Muscle pain from an intramuscular injection of hypertonic saline increases variability in knee extensor torque reproduction

Purpose: The intensity of exercise-induced pain (EIP) reflects the metabolic environment in the exercising muscle, so during endurance exercise this may inform the intelligent regulation of work rate. Conversely, the acute debilitating effects of EIP on motor unit recruitment could impair the estimation of force produced by the muscle and impair judgement of current exercise intensity. This study investigated whether muscle pain that feels like EIP, administered via intramuscular injection of hypertonic saline, interferes with the ability to accurately reproduce torque in a muscle group relevant to locomotive exercise. Methods: On separate days, fourteen participants completed an isometric torque reproduction task of the knee extensors. Participants were required to produce torque at 15 and 20% maximal voluntary torque (MVIT), without visual feedback before (Baseline), during (Pain/No Pain), and after (Recovery) an injection of 0.9% isotonic saline (Control) or 5.8% hypertonic saline (Experimental) into the vastus lateralis of the right leg. Results: An elevated reported intensity of pain, and a significantly increased variance in mean contraction torque at both 15% (P=0.049) and 20% (P=0.002) MVIT was observed in the Experimental compared to the Control condition. Both 15 and 20% target torques were performed at a similar pain intensity in the Experimental condition (15% MVIT, 4.2 ± 1.9; 20% MVIT, 4.5 ± 2.2; P>0.05). Conclusion: These findings demonstrate that the increased muscle pain from the injection of hypertonic saline impeded accurate reproduction of knee extensor torque. These findings have implications for the detrimental impact of EIP on exercise regulation and endurance performance.