CHANGES IN PERCEIVED RECOVERY STATUS SCALE
FOLLOWING HIGH-VOLUME MUSCLE DAMAGING
RESISTANCE EXERCISE
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ERIC M. SIKORSKI,1 JACOB M. WILSON,2 RYAN P. LOWERY,2 JORDAN M. JOY,2
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 04/02/2023
C. MATTHEW LAURENT,3 STEPHANIE M-C WILSON,4 DOMINI HESSON,1 MARSHALL A. NAIMO,2
BRIAN AVERBUCH,2 AND PHIL GILCHRIST2
1
Departments of Biology; and 2Health Sciences and Human Performance, The University of Tampa, Tampa, Florida; 3School of
Human Movement, Sport and Leisure Studies, Bowling Green State University, Bowling Green, Ohio; and 4Department of
Nutrition, IMG Performance Institute, IMG Academies, Bradenton, Florida
ABSTRACT
Sikorski, EM, Wilson, JM, Lowery, RP, Joy, JM, Laurent, CM,
Wilson, SM-C, Hesson, D, Naimo, MA, Averbuch, B, and
Gilchrist, P. Changes in perceived recovery status scale
following high-volume muscle damaging resistance Exercise.
J Strength Cond Res 27(8): 2079–2085, 2013—Currently no
research has investigated the relationship between muscle
damage, hormonal status, and perceived recovery scale
(PRS). Therefore, the purpose of this study was to determine
the effects of a high-volume training session on PRS and to
determine the relationship between levels of testosterone, cor-
tisol, and creatine kinase (CK) and PRS. Thirty-five trained
subjects (21.3 6 1.9 years) were recruited. All subjects par-
ticipated in a high-volume resistance training session consist-
ing of 3 sets of full squats, bench press, deadlifts, pullups, dips,
bent over rows, shoulder press, and barbell curls and exten-
sions. Pre-PRS and post-PRS measurements (0–10), sore-
ness, CK, cortisol, and testosterone were measured before
and 48 hours after training. Perceived recovery scale declined
from 8.6 6 2.3 to 4.2 6 1.85 (p , 0.05). Leg, chest, and arm
soreness increased from pre- to postexercise. Creatine kinase
significantly increased from pre- to postworkout (189.4 6
100.2 to 512 6 222.7 U/L). Cortisol, testosterone, and free
testosterone did not change. There was an inverse relationship
between CK and PRS (r2 = 0.58, p , 0.05). When muscle
damage was low before training, cortisol and free and total
testosterone were not correlated to PRS. However, when dam-
age peaked at 48 hours postexercise, free, but not total, tes-
tosterone showed a low direct relationship with PRS (r2 = 0.2,
p , 0.05). High-volume resistance exercise lowers PRS
Address correspondence to Dr. Eric M. Sikorski, emsikorski@gmail.com.
27(8)/2079–2085
Journal of Strength and Conditioning Research
Ó 2013 National Strength and Conditioning Association
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
scores. These changes are partly explained by a rise in serum
indices of muscle damage. Moreover, free testosterone seems
to have a positive relationship with PRS.
KEY WORDS creatine kinase, overtraining, testosterone,
soreness, cortisol
INTRODUCTION
I
t is important that an athlete train at the optimal train-
ing volume to achieve maximum performance gains.
Training below this level will cause failure to achieve
the proper physical and psychological adaptation for
maximum performance, whereas training above may lead to
a condition referred to as overtraining or burnout (1–4). One
important aspect of successful training is the level of recov-
ery for an individual before resuming training (1–4). Not
permitting athletes with adequate recovery time is detrimen-
tal to obtaining peak performance (5,6). Over the years,
research has demonstrated that programmed rest and vari-
ation in volume and intensity is probably the best mecha-
nism for recovery (1–3).
Despite the importance of recovery time, the methods of
measuring recovery that do exist use time consuming,
invasive, and/or potentially taxing techniques that typically
lead to low compliance by the subjects and may cause
adverse side effects (1,5,7,8). However, Laurent et al. (9) pro-
posed a perceived recovery status scale, which is similar but
opposite to a perceived exertion scale (10–12). Both scales
are based on the subjective physical and mental feelings of
the athlete, as it pertains to their body either before or after
a training session. The perceived recovery scale (PRS) dem-
onstrated itself as an effective mechanism to determine the
performance in a particular training session before a subject
commences training (9). Furthermore, research suggests that
the PRS may be well suited for the determination of over-
training syndrome and the prevention of overtraining (9).
Damaging skeletal muscle tissue is one of the outcomes of
high-intensity exercise. One mechanism for determining the
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 Percieved Recovery Status

The second goal of this study

was to determine the relation-
TABLE 1. Subject characteristics and lifting volume.
ship between resting testoster-
Age Lean body mass, kg Relative strength Total lifting volume, kg one and cortisol levels and an
individual’s perceived readiness
216 1.9 76.7 6 8.8 5.2 6 0.52 16,353 6 3,900
to train, as determined by the
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PRS. Therefore, we specifically

assayed for the levels of CK,
cortisol, testosterone, and CRP.
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level of damage is by the examination of various blood METHODS

markers such as creatine kinase (CK), lactate dehydrogenase, Experimental Approach to the Problem
fast myosin, and myoglobin to name a few (13–15). Inflam- This investigation was designed to determine the effects of
mation is another side effect of muscle damage and leads to a high-volume muscle damaging training session on PRS. Our
increases in the levels of proteins such as C-reactive protein secondary purpose was to determine the relationship between
(CRP), prostaglandin E2, tumor necrosis factor-alpha (TNF-a), resting serum levels of testosterone and cortisol on PRS. All
platelet activating factor, and interleukin 6 (16–20). These subjects were tested on 3 separate days. On day 1, subjects’ 1
proteins may be used as indirect markers as part of the repetition maximum (1RM) performance on the full squat,
evaluation of damage to muscle tissue (21–24). Finally, the bench press, and deadlift were assessed. In addition, lean body
various catabolic and anabolic hormones play a significant mass was assessed using dual x-ray absorbtiometery (iDXA; GE
role in recovery from muscle damage. The levels and expres- Lunar Corp., Madison, WI, USA). On day 2, which occurred 7
sion of these hormones, cortisol, and testosterone, for exam- days after day 1, all subjects performed a high-volume resis-
ple, vary with not only the level of damage but also with the tance training protocol designed to elicit a large amount of
level of hydration of the individuals (21–24). Both these fatigue and muscle damage. Before the resistance training bout,
direct and indirect markers for muscle damage have been baseline blood, soreness, and PRS status were assessed. Forty-
used to corroborate perceived exertion among training and eight hours after the muscle damaging bout, subjects returned
competing athletes (25,26). to the laboratory for postblood and PRS scores.
The goal of this study was to examine and determine if
there is a correlation between the perceived recovery status Subjects
scale used by the subjects and the presence of blood markers Thirty-five highly resistance-trained subjects aged 21.3 6 1.9
and other indices of muscle damage and readiness to train. years with an average squat, bench press, and deadlift of
1.7 6 0.2, 1.38 6 1.9, and 2.07 6 2.7 times their bodyweight
were recruited for the study (Table 1). All subjects had
a minimum of 3 years of resistance training experience. An
TABLE 2. Resistance training protocol.
institution review board approved the study for human sub-
Rest, RM load and jects, and written informed consent was obtained from each
Exercise s repetitions subject before any testing.
Full Squat 60 8–12 Repetitions Resting Blood Draws
(8-12 RM) Resting blood draws were obtained via venipuncture by
Bench Press 60 8–12 Repetitions
a trained phlebotomist at pretraining (day 2) and at 48 hours
(8-12 RM)
Deadlift 60 8–12 Repetitions after the resistance training bout (day 3). Whole blood was
(8-12 RM) collected and transferred into appropriate tubes for obtaining
Pull-ups 60 8–12 Repetitions serum and plasma and centrifuged at 1500g for 15 minutes at
(8-12 RM) 48 C. Resulting serum and plasma was aliquoted and stored
Dumbbell shoulder 60 8–12 Repetitions
at j808 C until subsequent analyses.
press (8-12 RM)
Bent over rows 60 8–12 Repetitions
(8-12 RM) Diet Control. Two weeks before and throughout the study,
Parallel dips 60 8–12 Repetitions subjects were placed on a diet consisting of 25% protein, 50%
(8-12 RM)
carbohydrates, and 25% fat by a registered dietician, who
Barbell curls 60 8–12 Repetitions
(8-12 RM) specialized in sport nutrition (RD, LDN, and CISSN).
Lying triceps 60 8–12 Repetitions
extensions (8-12 RM) Biochemical Analyses
Samples were thawed one time and analyzed in duplicate for
each analyte. All blood draws were scheduled at the same
time of day to negate confounding influences of diurnal
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moderately recovered and

expected similar performance,
and 8–10 representing high
perceived recovery with ex-
pected increases in perfor-
mance. Muscle soreness was
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assessed using a scale of 0–10

for the legs, chest, and
arms. On the scale, 0–1
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Figure 1. Changes in serum creatine kinase and perceived recovery scale. All changes occur from prior to and
after a high-volume muscle damaging resistance exercise session.
hormonal variations. Serum total testosterone, cortisol, and
CRP were assayed via enzyme-linked immunosorbent assay
kits obtained from Diagnostic Systems Laboratories (Webster,
TX, USA). All hormones were measured in the same assay on
the same day to avoid compounded interassay variance. Intra-
assay variance was less than 3% for all analytes. Serum CK
was measured using colorimetric procedures at 340 nm
(Diagnostics Chemicals, Oxford, CT, USA).
Resistance Training Protocol
All subjects participated in a high-volume resistance training
session consisting of 3 sets of 10- to 12-repetition maximum
loads for each of the following exercises: full squats, bench
press, deadlifts, pullups, bent over rows, dips, shoulder press,
barbell curls, and triceps extensions. Rest periods were 1 minute
between sets and 2 minutes between exercises (Table 2).
represented little to no
pain, 2 represented slight pain,
3–4 represented mild pain, 5–6
represented moderate pain,
and 7–8 and 9–10 was indica-
tive of severe to the worst pain,
respectively, that the subject
had experienced in their lives.
Statistical Analyses
Means and SDs were gener-
ated for all subject characteristics, including strength rela-
tive to body weight (combined 1RMs for the squat, bench
press, and deadlift divided by subject’s body weight), age,
and total volume lifted during the resistance training pro-
tocol ([weight] 3 [repetitions] 3 [total sets of each exer-
cise]). A repeated measures analysis of variance was used to
determine differences in PRS, soreness, and blood markers
of muscle damage and hormone status. Finally, correlation
coefficients were calculated for all variables by using a cor-
relation matrix from raw scores to determine which varia-
bles were related to PRS scores. A Tukey HSD post hoc
test was used to locate significance between time points if
there was a main group or time effect. All significance was
accepted at p # 0.05. All statistical procedures were carried
out on Statistica (StatSoft, Tulsa, OK, USA).

Perceived Recovery Status Scale and Muscle Soreness

RESULTS
Perceived Recovery Status scale consists of values between Average total weight lifted in the training session was
0 and 10, with 0–2 being very poorly recovered and with 16,353 6 3,691.8 kg (Table 1, p , 0.05). Perceived Recov-
anticipated declines in performance, 4–6 being low to ery Status declined from 8.6 6 2.3 to 4.2 6 1.85 (p , 0.05)
(Figure 1). Leg (0.58 6 0.84 to
6.3 6 2.3 cm, p , 0.05), chest
(0.29 6 0.53 to 3.7 6 2.1 cm,
TABLE 3. Changes in blood hormone, inflammatory factors, and muscle soreness. p , 0.05), and arm soreness
Pre exercise values Post exercise values (0.48 6 1.2 to 2.7 6 2.6 cm,
p , 0.05) increased from pre-
Total Testosterone (ng$dl21) 647 6 197.8 628.5 6 150.1 to postexercise (Table 3).
Free testosterone (pg$ml21) 101 6 32.6 99 6 24.2
Cortisol (mg$dl) 20.2 6 4.0 20.2 6 4.3 Serum CK significantly
C-reactive protein (mg$L21) 1.27 6 2.1 1.25 6 1.9 increased from pre- to post-
Leg soreness (0–10) 0.58 6 0.84 6.3 6 2.3* workout (189.4 6 100.2 to
Chest soreness (0–10) 0.29 6 0.52 3.7 6 2.1* 512 6 222.7 U/L, p , 0.05).
Arm soreness (0–10) 0.48 6 0.12 2.7 6 1.7* Cortisol, testosterone, and
*Indicates significantly different than preexercise. free testosterone did not
change from pre- to posttrain-
ing (Table 3, p , 0.05). There

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 Percieved Recovery Status

was a significant moderate

and inverse relationship
between leg soreness and
PRS scores. There were also
significant low inverse rela-
tionships between chest and
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arm soreness and PRS scores.

There was a significant mod-
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erate inverse relationship

between CK and PRS
(Figure 2, p , 0.05). When
muscle damage was low
before training, cortisol and
free and total testosterone
were not correlated to PRS.
However, when damage
peaked at 48 hours postexer-
cise, free testosterone, but not
total testosterone, showed
a low direct relationship with
PRS (Figure 4, p , 0.05).
Figure 2. Relationship between perceived recovery scale and creatine kinase. PRS = 0.05221x3 + 7.24 3
1025x2 2 3.34 3 1028x + 14.45; x = creatine kinase (U/L); R2 = 0.5862, p , 0.05.

Figure 3. Relationship between muscle soreness and perceived recovery scale. A) PRS = 20.6402x 6 0.7276 + 8.801 6 0.3539; x = leg soreness; R2 =
0.5324, p , 0.05. B) PRS = 20.6844x 6 0.1296 + 7.932 6 0.2908; x = chest soreness; R2 = 0.2908, p , 0.05. C) PRS = 20.4371x 6 0.1414 + 7.251 6
0.4062; x = arm soreness; R2 = 0.1233, p , 0.05.

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Figure 4. Relationship between free testosterone and perceived
recovery scale. PRS = 0.03388 6 0.01286x + 1.074 6 1.321; x = free
testosterone; R2 = 0.1737.
DISCUSSION
The main goal of this study was to examine and determine if
there is a correlation between the perceived recovery status
scale used by the subjects and the presence of blood markers
and other indices of muscle damage and readiness to train as
verification of recovery and potential training performance.
Subjects (Table 1) noted a significant drop in their physical
status following the high-volume resistance training session
(Table 2). The subjects reported their level of recovery, using
the PRS (Figure 1B), and on the level of muscle soreness
both before and after the training session. Significant
changes in muscle soreness in the legs, chest and arms were
reported by the subjects (Table 3) leading to a significant,
inverse relationship between soreness and the PRS for each
subject (Figure 3). To determine if there was a correlation
between muscle damage and the PRS, we decided to look at
a blood marker, which has been shown to be a muscle dam-
age indicator. Creatine kinase levels were assayed through
blood draws before the workout and 48 hours after the
workout. Results demonstrated a 2.5-foldincrease in serum
levels of CK 48 hours postexercise verifying potential muscle
damage (Figure 1A). However, it must be mentioned that
tissue damage may have been compromised because of the
receptor complexes that are not functioning (27). Yet, on
statistical comparison between the PRS (Figure 1B) and
CK levels (Figure 1A), the results demonstrated that there
was a significant and moderate inverse relationship between
the two (Figure 2). This suggests that the PRS may be used
not only as a measure of readiness to train and potential
performance but also as a measure of potential muscle dam-
age. The initial study investigating the potential utility of the
PRS was to investigate if individuals could subjectively assess
their level of recovery relative to expected performance.
Although novel, there are clearly a number of factors that
influence an individual’s performance during repeated bouts
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Journal of Strength and Conditioning Research | www.nsca.com
of work. Therefore, studies are needed to further examine
specific markers that may influence an individual’s level of
readiness after training. The results from this study suggest
that the PRS may have extended utility in not only identifi-
cation of performance change, but may indicate the magni-
tude of damage done at the level of the muscle and/or the
degree of recovery after a difficult bout of exercise. Clearly,
the ability of an individual to assess either the level of recov-
ery or degree of damage using a simple noninvasive percep-
tual scale is attractive across a number of populations and
has tremendous potential in prescribing training loads on
a day-to-day basis. Indeed, Laurent et al. (9), in the design
of the PRS suggested that an individual may be able to use
this measure as a means to manipulate daily workloads and,
if done appropriately, could serve to not only maximize
overload and training gains but also potentially avoid non-
functional overreaching.
The second goal of this study was to examine testosterone
(total and free), cortisol, and C-reactive protein and to
determine any significant relationship between these bio-
chemical levels and individual’s perceived readiness to train
as determined by the PRS. Results demonstrated no signif-
icant change in C-reactive protein or cortisol levels from pre-
to postworkout (Table 3). Our results for C-reactive protein
agreed with those of other researchers (18,28,29). Cortisol
also displayed no significant level of change after the high-
volume exercise, which was concurrent with results obtained
by others (24). Although some researchers have noticed
changes in levels of cortisol in blood and saliva after resis-
tance exercise (30–33), samples in these studies were taken
either immediately or shortly after (a few hours) exercise.
Changes in cortisol levels may have occurred at time inter-
vals different from the one chosen for our study. Further
experimentation is needed to determine if these changes
did occur. Our post exercise times for sampling were chosen
because this is when maximal concentrations of muscle dam-
age markers would be present.
Finally, testosterone levels were assayed both pre- and
postworkout. There was no significant correlation in the
levels of total and free testosterone to the PRS when muscle
damage was low before training, however, there was a low
and direct correlation between free testosterone and the
subject’s perceived level of recovery 48 hours postexercise.
This result alludes to the role of testosterone in maintaining
readiness for physical exertion in the presence of muscle
damage (34–36). While there was only a modest correlation
shared between these 2 variables, this finding is still novel.
The literature has clearly indicated that perceptual response
during exercise (i.e., RPE) is influenced by a number of dif-
ferent variables. Moreover, the degree to which a variable
will influence RPE is not constant, as its influence may
change relative to the intensity of the exercise and/or the
duration of the exercise bout (37–39). Because the PRS was
created analogous to the RPE scale, our results may indicate
that different biochemical markers of damage and/or
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 Percieved Recovery Status
recovery (i.e., CK, testosterone, etc.) will influence readiness
to train differently depending on the amount time an indi-
vidual has recovered or how much damage had occurred
during the exercise bout itself. Further investigation toward
the rate of change of readiness and appearance and clearance
of these biochemical markers, especially as they relate to
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performance change, is warranted.
PRACTICAL APPLICATIONS
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The results of this study demonstrate another mechanism,
which can be used by coaches and trainers of athletes to
assess the readiness of an athlete for continued training and
intensity of training to increase their performance. The PRS
is a novel measurement and not as widely accepted as the
RPE scale. By using perceived exertion, one is looking at the
detrimental physiological and psychological changes to
a subject during and immediately after an exercise session.
As suggested by Laurent et al. (9), this measurement may
not be the best mechanism to determine overtraining
because the measurements are taken after the training ses-
sion is over. To the contrary, the PRS looks at the readiness
of a subject before the training session begins. This would be
a better way to determine the readiness and potential per-
formance of an athlete for a particular training session and
may provide insight into potential onset of overtraining
syndrome.
Clearly, what the data from this study suggest is that after
a bout of heavy resistance training, an individual is able to
indicate level of recovery using the PRS. Although the
relationship shared between perception of recovery and the
biochemical makers reported here is not overwhelming,
considering the numerous factors that contribute to recov-
ery, even a moderate relationship is novel. Moreover, the
practical application of these findings are most important
for those individuals that have neither the resources (time,
monetary, or otherwise) nor the expertise to draw blood
and perform chemical assays to determine recovery status
and or muscle damage. In that sense, individuals working
with large groups of athletes (e.g., collegiate strength and
conditioning) may find the ability to estimate level of
muscle damage as a result of a certain workout program
quite attractive. This, in the bigger picture, may help
appropriately design periodization plans designed aimed
at functional overreaching and ensure proper overload.
Moreover, and perhaps more importantly, the ability to
indicate level of recovery following heavy resistance
training expeditiously and accurately may be a critically
important step in prevention of overtraining. Still, future
work is needed addressing other variables influencing
recovery and long-term studies investigating the usefulness
of the PRS in training.
REFERENCES
1. Bishop, PA, Jones, E, and Woods, AK. Recovery from training:
a brief review: brief review. J Strength Cond Res 22: 1015–1024, 2008.
the TM
2084 Journal of Strength and Conditioning Research
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
2. Lehmann, M, Foster, C, and Keul, J. Overtraining in endurance
athletes: a brief review. Med Sci Sports Exerc 25: 854–862, 1993.
3. Budgett, R. Overtraining syndrome. Br J Sports Med 24: 231–236,
1990.
4. Lane, KN and Wenger, HA. Effect of selected recovery conditions
on performance of repeated bouts of intermittent cycling separated
by 24 hours. J Strength Cond Res 18: 855–860, 2004.
5. Kentta, G and Hassmen, P. Overtraining and recovery. A conceptual
model. Sports Med 26: 1–16, 1998.
6. Laursen, PB and Jenkins, DG. The scientific basis for high-intensity
interval training: optimising training programmes and maximising
performance in highly trained endurance athletes. Sports Med 32:
53–73, 2002.
7. Urhausen, A and Kindermann, W. Diagnosis of overtraining: what
tools do we have? Sports Med 32: 95–102, 2002.
8. Lambert, MB and Borresen, J. A theoretical basis of monitoring
fatigue: a practical approach for coaches. Int J Sports Sci Coach 1:
371–388, 2006.
9. Laurent, CM, Green, JM, Bishop, PA, Sjökvist, J, Schumacker, RE,
Richardson, MT, and Curtner-Smith, M. A practical approach to
monitoring recovery: development of a perceived recovery status
scale. J Strength Cond Res 25: 620–628, 2011.
10. Noble, BJ. Clinical applications of perceived exertion. Med Sci Sports
Exerc 14: 406–411, 1982.
11. Robertson, RJ, Goss, FL, Rutkowski, J, Lenz, B, Dixon, C,
Timmer, J, Frazee, K, Dube, J, and Adreacci, J. Concurrent validation
of the OMNI perceived exertion scale for resistance exercise. Med Sci
Sports Exerc 35: 333–341, 2003.
12. Goss, F, Robertson, R, DaSilva, S, Suminski, R, Kang, J, and Metz, K.
Ratings of perceived exertion and energy expenditure during light to
moderate activity. Percept Mot Skills 96: 739–747, 2003.
13. Guerrero, M, Guiu-Comadevall, M, Cadefau, JA, Parra, J, Balius, R,
Estruch, A, Rodas, G, Bedini, JL, and Cussó, R. Fast and slow
myosins as markers of muscle injury. Br J Sports Med 42: 581–584,
2008; Discussion 584.
14. Baird, MF, Graham, SM, Baker, JS, and Bickerstaff, GF. Creatine-
kinase- and exercise-related muscle damage implications for muscle
performance and recovery. J Nutr Metab 2012: 960363, 2012.
15. Clarkson, PM, Nosaka, K, and Braun, B. Muscle function after
exercise-induced muscle damage and rapid adaptation. Med Sci
Sports Exerc 24: 512–520, 1992.
16. Gleeson, M. Immune function in sport and exercise. J Appl Physiol
103: 693–699, 2007.
17. Santos, RV, Bassit, RA, Caperuto, EC, and Costa Rosa, LF. The
effect of creatine supplementation upon inflammatory and muscle
soreness markers after a 30km race. Life Sci 75: 1917–1924, 2004.
18. Milias, GA, Nomikos, T, Fragopoulou, E, Athanasopoulos, S, and
Antonopoulou, S. Effects of eccentric exercise-induced muscle
injury on blood levels of platelet activating factor (PAF) and other
inflammatory markers. Eur J Appl Physiol 95: 504–513, 2005.
19. Mackinnon, L. Advances in Exercise and Immunology. Champaign, IL:
Human Kinetics; 1999.
20. Ronsen, O, Pedersen, BK, Øritsland, TR, Bahr, R, and Kjeldsen-Kragh, J.
Leukocyte counts and lymphocyte responsiveness associated with
repeated bouts of strenuous endurance exercise. J Appl Physiol 91:
425–434, 2001.
21. Judelson, DA, Maresh, CM, Yamamoto, LM, Farrell, MJ,
Armstrong, LE, Kraemer, WJ, Volek, JS, Spiering, BA, Casa, DJ, and
Anderson, JM. Effect of hydration state on resistance exercise-
induced endocrine markers of anabolism, catabolism, and
metabolism. J Appl Physiol 105: 816–824, 2008.
22. Martinez, AC, Seco Calvo, J, Tur Marı́, JA, Abecia Inchaurregui, LC,
Orella, EE, and Biescas, AP. Testosterone and cortisol changes in
professional basketball players through a season competition.
J Strength Cond Res 24: 1102–1108, 2010.

23. Ahtiainen, JP, Lehti, M., Hulmi, JJ, Kraemer, WJ, Alen, M,
Nyman, K, Selänne, H, Pakarinen, A, Komulainen, J, Kovanen, V,
Mero, AA, and Häkkinen, K. Recovery after heavy resistance
exercise and skeletal muscle androgen receptor and insulin-like
growth factor-I isoform expression in strength trained men.
J Strength Cond Res 25: 767–777, 2011.
24. Goto, K, Takahashi, K, Yamamoto, M, and Takamatsu, K. Hormone
Downloaded from http://journals.lww.com/nsca-jscr by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCyw
and recovery responses to resistance exercise with slow movement.
J Physiol Sci JPS 58: 7–14, 2008.
25. Twist, C and Eston, RG. The effect of exercise-induced muscle
damage on perceived exertion and cycling endurance performance.
CX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 04/02/2023
Eur J Appl Physiol 105: 559–567, 2009.
26. Burnett, D, Burns, S, and Smith, K. Perceived muscle soreness in
recreational female runners. Int J Exerc Sci 3: 108–116, 2010.
27. Serra, C, Tangherlini, F, Rudy, S, Lee, D, Toraldo, G, Sandor, NL,
Zhang, A, Jasuja, R, and Bhasin, S. Testosterone improves the
regeneration of old and young mouse skeletal muscle. J Gerontol Biol
Med Sci, 2012.
28. Franklin, ME, Chamness, M, Smith, LL, Chenier, TC, Sizemore, CS,
Rogers, M, and Forgione, K. Effects of isokinetic soreness-inducing
exercise on blood levels of C-reactive protein and creatine kinase.
J Orthop Sports Phys Ther 16: 208–214, 1992.
29. Malm, C, Sjödin, B, Sjöberg, B, Lenkei, R, Renström, P,
Lundberg, IE, and Ekblom, B. Leukocytes, cytokines, growth factors
and hormones in human skeletal muscle and blood after uphill or
downhill running. J Physiol 556: 983–1000, 2004.
30. Nunes, JA, Crewther, BT, Ugrinowitsch, C, Tricoli, V, Viveiros, L,
De Rose Jr, D, and Aoki, MS. Salivary hormone and immune
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
the TM
Journal of Strength and Conditioning Research | www.nsca.com
responses to three resistance exercise schemes in elite female
athletes. J Strength Cond Res 25: 2322–2327, 2011.
31. Rogers, RS, Dawson, AW, Wang, Z, Thyfault, JP, and Hinton, PS.
Acute response of plasma markers of bone turnover to a single bout of
resistance training or plyometrics. J Appl Physiol 111: 1353–1360, 2011.
32. Szivak, TK, Hooper, DR, Dunn-Lewis, C, Comstock, BA,
Kupchak, BR, Apicella, JM, Saenz, C, Maresh, CM, Denegar, CR, and
Kraemer, WJ. Adrenal cortical responses to high intensity, short rest,
resistance exercise in men and women. J Strength Cond Res, 2012.
33. Leite, RD, Prestes, J, Rosa, C, De Salles, BF, Maior, A, Miranda, H, and
Simão, R. Acute effect of resistance training volume on hormonal
responses in trained men. J Sports Med Phys Fitness 51: 322–328, 2011.
34. Harridge, SD. Plasticity of human skeletal muscle: gene expression
to in vivo function. Exp Physiol 92: 783–797, 2007.
35. Rooyackers, OE and Nair, KS. Hormonal regulation of human
muscle protein metabolism. Annu Rev Nutr 17: 457–485, 1997.
36. Phillips, BE, Hill, DS, and Atherton, PJ. Regulation of muscle protein
synthesis in humans. Curr Opin Clin Nutr Metab Care 15: 58–63, 2012.
37. Robertson, RJ and Noble, BJ. Perception of physical exertion:
methods, mediators, and applications. Exerc Sport Sci Rev 25: 407–
452, 1997.
38. Green, JM, McLester, JR, Crews, TR, Wickwire, PJ, Pritchett, RC,
and Redden, A. RPE-lactate dissociation during extended cycling.
Eur J Appl Physiol 94: 145–150, 2005.
39. Chen, MJ, Fan, X, and Moe, ST. Criterion-related validity of the
Borg ratings of perceived exertion scale in healthy individuals:
a meta-analysis. J Sports Sci 20: 873–899, 2002.
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