Susceptibility to movement-evoked pain following resistance exercise

Einat Kodesh, Anat Sirkis-Gork, Tsipora Mankovsky-Arnold, Simone Shamay-Tsoory, Irit Weissman-Fogel

Research output: Contribution to journalArticlepeer-review


Objective To investigate the: (1) role of basic muscle pain sensitivity and psychological factors in the prediction of movement-evoked pain (MEP) following delayed onset muscle soreness (DOMS), and (2) association of MEP with changes in systemic muscle pain sensitivity following DOMS induction. Methods Fifty-one participants were assigned to either eccentric resistance exercise or control groups. They completed questionnaires evaluating psychological distress and underwent muscle pain sensitivity evaluation by the pressure pain threshold (PPT) test at the exercised and remote muscles, before and 24 hours following the intervention. MEP intensity was determined in response to lifting a 3kg canister using a visual analogue scale (VAS). Results The exercise group demonstrated MEP intensity of 5/10 on VAS and reduced PPTs at the main exercised muscle (p<0.001). A regression tree analyses revealed that the level of anxiety trait predicted a higher MEP intensity. A secondary analysis showed that 53% participants who were DOMS responders (MEP > mild intensity; ≥ 3/10 VAS) exhibited decreased PPTs in the exercised (p<0.001) and remote (p = 0.027) muscles following eccentric exercise. Characterization of DOMS responders revealed that, at baseline, they had lower PPTs in the exercised (p = 0.004) and remote (p = 0.001) muscles and reported higher psychological distress i.e., anxiety trait and depression symptoms (p<0.05), compared to non-responders. A regression analysis revealed that lower PPT or high levels of anxiety trait increased the probability to become a responder (p = 0.001). Conclusions Susceptibility to MEP following DOMS is determined by muscle pain hypersensitivity and high levels of anxiety trait. MEP at the early stage of DOMS is linked with an increase in systemic muscle pain sensitivity suggestive of central mechanisms. This knowledge is valuable in translating science into clinical musculoskeletal pain management.

Original languageEnglish
Article numbere0271336
JournalPLoS ONE
Issue number7
StatePublished - Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 Kodesh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


  • Exercise/physiology
  • Humans
  • Muscle, Skeletal/physiology
  • Myalgia
  • Pain Threshold/physiology
  • Resistance Training

ASJC Scopus subject areas

  • General


Dive into the research topics of 'Susceptibility to movement-evoked pain following resistance exercise'. Together they form a unique fingerprint.

Cite this