Preventive effect of the neurodynamic mobilization technique on delayed onset of muscle soreness: a randomized, single-blinded, placebo-controlled study

Abstract

Background: The neurodynamic mobilization (NM) technique is an intervention designed to restore homeostasis by mobilizing the nervous system and its surrounding structures. NM, through its physiological and biomechanical mechanisms, may play a role in modulating delayed Onset Muscle Soreness (DOMS) symptoms and regulating the emerging inflammatory response. The aim of this study was to determine the preventive effects of the NM technique on DOMS.

Methods: Thirty-four untrained males were randomized into the NM (n = 17) or placebo NM (n = 17) group. Femoral nerve NM and placebo NM techniques were performed for three weeks in both groups. All the participants subsequently performed 300 maximal isokinetic eccentric contractions of the dominant knee extensors. Markers of muscle damage (creatine kinase, lactate dehydrogenase) and inflammation (IL-6, TNF-α), as well as muscle soreness, pressure pain threshold (PPT) and muscle function, were measured at baseline; immediately before (pre) and after (0 h) the completion of the exercise-induced muscle damage (EIMD) protocol; and at 24, 48, and 72 h.

Results: Following the EIMD protocol, muscle soreness peaked at 24 h, while PPT reached its lowest level. The NM group exhibited significantly lower muscle soreness scores (F_3.160 = 5.436, p = 0.001) and higher PPT values (F_3.160 = 12.580, p < 0.001) compared to the placebo NM group at 0, 24, 48, and 72 h. Muscle function scores reached their lowest point at 0 h, with the NM group demonstrating significantly higher function scores than the placebo NM group both before the EIMD protocol and at 0 h (F_3.160 = 8.532, p < 0.001). IL-6 levels peaked at 0 h, with the placebo NM group showing significantly higher IL-6 values compared to the NM group only at the 0 h time point (F_5.160 = 5.377, p < 0.001). No significant group × time interaction effects were observed for the other variables (p > 0.05).

Conclusions: Three weeks of femoral nerve NM applied to healthy untrained participants had positive effects on the possible negative consequences of DOMS. NM may help alleviate inflammation and muscle damage symptoms and shorten the overall recovery time following DOMS.

Trial registration: (retrospectively registered): The trial was registered on [03/29/2022] with ClinicalTrials.gov (No: NCT05326893) and conducted according to Consolidated Standards of Reporting Trials (CONSORT) guidelines.

Keywords: Eccentric exercise; Inflammation; Muscle damage; Muscle soreness; Nerve.