Effects of Soft Tissue Treatment vs Mechanisms Explanation to Treat Delayed Onset Muscles Soreness Among Sport Climbers
Condition: Central Nervous System Sensitization; Peripheral Nervous System Disorders; Muscle Soreness; Muscle Strength
MeSH terms: Myalgia; Nervous System Diseases; Peripheral Nervous System Diseases
Study type: Interventional

Summary: 
      The aim of the present research is to define the effects of short manual treatment of soft
      tissues compared to mechanisms explaining in Delayed Onset Muscle Soreness (DOMS) among sport
      climbers and to address the mechanisms of peripheral and central sensitization involved in
      DOMS phenomena.
    

Detailed description: 
      Sport climbing is a growing success sport that will be debuting as an official discipline in
      the Tokyo 2020 Olympics game. They are used during competitions.

      To practice this discipline, both dexterity in movement and extreme physical strength are
      needed to climb the sloping and vertical walls that are used during competitions.

      The appearance of muscle pain induced by an unusual and strenuous physical activity (DOMS) is
      an extremely common factor in all sports activities that involves a maximum and repeated
      muscular effort. In the sport climbing practice this physiological phenomenon is common and
      occurs both in those who practice at as professional and amateur level. Numerous studies have
      shown that muscle pain is induced by physical activity and independent of damage to muscle
      fibers and classic inflammation of tissues. The phenomenon of DOMS is accompanied by
      hyperalgesia and allodynia during muscle contraction, these are conditions of irritation of
      the peripheral nervous system (SNP) and central nervous system (CNS), but today no evidence
      of such sensitization phenomena of the SNP and SNC has been provided. The presence of muscle
      pain is one of the main causes of impossibility to practice sports not only for those who
      practice sport climbing at a professional level, but for most amateur sportsmen. Thanks to
      the tools validated in the last decade, it is possible to study the involvement and awareness
      responses of the SNP and SNC with reliable and non-invasive techniques in the phenomenon of
      DOMS. Understanding the mechanisms underlying the appearance of the DOMS is today a primary
      priority for sports practice and for physical training for muscular effort both as a
      professional and amateur level.

      Presence of peripheral and central sensitization in DOMS will be assessed and a three arm
      randomized controlled double blind multicentric study will be performed to assess the effects
      of treatment on peripheral tissues compared to pain mechanisms explanation. Healthy
      participants of both sexes will be assessed before DOMS, at 48 hours (the peak phase of
      symptoms) before and after treatment and at 96 hours when symptoms usually are in remission.
    

Intervention name(s): Soft tissue treatment; Mechaninsms explanation; Control Group; Neurodynamic treatment
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Participants will be asked to sit in front of a medical table with their forearms supinated and relaxed. 5 minutes of deep tissue manual flossing on the proximal and medial aspect of the forearm of each side will be administered by keeping the hands contact on the skin of the participants for all the treatment duration. Direction of the gentle repeated manual compressions and shifts will be proximal to distal or vicerversa depending on the symptom reduction reported by the participants. Stimuli frequencies will be about 0,2-03 Hz. Subjects will be instructed to report immediately if the manual treatment starts to induce an increase in symptoms; Participants will be instructed with a 10 minutes lesson on mechanisms hypothesized to generate Delayed Onset Muscle Soreness. To trigger the most the bottom down pain modulation given by the placebo effect lesson will be concluded stressing the fact that DOMS have a good prognosis and that in a short amount of time they will be pain free and also that no drugs are effective to reduce pain intensity in DOMS condition suggesting them to stay physically active.; Participants will be asked to wait 10 minutes and to relax until the tests will be performed again.; Participants will be asked to lay supine on a medical table and keep their arms relaxed. 30 repetitions of gentle upper limb nerves mobilization, performed through a combination of neck and arm physiological movements, will be administered with cycles of tensions and relaxation of 1/5 seconds for 3 minutes in total for each arm. Subjects will be instructed to report immediately if the manual treatment starts to induce an increase in symptoms
Other intervention name(s): compression combined to longitudinal repeated mobilization of the forearm soft tissues
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized trial
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Sport climber; Delayed Onset Muscle Soreness; Central sensitization; Peripheral sensitization; Soft tissue treatment