Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
©Journal of Sports Science and Medicine (2022) 21, 419 - 425   DOI:

Research article
Effects of Maximal Eccentric Exercise on Deep Fascia Stiffness of the Knee Flexors: A Pilot Study using Shear-Wave Elastography
Jan Wilke1,2, , Carsten Schwiete3, Michael Behringer3
Author Information
1 Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
2 Department of Movement Sciences, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
3 Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt/Main, Germany

Jan Wilke
✉ Goethe University Frankfurt, Institute of Occupational, Social and Environmental Medicine, Theodor-Stern-Kai 7, 60596 Frankfurt/Main, Germany
Publish Date
Received: 11-04-2022
Accepted: 09-08-2022
Published (online): 01-09-2022
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The deep fascia is intimately linked to skeletal muscle and may be involved in delayed onset muscle soreness (DOMS). The present study therefore explored the effect of eccentric exercise on fascia stiffness and its relation with DOMS. Healthy active male adults (n = 19, 27 ± 4 years) performed 6 x 10 maximal eccentric knee flexions using an isokinetic dynamometer. Before (baseline) as well as immediately (T0), 1 hour (T1), and each day up to 72 hours (T24 to T72) afterwards, shear wave elastography was used to measure the mechanical stiffness of the biceps femoris muscle and the overlying fascia. As a surrogate of DOMS, pain upon palpation was captured by means of a 100mm visual analogue scale. While muscle stiffness remained unchanged (p > 0.05), deep fascia stiffness increased from baseline to T24 (median: 18 kPa to 21.12 kPa, p = 0.017) and T72 (median: 18 kPa to 21.3 kPa, p = 0.001) post-exercise. Linear regression showed an association of stiffness changes at T24 and pressure pain at T72 (r2 = 0.22, p < 0.05). Maximal eccentric exercise leads to a stiffening of the fascia, which, in turn, is related to the magnitude of future DOMS. Upcoming research should therefore gauge the effectiveness of interventions modifying the mechanical properties of the connective tissue in order to accelerate recovery.

Key words: DOMS, ultrasound, fatigue, connective tissue, exercise

           Key Points
  • Eccentric exercise increases the stiffness of the deep fascia
  • Stiffness increases correlate with DOMS palpation pain on subsequent days.
  • Interventions to prevent or treat DOMS may need to focus on the fascial connective tissue
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