“…Although histological alterations provide a direct evidence of muscle damage, eccentric exercise-induced muscle damage is often assessed indirectly by increases in muscle proteins in the blood (e.g., creatine kinase: CK), ratings of delayed onset muscle soreness, and decreases in muscle strength and range of motion (Nosaka & Clarkson, 1995;Chen et al, 2010Chen et al, , 2011. Among these, a prolonged decrease in maximum voluntary contraction (MVC) peak force or torque has been considered to be the best indirect measure of eccentric exercise-induced muscle damage (Warren et al, 1999;Nosaka et al, 2006). Large decreases in MVC peak force (30-50%) are evident for several days following maximal eccentric elbow flexor exercise, together with abnormalities shown by ultrasound and/or magnetic resonance imaging (Nosaka & Clarkson, 1996) and myofibril necrosis (Jones et al, 1986;Mackey et al, 2011).…”