0.36ML 0.0 6 0.5 0.00 6 0.43U
VOLUME 30 | NUMBER 12 | DECEMBER 2016 |

MS (0–6) 1.6 6 1.0 (1.2–2.0) 3.9 6 1.3z (3.3–4.5) 1.4 6 1.2§ (0.9–1.9) 2.3 6 0.6 2.22 6 0.59ML 22.5 6 0.6 22.45 6 0.55ML 20.2 6 0.6 20.23 6 0.57U

*CI = confidence interval; %Δ = mean percentage change; 90% CL = 90% confidence limits; Δ = mean absolute change; ES = standardized change (Cohen’s d effect size);
1RMest = estimated 1 repetition maximum; MVIC = maximal voluntary isometric contraction; CMJ = countermovement jump; MRJ = multiple rebound jumps; RSI = jump efficiency
(reactive strength index); Dm = maximal radial displacement of the muscle belly; Td = delay time; Tc = contraction time; V90 = muscle contraction velocity; CK = serum creatine kinase
concentration; DOMS = delayed-onset muscle soreness; PPC = physical performance capability; MS = muscular strain.
†Data are mean 6 SD (95% CI), unless otherwise stated. Uunclear, Ttrivial, Ppossibly, Llikely, VLvery likely, MLmost likely standardized change.
zSignificantly different from Pre.
§Significantly different from Post1.

TM
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 Assessment of Fatigue in Heavy Strength Training

TABLE 3. Accuracy of selected markers of fatigue and recovery in relation to the criterion measure.*

Positive predictive Negative predictive Diagnostic

value (%) value (%) effectiveness (%)
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ΔPre– ΔPre– ΔPre– ΔPre– ΔPre– ΔPre–

Post1 Post4 Post1 Post4 Post1 Post4
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Neuromuscular function
MVIC (N) 73.3 62.5 37.5 87.5 60.9 75.0
CMJ (cm) 81.3 37.5 57.1 62.5 73.9 50.0
MRJ (cm) 77.8 66.7 40.0 100.0 69.6 81.3
RSI (index) 83.3 83.3 80.0 90.0 82.6 87.5
Skeletal muscle contractile properties
Dm (mm) 75.0 50.0 42.9 66.7 65.2 62.5
V90 (mm$s21) 80.0 66.7 50.0 69.2 69.6 68.8

*MVIC = maximal voluntary isometric contraction; CMJ = countermovement jump; MRJ = multiple rebound jumps; RSI = jump
efficiency (reactive strength index); Dm = maximal radial displacement of the muscle belly; V90 = muscle contraction velocity.

[GCT, s]21) were recorded. The mean jump height (cm) Skeletal Muscle Contractile Properties. Tensiomyography was
calculated from flight time and mean jump efficiency deter- used as a noninvasive and involuntary (independent of
mined from the reactive strength index (RSI; [jump height, m] central activation) measure of skeletal muscle contractile
3 [GCT, s]21) (4) were taken for later analysis of those pre- properties of the lower extremity without inducing addi-
selected 5 best jumps. Both jump tests, CMJ and MRJ, were tional fatigue (13). Tensiomyography measurements were
used because of their practicability and reliability as well as conducted using a specific electrical stimulator (TMG-S2),
their minimal amount of additional fatigue induced (21,34). analogous TMG-OK 3.0 software, as well as a spring-loaded
Previously measured reliability scores were regarded reliable displacement sensor tip (TMG-BMC, Ljubljana, Slovenia)
in MVIC (N), n = 38, ICC = 0.920, TE = 124; CMJ (cm), with a prefixed tension of 0.17 N$m that was positioned
n = 38, ICC = 0.915, TE = 1.86; MRJ (cm), n = 38, ICC = rectangular to the muscle belly of the vastus medialis (13).
0.901, TE = 1.91; RSI (Index), n = 38, ICC = 0.914, TE = 0.13. The measuring point on the muscle belly was carefully

Figure 2. Standardized differences in relative changes of 1RMest (A) and MVIC (B) between male and female athletes. Data are mean 6 SD. 1RMest =
estimated 1 repetition maximum; MVIC = maximal voluntary isometric contraction; Circles in dotted and solid lines represent likely and most likely within-sex
changes. Ttrivial between-sex difference; Ppossibly between-sex difference.

the TM

3418 Journal of Strength and Conditioning Research

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 the TM

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properties assessed were the

maximal radial displacement
of the muscle belly (Dm,
mm), the delay time between
the onset of electrical stimula-
tion and 10% of Dm (Td, ms),
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the contraction time between

10 and 90% of Dm (Tc, ms),
and the mean velocity of mus-
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cle contraction from the onset

of electrical stimulation until
90% of Dm (V90, mm$s21)
(13). The parameter Dm has
been proposed as an indicator
of muscle stiffness or muscle
contractile force, whereas the
parameters Td and Tc have
been introduced as measures
of muscle response or muscle
activation time and speed of
force generation, respectively
(13,19,26).
During squat exercise, the
activity of the vasti muscles
(vastus medialis and vastus
lateralis) is greater than that
of the rectus femoris (little or
no change in whole muscle
length during the squat move-
ment), with (a) the vasti
muscles equally contributing
to muscle force output and
(b) the vasti muscles approxi-
mately producing a 50%
greater muscle force output
as the rectus femoris (40).
Therefore, we measured the
muscle contractile properties
of the vastus medialis in this
study, expecting a greater
responsiveness because of
Figure 3. Standardized differences in relative changes of CMJ (A), MRJ (B), and RSI (C) between male and higher mechanical strains.
female athletes. Data are mean 6 SD. CMJ = countermovement jump; MRJ = multiple rebound jumps; RSI = jump Reliability scores were previ-
efficiency (reactive strength index). Circles in dotted, dashed, and solid lines represent likely, very likely, and most
U P
ously determined in our own
likely within-sex changes. unclear between-sex difference; possibly between-sex difference.
laboratory and considered
reliable in Dm (mm): ICC =
0.918, TE = 1.0; Td (ms):
determined as a point of maximal muscle belly displacement ICC = 0.856, TE = 1.3; and Tc (ms): ICC = 0.926, TE = 2.3.
during voluntary knee extension. This exact position was
marked with a dermatological pen and was kept constant Muscle Damage. Venous blood samples of serum CK concen-
during the study period. The self-adhesive electrodes were tration were used as indirect evidence of muscle damage and
placed symmetrically approximately 5 cm away from the taken at Pre, Mid, Post1, Post2, Post3, and Post4 (between 8 and
sensor. The TMG measurements were performed in a supine 10 AM) from an antecubital arm vein using a 20-gauge dispos-
position, and a knee joint angle of 1208 was held constant able Safety-Multifly needle (Sarstedt, Nürnbrecht, Germany),
using supporting pads. The TMG skeletal muscle contractile with the subjects lying in a supine position. The blood

VOLUME 30 | NUMBER 12 | DECEMBER 2016 | 3419

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 Assessment of Fatigue in Heavy Strength Training

whose end points were labeled

with “no pain” (left) and
“unbearable pain” (right). The
subjects were asked to palpate
their lower limbs and mark
a vertical line at a point on
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the line that best represented

their rating of soreness at the
time of measurement. The
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score was the distance, in cen-

timeters, from the left side of
the scale to the point marked
(30).

Perceived Recovery and Stress.

The subjective rating of per-
ceived recovery and stress
were determined before (Pre),
during (Td2, Td3, Mid, Td5,
and Td6) and after (Post1,
Post2, Post3, and Post4) the
STM using the short recovery
and stress scale (SRSS) (28).
The subjects were asked to
provide responses to 8 items
on a rating scale ranging from
“0” (does not apply at all) to “6”
(fully applies). Numbers “1” to
“5” on this scale were unde-
fined and were used to delin-
eate the degrees of perceived
recovery and stress between
the 2 endpoints of the scale.
Figure 4. Standardized differences in relative changes of Dm (A) and V90 (B) between male and female athletes. The items used in this study
Data are mean 6 SD. Dm = maximal radial displacement of the muscle belly; V90 = muscle contraction velocity. were “physical performance
Circles in dotted, dashed, and solid lines represent likely, very likely, and most likely within-sex changes. Uunclear
between-sex difference; Ppossibly between-sex difference; Llikely between-sex difference; VLvery likely between- capability” (PPC) and “muscu-
sex difference. lar strain” (MS). Scores for
internal consistencies of the
SRSS were previously exam-
ined among elite athletes and
samples were collected using 7.5-ml serum gel tubes with considered to be sufficient (n = 574; Cronbach a = 0.76).
clotting activator (Sarstedt). After blood collection, the sam-
ples were positioned upright for 20 minutes and subsequently Session Intensity and Internal Training Load. The session
centrifuged at 3,500 rpm for 15 minutes. Serum was aliquoted intensity was determined 30 minutes after each training
into microtubes (Sarstedt), frozen at 2808 C within 60 mi- session using the CR-10 RPE scale (i.e., session-RPE) (43).
nutes after blood collection, and stored for later analysis. The In this regard, the session-RPE represents a global rating
analysis of CK activity was conducted by routine techniques of the perceived intensity for the complete training session
(UniCell DxC 600 Synchron; Beckmann Coulter, Krefeld, (12). The internal training load (TL) was then calculated
Germany). The diagnostic laboratory used in this study held by multiply the session-RPE by the training duration
current quality assurance certification. (minutes) to obtain a single measure of TL, in arbitrary
units (AU), based on the session-RPE method (43). Pre-
Muscle Soreness. Delayed-onset muscle soreness was mea- vious research indicates that the session-RPE method is
sured before (Pre), during (Td2, Td3, Mid, Td5, and Td6), simple, valid, and reliable in assessing exercise intensity
and after (Post1, Post2, Post3, and Post4) the STM using (21). Before the start of the study, all subjects were thor-
a visual analog scale (VAS). The VAS consists of a 10-cm line oughly familiarized with the CR-10 RPE scale.
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 the TM

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and recovered athletes in com-

parison with the criterion mea-
sure of fatigue (1RMest). The
table was composed of hori-
zontal lines to indicate the
presence or absence of fatigue
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in accordance with changes in

potential surrogate markers,
and vertical lines to indicate
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the “true” condition of an ath-

lete according to the criterion
measure. Positive predictive
value (proportion that a positive
test result in a given surrogate
marker indicates the presence
of fatigue or recovery), negative
predictive value (proportion that
a negative test result in a given
surrogate marker indicates the
absence of fatigue or recovery)
as well as diagnostic effectiveness
(proportion of athletes correctly
categorized by the surrogate
marker) were calculated from
the constructed table (41). Fur-
thermore, correlational analyses
were performed to determine re-
lationships between changes in
surrogate fatigue markers and
changes in the criterion measure
of fatigue. Statistical significance
Figure 5. Standardized differences in changes from pre of serum CK (A) and perceived muscle soreness was set at p # 0.05.
(DOMS) (B) before, during, and after the STM between male and females athletes. Data are mean 6 SD. CK = In addition, the data were
creatine kinase; DOMS = delayed-onset muscle soreness; Td = training day. Circles in dashed and solid lines
U
represent very likely and most likely within-sex changes from Pre. unclear between-sex difference in changes from
evaluated through analyses
Pre; Llikely between-sex difference in changes from Pre; VLvery likely between-sex difference in changes from Pre. of practical relevance using
magnitude-based inferences
(MBI), calculated from 90%
Statistical Analyses CLs using a published spreadsheet, to assess the probability
Classical statistical analyses were performed with IBM SPSS that a change in the mean is practically meaningful or
statistical package (version 22; IBM, Chicago, IL, USA). Data relevant (i.e., relating to the magnitude of change in a given
are presented as mean 6 SD (95% confidence interval, CI), marker) (25). The smallest worthwhile change was defined as
unless otherwise stated. The assumption of normality was pre- 0.20 of the between-subject variation of the pretest in all
viously checked using Shapiro-Wilk test before conducting any analyses, and quantitative changes of all markers were
parametric tests. In case of normally distributed data, differ- allocated a qualitative descriptor representing the probability
ences between all measurement points and between male and that the true value is of the observed magnitude (24). Qual-
female athletes were determined using a 2-factor (time, sex) itative inferences were considered as chances (%) of having
repeated-measures analysis of variance (ANOVA). Violation of a negative (2), trivial, or positive (+) effect and evaluated as
sphericity was adjusted by Greenhouse-Geisser. Bonferroni follows: ,0.5%, almost certainly not; 0.5–5.0%, very
post hoc comparisons were used if ANOVA main effect was unlikely; .5.0–25.0%, unlikely; .25.0–75.0%, possibly;
significant. For non-normally distributed data, differences .75.0–95.0% likely; .95.0–99.5%, very likely; .99.5%: most
between measurement points were tested using Friedman test. likely (25). If the chance of having a substantially positive or
If significance was found, post hoc Wilcoxon signed rank tests negative effect was both .5%, the true change was assessed
were performed to determine differences between time points. as “unclear.” Threshold values of 0.00–0.19, 0.20–0.59,
A 2 3 2 contingency table was used to evaluate the accu- 0.60–1.19, 1.20–1.99, and .2.00 for standardized changes
racy of selected markers to differentiate between fatigued (Cohen d effect sizes 6 90% CLs) were considered of having

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 Assessment of Fatigue in Heavy Strength Training

a trivial, small, moderate, large, and very large effect, respec- (Dm, p = 0.001; V90, p = 0.001), muscle damage and sore-
tively (24,25). ness (CK, p = 0.001; DOMS, p = 0.001), and perceived
recovery and stress (PPC, p = 0.001; MS, p = 0.001). Each
RESULTS of these markers reflected significant changes in fatigue
There was no significant time 3 sex interaction (p = 0.273) between Pre and Post1. For the markers CMJ, MRJ, CK,
but a significant main effect for time (p = 0.007) in maximal DOMS, PPC, and MS, a significant return to baseline levels
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dynamic strength (1RMest) with 1RMest showing a significant could be detected between Post1 and Post4, whereas the
decrease between Pre and Post1 and a significant return to markers RSI, Dm, and V90, however, remained significantly
baseline levels between Post1 and Post4. There was no sig- reduced after the recovery period. No significant differences to
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nificant difference between Pre and Post4 (Table 2). In addi- baseline levels were found in MVIC, CMJ, MRJ, CK, DOMS,
tion, MBI revealed a possibly decreased performance in PPC, and MS between Pre and Post4. The markers Td and Tc
1RMest between Pre and Post1 and a trivial change to initial remained statistically insignificant throughout the study period
values from Post1 to Post4 with a trivial difference to base- (Table 2). Additionally, MBI showed possibly to most likely
line levels after 3 days of recovery (Table 2). decreased performances in markers of neuromuscular function,
No significant time 3 sex interactions were found in all most likely decreased muscle contractile properties, most likely
analyzed markers. However, significant main effects for time increases in markers of muscle damage and soreness, and
could be detected in markers of neuromuscular function most likely relevant changes in markers of perceived
(MVIC, p = 0.042; CMJ, p = 0.001; MRJ, p = 0.001; recovery and stress between Pre and Post1 (Table 2).
RSI, p = 0.001), skeletal muscle contractile properties Furthermore, the markers CMJ, CK, DOMS, PPC, and

Figure 6. Standardized differences in changes from Pre of perceived recovery (PPC) (A) and stress (MS) (B) before, during, and after the STM between male
and female athletes using the short recovery and stress scale (SRSS). Data are mean 6 SD. MS = muscular strain; PPC = physical performance capability; Td =
training day. Circles in dotted, dashed, and solid lines represent likely, very likely and most likely within-sex changes from Pre. Uunclear between-sex difference in
changes from Pre; Ttrivial between-sex difference in changes from Pre; Llikely between-sex difference in changes from Pre.

the TM

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 the TM

Journal of Strength and Conditioning Research | [Link]

MS likely to most likely returned to baseline levels between intensified STM designed to purposefully overreach. As
Post1 and Post4. However, MRJ, RSI, Dm, and V90 likely to expected, the 6-day STM caused a decline in 1RMest from
most likely remained compromised after 3 days of recovery pretraining to posttraining and a return to baseline levels
(Table 2). For the markers Td and Tc, there were only unclear after 3 days of recovery indicating a temporary state of
pre-post effects. fatigue. However, regular testing of maximal dynamic
Positive and negative predictive values as well as diagnos- strength for routine assessment of fatigue and recovery
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tic effectiveness of selected surrogate markers are given in seems to be physically too demanding, could cause undue
Table 3. Overall, none of these markers showed sufficient additional fatigue, and thus may interfere with the normal
accuracy to differentiate between fatigued and recovered training routine in most athletes (21,42). Therefore, the pres-
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athletes in relation to the criterion measure. In this regard, ent study revealed that, in particular, CMJ, MRJ, CK,
the diagnostic effectiveness (accuracy) in surrogate markers DOMS, PPC, and MS represent potentially useful surrogate
ranged from 61 to 83% and from 50 and 88% to discriminate markers that are less demanding and easy to implement in
correctly between fatigued or nonfatigued athletes and the applied field. This could be shown by significant changes
between athletes who recovered from fatigue or not, respec- of these markers following the STM and after the 3-day
tively. Above all, the marker RSI demonstrated an overall recovery period. Moreover, it can be assumed that the lack
accuracy of more than 80% to differentiate between athletes of significant relationships between changes in 1RMest and
in a fatigued or recovered condition. Additionally, correlational all analyzed markers as well as the insufficient accuracy of
analyses revealed no significant relationships (p . 0.05) markers to discriminate correctly between fatigued and
between changes in 1RMest (i.e., criterion measure) and all recovered athletes may be related to individual responses
analyzed surrogate markers of fatigue and recovery. to the overreaching program. The application of potential
A more detailed presentation of the sex-specific time surrogate markers should therefore be proven at the individ-
course of fatigue and recovery in selected surrogate markers ual level. Given that the STM-induced fatigue and subse-
using multiple measurement points during and after the quent recovery were largely similar in analyzed markers
STM is given in Figures 2–6. Overall, there were no signif- across the sexes, potential surrogate markers could be used
icant time 3 sex interactions in all analyzed markers and equally by male and female athletes.
neuromuscular, physiological, and perceptual responses of Markers of neuromuscular function (MVIC, CMJ, MRJ,
fatigue and recovery to the overreaching program were and RSI) were used as practical and nondemanding tools for
largely similar across the sexes. Using MBI, we observed the lower limbs to assess changes in fatigue and recovery in
differences between male and female athletes that may be response to intensified strength training. In this regard, jump
primarily related to the varying magnitude of changes in height performance (CMJ and MRJ) followed the changes in
markers of fatigue and recovery. In this regard, we detected maximal dynamic strength reflected by a significant decrease
possibly to very likely small between-sex differences in in performance after the STM and a significant return to
changes from baseline for markers of neuromuscular func- baseline levels after the recovery period (Table 2). The
tion with male athletes showing greater performance observed performance changes can be considered to be prac-
decreases than female athletes, except for MVIC (Figures 2 tically meaningful. Maximal voluntary isometric strength and
and 3). In addition, male athletes demonstrated greater jump efficiency (RSI) also showed significant performance
increases in CK levels from Pre to Mid compared with decrements of practical relevance after the training period
female athletes reflected by a likely large between-sex differ- (Table 2). However, there were only slight performance in-
ence (Figure 4). In case of DOMS, female athletes seem to creases in MVIC and RSI within 3 days of recovery with
perceive more muscle soreness during the first half of the MVIC showing no significant difference to baseline levels,
STM compared with male athletes, which was evident by whereas RSI remained significantly reduced (Table 2).
likely to very likely very large differences in respective The performance decrement in 1RMest and in markers of
changes from Pre (Figure 4). neuromuscular function is in line with previous findings
To provide comparative data, daily values of the session- showing similar decreases after intense resistance exercise
RPE are given in Table 1. In addition, mean session intensity (9,37,38). Generally, this may be related to successive
was 7.0 6 0.8 and 6.5 6 0.6 in male and female athletes mechanical overloading accompanied by insufficient recov-
during the STM, respectively. Mean and total accumulated ery between the training sessions (22). More precisely, dur-
TL was 629 6 79 and 6,667 6 1,300 AU, respectively, in ing the STM, the subjects performed a total of 11
male athletes and 583 6 51 and 5,970 6 947 AU, respec- consecutive training sessions, twice a day, consisting of high
tively, in female athletes. load (85% 1RMest) combined with maximal eccentric muscle
actions (100% 1RMest) that most probably caused high
DISCUSSION mechanical tensile forces within the involved muscle cells.
This study aimed to evaluate the effectiveness of potential This may evoke progressive sarcomere overstretching, pro-
surrogate markers to reflect changes in fatigue and recovery moting the destruction of cell membrane integrity, myofibril-
in strength-trained male and female athletes following an lar disruption of the z-disks in the sarcomeres, and damage

VOLUME 30 | NUMBER 12 | DECEMBER 2016 | 3423

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 Assessment of Fatigue in Heavy Strength Training

to the contractile proteins (10,34,37). In this regard, our re- the noninvasive and nondemanding TMG method. In this
sults showed a significant increase in serum CK activity after regard, Dm and V90 revealed significant decreases after the
the training period, which can be considered as indirect training period but remained significantly reduced after 3
evidence of structural muscle damage (5), because CK days of recovery (Table 2). The impaired muscle function is
leak into the plasma and interstitium from damaged muscle in agreement with previous studies and could be explained
fibers including damage to the sarcolemma associated with an by reduced efficiency of excitation-contraction coupling,
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increased membrane permeability and mechanical disruption impaired conducting properties of membrane potentials,
of muscle contractile components (10,34,42). In addition, the and disrupted muscle cell structures (13,18,26). This may
observed performance decline was also accompanied by have deleterious effects on the full performance capacity of
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increased muscle soreness (DOMS) that might be caused by the contractile apparatus, which was evident by practically
increased nociceptor sensitization of groups III and IV afferent meaningful reductions in Dm and V90. Because both
fibers located within the muscle (10,37). These findings are in markers did not show any indication of recovery, and thus,
line with previous studies reporting similar increases in CK apparently did not consistently follow the changes in
and DOMS after a single heavy strength exercise session 1RMest, their use as potential surrogate markers for assess-
(5,11) or after a period of intensified strength training (16). ment of fatigue and recovery, based on the conditions of this
Based on our data, we therefore assume that the STM- study, may only be recommended to a limited extent.
induced fatigue is mainly located in the muscle periphery, as Contrary to Dm and V90, TMG markers Td and Tc
reflected by repeated damage to muscle cell structures fol- remained unaffected and revealed no practically relevant
lowed by a local muscle inflammatory response (3,17,37). Con- changes after the training and recovery period (Table 2).
sequently, the muscle contractile apparatus would be Obviously, the STM-induced fatigue had no detrimental
compromised, and we propose this mechanism as the primary effects on the 2 TMG measures. Our results are in contrast
cause of the present performance loss in 1RMest and in to previous studies showing a decrease in Td after ultraen-
markers of neuromuscular function after the training period durance exercise and an increase in Tc immediately after
(9). Given that jump height performance was almost restored intense eccentric strength exercise (19,26). Regarding Td,
after the recovery period and performance in MVIC and RSI comparisons, however, are difficult because of strongly con-
also showed slight trends toward recovery, this may indicate trasting training forms (i.e., ultraendurance vs. heavy
that MVIC, CMJ, MRJ, and RSI could be considered as poten- strength exercise) and different measurement points used.
tial surrogate markers to assess changes in fatigue and recov- In the case of Tc, on the one hand, one might have expected
ery of athletes’ neuromuscular function. an increase in Tc as a result of muscle fiber injury causing
However, the analyses of practical relevance using MBI a greater latency for the muscle to contract (26). On the
indicate likely and very likely small performance impair- other hand, Tc seems to be highly affected by the magnitude
ments in MRJ and RSI after 3 days of recovery. This is in of the Dm response. Thus, the decrease in Dm accompanied
agreement with previous research and may be primarily by unchanged contraction times after the training period
related to a reduced stress tolerance to ground impact forces indicates that the same amount of time was needed for the
during fast stretch-shortening cycle movements (i.e., maxi- muscle to contract but for a smaller displacement because
mal ankle rebound efforts) reflected by decreased ground muscle damage. This suggests a less steep rise of Dm, which
reaction forces, stretch reflex sensitivity, and joint stiffness seems to be more important in terms of muscle damage
regulation as a consequence of structural muscle damage rather than the Tc response. Furthermore, the conflicting
(9,35). Compared with this, CMJ performance was fully results may also be related to different exercise protocols
recovered, which was evident by no practically meaningful used (e.g., volume, intensity, exercise choice, and muscle
differences to preexercise values after the recovery period. action) and the severity of the exercise-induced muscle dam-
This could be principally explained by the task specificity age. Based on the present findings, we would therefore not
during testing (no high impact forces) and the contribution recommend the use of Td and Tc as potential surrogate
of the slow stretch-shortening cycle (i.e., enhanced time to markers for assessment of fatigue and recovery in response
develop force, storage and recoil of elastic energy, and poten- to high-resistance strength training.
tiation of the contractile response), which may probably alle- The measurement of serum CK activity was used as
viate more rapidly the negative impact on CMJ performance commonly accepted marker of muscle damage because CK
associated with exercise-induced muscle damage (9,35). has been attributed to reflect the mechanical-muscular
Based on the present results, we would therefore recommend strains of training in the preceding days (34,42). According
a combined use of the jump tests for assessing fatigue and to this, CK was significantly increased after the training
recovery in athletes’ neuromuscular function, because both period with a corresponding response in perceived muscle
tests seem to measure independent performance qualities soreness (DOMS) (Table 2). This supports the assumption
associated with varying degrees of fatigue and recovery. that structural damage of muscle fibers seemed likely to be
Markers of skeletal muscle contractile properties (Dm, Td, the primary mechanism of the observed performance de-
Tc, and V90) of the lower extremity were determined using creases after the training period. After 3 days of recovery,
the TM

3424 Journal of Strength and Conditioning Research

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 the TM

Journal of Strength and Conditioning Research | [Link]

CK and DOMS almost reached preexercise values, which potentially useful markers for assessment of fatigue and
could be mainly attributed to the cessation of mechanical recovery in high-resistance strength training. However, in
overloading (42). This may enable a more rapid restoration relation to the criterion measure (i.e., 1RMest), which was
of cell membrane integrity and CK clearance from the serum considered the most relevant marker for assessment of
and may also cease nociceptor sensitization perceiving less fatigue and recovery in the present study (21,32,42), none
muscle soreness (3,10,26). Obviously, both markers, CK and of the selected surrogate markers showed sufficient accuracy
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DOMS, followed the changes in maximal dynamic strength to completely differentiate between fatigued and recovered
and may thus be used to detect strength training–induced athletes (Table 3). Above all, the marker RSI seems to be
muscle damage and soreness for assessment of athletes’ promising with an overall accuracy of more than 80% to
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fatigue and recovery condition. However, one should also discriminate between athletes in a fatigued or recovered con-
bear in mind that CK levels do not differ widely after a single dition. Moreover, correlational analyses revealed no relation-
strength exercise session or a short period of intensified ships between changes in 1RMest and all analyzed surrogate
training making it difficult to differentiate between acute markers. Therefore, these results may indicate that responses
and severe fatigue (16,22). Accordingly, CK seems to be of markers of fatigue and recovery to the STM seem to be
more useful to indicate an acute impairment of muscle func- individual and variable, especially in terms of intensified
tion rather than a serious decrement in performance capacity training periods (21,34). Additionally, it has been observed
(22,42). Moreover, measurements of CK activity usually dis- that differences in the time course of fatigue and recovery
play a high interindividual variability with some athletes among various neuromuscular and biochemical functions
being nonresponders and showing only small increases in could be regarded as a further factor contributing to the
CK activity (21,42). Therefore, athletes’ individual physical weak relationships found between changes in surrogate
properties should be considered when used as a marker for markers and maximal dynamic strength (2). Consequently,
fatigue and recovery. Consequently, we recommend not to each potentially useful surrogate marker of fatigue and
use CK and DOMS as the only markers for assessment of recovery including MVIC, CMJ, MRJ, RSI, Dm, V90, CK,
fatigue and recovery, but in combination with other meas- DOMS, PPC, and MS needs to undergo an individual con-
ures, following high-resistance strength training because sideration and longitudinal evaluation in relation to maximal
both markers have been also ascribed to show only a low strength performance to verify its use in the applied field for
temporal relationship with functional performance recovery each individual athlete.
(9,21). A sole reliance on CK and DOMS could therefore According to the sex-specific perspective, there were no
certify a too early state of recovery, which may increase the significant time 3 sex interactions in all analyzed markers
risk of injury and could also negatively affect performance across all measurement points during and after the STM, and
and readiness (9). Finally, it should be noted that regular neuromuscular, physiological, and perceptual responses of
venous blood sampling for determination of serum CK activ- fatigue and recovery to the overreaching program tended
ity may become too cost prohibitive in the long term and to be largely similar across the sexes (Figures 2–6). This
could also challenge the athletes’ compliance. Thus, capillary may suggest that potential surrogate markers could be used
sampling for total CK activity could provide a valid and equally by male and female athletes. However, the analyses
more compliant alternative to venipuncture and should be of practical importance (MBI) revealed some differences
considered by researchers and practitioners (29). regarding the intensity of changes in markers of fatigue
The SRSS is a recently developed questionnaire and was and recovery between male and female athletes. In this
used as a simple and practical tool to determine athletes’ respect, the present results indicate that male athletes possi-
perceived recovery and stress levels comprising among bly to likely fatigued greater in CMJ, Dm, and V90 (Figures 2
others the subjective rating of PPC and muscular strain and 3) during and after 6 days of intensified training.
(MS) (28). According to this, the selected markers, PPC This difference may be primarily related to the fact that
and MS, were sensitive to changes in training-induced male athletes usually are more susceptible to increased mus-
fatigue, showing a decrease in PPC and an increase in MS cle fatigue because of higher levels of muscle mass and
after the training period as well as a subsequent return to muscle strength as well as larger proportional areas of type
baseline levels after the 3-day recovery period (Table 2). II muscle fibers (27). This is also supported by our own
Comparisons with previous research are difficult, however, results regarding serum CK activity with male athletes show-
because we are not aware of similar studies using the novel ing greater peak CK levels than female athletes (Figure 5).
SRSS. Therefore, this study may provide comparative data Consequently, it can be expected that a greater responsive-
for future directions and the present data also suggest, in ness of the aforementioned markers in male athletes to
particular, that PPC and MS may be potentially useful training-induced fatigue needs to be considered in an applied
markers to assess athletes’ fatigue and recovery states after environment. Interestingly, female athletes seem to suffer
high-resistance strength training. from greater muscle soreness during the initial training days,
As previously outlined, measures of neuromuscular func- which was evident by likely to very likely between-sex differ-
tion, CK and DOMS, as well as PPC and MS seem to be ences in the first half of the STM. Therefore, coaches and

VOLUME 30 | NUMBER 12 | DECEMBER 2016 | 3425

Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
 Assessment of Fatigue in Heavy Strength Training

scientists should pay attention to these findings, as the mag- properties (i.e., Dm, V90) may also be a potentially useful
nitude of fatigue and recovery responses may vary between strategy to assess lower-body fatigue in both, male and
sexes after high-resistance strength training. female athletes. However, responses to the same exposed
There are some limitations to the present study that need training stimuli might vary between athletes, which were
to be taken into account. First, there was no control group to evident by the insufficient accuracy of selected markers to
provide a baseline during the experimental period, but we correctly assess the athletes’ state of fatigue and recovery in
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stated reliability data to indicate typical variation in certain relation to the criterion measure (i.e., 1RMest) as well as the
markers. Second, the analyzed intensified training phase was poor relationships found between changes in maximal
not preceded by a normal training phase under controlled dynamic strength and all analyzed markers. Therefore, the
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experimental conditions, making it difficult to differentiate present surrogate markers should be used regularly at fre-
between normal and severe levels of fatigue. This, however, quent intervals by coaches to evaluate their effectiveness for
would be a relevant aspect for future directions. Third, the each individual athlete. According to this, we would suggest
general transferability of the present results to male and the purchase of a contact platform, and also TMG with the
female athletes for assessment of fatigue and recovery could assistance of an expert, if resources are available, to measure
be limited because of individual responses, because the main jump performance and muscle contractile properties as
approach of this study was to evaluate the usefulness of a daily routine in an applied environment (e.g., Olympic
surrogate markers based on mean changes in relation to the training centers, professional clubs). This setting may ensure
criterion measure (1RMest). Coaches and practitioners are regular monitoring of athletes’ fatigue and recovery status
therefore instructed to carefully evaluate athletes’ individual and adjustment of training loads at the individual and longi-
responses to periods of intensified training. Knowing that an tudinal level (21). Moreover, perceptual measures including
athlete is actually fatigued or has recovered may allow for DOMS (using a VAS) as well as PPC and MS (using the
improved training prescription at the individual level. Last, short recovery and stress scale) could also be considered as
the incorporation of upper-body strength exercises may simple, practical, and potentially useful tools to assess
affect the overall CK response. Owing to higher levels of whether an athlete is in a fatigued or already recovered
muscle mass and greater training volume of the lower condition. Additionally, CK as a routine blood marker may
extremity, we assume that this was the main contributing be beneficial to determine the acute mechanical-muscular
factor to the elevated CK response. strains of high-resistance strength training in the preceding
In conclusion, this study showed that, in particular, CMJ, days (42). Finally, we would recommend a combined use of
MRJ, CK, DOMS, PPC, and MS represent potentially useful potential surrogate markers as “best practice method” in the
surrogate markers for assessment of fatigue and recovery. applied field to allow a monitoring of fatigue and recovery at
This was evident by significant changes of these markers the neuromuscular, physiological, and perceptual level.
after the training period and after 3 days of recovery, which
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