• To reduce damage, pain, and stiffness after strenuous physical activity, it is important to take appropriate measures before aerobic activity including warming up and stretching.

• Applying heat therapy will increase blood flow and muscle flexibility, this can be done by applying a heat pack, taking an herbal bath, checking out a new hot spring, or using the sauna at your local gym.

• Cold therapy will numb the pain and reduce inflammation, this can be done by using an ice pack, cryotherapy, or (some might say) a jump in the lake.

• Introduce rest and relaxation techniques such as yoga, meditation, reading a book, taking a bath, or low-impact forest therapy.

• Whey protein, fish oil, isoflavones, glutamine, l-carnitine, antioxidants, vitamins, and branched-chain amino acid (BCAA) have shown positive results in athletes.

• Ginseng (P. ginseng), eleuthero (E. radix), and green tea extract (GTE) are plant-based therapeutics that have been shown to improve energy and endurance in athletes.

• Bindii (T. terrestris) and cordyceps mushrooms (C. sinensis) have been studied and utilized for post-exercise recovery.

• For possible prevention of delayed-onset muscle soreness (DOMS), which typically occurs 8-24 after a work-out and peaks after 24-48 hours, saffron (C. sativus), turmeric (C. longa), and cinnamon (Cinnamomum ssp.) have shown significant results in reducing inflammation, boosting antioxidants, and circulatory properties.

• Ashwagandha (W. somnifera) is an adaptogenic herb that not has mood-enhancing benefits, but it has been investigated for its ability to reduce the stress associated with athletic performance.

• Taking two capsules of a combination of Boswellia 100 mg, ashwagandha 450 mg, turmeric 50 mg, and zinc complex 50 mg (Articulin-F) three times daily.

To reduce damage, pain, and stiffness after strenuous physical activity, it is important to take appropriate measures before aerobic activity including warming up and stretching.  Applying heat therapy will increase blood flow and muscle flexibility, this can be done by applying a heat pack, taking an herbal bath, checking out a new hot spring, or using the sauna at your local gym. Cold therapy will numb the pain and reduce inflammation, this can be done by using an ice pack, cryotherapy, or (some might say) a jump in the lake. Whey protein, fish oil, isoflavones, glutamine, l-carnitine, antioxidants, vitamins, and branched-chain amino acid (BCAA) have shown positive results in athletes.  Beyond these (and rest and relaxation techniques), re Ginseng (P. ginseng), eleuthero (E. radix), and green tea extract (GTE) are plant-based therapeutics that have been shown to improve energy and endurance in athletes. Bindii (T. terrestris) and cordyceps mushrooms (C. sinensis) have been studied and utilized for post-exercise recovery. For possible prevention of delayed-onset muscle soreness (DOMS), which typically occurs 8-24 after a work-out and peaks after 24-48 hours, saffron (C. sativus), turmeric (C. longa) , and cinnamon (Cinnamomum ssp.) have shown significant results in reducing inflammation, boosting antioxidants, and circulatory properties. Ashwagandha (W. somnifera) is an adaptogenic herb that not has mood-enhancing benefits, but it has been investigated for its ability to reduce the stress associated with athletic performance.

Introduction

During vigorous activity, glucose (from blood and glycogen stored in muscle) is used to produce adenosine triphosphate (ATP), the energy source for muscle movement.  The metabolized glucose creates an accumulation of lactic acid, which is responsible for the uncomfortable downside to exercise, muscle soreness and fatigue. Strenuous activity is associated with temporary musculoskeletal pain including; joint pain, muscle stiffness, cramps, and fatigue (Marieb & Hoehn, 2018). In addition, Meamarbashi (2017) indicated the inflammatory mediators (thromboxanes, prostaglandins, and leukotrienes) via cyclooxygenase and lipoxygenase pathways attribute to pain and swelling post-exercise.  Muscle pain goes away as circulation increases and lactic acid and inflammatory cytokines are removed from the blood. To reduce damage, pain, and stiffness, it is important to take appropriate measures before aerobic activity including warming up and stretching (Marieb & Hoehn, 2018). Other techniques include using heat therapy to increase blood flow and flexibility (heat pack, bath, hot spring, and sauna), cold therapy for numbing pain and reducing inflammation (ice pack and cryotherapy), rest, relaxation techniques, and compression (Hoffman, 2003). 

Beyond basic techniques, over-the-counter drugs such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), such as Tylenol & Ibuprofen, are used to alleviate painful musculoskeletal symptoms.  However, studies show that these drugs have potentially harmful consequences and are responsible for 9,000 American deaths each year. Side effects of NSAIDs include; (gastrointestinal) heartburn, dyspepsia, ulcers, stomatitis, (central nervous system) insomnia, dizziness, tinnitus, weakness, (cardiovascular) edema, palpitations, heart failure, (genitourinary) painful urination, bleeding, cystitis.

Current studies indicate the therapeutic benefits of using herbal medicine and essential oils to work with the body process to alleviate post-exercise soreness, without harmful consequences if used correctly (Hoffman, 2003). Clinical and statistical evidence suggests that musculoskeletal relief from plant-based medicine is attributed to their bioactive compounds such as polyphenols, terpenoids, and alkaloids (Sellami et al., 2018).  Oftentimes alternative medicine practitioners look for anti-inflammatory and pain-relieving herbal medicine for the treatment of delayed-onset muscle soreness caused by excessive muscular contractions (via exercise, weightlifting, and sports). Beyond herbal medicine, whey protein, fish oil, isoflavones, caffeine, l-carnitine, antioxidants, vitamins, and branched-chain amino acid (BCAA) have also shown positive results in athletes (Meamarbashi, 2017). 

Energy and endurance

According to Sellami et al. (2018), human clinical trials suggest ginseng (Panax ginseng) to have adaptogenic, anti-fatigue anti-inflammatory, antioxidant, brain function, immunostimulant, blood homeostasis, stress reduction, and as an endurance performance enhancer. Ginseng has an affinity with the central nervous system, with the ability to improve adrenal, and sexual function. 

Ginseng contains vitamins A, B, C, and E, iron, magnesium, potassium, and phosphorus. An alternative to ginseng is eleuthero (Eleutherococci radix) for its strengthening, invigorating, performance-enhancing, and stimulating activities. Maximum beneficial dosage 200mg/day, preferably in the morning. Precautions: taking more than 400mg a day can cause stomach upset or an overactive heartbeat, ginseng should not be taken within hours of sleep, adjust as needed.

Green tea extract (GTE) has been shown to reduce oxidative damage caused by endurance training. The antioxidative and nervous system stimulating effects have been shown to be a healthy and beneficial energy source for athletes (Sellami et al., 2018). 200mg, 1 hour before a workout when extra energy support is needed. Slowly increase dosage as needed, benefits seen as high as 800mg, however, start slow. 

Post-exercise recovery  

Bindii (Tribulus terrestris) is an anti-inflammatory, anti-oxidative herb. T. terrestris has been shown to have cardiovascular, prostate, and urinary system benefits. With reported improvements in male libido, muscle growth, and physical fitness. Many Olympians, athletes, and weightlifters commonly use Bindii for performance and recovery (Sellami et al., 2018). Maximum benefit was seen after 5 weeks, at 450mg/day, taking more than 1000mg/day could lead to insomnia and/or fatigue. 

The polysaccharides in cordyceps mushrooms (Cordyceps sinensis) were shown to reduce blood glucose level of hyperglycemic and diabetic mice, regulating the metabolism providing energy, amino acids, and balancing intestinal microbes (Shang et al., 2018).  Cordyceps also has an affinity with the bones, improving bone metabolism and strength (Yu et al., 2018).

Prevention of delayed-onset muscle soreness (DOMS)

Saffron (Crocus sativus) is a powerful antioxidant, anti-inflammatory, and antinociceptive (blocks pain stimulus via sensory neurons). Human studies have shown an effect of reducing DOMS symptoms (Meamarbashi, 2017). Standard dosage, 300mg/day. Maximum dosage of 1.5 grams.

Clinically, turmeric (Curcuma longa) has been shown to reduce muscle soreness in humans and significant research indicates that turmeric has highly anti-inflammatory and anti-oxidative properties (similar to NSAIDs) taken internally or topically (Meamarbashi, 2017). Traditional Chinese Medicine (TCM) indicates a reduction of swelling and pain and is useful for even chronic musculoskeletal issues including arthritis (Wichtl, 2004). 1.5-3g/day

Cinnamon (Cinnamomum ssp.) has circulatory, antioxidant, and anti-inflammatory effects due to phenolic and flavonoids (Meamarbashi, 2017). Oral consumption of 420mg/day 7 days prior, and 3 days after exercise has been shown for DOMS.

Ashwagandha (Withania somnifera) has been shown to help the body with physical and emotional stress (and stress resistance), reduce pain and inflammation, regulate metabolism, relax smooth muscle, and enhance performance. In an 8-week trial, 57 male participants were blindly separated into placebo and Ashwagandha groups.  The purpose of the study was to investigate the effects of Ashwagandha on muscle strength and recovery; muscle strength and muscle size, serum testosterone levels, and muscle recovery. Results showed an increase in muscle strength, and significantly greater muscle size, reduction of muscle damage, increased testosterone levels, and decreased body fat percentage (Wankhede et al., 2015). Beneficial dosage started at 300mg twice daily.