Author Identifier (ORCID)
Kazunori Nosaka: https://orcid.org/0000-0001-7373-4994
Abstract
Skeletal muscle exhibits remarkable plasticity following injury, yet most research has focused on responses to a single bout of eccentric contractions. This review addresses adaptations to repeated eccentric contraction–induced injuries across physiological and pathological conditions, with emphasis on insights from preclinical rodent models. In healthy muscle, the repeated bout effect (RBE) reduces strength loss and accelerates recovery after subsequent bouts. However, these adaptations are highly condition dependent. Aging can attenuate the RBE, while dystrophic muscle remains vulnerable to repeated injury despite compensatory remodeling. Other factors, including but not limited to, chronic alcohol intake and malignant hyperthermia can influence these responses, though their effects vary and do not universally abolish adaptation. Collectively, these findings highlight that the trajectory of muscle adaptation depends on its physiological state and underlying pathology. Understanding these condition-specific mechanisms is essential for developing targeted strategies to optimize recovery, maximize adaptations, and preserve muscle health across diverse populations.
Keywords
aging, eccentric contractions, muscular dystrophy, repeated bout effect, skeletal muscle adaptation
Document Type
Journal Article
Date of Publication
5-1-2026
Volume
14
Issue
10
Publication Title
Physiological Reports
Publisher
American Physiological Society
School
School of Medical and Health Sciences
Funding Information
Funding through the National Institutes of Health (R03-AG081950 and R01-AG097530 to CWB and R01-AR078903 to JAC) and a Glenn Foundation for Medical Research and American Federation of Aging Research Grant (to CWB). CWB acknowledges the support of the Osteopathic Heritage Foundation through funding for the Ralph S. Licklider, D.O., Endowed Faculty Fellowship in the Heritage College of Osteopathic Medicine.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Baumann, C. W., Ingalls, C. P., Nosaka, K., & Call, J. A. (2026). Beyond the first bout: Adaptations to repeated injuries across physiological and pathological conditions. Physiological Reports, 14(10), e70929. https://doi.org/10.14814/phy2.70929