muscle damage

Background Exercise-induced muscle damage (EIMD) commonly follows strenuous exercise and is marked by delayed onset muscle soreness (DOMS), reduced muscle strength, and increased creatine kinase (CK) and C-reactive protein (CRP), which may impair recovery and subsequent training. Plant-derived polyphenols such as anthocyanins or flavanols are widely used to support recovery, but their comparative effects remain uncertain. Methods We conducted a systematic review and network meta-analysis (NMA) following established methodological guidance. PubMed, Web of Science, CENTRAL, and Embase were searched from inception to January 2026 for randomized controlled trials in healthy adults with acute EIMD that compared plant-derived anthocyanin- or flavanol-rich supplements with placebo or control conditions. Primary outcomes were DOMS, muscle strength, CK, and CRP at 48 h post-exercise; 24 h and 72 h outcomes were secondary. Frequentist random-effects network meta-analysis was performed in Stata 19.5, with interventions ranked using SUCRA. Pairwise meta-analyses, subgroup analyses, and sensitivity analyses were conducted for the main 48 h outcomes. Risk of bias and certainty of evidence were assessed using RoB 2.0 and CINeMA. Results Thirty trials involving 595 participants and eight supplement types were included. In the primary analysis, only pomegranate and tart cherry significantly reduced 48 h DOMS vs. the placebo node, ranking first and second, respectively. No intervention showed a clear advantage for 48 h muscle strength, CK, or CRP. Pairwise meta-analyses were generally consistent with the network findings. For secondary outcomes, tart cherry was the only supplement associated with significant DOMS reduction at both 24 h and 72 h. No consistent benefits were observed for muscle strength, CK, or CRP at these time points. Sensitivity analyses did not materially alter the conclusions, although some estimates varied by supplementation protocol, outcome definition, or comparator characteristics. Certainty of evidence was generally low. Conclusion Plant-derived polyphenol supplements did not provide consistent benefits across all recovery outcomes after EIMD. Their main potential value appears to lie in reducing DOMS, with tart cherry showing the most consistent favorable pattern and pomegranate showing potential benefit. These supplements should therefore be considered as targeted options for subjective soreness relief rather than universal strategies for accelerating objective physiological recovery. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261340555 , identifier CRD420261340555.

matched text: “muscle damage”

Background/Objectives: Exercise-induced muscle damage, inflammation, oxidative stress, and accumulated fatigue affect post-exercise recovery and long-term training adaptations in athletes. Consequently, nutritional strategies supporting recovery have gained attention in sports nutrition. Among emerging compounds, adaptogens have attracted particular interest due to their potential anti-fatigue, antioxidant, and sleep-enhancing properties. However, evidence in trained athletes remains limited. Therefore, the aim of this narrative review is to summarize the current scientific evidence regarding the use of selected adaptogens in sport and to evaluate their potential roles in exercise recovery, training adaptation and exercise performance. Particular attention is given to Withania somnifera (ashwagandha), Panax species, Rhodiola rosea and Cordyceps species. Furthermore, this review discusses the practical implications and current limitations of the available evidence for athletes and sports practitioners. Conclusions: Current evidence from a limited number of heterogeneous studies suggests that selected standardized adaptogen preparations may provide beneficial effects on specific exercise-recovery-related outcomes and selected aspects of exercise performance in trained athletes. Among the adaptogens discussed, most consistent evidence concerns Withania somnifera, whereas the evidence for Panax species, Rhodiola rosea and Cordyceps species remains limited and should be considered preliminary. Furthermore, the available literature is characterized by a limited number of studies conducted in trained athletes, the underrepresentation of female athletes, and considerable heterogeneity in extract composition and supplementation protocols. Consequently, the current evidence is insufficient to formulate definitive recommendations regarding the efficacy, optimal dosage, or long-term safety of adaptogen supplementation. Further well-designed randomized controlled trials are required to establish evidence-based recommendations.

matched text: “muscle damage”