Curcumin Supplementation and Delayed Onset Muscle Soreness for Athletes
Abstract
Curcumin is the main active ingredient of the spice turmeric and is believed to have anti-inflammatory properties. This has prompted many research studies to see if curcumin supplementation could lessen the delayed onset muscle soreness (DOMS) associated with eccentric or unaccustomed exercise. Curcumin could potentially provide both amateur and elite athletes with a natural alternative to non-steroidal anti-inflammatory drugs. This literature review analyzes the results of ten original research studies published in the last five years that attempted to determine whether or not curcumin reduces DOMS after exercise. While some studies found that curcumin did reduce DOMS, others found only a weak association or no evidence of a correlation, and thus the results are varied and inconsistent. This could be because of the various types of exercise used in each study (eccentric vs. aerobic exercise), the size of the groups studied, or the different types of curcumin supplements and the amounts administered. There is still potential that curcumin may reduce DOMS and act as an anti-inflammatory for athletes, however more research is needed.
Introduction
Curcumin is the main active ingredient in the plant Curcuma longa, also known as turmeric. Turmeric has been used in traditional Chinese and Indian medicine for over 5000 years (Cîrjoescu, Mavritsakis, & Tache, 2017). Curcumin is believed to have antioxidant, anti-inflammatory, and anti-microbial properties, with the potential of acting as an anticancer agent (Jamison, 2003). Because inflammation is associated with many chronic diseases such as diabetes, cardiovascular disease, and metabolic syndrome, the anti-inflammatory effects of curcumin could potentially help reduce the risk of these diseases (Hewlings & Kalman, 2017). The anti-inflammatory properties of curcumin have also inspired many research studies to determine whether or not supplementation could lessen the effects of delayed onset muscle soreness (DOMS) for athletes.
DOMS is defined as muscle damage and soreness that occurs within one to three days after an unaccustomed exercise routine (Connolly, Sayers, & McHugh, 2003). This can occur in either trained or untrained people engaging in any challenging physical activity. Most often, DOMS occurs following higher intensity and unfamiliar actions, such as at the start of a new training season or when attempting a new form of exercise. This type of exercise is often referred to as “eccentric exercise,” which indicates an “unaccustomed exercise, especially that consists of high-intensity and/or large number of eccentric (lengthening) contractions (Tanabe et al., 2015).” DOMS affects both elite and novice athletes and can negatively impact their athletic performance and quality of life.
As an anti-inflammatory supplement, curcumin has the potential to improve the recovery and performance of athletes and could possibly reduce their need for non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are often used to combat muscle soreness and damage induced by eccentric exercise. However, long-term NSAID use (such as aspirin or ibuprofin) has been shown to increase the risk of gastrointestinal ulceration and bleeding, kidney toxicity, and hemorrhagic stroke (Davis et al., 2017). If curcumin could prove to be a natural supplement to lessen the effects of DOMS, it could also lessen an athlete’s need for potentially harmful NSAIDs.
This literature review compares the most current research studies to determine whether or not curcumin supplementation reduces the effects of DOMS after exercise. Ten original research studies are analyzed and the findings of the paper include inconclusive and conflicting results. Curcumin supplementation may still prove to lessen the effects of DOMS for athletes, however more research is needed.
Results
The purpose of this literature review is to evaluate the most recent studies published on this topic to see whether or not curcumin can be used to enhance recovery as an anti-inflammatory for athletes. The researcher used the search parameters “delayed onset muscle soreness” AND “eccentric exercise” AND (turmeric OR curcumin) in ProQuest Central, PubMed, and Google Scholar. The researcher limited the search to original research studies published within the last 5 years that sought to determine whether or not a correlation exists between curcumin supplementation and recovery from exercise. This review includes the ten research studies that were found with these parameters.
In a randomized, placebo-controlled trial, Drobnic et al. (2014) followed 20 healthy, moderately active men over four days to see if curcumin supplementation (Phytosome® 200 mg) administered twice daily could lessen the effects of DOMS from downhill running. They found that curcumin supplementation was associated with reduced muscle injury in the posterior or medial compartment of the thigh, reduced pain in the lower leg, and a reduced inflammatory response. However, most findings were not statistically significant. The researchers noted that the findings of this study may be limited to aerobic exercise and the results could vary for different types of exercise. Another limitation could be that the study was short and followed a small group of participants; larger studies are needed to provide statistical significance. The study shows that curcumin likely has a positive effect on reducing DOMS, however more research is needed.
In another study of the effect of curcumin supplementation on DOMS, Nakhostin-Roohi, Moradlou, Hamidabad, and Ghanivand (2016) gave 10 healthy young men either a placebo or 150 mg of curcumin (Thera Values Corporation design) immediately after unaccustomed intensive exercise (eccentric squat exercises). They participated in two test trials with at least 14 days in between. Measurements showed significantly reduced levels of pain, creatine kinase, alanine aminotransferase, and aspartate aminotransferase in the curcumin group, as well as increased antioxidant capacity. The researchers concluded that 150 mg curcumin supplementation could reduce pain between 48 and 72 hours after eccentric exercise. This supports earlier research from Drobnic et al. (2014) and no limitations or biases are noted within the study.
In a double-blind randomized-controlled crossover trial, Nicol, Rowlands, Fazakerly, and Kellett (2015) sought to determine the effect of curcumin on muscle damage, inflammation, and DOMS in humans. Similar to the study by Nakhostin-Roohi et al. (2016), 17 men were administered either curcumin (2.5g) or a placebo twice daily before and after exercise, in two test trials with 14 days in between. They performed single-leg jump and leg press exercises. After 24 and 48 hours, curcumin caused moderate to large reductions in pain and small reductions in creatine kinase activity. There was also a small increase in single-leg jump performance. The findings suggest that curcumin supplementation reduces DOMS following eccentric exercise, and may have performance benefits, although more research for performance enhancement is necessary. The researchers suggest that further study is needed to identify the mechanisms of action and how these results translate to other sports and activities, as well as the longterm effects of supplementation on training and its effect on females and clinical populations.
In a crossover, double-blind, placebo controlled trial, Rynders et al. (2014) gave 16 participants (7 men, 9 women) either a placebo or StemSport supplement (6150 mg/day) for 14 days, with DOMS induced on day 7 from an eccentric upper arm exercise. StemSport is a supplement that contains herbal antioxidants and anti-inflammatory substances: aphanizomenon flos-aquae extract, cats claw, mangosteen, rehmannia, berry extracts, nattokinase, serrapeptase, and curcumin. The manufacturer claims that “by assisting in increasing the number of adult stem cells in the bloodstream the StemSport concept may help your body naturally repair, rebuild and recover faster, so you can return to activity and athletic participation more quickly.” The researchers found that StemSport did not accelerate recovery from an acute bout of single upper-arm eccentric exercise in non-resistance trained adults. They admit that their study is limited in the specific type of DOMS that they chose; the tissue damage may have been too great and the muscle mass too small to produce effects. For the purpose of this review, curcumin is studied in conjunction with several other herbal antioxidants, not exclusively.
After admitting the limitations of the above mentioned research study, Furlong et al. (2014) again analyzed the effect of StemSport supplementation on recovery from resistance training. They hypothesized that by changing the exercise type, they may see a positive correlation between StemSport supplementation and improvement in strength, balance, and muscle function following exercise. In a double blind, placebo-controlled parallel group trial, 24 young adults (16 men, 8 women) were given either a placebo or StemSport supplement during a 12-week training program. Participants performed supervised resistance training exercises 3 times a week for 12 weeks. Pre- and post-training tests (1RM bench press, 1RM leg press, isokinetic strength, vertical jump height, and balance) were measured before and after the 12-week program. Twelve weeks of strength training was found to significantly improve muscle strength and function, however StemSport supplementation did not provide additional benefits above resistance training. There were no significant differences found between the placebo and StemSport groups. The researchers conclude that diet (which was not controlled) could been a possible limitation to the study, as well as the use of untrained subjects (rather than trained athletes) could have affected the results of the study.
A study by Sciberras, Galloway, Fenech, Grech, Farrugia, & Mifsud (2015) aimed to discover whether or not curcumin supplementation could reduce cytokine release after exercise. Eleven male recreational athletes consuming a low carbohydrate diet underwent three double blind trials with curcumin supplementation (500 mg), placebo supplementation, and no supplementation (control). Meriva® curcumin was chosen for its high bioavailability. After two hours of cycling, the study did not find a statistically significant difference between curcumin supplementation and the placebo or control. This could be due to the small sample size, mode of exercise, intensity of exercise, or the dose of curcumin. The researchers hypothesize that a larger sample size could achieve statistical significance. Also, the choice of cyclists as participants and lack of eccentric contractions or weight bearing exercise could affect the results of the study. The researchers conclude that based off their findings and those of previous studies, further research is needed to assess whether or not curcumin may affect cytokine production and inflammation in athletes.
Tanabe et al. (2015) studied fourteen untrained men who performed 50 elbow contractions with one arm and the same exercise with the other arm 4 weeks later, taking either 150 mg curcumin (theracumin) or a placebo before and after exercise. The researchers found that curcumin supplementation improved some aspects of muscle damage (maximal voluntary contraction loss and creatine kinase activity), however no other significant differences were found. Possible limitations include the sample population (untrained men); the results may not be representative of trained athletes or women.
The purpose of the study by McFarlin et al. (2016) was to determine the effects of oral curcumin supplementation on muscle damage and soreness, creatine kinase, and inflammatory cytokines following the exercise-induced muscle damage of a dual-leg press exercise. 28 participants received either curcumin (Longvida® 400 mg/day) or a placebo (rice flour) two days before to four days after exercise. They found that curcumin supplementation reduced inflammation but not quadriceps muscle soreness after exercise. The researchers theorize that these observations may translate to faster recovery and improved performance. DOMS is often treated with NSAIDs, which can inhibit the initial stages of healing and have negative effects on the central nervous system. Curcumin could be a naturally occurring alternative with less negative side effects.
In a study of the aerobic exercise capacity (AEC) of rats, Cîrjoescu, Mavritsakis, and Tache (2017) sought to establish whether or not branched-chain amino acid (BCAA) and curcumin supplementation could affect AEC. The research was performed in 7 groups, varying supplementation and level of intensity of exercise. AEC was measured by swimming, and intensity was amplified with a 5-10% load increase. Rats that were given curcumin were administered 30 mg/kg body weight. After 28 days, they found that BCAA and curcumin supplementation caused a significant increase in AEC in exercise trained animals. They conclude that the BCAA and curcumin complex has ergotropic (ability to expend energy), trophotropic (promoting rest and reconstitution of energy), and oxidative stress reducing effects in exercise trained animals.
Similarly, Sahin et al. (2016) aimed to investigate the effect of curcumin supplementation on exercise performance and endurance of rats after exhaustive exercise (running). The 28 rats were divided into four groups with varied levels of exercise and either control or 100 mg/kg of CurcuWin®, a curcumin supplement with increased bioavailability. After a five day period, the antioxidant and anti-inflammatory properties of curcumin was found to improve the run to exhaustion time of the exercised rats and prevent muscle damage.
Discussion
Of the eight research studies that followed human participants, three studies found only statistically insignificant results that curcumin supplementation could reduce the effects of DOMS in athletes (Drobnic et al., 2014; Sciberras et al., 2015; Tanabe et al., 2015). Another three studies found that curcumin did significantly reduce DOMS (McFarlin et al., 2016; Nakhostin-Roohi et al., 2016; Nicol et al., 2015). The two studies on StemSport supplementation found no evidence of a relationship (Rynders et al., 2014; Furlong et al., 2014). The two studies of rats found that curcumin did prevent muscle damage; however, these studies focused more on aerobic capacity and performance than on muscle recovery, thus their findings are limited for the purpose of this review (Cîrjoescu et al., 2017; Sahin et al., 2016). From these findings, there is evidence that curcumin may still improve DOMS associated with eccentric exercise, but the results are inconclusive and more research is needed.
There are several possible reasons for the discrepancies of these findings. As noted in several of the studies above, it is possible that the type of exercise could affect the results of these studies. A single-leg press exercise uses very different muscles than downhill running or elbow contractions. Whether or not the participants are athletically trained will also change how the exercises affect their muscles, as will their gender. Also, the type and amount of curcumin administered was different for each of these studies. Because curcumin has poor water solubility, it is metabolized and eliminated quickly in the body, and thus its level of absorption is rather low (Sahin et al., 2016). Several studies chose to use a manufactured form of curcumin that allows for a higher rate of bioavailability. It may also be unrealistic to obtain the necessary amount of curcumin (400 mg or more) to reduce the effects of DOMS by solely supplementing with the spice turmeric (Heaton et al., 2017). Finally, a few of these studies also noted that a small sample size may have contributed to the insignificance of their findings.
Conclusion and Recommendations
Current research is inconclusive in determining whether or not curcumin supplementation lessens the effects of DOMS and improves the recovery of athletes. Depending on the type of exercise, the person’s level of physical fitness, and the type and amount of curcumin administered, future research could still find a positive correlation. Considering DOMS is often treated with NSAIDS, curcumin could potentially provide athletes with a natural alternative with less negative side effects. While the effect of curcumin on muscle soreness and inflammation after eccentric exercise has yet to be conclusively determined, inflammation is also associated with many chronic diseases such as diabetes, cardiovascular disease, and metabolic syndrome. The anti-inflammatory effects of curcumin may lower one’s risk of these diseases and many more.
Future research should focus on narrowing down and eliminating the above mentioned discrepancies. Larger sample sizes may help to establish more significant findings. A possible future research study could utilize a set type and amount of curcumin in several different types of exercises. This could be useful to see how one supplement could affect the DOMS of various exercises (i.e. eccentric muscle contractions vs. endurance exercise) to narrow down what variables might change the results.
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