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# Sex influence on the functional recovery pattern after a 20 km graded running race

## INTRODUCTION:

Women are reported as usually less fatigable than men for similar intensity of fatiguing isometric contractions, but sex difference in fatigability is also known as task specific (1). Over the last 25 years, participation and performances of women have risen in endurance running races (2). However, information is lacking about the women functional recovery pattern as compared to the classical biphasic pattern reported for the men (3). This study investigated the sex influence on the acute and prolonged fatigue effects of a 20 km graded running race (~ 400 m) on the neuromuscular function of recreational runners.

## METHODS:

Nineteen healthy runners (32±7 yrs), 10 women (W) and 9 men (M), completed the race. The testing protocol included 5 sessions: a week before (PRE), 35±15 min after (POST) as well as 2h, 2 and 4 days later (2h, 2D & 4D). Each session included 3 maximal tests: a bilateral isometric maximal voluntary contraction of the knee extensors (KE MVC), a squat jump (SJ) and a drop jump (DJ). Muscle soreness was quantified using visual analogic scale (0-10). The KE MVC analyses focused on the bilateral peak force. Vertical ground reaction force (1500 Hz) was used to calculate jumping height, relative maximal power output, as well as mean force and speed values. Men and women racing times were compared using independent t-test. One-way repeated ANOVAs were used to test the functional recovery along time of each sex group separately (α = 0.05).

## RESULTS:

Racing time did not differ between men and women (M: 125±15, W: 128±23 min; NS). Muscle soreness was slightly increased at POST, 2h and 2D (p<0.001) for each group. The SJ test did not reveal any significant change. The KE MVC test revealed significant decreases in peak force for both men and women, but only at POST and 2h (M: -46±9 and -35±18%, p<0.001; W: -27±18 and -28±9%, p<0.01). In women, the DJ test revealed acute reductions in mean force (-13±8% at POST, p<0.01) and mean speed (-11±7 at POST and -10±14% at 2h, p<0.05). Men presented both acute and delayed decrements in DJ height (from POST: -21±15 to 2D: -14±8%, p<0.05), relative maximal power output (from POST: -25±12 to 4D: -15±15%, p<0.01), mean force (from POST: -11±8 to 4D: -8±11%, p<0.05) and mean speed (from POST: -14±7 to 4D: -7±6, p<0.05).

## DISCUSSION:

According to our knowledge, this is the first 20 km running study describing up to 4 days the functional recovery pattern of women versus men. In line with earlier studies (3) on men, women presented larger acute decreases in KE MVC than in jumping type performances that are closer to the running ones. Comforting the less fatigable women hypothesis (1), our results emphasize the absence of delayed functional decreases for the sole women.

## REFERENCES

1. Hunter, Med Sci Sports Exerc, 2016

2. Scheer, Sports Med Arthrosc Rev, 2019

3. Nicol & Komi, in: Neuromuscular Aspects of Sports Performance, 2010
# Sex influence on the neuromuscular fatigue examined by a force-velocity concentric test

R. Macchi<fnref n="1" />, A. Santuz<fnref n="2" />,<fnref n="3" />, A. Hays<fnref n="1" />, F. Vercruyssen<fnref n="4" />, A. Arampatzis<fnref n="2" />,<fnref n="3" />, C. Nicol<fnref n="1" />

## SUMMARY

Recent studies suggest that women may be less fatigable than men, but this has been mostly studied in isometric test condition and in the acute recovery phase. This study assessed the sex influence on the delayed neuromuscular fatigue two and four days after a 20 km graded running race by using a pluri-articular horizontal force-velocity (HF-V) test. Only men presented delayed performance decrease in power. Sex, but not recovery time, influenced the timing of the synergistic muscle activations patterns.

## INTRODUCTION

Women are usually reported as less fatigable than men after a fatiguing running exercise [1]. However, this has mainly been assessed by monoarticular isometric tests which tend to overestimate the fatigue observed in pluriarticular tests [2]. On the other hand, previous studies have rarely detected any delayed fatigue in pure-concentric tests. Yet, no studies have assessed the fatigue-induced changes of the force-velocity relationship and in the associated muscle activation patterns. Our purpose was to analyze the influence of sex on the delayed neuromuscular fatigue after a 20 km graded running race by using a concentric pluriarticular test.

## METHODS

Seventeen recreational runners (nine women) completed the race. They underwent three recording sessions: a week before the race (PRE), two and four days (2D and 4D) after the race. Delayed onset muscle soreness (DOMS) was quantified using a visual analogue scale (0-10). For each session, the HF-V test was performed under four resistive conditions. Surface EMG activity of eight ipsilateral muscles was recorded synchronously with the bilateral force production. For each session, force-velocity (F-V) and power-velocity (P-V) relationships were quantified by the theoretical values of maximal force at null velocity (F0), maximal velocity at null force (V0) and the resulting Pmax [3]. Muscle synergies were extracted from the EMG signals through non-negative matrix factorization [4] and divided into motor modules (i.e., relative muscle contribution) and motor primitives (i.e., temporal coefficients) for the heaviest load.

## RESULTS

Mixed ANOVAs showed DOMS in most muscles at 2D, but only for women in the hamstrings (p<0.001). A sex × time interaction was found for V0 (p=0.025) and Pmax (p=0.024), but not for F0 (Figure 1). Planned contrasts showed significant decreases at 2D only for men in V0 (p=0.009) and

in Pmax (p=0.004). Regardless of the session and sex, three muscle synergies were extracted from EMG data. The first synergy referred to the movement initiation with a major influence of the knee extensors, especially in women (p=0.001). There was a session effect on the relative contribution of knee extensors, flexors and ankle flexors to this synergy (p=0.033) and in women the main activity of motor primitives was shifted later in time compared to men (p<0.001). The second synergy (mid push-off) showed a similar involvement of all muscles. In women, the motor primitives of this synergy were narrower (i.e., shorter in duration) and shifted later in time compared to men (p<0.001). The third synergy corresponding to the late push-off phase showed a main contribution of the ankle joint flexors and extensors, with no sex- or session-related differences in the timing of motor primitives.

<figure><img src="image_101.png" /><figcaption>**Figure 1.** Normalized F-V and P-V relationships as compared to PRE (black curves) for men (blue curves) and for women (pink curves) at 2D and 4D (in bold and light, respectively)</figcaption></figure>

## DISCUSSION AND CONCLUSION

This study reveals a sex influence on the F-V profile in a pluriarticular concentric test. Only men presented a 2D drop in performance. The relative muscle contributions to the movement initiation synergy were affected by both sex and session, suggesting that women modulate this synergy differently than men along the recovery. Sex also influenced the main activation timing of the initiation and mid push-off synergies. Taken together, our results suggest that the sex-specific organization of muscle synergies might explain the different timeline of recovery after a fatiguing run.

## REFERENCES

[1] Hunter SK et al. (2016). *MSSE*, **48**: 2247–2256

[2] Chen TC et al. (2007). *J. Sports Sci*, **25**: 55–63

[3] Samozino P et al. (2012). *MSSE*, **44**: 313–322

[4] Santuz A et al. (2018). *Sci. Rep.* **8**: 2740

<footnote n="1">¹ ISM, CNRS & Aix Marseille Univ, Marseille, France</footnote>

<footnote n="2">² Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10115 Berlin, Germany</footnote>

<footnote n="3">³ Berlin School of Movement Science, Humboldt-Universität zu Berlin, 10115 Berlin, Germany</footnote>

<footnote n="4">⁴ IAPS, University of Toulon, Toulon, France</footnote>

<footnote>Email: robin.macchi@gmail.com</footnote>
# Do women recover better than men after a 20 km graded running race?

Robin Macchi<fnref n="1" />*, Yoko Kunimasa<fnref n="1" />, Baptiste Corcelle<fnref n="2" />, Laura Pomportes<fnref n="1" />, Camille Fazzari<fnref n="1" />, Pascale Chavet<fnref n="1" />, Fabrice Vercruyssen<fnref n="3" />,
David Bendahan<fnref n="4" />, Caroline Nicol<fnref n="1" />

*corresponding author. Email: robin.macchi@gmail.com
3ème année de doctorat

**Keywords:** Sex, Running, Muscle inflammation, Recovery, Ultrasonography

## 1. Introduction

According to a recent survey of 70,000 road races from 5 km to marathon, female participation in running has increased considerably over the last decade, reaching 50% in 2018. Women have long been banned from endurance races. In 1967, Kathrine Switzer became the first woman to run a marathon, which led to a significant professionalisation of women's sport in endurance running and thus to a clear improvement in records [1]. Indeed, women may have predispositions to this type of event, such as greater proportional area of type I fibers, greater utilisation of fatty, preserved carbohydrates and potentially less fatigue after such events. Recently, several women outperformed men in ultra-distance races. For instance, Jasmin Paris won the Montane Spine race, shattering the previous male record by 12 h. This suggests that women are less susceptible to muscle damage.

Endurance running races are likely to induce reversible ultrastructural muscle damage with subsequent oedema, remodelling/inflammation processes and delayed onset muscle soreness (DOMS). In men, recovery is characterized by a delayed phase of functional reductions 1-2 days later, which may persist for up to 1-2 weeks depending on training status and exercise severity [2]. In women, despite the lack of information, some studies reported potentially better recovery due to the combined direct and indirect influences of sex hormones (oestrogens in particular) [3].

The present study investigated the sex influence on the delayed fatigue effects of a 20 km graded running race (~ 400 m) in recreational runners. It was hypothesized that women would show earlier structural and functional recoveries.

## 2. Methods

A total of 38 recreational runners volunteered. They were separated into 3 groups. Two groups of runners completed the race: one consisted of 13 women (W: 28±6 yrs, 167±7 cm, 60±8 kg) and the other of 14 men (M: 36±9 yrs, 181±6 cm, 77±7 kg). The control group consisted of 4 women and 8 men (C: 24±4 yrs, 170±7 cm, 64±8 kg) who did not run the race.

For both W and M groups, the protocol included a familiarisation session and 3 testing sessions: a week before the race (PRE), and either on days 1 and 3 (D1 & 3) or on days 2 and 4 (D2 & 4). D1-2 correspond to the expected peak of delayed fatigue effects. The C group performed 2 testing sessions at 2 days interval.

In each test session, DOMS were quantified using visual analogic scale (0-10).

This was followed by resting ultrasound quantification (Aixplorer Mach 30, Supersonic imagine) of 3 cross sectional areas (CSA) for 9 muscles of the dominant lower-limb.

After 10 min of warm-up on a treadmill, the functional evaluation included 3 maximal squat jumps (SJ) and drop jumps (DJ) performed on an inclined sledge ergometer.

For both jumps, the normal reaction force component was used to calculate the velocity at take-off (vto), the mean values of power (Pmean), force (Fmean) and velocity (Vmean), and the push-off height (Hpo). For the DJ test, the braking and push-off phases were analysed separately.

Linear mixed models were used to test the functional recovery along sessions as function of group ($α = 0.05$).

<footnote n="1">¹ISM, CNRS & Aix Marseille Univ, Marseille, France</footnote>

<footnote n="2">²LAMHESS, Univ Côte d'Azur, Nice, France</footnote>

<footnote n="3">³IAPS, Univ Toulon, Toulon, France</footnote>

<footnote n="4">⁴ CEMEREM, APHM, Aix Marseille Univ, Marseille, France</footnote>
## 3. Results

The running time differed between sex in absolute values (M: 104±9, W: 118±15 min; p<0.01), but not when related to the best time for each sex. Compared to PRE, DOMS increased at D1-2 (p<0.05) for both sexes and for all muscle groups (quadriceps, hamstrings and triceps surae), but recovered at D3-4.

In DJ, group × session interactions were found: only men showed decreases in performance (vto) (p<0.001), at D1-2 (p<0.01) and D3-4 (p<0.05), in Vmean during the push-off phase at D1-2 (p<0.01), and in Hpo up to D3-4 (p<0.001).

In SJ, both sexes decreased in vto and Hpo up to D3-4 (p<0.05), but increased for the control group (p<0.05).

<figure><img src="image_102.png" /><figcaption>**Figure 2.** Relative estimate changes (in %) compared to PRE ± standard error for men (blue), women (pink) and control group (black). \*: p<0.05.</figcaption></figure>

Ultrasound analysis revealed for both sexes increased CSA at D1-2 and D3-4 for the lateral gastrocnemius, tibialis anterior, vastus lateralis, and semi-membranosus (p<0.05).

## 4. Discussion

This study reports for the first time the respective structural and functional recoveries of men and women runners up to 3 to 4 days.

As expected, DOMS disappeared on days 3-4 although some lower limb muscles were still swollen for both sexes and thus probably inflamed, as suggested by the associated functional decreases. Interestingly, men and women had similar sites and time course of muscle inflammation, but differed in their functional recovery.

Surprisingly, both sexes showed decreases up to D3-4 in the pure concentric test (SJ), which is often described as not demanding enough to reveal fatigue [4]. This is attributed to the additional mass of the sledge seat, which may have made the task more demanding with fatigue, especially for the lighter women.

In line with the earlier functional recovery of women in DJ [4], only men decreased in DJ. The discrepancy found between the two tests confirms that fatigue is testing-task dependent and differs by sex. The decrease in performance in both jumps is attributed to the decrease in push-off distance (hpo). This was opposite to the learning effect showed by control group. This could reflect a specific triceps surae fatigue.

## 5. Conclusion

Differing from the reported protective effects of oestrogens, the indirect signs of muscle inflammation (CSA and DOMS) after a graded run did not differ between sex. Once again women were found to recover functionally earlier in DJ. Importantly DOMS disappeared too early for both sexes emphasizing the risk of injury.

## References

[1] M. Joyner (2017) Physiological limits to endurance exercise performance: influence of sex. J Physiol. 595: 2949-54.

[2] C. Nicol et al. (2006) The stretch-shortening cycle: a model to study naturally occurring neuromuscular fatigue. Sports Med. 36: 977-99.

[3] S.K. Hunter (2016) The Relevance of Sex Differences in Performance Fatigability, Med Sci Sports Exerc. 48: 2247-56.

[4] R. Macchi et al. (2021) Sex influence on the functional recovery pattern after a graded running race: original analysis to identify the recovery profiles, Front. Physiol. 12: 649396.