Neuromuscular consequences of an extreme mountain ultra-marathon

Guillaume Y Millet, Katja Tomazin, Samuel Verges, Christopher Vincent, Régis Bonnefoy, Renée-Claude Boisson, Laurent Gergelé, Léonard Féasson, Vincent Martin, Guillaume Y Millet, Katja Tomazin, Samuel Verges, Christopher Vincent, Régis Bonnefoy, Renée-Claude Boisson, Laurent Gergelé, Léonard Féasson, Vincent Martin

Abstract

We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM) with 9500 m of positive and negative elevation change. For this purpose, (i) the fatigue induced by the MUM and (ii) the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF) and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22), and 2, 5, 9 and 16 days after the MUM (n = 11) in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (-35% [95% CI: -28 to -42%] and -39% [95% CI: -32 to -46%] for KE and PF, respectively), with alteration of maximal voluntary activation, mainly for KE (-19% [95% CI: -7 to -32%]). Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144 ± 94 to 13,633 ± 12,626 UI L(-1)), myoglobin (from 32 ± 22 to 1,432 ± 1,209 µg L(-1)), and C-Reactive Protein (from <2.0 to 37.7 ± 26.5 mg L(-1)). Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration) were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. General view of the experiment…
Figure 1. General view of the experiment and race profile.
General view of the experimental testing (panel A) and the course of the race supporting the study (panel B).
Figure 2. Typical torque and EMG traces…
Figure 2. Typical torque and EMG traces during voluntary and electrically evoked contractions.
Typical torque trace (black line) during the knee extensor maximal voluntary contraction and determination of maximal activation level, as well as high- and low frequency doublets (100 Hz and 10 Hz, respectively) and single twitch, after the mountain ultra-marathon. The black arrows indicate the timing of delivery of the stimuli. EMG is represented with a grey line.
Figure 3. Self-reported general fatigue and maximal…
Figure 3. Self-reported general fatigue and maximal voluntary contraction on the knee extensor and plantar flexor muscles.
Self-reported general fatigue, knee extensors (KE) and plantar flexors (PF) pain and digestive system sensations (panel A) as well as maximal voluntary contraction (MVC) on the knee extensor muscles (panel B) and on the plantar flexor muscles (panel C) before (PRE), after (POST) and 2, 5, 9 and 16 days after the race (D+2, D+5, D+9 and D+16, respectively). Data are mean values ± SD. $$$: P

Figure 4. Maximal voluntary activation on the…

Figure 4. Maximal voluntary activation on the knee extensor and plantar flexor muscles.

Maximal voluntary…

Figure 4. Maximal voluntary activation on the knee extensor and plantar flexor muscles.
Maximal voluntary activation (%VA) of the knee extensor muscles (panel A) and the plantar flexor muscles (panel B) before (PRE), after (POST) and 2, 5, 9 and 16 days after the race (D+2, D+5, D+9 and D+16, respectively). Data are mean values ± SD. $$$: P

Figure 5. Mechanical responses to the high-frequency…

Figure 5. Mechanical responses to the high-frequency doublets and to the low-to-high frequency doublet ratio.

Figure 5. Mechanical responses to the high-frequency doublets and to the low-to-high frequency doublet ratio.
Maximal high frequency doublet (Db 100 Hz) on the knee extensor muscles (panel A) and the plantar flexor muscles (panel B) as well as the low- to high-frequency doublet ratio (10∶100 ratio, panel C) before (PRE), after (POST) and 2, 5, 9 and 16 days after the race (D+2, D+5, D+9 and D+16, respectively). Data are mean values ± SD. Panels A and B: $$$: P

Figure 6. Individual creatine kinase activities.

Individual…

Figure 6. Individual creatine kinase activities.

Individual creatine kinase activities (CK) before (PRE, panel A)…

Figure 6. Individual creatine kinase activities.
Individual creatine kinase activities (CK) before (PRE, panel A) and after (POST, panel B) the mountain ultra-marathon. Note the different scale.
Similar articles
Cited by
References
    1. Hoffman MD, Ong JC, Wang G. Historical analysis of participation in 161-km ultramarathons in North America. Int J History Sport. 2010;27:1877–1891. - PubMed
    1. Martin V, Kerhervé H, Messonnier LA, Banfi JC, Geyssant A, et al. Central and peripheral contributions to neuromuscular fatigue induced by a 24-h treadmill run. J Appl Physiol. 2010;108:1224–1233. - PubMed
    1. Pearson H. Physiology: freaks of nature? Nature. 2006;444:1000–1001. - PubMed
    1. Enoka RM, Stuart DG. Neurobiology of muscle fatigue. J Appl Physiol. 1992;72:1631–1648. - PubMed
    1. Millet GY, Lepers R. Alterations of neuromuscular function after prolonged running, cycling and skiing exercises. Sports Med. 2004;34:105–116. - PubMed
Show all 47 references
Publication types
MeSH terms
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM

NCBI Literature Resources

MeSH PMC Bookshelf Disclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

Follow NCBI
Figure 4. Maximal voluntary activation on the…
Figure 4. Maximal voluntary activation on the knee extensor and plantar flexor muscles.
Maximal voluntary activation (%VA) of the knee extensor muscles (panel A) and the plantar flexor muscles (panel B) before (PRE), after (POST) and 2, 5, 9 and 16 days after the race (D+2, D+5, D+9 and D+16, respectively). Data are mean values ± SD. $$$: P

Figure 5. Mechanical responses to the high-frequency…

Figure 5. Mechanical responses to the high-frequency doublets and to the low-to-high frequency doublet ratio.

Figure 5. Mechanical responses to the high-frequency doublets and to the low-to-high frequency doublet ratio.
Maximal high frequency doublet (Db 100 Hz) on the knee extensor muscles (panel A) and the plantar flexor muscles (panel B) as well as the low- to high-frequency doublet ratio (10∶100 ratio, panel C) before (PRE), after (POST) and 2, 5, 9 and 16 days after the race (D+2, D+5, D+9 and D+16, respectively). Data are mean values ± SD. Panels A and B: $$$: P

Figure 6. Individual creatine kinase activities.

Individual…

Figure 6. Individual creatine kinase activities.

Individual creatine kinase activities (CK) before (PRE, panel A)…

Figure 6. Individual creatine kinase activities.
Individual creatine kinase activities (CK) before (PRE, panel A) and after (POST, panel B) the mountain ultra-marathon. Note the different scale.
Similar articles
Cited by
References
    1. Hoffman MD, Ong JC, Wang G. Historical analysis of participation in 161-km ultramarathons in North America. Int J History Sport. 2010;27:1877–1891. - PubMed
    1. Martin V, Kerhervé H, Messonnier LA, Banfi JC, Geyssant A, et al. Central and peripheral contributions to neuromuscular fatigue induced by a 24-h treadmill run. J Appl Physiol. 2010;108:1224–1233. - PubMed
    1. Pearson H. Physiology: freaks of nature? Nature. 2006;444:1000–1001. - PubMed
    1. Enoka RM, Stuart DG. Neurobiology of muscle fatigue. J Appl Physiol. 1992;72:1631–1648. - PubMed
    1. Millet GY, Lepers R. Alterations of neuromuscular function after prolonged running, cycling and skiing exercises. Sports Med. 2004;34:105–116. - PubMed
Show all 47 references
Publication types
MeSH terms
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 5. Mechanical responses to the high-frequency…
Figure 5. Mechanical responses to the high-frequency doublets and to the low-to-high frequency doublet ratio.
Maximal high frequency doublet (Db 100 Hz) on the knee extensor muscles (panel A) and the plantar flexor muscles (panel B) as well as the low- to high-frequency doublet ratio (10∶100 ratio, panel C) before (PRE), after (POST) and 2, 5, 9 and 16 days after the race (D+2, D+5, D+9 and D+16, respectively). Data are mean values ± SD. Panels A and B: $$$: P

Figure 6. Individual creatine kinase activities.

Individual…

Figure 6. Individual creatine kinase activities.

Individual creatine kinase activities (CK) before (PRE, panel A)…

Figure 6. Individual creatine kinase activities.
Individual creatine kinase activities (CK) before (PRE, panel A) and after (POST, panel B) the mountain ultra-marathon. Note the different scale.
Figure 6. Individual creatine kinase activities.
Figure 6. Individual creatine kinase activities.
Individual creatine kinase activities (CK) before (PRE, panel A) and after (POST, panel B) the mountain ultra-marathon. Note the different scale.

References

    1. Hoffman MD, Ong JC, Wang G. Historical analysis of participation in 161-km ultramarathons in North America. Int J History Sport. 2010;27:1877–1891.
    1. Martin V, Kerhervé H, Messonnier LA, Banfi JC, Geyssant A, et al. Central and peripheral contributions to neuromuscular fatigue induced by a 24-h treadmill run. J Appl Physiol. 2010;108:1224–1233.
    1. Pearson H. Physiology: freaks of nature? Nature. 2006;444:1000–1001.
    1. Enoka RM, Stuart DG. Neurobiology of muscle fatigue. J Appl Physiol. 1992;72:1631–1648.
    1. Millet GY, Lepers R. Alterations of neuromuscular function after prolonged running, cycling and skiing exercises. Sports Med. 2004;34:105–116.
    1. Millet GY, Lepers R, Maffiuletti NA, Babault N, Martin V, et al. Alterations of neuromuscular function after an ultramarathon. J Appl Physiol. 2002;92:486–492.
    1. Millet GY, Martin V, Lattier G, Ballay Y. Mechanisms contributing to knee extensor strength loss after prolonged running exercise. J Appl Physiol. 2003;94:193–198.
    1. Place N, Lepers R, Deley G, Millet GY. Time course of neuromuscular alterations during a prolonged running exercise. Med Sci Sports Exerc. 2004;36:1347–1356.
    1. Davies CTM, Thompson MW. Physiological responses to prolonged exercise in ultramarathon athletes. J Appl Physiol. 1986;61:611–617.
    1. Jones DA. High-and low-frequency fatigue revisited. Acta Physiol Scand. 1996;156:265–270.
    1. Hill CA, Thompson MW, Ruell PA, Thom JM, White MJ. Sarcoplasmic reticulum function and muscle contractile character following fatiguing exercise in humans. J Physiol. 2001;531:871–878.
    1. Overgaard K, Lindstrom T, Ingemann-Hansen T, Clausen T. Membrane leakage and increased content of Na+ -K+ pumps and Ca2+ in human muscle after a 100-km run. J Appl Physiol. 2002;92:1891–1898.
    1. Millet GY, Banfi JC, Kerhervé H, Morin JB, Vincent L, et al. Scand J Med Sci Sports. In press; 2010. Physiological and biological factors associated with a 24 h treadmill ultramarathon performance.
    1. Hermens HJ, Freriks B, Merletti R, Hagg G, Stegeman D, et al. SENIAM 8: European recommendations for surface electromyography; Development RRa, editor. 1999.
    1. Verges S, Maffiuletti NA, Kerherve H, Decorte N, Wuyam B, et al. Comparison of electrical and magnetic stimulations to assess quadriceps muscle function. J Appl Physiol. 2009;106:701–710.
    1. Merton PA. Voluntary strength and fatigue. J Physiol. 1954;123:553–564.
    1. Millet GY. The flush model. Sports Med. In press; 2011. Can neuromuscular fatigue explain running strategies and performance in ultra-marathons?
    1. Noakes TD. The central governor model of exercise regulation applied to the marathon. Sports Med. 2007;37:374–377.
    1. Amann M, Proctor LT, Sebranek JJ, Pegelow DF, Dempsey JA. Opioid-mediated muscle afferents inhibit central motor drive and limit peripheral muscle fatigue development in humans. J Physiol. 2009;587:271–283.
    1. Taylor JL, Todd G, Gandevia SC. Evidence for a supraspinal contribution to human muscle fatigue. Clin Exp Pharmacol Physiol. 2006;33:400–405.
    1. Noakes TD. Hydration in the marathon: using thirst to gauge safe fluid replacement. Sports Med. 2007;37:463–466.
    1. Martin V, Millet GY, Lattier G, Perrod L. Effects of recovery modes after knee extensor muscles eccentric contractions. Med Sci Sports Exerc. 2004;36:1907–1915.
    1. Ostrowski K, Hermann C, Bangash A, Schjerling P, Nielsen JN, et al. A trauma-like elevation of plasma cytokines in humans in response to treadmill running. J Physiol. 1998;513(Pt 3):889–894.
    1. Martin V, Millet GY, Martin A, Deley G, Lattier G. Assessment of low-frequency fatigue with two methods of electrical stimulation. J Appl Physiol. 2004;97:1923–1929.
    1. Krssak M, Petersen KF, Bergeron R, Price T, Laurent D, et al. Intramuscular glycogen and intramyocellular lipid utilization during prolonged exercise and recovery in man: a 13C and 1H nuclear magnetic resonance spectroscopy study. J Clin Endocrinol Metab. 2000;85:748–754.
    1. Yokozawa T, Fujii N, Ae M. Muscle activities of the lower limb during level and uphill running. J Biomech. 2007;40:3467–3475.
    1. Lay AN, Hass CJ, Gregor RJ. The effects of sloped surfaces on locomotion: a kinematic and kinetic analysis. J Biomech. 2006;39:1621–1628.
    1. Foissac MJ, Berthollet R, Seux J, Belli A, Millet GY. Effects of hiking pole inertia on energy and muscular costs during uphill walking. Med Sci Sports Exerc. 2008;40:1117–1125.
    1. Petersen K, Hansen CB, Aagaard P, Madsen K. Muscle mechanical characteristics in fatigue and recovery from a marathon race in highly trained runners. Eur J Appl Physiol. 2007;101:385–396.
    1. Fallon KE, Sivyer G, Sivyer K, Dare A. The biochemistry of runners in a 1600 km ultramarathon. Br J Sports Med. 1999;33:264–269.
    1. Kim HJ, Lee YH, Kim CK. Biomarkers of muscle and cartilage damage and inflammation during a 200 km run. Eur J Appl Physiol. 2007;99:443–447.
    1. Skenderi KP, Kavouras SA, Anastasiou CA, Yiannakouris N, Matalas AL. Exertional Rhabdomyolysis during a 246-km continuous running race. Med Sci Sports Exerc. 2006;38:1054–1057.
    1. Canu P, Poletti L, Herry JP, Durand M, Duhil E, et al. La rhabdomyolyse d'effort du sportif. Cardiol Sport. 2009;20:5–7.
    1. Goussetis E, Spiropoulos A, Tsironi M, Skenderi K, Margeli A, et al. Spartathlon, a 246 kilometer foot race: effects of acute inflammation induced by prolonged exercise on circulating progenitor reparative cells. Blood Cells Mol Dis. 2009;42:294–299.
    1. Margeli A, Skenderi K, Tsironi M, Hantzi E, Matalas AL, et al. Dramatic elevations of interleukin-6 and acute-phase reactants in athletes participating in the ultradistance foot race spartathlon: severe systemic inflammation and lipid and lipoprotein changes in protracted exercise. J Clin Endocrinol Metab. 2005;90:3914–3918.
    1. Mounier R, Pialoux V, Mischler I, Coudert J, Fellmann N. Effect of hypervolemia on heart rate during 4 days of prolonged exercises. Int J Sports Med. 2003;24:523–529.
    1. Fellmann N, Bedu M, Giry J, Pharmakis-Amadieu M, Bezou MJ, et al. Hormonal, fluid, and electrolyte changes during a 72-h recovery from a 24-h endurance run. Int J Sports Med. 1989;10:406–412.
    1. Neumayr G, Pfister R, Hoertnagl H, Mitterbauer G, Prokop W, et al. Renal function and plasma volume following ultramarathon cycling. Int J Sports Med. 2005;26:2–8.
    1. Peters EM, Robson PJ, Kleinveldt NC, Naicker VL, Jogessar VD. Vitamin C Supplementation Attenuates the Increases in Circulating Cortisol, Adrenaline and Anti-Inflammatory Polypeptides Following Ultramarathon Running. Int J Sports Med. 2001;22:537–543.
    1. Howell JN, Chleboun G, Conatser R. Muscle stiffness, strength loss, swelling and soreness following exercise-induced injury in humans. J Physiol. 1993;464:183–196.
    1. Nosaka K, Clarkson PM. Changes in indicators of inflammation after eccentric exercise of the elbow flexors. Med Sci Sports Exerc. 1996;28:953–961.
    1. Gauche E, Lepers R, Rabita G, Leveque JM, Bishop D, et al. Vitamin and mineral supplementation and neuromuscular recovery after a running race. Med Sci Sports Exerc. 2006;38:2110–2117.
    1. Hoheisel U, Unger T, Mense S. Excitatory and modulatory effects of inflammatory cytokines and neurotrophins on mechanosensitive group IV muscle afferents in the rat. Pain. 2005;114:168–176.
    1. Raastad T, Owe SG, Paulsen G, Enns D, Overgaard K, et al. Changes in calpain activity, muscle structure, and function after eccentric exercise. Med Sci Sports Exerc. 2010;42:86–95.
    1. Skurvydas A, Sipaviciene S, Krutulyte G, Gailiuniene A, Stasiulis A, et al. Dynamics of indirect symptoms of skeletal muscle damage after stretch-shortening exercise. J Electromyogr Kinesiol. 2006;16:629–636.
    1. Hoffman MD. Ultramarathon trail running comparison of performance-matched men and women. Med Sci Sports Exerc. 2008;40:1681–1686.
    1. Wegelin JA, Hoffman MD. Eur J Appl Physiol. In press; 2011. Variables associated with odds of finishing and finish time in a 161-km ultramarathon.

Source: PubMed

3
Tilaa