Post Exercise Alcohol Ingestion Exacerbates Eccentric-Exercise Induced Losses in Performance

Abstract

The effect of acute alcohol intake on muscular performance in both the exercising and non-exercising legs in the days following strenuous eccentric exercise was investigated to ascertain whether an interaction between post-exercise alcohol use and muscle damage causes an increase in damage-related weakness. Ten healthy males performed 300 maximal eccentric contractions of the quadriceps muscles of one leg on an isokinetic dynamometer. They then consumed either a beverage containing 1 g of ethanol per kg bodyweight ethanol (as vodka and orange juice; ALC) or a non-alcoholic beverage (OJ). At least 2 weeks later they performed an equivalent bout of eccentric exercise on the contralateral leg after which they consumed the other beverage. Measurement of peak and average peak isokinetic (concentric and eccentric) and isometric torque produced by the quadriceps of both exercising and non-exercising legs was made before and 36 and 60 h post-exercise. Greatest decreases in exercising leg performance were observed at 36 h with losses of 28.7, 31.9 and 25.9% occurring for OJ average peak isometric, concentric, and eccentric torques, respectively. However, average peak torque loss was significantly greater in ALC with the same performance measures decreasing by 40.9, 42.8 and 44.8% (all p < 0.05). Performance of the non-exercising leg did not change significantly under either treatment. Therefore, consumption of moderate amounts of alcohol after damaging exercise magnifies the loss of force associated with strenuous eccentric exercise. This weakness appears to be due to an interaction between muscle damage and alcohol rather than the systemic effects of acute alcohol consumption.

Full text

ORIGINAL ARTICLE
Post-exercise alcohol ingestion exacerbates eccentric-exercise
induced losses in performance
Matthew J. Barnes •Toby Mu
¨ndel •
Stephen R. Stannard
Accepted: 23 November 2009 / Published online: 11 December 2009
ÓSpringer-Verlag 2009
Abstract The effect of acute alcohol intake on muscular
performance in both the exercising and non-exercising legs
in the days following strenuous eccentric exercise was
investigated to ascertain whether an interaction between
post-exercise alcohol use and muscle damage causes an
increase in damage-related weakness. Ten healthy males
performed 300 maximal eccentric contractions of the quad-
riceps muscles of one leg on an isokinetic dynamometer.
They then consumed either a beverage containing 1 g of
ethanol per kg bodyweight ethanol (as vodka and orange
juice; ALC) or a non-alcoholic beverage (OJ). At least 2
weeks later they performed an equivalent bout of eccentric
exercise on the contralateral leg after which they consumed
the other beverage. Measurement of peak and average peak
isokinetic (concentric and eccentric) and isometric torque
produced by the quadriceps of both exercising and non-
exercising legs was made before and 36 and 60 h post-
exercise. Greatest decreases in exercising leg performance
were observed at 36 h with losses of 28.7, 31.9 and 25.9%
occurring for OJ average peak isometric, concentric, and
eccentric torques, respectively. However, average peak tor-
que loss was significantly greater in ALC with the same
performance measures decreasing by 40.9, 42.8 and 44.8%
(all p\0.05). Performance of the non-exercising leg did not
change significantly under either treatment. Therefore,
consumption of moderate amounts of alcohol after damaging
exercise magnifies the loss of force associated with strenuous
eccentric exercise. This weakness appears to be due to an
interaction between muscle damage and alcohol rather than
the systemic effects of acute alcohol consumption.
Keywords Ethanol Muscle strength Soft tissue injuries
Introduction
The mechanisms and consequences of exercise-induced
muscle damage (EIMD) have received considerable sci-
entific attention over the past 20 years. Strenuous eccentric
muscle action is now known to cause micro-structural
damage resulting in delayed onset muscle soreness
(DOMS), inflammation and more importantly, impaired
muscle function which typically lasts for a number of days,
depending on the severity of the damage (Cleak and Eston,
1992; Proske and Morgan, 2001). Over this same period
EIMD has been employed as a model of soft tissue injury
where a number of modalities aimed at improving the rate
of recovery (e.g. cold water immersion therapy (Eston and
Peters 1999), non-steroidal anti-inflammatory medication
(Gulick et al. 1996), massage (Jo
¨nhagen et al. 2004) and
compression therapy (Kraemer et al. 2001)) have been
tested. This research has provided mixed and often
inconclusive results. Surprisingly, compared to these and
other recovery modalities, less attention has been afforded
to post-exercise behaviours that may simultaneously impair
the recovery process after EIMD.
One such behaviour is post-exercise alcohol use. While
the consumption of large amounts of alcohol by sports-
people, often after competition or training, is common
place (Nelson and Wechsler 2001; Snow and Munro 2006;
O’Brien et al. 2007) little is known about how this
behaviour effects recovery and subsequent performance in
Communicated by William Kraemer.
M. J. Barnes (&)T. Mu
¨ndel S. R. Stannard
Institute of Food, Nutrition, and Human Health,
Massey University, Private Bag 11-222,
Palmerston North, New Zealand
e-mail: M.Barnes@massey.ac.nz
123
Eur J Appl Physiol (2010) 108:1009–1014
DOI 10.1007/s00421-009-1311-3

the days after exercise. We have recently shown that
moderate amounts of alcohol (1 g per kg of body weight)
consumed immediately after strenuous eccentric exercise
exacerbates the weakness normally seen in the days fol-
lowing such exercise (Barnes et al. 2009). This finding
suggests that athletes competing in sports involving stren-
uous eccentric muscular work or those suffering from soft
tissue injury should avoid alcohol consumption, at least
immediately after exercise or injury, if rapid recovery is
important. However, the design of this previous study did
not allow us to ascertain whether this alcohol-induced
weakness was due to delayed recovery from strenuous
eccentric exercise or whether alcohol alters the ability to
recruit and create tension in any muscle group in the 60-h
period after drinking.
Previous research (Poulsen et al. 2007) suggests that the
acute consumption of clinically relevant levels of alcohol
does not affect muscular performance in the days following
a drinking session. Further, indices of EIMD are unaffected
when alcohol is acutely consumed prior to a bout of
damaging exercise (Clarkson and Reichsman 1990). The
results of these studies suggest that our previous findings
are due to the alcohol affecting the recovery processes in
already damaged muscle, not systemically weakening all
skeletal muscles.
The purpose of this study, therefore, was to investigate
whether alcohol interacts with damaged skeletal muscle to
magnify the typical weakness associated with EIMD or
whether our previous findings are due to the systemic effects
of acute alcohol consumption, independent of EIMD.
Methods
Overview
The current study utilised a modified version of the pro-
tocol described by Barnes et al. (2009). Adapted from the
work of MacIntyre et al. (1996), this exercise protocol has
previously been shown to bring about significant levels of
muscle damage as characterised by decreased muscular
performance, DOMS and elevations in circulating creatine
kinase concentrations (MacIntyre et al. 1996; Barnes et al.
2009). Briefly, subjects performed 300 maximal eccentric
contractions of the quadriceps muscles of one leg on an
isokinetic dynamometer. They then consumed either an
alcoholic beverage or a non-alcoholic control beverage. At
least 2 weeks later they performed an equivalent bout of
eccentric exercise on the contralateral leg after which they
consumed the other beverage. Muscular performance of the
damaged (exercising) and non-damaged (non-exercising)
legs was measured prior to the damaging exercise bout and
at 36 and 60 h post-exercise.
Subjects
Twelve males volunteered to participate in this study.
However, due to an obvious learning effect the results of
two subjects were excluded from statistical analysis, as
their strength was higher than pre-exercise values in the
days after the damaging protocol. Analysis was there-
fore carried out on the results of 10 subjects (age
23.5 ±5.1 years, body mass 76.9 ±12.9 kg). All subjects
were healthy and had at least 2 years of resistance training
experience at a recreational level (minimum twice per
week). The protocol was approved by the Massey Uni-
versity Human Ethics Committee and written consent was
obtained from each subject.
Familiarisation of the protocol was carried out at least 1
week before the first trial. Subjects were instructed to
abstain from alcohol consumption and any form of exercise
from 48 h before and until 60 h after the exercise bout.
Subjects were also instructed to abstain from practices that
could potentially improve or delay their recovery during
the 60 h post-exercise period. Subject’s diets were repli-
cated between trials by way of a food diary that was filled
out from the morning of the first trial until the last mea-
surements were taken at 60 h post-exercise. Utilising a
single cross-over design, treatment and leg were randomly
allocated in a counter-balanced fashion. This was done to
account for ordering and (leg) dominance effects.
Muscular performance
Four hours after consuming a standardised, solid meal
(3765 kJ; CHO 133 g, Fat 28 g, Protein 25 g) subjects
returned to the laboratory in the evening and warmed up on
a cycle ergometer (Monark, Varberg, Sweden) for five
minutes at 100 W. They were then seated on a Biodex
Ò
isokinetic dynamometer (Biodex Medical Systems, New
York, USA) and straps were fixed across the chest, hips and
active leg to isolate movement to the quadriceps. Knee
joint range of motion was set and recorded for use in
subsequent follow-up tests. Subjects then performed sepa-
rate sets of five maximal isometric, concentric and eccen-
tric contractions of the quadriceps muscles of both the
non-exercising and the exercising legs. Each set was sep-
arated by 2 min of passive recovery. Isometric tension was
measured at a knee angle of 758(1.31 rad). Concentric and
eccentric torques were measured at an angular velocity of
30°s
-1
(0.52 rad s
-1
). Absolute peak torque and average
peak torque over five contractions were recorded. Pre-
exercise muscular performance measures were made in the
early evening with subsequent follow-up measurements
made 36 and 60 h post-exercise. The time of day at which
subjects completed these measurements was standardised
between trials. Although time of day was different between
1010 Eur J Appl Physiol (2010) 108:1009–1014
123

measurements the lack of change in the performance of the
non-exercising leg illustrates that changes in circadian
rhythms did not affect force development capabilities in the
current study.
Exercise protocol
Subjects remained on the Biodex and completed 3 sets of
100 maximal eccentric contractions, over a 60°(1.05 rad)
range of motion at an angular velocity of 30°s
-1
, using the
quadriceps muscles of one leg. Each set was separated by
5 min of passive recovery. Subjects were verbally encour-
aged to resist the downward action of the dynamometer arm
as hard as possible and had access to visual feedback of
their torque throughout the protocol to ensure continuous
maximal effort. Total work completed during the eccentric
exercise bouts was not significantly different between trial
one (34.9 ±11.5 kJ) and trial two (36.7 ±11.1 kJ)
(p =0.14) or between control (OJ) (35.2 ±11.5 kJ) and
alcohol (ALC) trials (36.5 ±11.5 kJ) (p=0.29).
Treatment
Thirty minutes after completion of the exercise bout, and
having consumed a standardised meal immediately after
exercise (1532 kJ; CHO 50.4 g, fat 9.1 g, protein 7 g),
subjects began drinking a beverage containing either 1 g of
alcohol per kg of body weight as vodka (37.5% alcohol/
volume; Smirnoff, Australia) in orange juice (Frucor
Beverages, New Zealand) (ALC) or a control beverage of
orange juice alone (OJ). Equivalent to 8 ±2.8 standard
drinks, the mean volume of vodka consumed per subject
was 211.9 ±51.4 ml. In order to balance total energy
value (2794.5 ±476.1 kJ) and fluid volume (1638 ±
268 ml) between trials, subjects consumed a greater vol-
ume of orange juice in the OJ trial while in the ALC trial
they consumed an additional volume of water (751 ±
128 ml) along with the alcoholic beverage. An equal vol-
ume of beverage was consumed every 15 min over a total
time of 90 min. Once the required amount of beverage was
consumed participants were driven home and instructed to
go directly to bed.
For the second trial, the contralateral leg was exercised
and the other beverage was consumed using the same
protocol, as outlined above.
Statistical analysis
Data were analysed using the Statistical Program for Social
Sciences (SPSS) for Windows (version 15.0, SPSS Inc.,
Chicago, IL). A general linear-model three-way repeated-
measures ANOVA (treatment 9time 9leg) was used to
compare conditions over time for each performance
measure. This analysis provided main effects of time,
treatment and leg; thus treatment 9time, treatment 9leg,
time 9leg and treatment 9time 9leg interactions were
also investigated. If conditions differed significantly, post
hoc pairwise comparisons using Bonferroni adjustment
were performed to identify the differences between time
points within each treatment and leg. As no significant
change was seen in muscular performance of the non-
exercising leg (see Results section for details) and to allow
comparison between the results of the current study and our
previous findings (Barnes et al. 2009), exercising leg data
was analysed separately with two-way repeated-measures
ANOVA providing additional treatment 9time interac-
tions. As different legs were used for each trial, resulting in
significantly different pre-exercise values between treat-
ments, data was analysed as absolute change in torque
relative to pre-exercise values. Reported values are
means ±standard deviation (SD). Statistical significance
was set at the 95% level of confidence (P\0.05).
Results
Completion of 300 eccentric muscular contractions of the
quadriceps resulted in significant decreases in isometric,
concentric and eccentric peak and average peak torque over
time in the exercising leg only (all P\0.001, Table 1). No
significant change in non-exercising leg performance was
observed at any time point under either treatment (all
P[0.2). Significant Treatment 9Time 9Leg interac-
tions were found for isometric (P=0.036) and eccentric
(P=0.02) peak torques as well as for isometric (P=
0.032), concentric (P=0.032) and eccentric (P=0.023)
average peak torques.
Analysis of the exercising leg data, independent of the
leg variable, found significant changes over time for all
performance measures (all P\0.001). Significant treat-
ment effects (all P\0.02) and treatment 9time interac-
tions (all P\0.05) were seen for all performance
measures except peak concentric torque (P=0.16 and
0.42, respectively). Greatest decreases in performance were
seen with ALC at 36 h while no significant change in
performance was observed between 36 and 60 h under
either treatment.
Repeated-measures ANOVA of trial one versus trial two
found no significant order effect for any of the muscular
performance measures (all P[0.15).
Discussion
The aim of the present study was to investigate whether the
systemic effects of alcohol bring about muscular weakness
Eur J Appl Physiol (2010) 108:1009–1014 1011
123

in the days following alcohol consumption after strenuous
eccentric exercise or whether alcohol interacts with EIMD
to exacerbate the loss of muscular performance, as previ-
ously observed (Barnes et al. 2009).
Completion of 300 maximal eccentric contractions of
the quadriceps resulted in significant decreases in all per-
formance measures in the exercising leg only (Table 1). In
accordance with the results of Poulsen et al. (2007), our
data confirm that a moderate dose of alcohol has no affect
on muscular performance in the days following a drinking
episode provided the muscle has not been damaged as a
result of strenuous eccentric work. The results of our pre-
vious study (Barnes et al. 2009) are thus due to an inter-
action between post-exercise alcohol consumption, the
damaged muscle and/or the recovery processes initiated by
EIMD.
Confirming our previous observations, in the current
study significant differences in post-exercise muscle per-
formance between treatments were seen after 36 h. At this
time point, isometric and eccentric peak torques were 39
and 44% lower than pre-exercise measures, respectively,
with ALC compared to losses of 29 and 27% for the same
measures with OJ. Perhaps more important than a single all
out effort, the ability to generate force repeatedly was
greatly reduced, with losses in average peak torque of 41%
(isometric), 43% (concentric) and 45% (eccentric) with
ALC compared to 29, 32 and 26% with OJ, respectively.
Together with the results of our previous work (Barnes
et al. 2009), the current study reinforces the observation
that the consumption of moderate amounts of alcohol after
damaging exercise magnifies the loss in force production
capability typically associated with EIMD.
To date considerable effort has been made to identify
modalities that improve the rate of performance recovery
after strenuous eccentric exercise. The majority of this
research, however, has failed to conclusively show that
losses in performance can be minimised if a particular
modality is used during the post-exercise period (Cleak and
Eston 1992; Barnett 2006; Wilcock et al. 2006). An alter-
native, as suggested by Reilly and Ekblom (2005), is to
adhere to proper nutritional strategies including moderation
when drinking alcohol. Indeed, given our current and
previous findings, moderation of alcohol after strenuous,
damaging exercise is a sound advice if a timely return to
optimal performance is desired. However, whether mod-
eration alone is sufficient to avoid the negative effects of
Table 1 Absolute changes in torque (N-m) following strenuous eccentric exercise
Exercising leg Non-exercising leg
Pre 36 h 60 h Pre 36 h 60 h
Peak ISO
OJ 275.8 ±48.9 -78.8 ±38.7* -72.9 ±48.7* 286.0 ±51.2 -3.4 ±16.0 -0.1 ±19.6
ALC 295.6 ±49.8

-113.7 ±45.3*

-108.9 ±84.4* 289.6 ±62.6 -10.0 ±21.8 -3.0 ±42.7
Peak CON
OJ 227.8 ±50.3 -71.5 ±32.4* -57.9 ±22.8* 255.9 ±69.4 -11.5 ±26.0 -12.1 ±23.2
ALC 240.9 ±50.4 -88.3 ±44.4* -78.2 ±64.6* 238.3 ±45.3 -11.4 ±24.2 -3.5 ±37.7
Peak ECC
OJ 284.9 ±77.3 -77.1 ±59.3* -63.5 ±51.9* 311.0 ±81.7 -0.3 ±32.2 4.9 ±37.8
ALC 345.6 ±81.7
à
-150.2 ±58.8*
à
-133.2 ±88.2*

335.6 ±79.0 -22.6 ±47.7 -33.0 ±73.1
Average ISO
OJ 256.9 ±39.0 -73.8 ±41.5* -72.0 ±55.7* 271.3 ±40.1 -7.8 ±18.7 -1.5 ±22.1
ALC 281.1 ±37.7

-115.1 ±50.3*

-111.7 ±86.8*

271.3 ±54.1 -8.9 ±15.3 -3.7 ±43.7
Average CON
OJ 205.1 ±31.2 -65.6 ±32.7* -55.3 ±32.7* 230.7 ±50.2 -10.0 ±19.7 -9.9 ±32.8
ALC 226.8 ±37.9

-97.0 ±47.7*

-91.0 ±64.0*

222.7 ±36.2 -11.6 ±16.8 -9.4 ±40.5
Average ECC
OJ 266.9 ±76.9 -69.1 ±93.6
#
-63.6 ±47.4* 291.3 ±84.3 2.6 ±33.7 6.4 ±41.5
ALC 320.4 ±70.1

-143.5 ±68.6*

-127.8 ±91.6*

306.3 ±75.9 -8.6 ±37.1 -23.8 ±60.1
ISO isometric, CON concentric, ECC eccentric torque (N-m), OJ control, ALC alcohol treatment
Data presented as mean ±SD
Significant difference from pre-exercise value: *P\0.01,
#
P\0.05
Significant difference between trials:
à
P\0.01,

P\0.05
No significant difference between 36 and 60 h values under either treatment
1012 Eur J Appl Physiol (2010) 108:1009–1014
123

alcohol on recovery after damaging exercise is currently
unclear as only one dose (1 g of alcohol per kg of body
weight) has been investigated. In fact, the dose used in the
current study is considerably lower than levels of alcohol
consumption frequently reported by sportspeople (Snow
and Munro 2006; O’Brien et al. 2005; O’Brien et al. 2007)
suggesting that alcohol use would have to be restricted to
an even greater extent if results such as those observed in
the present study are to be avoided. Further research is
warranted to investigate the dose effects of alcohol use in
the post-exercise period.
Although the mechanisms behind our findings are not
yet understood, previous research into acute alcohol use
suggests that a number of similarities may exist between
the separate effects of EIMD and acute alcohol consump-
tion on skeletal muscle. Alterations in excitation–contrac-
tion (E–C) coupling and central nervous system (CNS)
function have been proposed as contributors to the force
loss associated with EIMD (Deschenes et al. 2000; Carson
et al. 2002; Prasartwuth et al. 2005; Racinais et al. 2008;
Dartnall et al. 2009). Similarly, acute alcohol exposure has
been shown to negatively affect sarcoplasmic Ca
2?
trans-
port, thus altering E–C coupling (Cofa
´n et al. 2000); while
alcohol acts on the CNS to impact axonal conductance and
neurotransmission leading to dose-dependent impairment
of psychomotor and cognitive skills. These actions con-
tribute to the popularity of alcohol as a recreational drug
(Valenzuela 1997; Reilly 2003). Finally, a well-coordi-
nated immune response is initiated by EIMD to facilitate
repair and recovery of damaged tissue (Tidball 2005). As
acute alcohol use has been shown to adversely affect
recovery from trauma/injury by altering the normal
inflammatory response (Szabo and Mandrekar 2009), our
results may be due to alcohol-related impairment of the
normal recovery processes. Whether any or all of these
factors combine to bring about the results observed in the
current study is worth further investigation.
Conclusion
When consumed after strenuous eccentric exercise, a
moderate dose of alcohol magnifies the temporary loss of
muscular performance associated with EIMD but does not
affect performance of the unexercised muscle. Alcohol thus
appears to exert its ergolytic effect by impairing the normal
recovery processes which occur following exercise-
induced microstructural damage, not by a systemic effect
on skeletal muscle innervation. This study provides evi-
dence that the management of alcohol use after strenuous
eccentric exercise is as important, if not more important,
than the use of popular recovery modalities if optimal
recovery of performance is desired. The mechanisms
behind our findings are yet to be fully elucidated.
Conflict of interest statement None.
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