Muscular injuries are common in the active population and cause the majority of players to leave the world of sports. Depending on the severity, recovery of muscle function is quite slow and may require surgery, medication and rehabilitation. Now, a study led by the University of Barcelona reveals a strategy to improve and speed up recovery from muscle injuries that has potential application in sports and health in general.
This is the first study to provide scientific evidence for faster and more effective recovery from muscle injuries through intermittent exposure to low oxygen availability (hypoxia) in a low barometric pressure (hypobaric) chamber that simulates high-altitude geographic conditions.
The new approach is important for the recovery of athletes—particularly in the competitive elite—but also for mitigating the socioeconomic impact of lost work productivity caused by these injuries in the active population.
The study, carried out using animal models, was published in Journal of Physiology. The authors of the study are experts Garoa Santoildes, Teresa Pagès, Joan Ramon Torrella and Ginés Viscor, from the Department of Cell Biology, Physiology and Immunology of the UB School of Biology.
Why does hypoxia help regenerate injured muscles?
Hypobaric chambers have long been used to improve physical condition in high-performance sports (climbers, climbers, etc.) and in professional fields (high-altitude mining, astronomical observation, border control). In hypobaric hypoxia, the body is exposed to a low atmospheric pressure environment in which cells take up less oxygen and create a physiological response. The beneficial effects of intermittent exposure to hypoxia on the organism are well described, but its potential applications in biomedicine are still being explored.
The study shows that any type of muscle injury could recover faster with intermittent exposure to hypobaric hypoxia (simulated altitude), but possibly myotendinous injuries could also accelerate their recovery.”
Professor Ginés Viscor, head of the Adaptive Physiology Group: Hypoxia, Exercise and Health at UB
In tissues, hypoxia causes local activation of the HIF (hypoxia-inducible factor) pathway, which is a sensor of oxygenation levels. “When the amount of oxygen reaching the cells is not sufficient, the HIF protein acts as a switch that activates a series of changes in metabolic pathways to compensate for this deficit,” explains Professor Garoa Santocildes.
Among other pathways, HIF protein activates the proliferation of more capillaries through endothelial growth factor (VEGF), a process that will bring more growth factors, metabolic substrates and oxygen to the muscle level to support the muscle regeneration process after injury .
As Professor Teresa Pagès explains, “in parallel, the HIF protein would also enhance the synthesis of specific proteins, the activity of certain enzymes and the efficiency of mitochondria, which are the cellular organelles that provide energy for cellular functions.”
Muscle injuries and treatments: a paradigm shift
In approaching muscle injuries, the classic view of RICE (Rest, Ice, Compression and Elevation) treatment has evolved into a more holistic and active view known as PEACE (Protection, Elevation, NSAD Avoidance, Compression, Education) and LOVE ( load management). , Optimism, Vascularization, Exercise).
“All this means a major paradigm shift in the field of muscle injury rehabilitation,” says Professor Joan Ramon Torrella. “Exposure to hypobaric hypoxia – continues the expert – is fully compatible with this new paradigm and could even contribute to improving the results of emerging therapies to accelerate the recovery of injured muscle.”
Therapy based on exposure to low oxygen concentrations could also help explore new treatments for pathophysiological injuries. Thus, it would be important to test whether hypoxia can counteract the muscle atrophy that characterizes sarcopenia—a disease characterized by loss of muscle mass and strength—through the processes involved in muscle repair (capillary proliferation, more efficient oxidative metabolism, etc.).
“In these cases, hypobaric hypoxia intervention would likely be improved if combined with individualized strength and endurance training activities. Even its application in the recovery of patients with persistent COVID-19 syndrome could be improved,” the team concludes.
Source:
Journal Reference:
Santocildes, G., et al. (2023). Simulated altitude is medicine: intermittent exposure to hypobaric hypoxia and cold accelerates the repair of injured skeletal muscle. The Journal of Physiology. doi.org/10.1113/jp285398.
