Pilot study to establish if Transdermal Magnesium can help relieve physical symptoms of Post training fatigue

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Pilot study to establish if Transdermal
Magnesium Oil can help relieve physical
symptoms of Post training fatigue?
Monica McSherry PG dip
Dissertation submitted as part
requirement for the Master of
Science in Diet Nutrition and
Health at the University of
Worcester.

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Acknowledgments
I would like to thank my Supervisor Jane
Richardson who was an inspiration throughout
my study. I would also like to thank my
Husband Andrew McSherry for being so kind
and supportive, whilst I was locked away in the
kitchen, researching for months on end.

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ABSTRACT
Objectives: Cycling is one of the most high-energy
consuming exercises leading to depletion of energy
sources and development of fatigue. Post-training
fatigue has significant effects on the mood and stress
responses of cyclists. Furthermore, high stamina
cycling can have an adverse impact on
dehydroepiandrosterone sulphate (DHEA-S) and
cortisol resulting in poor recovery. The transdermal
application of magnesium can help by improving DHEA
and cortisol. The current study investigated the
effectiveness of transdermal magnesium in decreasing
post-exercise fatigue in cyclists.
Methodology: Quantitative research methodology,
based on a previous study by Waring (2011), was
chosen for the primary investigation of pre- and post-
fatigue in 3
cyclists. Five participants were selected
and investigated using the Hecimovich- Peiffer-
Harbaugh Exercise Exhaustion Scale (HPHEES).
Correlation and regression coefficients were measured
collectively for the pre- and post-training fatigue
periods for three weeks, that is, week 2, week 4 and
week 6.
Results: The correlation and regression results of
week 2 and week 4 showed a strong negative
relationship between post-training fatigue components
and transdermal application of magnesium, such as
recovery (-0.702), easiness (-0.617) and mentally
drained (-0.696), while a moderate negative correlation
was found for post-exercise energy (-0.441),
refreshness (-0.58), replication of last game event (-
0.306), muscle ache (-0.481) and mental sharpness (-
0.484). In contrast, the week 6 results showed strong
positive effects of transdermal magnesium oil on the
post- training fatigue in cyclists.

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Conclusion: There is a positive and significant
transdermal effect of magnesium in decreasing post-
exercise fatigue in cyclists.

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TABLE OF CONTENTS
LIST OF TABLES
........................................................................................................
viii

LIST OF FIGURES
........................................................................................................
ix

CHAPTER 1: INTRODUCTION
...................................................................................
x

1.1
Background
.......................................................................................................
x

1.1.1
Fatigue in sports
........................................................................................
x

1.1.2
Energy sources affecting fatigue in sports
..........................................
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1.1.3
Physiology of the skin
............................................................................
xiv

1.2
Research opportunity
...................................................................................
xvii

1.3
Research Aim and Objectives
.....................................................................
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1.4
Research Significance
..................................................................................
xix

1.5
Research Layout
...........................................................................................
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CHAPTER 2: LITERATURE REVIEW
......................................................................
xx

2.1
Introduction
......................................................................................................
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2.2
Aetiology of skeletal muscle cramps during exercise
...............................
xx

2.3
The effects of strenuous exercise on intramuscular magnesium
concentrations
.......................................................................................................
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2.4
Applications of magnesium in sports
........................................................
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2.5
Maintaining magnesium status
.................................................................
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2.6
Magnesium absorption and excretion
.......................................................
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2.7
Role of transdermal magnesium in inflammatory conditions
.................
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CHAPTER 3: METHODS AND METHODOLOGY
................................................
xxx

3.1
Introduction
....................................................................................................
xxx

3.2
Development of the trial
...............................................................................
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3.3
Ethical considerations
................................................................................
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3.4
Participants
..................................................................................................
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3.5
Procedure
....................................................................................................
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3.6
Reflection on the recruitment process
......................................................
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CHAPTER 4: EMPIRICAL RESULTS INTERPRETATION
...............................
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4.1
Introduction
..................................................................................................
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4.2
Weekly results of pre- and post-exercise symptoms
............................
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4.2.1
Pre- and post-exercise results: Week 2
..........................................
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4.2.2
Pre and Post Exercise Results: Week 4
.............................................
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4.2.3
Pre and Post Exercise Results: Week 6
...............................................
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4.3
Discussion of results
....................................................................................
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4.4
Conclusion
.....................................................................................................
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CHAPTER 5: DISCUSSION
...................................................................................
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5.1
Summary of main findings
.........................................................................
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5.2
Limitations of study
.....................................................................................
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5.2.1
Participants
...........................................................................................
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5.2.2
Study period
..........................................................................................
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5.3
Conclusion
....................................................................................................
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MASTERS DISSERTATION PROPOSAL FORM
.........................................
lxxxvii

Application for Ethical Approval (Student)
.........................................................
xciii

Participant Consent Form
.......................................................................................
cii

Participant Information Sheet
.................................................................................
cv

Fatigue Questionnaire
..........................................................................................
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3-DAY FOOD, DRINK AND DIARY
.....................................................................
112

Worcester Advert
....................................................................................................
115

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LIST OF TABLES
Table 1: Week 2 Correlation Analysis - Pre and Post Exercise Fatigue
.....................
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Table 2: Week 2 Regression Analysis - Pre and Post Exercise Fatigue
........................
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Table 4: Week 4 Regression Analysis - Pre and Post Exercise Fatigue
..........................
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LIST OF FIGURES

Figure 1: Week 2: Recovery among all participants
........................................................
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Figure 2: Week 2: Energy among all participants
.............................................................
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Figure 3: Week 2: Refresness among all participants
..........................................................
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Figure 4: Week 2: Easiness among all participants
..............................................................
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Figure 5: Week 2: Physically drained among all participants
..............................................
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Figure 6: Week 2: Replication of last game event among all participants
........................
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Figure 7: Week 2: Increased training among all participants
..............................................
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Figure 8: Week 2: Weak legs and arms among all participants
.........................................
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Figure 9: Week 2: Muscle Ache among all participants
......................................................
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Figure 10: Week 2: Mentally Sharpness among all participants
.......................................
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Figure 11: Week 2: Relax among all participants
................................................................
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Figure 12: Week 2: Mentally Drained among all participants
...........................................
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Figure 13: Week 2: Easy walk among all participants
.......................................................
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Figure 14: Week 2: Mentally cloudy among all participants
..............................................
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Figure 17: Week 4: Refreshness among all participants
.................................................
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Figure 21: Week 4: More training among all participants
......................................................
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Figure 26: Week 4: Mentally drained among all participants
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Figure 37: Week 6: Muscle ache among all participants
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CHAPTER 1: INTRODUCTION
This chapter introduces the research context and justifies the research
rationale, providing a detailed discussion on general fatigue and sport-
related fatigue in order to validate the importance of energy sources in
affecting the hormonal balance in skin based on the skin physiology. The
transdermal route of magnesium and its effects on skin are further
discussed to provide the foundation for the current research opportunity,
that is, to investigate if transdermal application of magnesium is effective
in dealing with the post-exercise fatigue in cycling.
1.1 Background
1.1.1 Fatigue in sports
Fatigue is a common symptom presenting in both athletic and general
populations. Fatigue, as a clinical indication, is subjective in nature; it is
not the same as muscle weakness or fatigability (Chaudhuri & Behan,
2004). Moreover, up to 60% of well-trained athletes may exhibit
persistent fatigue associated with the overtraining syndrome (Morgan et
al., 1988). The causes of fatigue in athletes are numerous, although the
three main causes can be broadly categorized under three sections
according to the European committee of sports science (Meeusen et al.,
2006): medical causes, over-performing and overtraining which come
under the same cause, and psychological stress. Athletes with ongoing
fatigue experience impaired performance and endurance during sport
(Meeusen et al., 2006), with their fatigue being central rather than
peripheral (Chaudhuri & Behan, 2004) and associated with hypothalamic
and neuroendocrine changes (Barron et al., 1985; Hooper et al., 1993;

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Mackinnon et al., 1997; Urhausen et al., 1998; Meeusen et al., 2004).
With regard to normal sports-related fatigue, exercise-induced fatigue is
defined as a reversible reduction in the force and power-generating ability
of the neuromuscular system (Fitts & Holloszy, 1976; Bigland-Ritchie et
al., 1983), manifesting through central and/or peripheral mechanisms.
Specifically, central fatigue results in a failure of the central nervous
system to excite and drive motor neurons (Gandevia, 2001), whereas
peripheral fatigue results in a failure of the muscle to respond to neural
excitation (Allen et al., 2008). Studies have suggested that power
produced during maximal cycling exercise is limited by numerous
mechanisms at various locations along the neuromuscular and contractile
pathways. In order for a muscle to produce power in a cyclical manner
(i.e., cycling, locomotion, etc.), there is a neural input from the central
nervous system via alpha motor neurons (McArdle, Katch, & Katch,
2001). The neural impulse crosses the neuromuscular junction and
enters the skeletal muscle cell. Calcium ions are then released from the
sarcoplasmic reticulum (SR) in order to initiate activation (excitation).
Actin/myosin is formed quickly and calcium is then re-sequestered into
the SR to relax the muscle, allowing lengthening before the next
contraction can occur. Furthermore, these processes occur with
adequate speed in order for the muscle and therefore the entire
organism, to maintain a maximum power output (McArdle, Katch, &
Katch, 2001).
The fatigue experiences are further associated with the lack or deficiency

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of energy sources.
1.1.2 Energy sources affecting fatigue in sports
Glucose is the major energy source in cells and glucose mobilization in
the circulatory system and local body system during exercise is complex.
Previous studies have shown that hypoglycaemia may occur during high
intensity exercise, but continual or exhaustive exercise may induce
hyperglycaemia (Gotoh et al., 1998). Generally, muscle glycogen is the
major nutrient depleted during the acute phase of exercise and blood
vessels carry nutrients, including glucose, to working muscles to support
continued exercise. Furthermore, the brain is a heavy energy consumer,
playing a decisive role in the regulation of whole body energy
metabolism. In previous studies, brain glucose concentrations increased
during exercise but remain unchanged in cycling (Bequet et al., 2001). It
has also been shown that brain glucose concentrations decrease in high
intensity exercise. Generally, exercise requires the integration of several
body systems, for example, the muscle-skeletal system responds to the
action and the circulatory system needs to increase the cardiac output to
supply more oxygen and other related compounds, with the brain and
spinal cord controlling, planning, and regulating the motor commands.
Previous studies have investigated glucose changes in blood muscle and
brain to establish system effects of exercise (Bequet et al., 2001). It is
important to identify and explore the glucose changes in the blood,
muscle, and brain simultaneously in order to understand the systemic
changes in exercise and magnesium dependency. Magnesium plays a

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central role in glucose utilization and metabolism; however, exercise may
result in magnesium deficiency due to increased magnesium excretion in
sweat and urine (Consolazio, 1963).
Magnesium (Mg) is the second most abundant intracellular cation and
serves as a co-factor in more than three hundred enzymatic reactions,
including energy production (Lukaski, 2000). Magnesium is involved in
glucose metabolism and enhances exercise performance. As mentioned
previously, long-term exercise increases Mg excretion through sweat and
urine, resulting in magnesium deficiency. Exercise performance is highly
dependent on the regulation and maintenance of Mg homeostasis.
Moreover, exercise performance appears to be impaired under conditions
of Mg deficiency (Bohl, 2001). Significantly, in this context, a low dietary
intake of magnesium is very common in general population. Additionally,
there are categories of population that are even more predisposed to
hypomagnesaemia, for example, top athletes due to their increased
urinary and sudorific losses, and in the case of heavyweight disciplines,
due to a decreased dietary intake (Nica et al., 2015).
Magnesium is also involved in cortisol and adrenocorticotropin (ACTH)
regulation. Exercise causes the release of ACTH, which leads to the
increased production and release of cortisol. High levels of cortisol cause
the release of amino acids from muscle tissue and prevent absorption of
glucose, causing the catabolic breakdown of muscle tissue. Many cortisol
blockers can be used to prevent the catabolic breakdown of muscle
tissue, including leucine, antioxidants, and glutamic acid (Cinar et al.,

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2008). Magnesium regulates the secretion of cortisol, thus helping with
the uptake of glucose into muscle tissue. In addition, Mg is also
necessary for enzyme function and several biochemical reactions, since
the Mg requirement increases during exercise. The daily magnesium
requirment of high-performance athletes is estimated to be approximately
548 mg (Fogelholm et al., 1992). Nevertheless, the changes in Mg
requirements differ according to exercise type. In general, the Mg level
increases with exhaustion in high-intensity, short term exercise but
decreases with exhaustion in intense, long term exercise (Rayssiguiery et
al., 1990).
The above-mentioned energy sources are effective in dealing with the
changes occurring within the athletes’ skin due to fatigue. Therefore, the
responses of the energy sources cannot be understood effectively
without prior understanding of the physiology of the skin.
1.1.3 Physiology of the skin
Skin is the largest organ in the human body accounting for 7% of body
weight and is also the organ most exposed to external stress and foreign
particles. The skin not only acts as protective barrier but also plays a vital
role in maintaining homeostasis through physiological and immunological
processes (Marks, 2004). The structure of skin is broadly classified into
three main layers: the epidermis, the dermis, and the subcutaneous
tissue. The outermost layer is the stratum corneum (SC) that protects the
epidermis and is formed due to cornification of granular cells. In normal
skin, the SC is formed by continuous replacement from the newly

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differentiated daughter cells of keratinocyte stem cells displacing
outwards (Denda, 2000; Nohynek et al., 2007). The epidermis is made of
several layers of cells at different stages of differentiation and is
approximately 120 µm thick containing 70% of the total water content of
the skin (Forslind et al., 1997; Egawa et al., 2007; Marks, 2004). The
major cell types found in the epidermis are keratinocytes (90-95%), along
with melanocytes, Langerhans cells and Merkel’s cells (Tortora et al.,
2005). The layers in the epidermis are the stratum granulosum, stratum
spinosum and stratum basale which is followed by the dermal layer. The
epidermis also contains nerve endings, hair follicles and sweat glands,
thus integrating the skin along with the nervous and immune system in
order to achieve homeostasis (Tortora et al., 2005). For this reason, the
transdermal route for magnesium uptake was selected as the basis for
the current investigation.
1.4 Transdermal route of magnesium and its effects on skin
Transdermal delivery is one of the important and well-characterized
routes of administration for treatments that have local and systemic
effects. Permeability of magnesium ions could be dependent on
pathways associated with appendages, the hydrated condition of skin
and integrity, or lack thereof, of the stratum corneum (Chandrasekaran et
al., 2014). The main pathways involved in transport of substances across
the stratum corneum contributing to percutaneous absorption are bulk
diffusion, shunt diffusion and the intercellular route (Tortora, 2005). Lipid-
soluble substances penetrate through the lipid-rich membrane. Small,

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water-soluble molecules are able to enter through the pores created by
protein subunits in the lipid membrane (Tortora, 2005).
Magnesium is believed to be the key component involved in ameliorating
or subduing an inflammatory response. Indeed, evidence suggests
increased levels of systemic magnesium through oral supplementation or
diet can prevent a range of inflammatory disorders (Malpuech-Brugère et
al., 1999; Mazur et al., 2007). However, the effect of topical magnesium
application on barrier function and epidermal integrity of human skin is
less understood. In order for topically applied magnesium to be effective
in treating inflammatory skin conditions, transport of its ions across the
stratum corneum is a critical precondition. The stratum corneum under
normal circumstances would repel magnesium, however, with hydration
and temperature change and the assistance of transmembrane proteins,
magnesium ions can easily transport through membrane (Goytain &
Quamme, 2005; Sahni et al., 2007). Past studies on magnesium and
other metal ion permeation through human skin demonstrated that it is
not readily absorbed under normal physiological conditions, when the
skin is intact and healthy (Lansdown, 1995 Jahnen-Dechen, 2012)
However, there is a considerable body of anecdotal and research data
concerning magnesium’s role in skin barrier and epidermal recovery after
damage (Proksch, 2005). In the case of a compromised stratum
corneum, the viable epidermis and nerve endings in the atopic dermatitis
(AD) are exposed to incoming particles and chemicals (Takano, 2005;
Washington, 2001). Consequently, there is no effective barrier to restrict
the movement of Mg ions to epidermal cells or nerve endings, thus

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permitting a role for Mg in skin recovery and modulation of the immune or
nervous systems (Proksch, 2005).
A review article by Lansdowne reported that magnesium, in the form of
hydrous polysilicate (talc), is not readily absorbed by normal skin;
however, commonly used therapeutic formulations of magnesium utilize
other salts such as chloride or sulphates due to their different absorption
kinetics, such as solubility and permeation coefficients (Lansdowne,
1995). Another factor influencing percutaneous absorption of Mg ions
through skin is the negative charge carried on the surface of tissues; it is
likely that the positively charged Mg ions can be absorbed on the
negatively charged stratum corneum enhancing the retention time and
bioavailability on the skin surface (Piemi, 1999). In relation to Dead Sea
therapy on normal human skin, the high salt concentration coupled with
the hydrated state of the skin could together cause an osmotic effect
(Hirvonen, 1998), leading to an increased flux of ions through the skin
due to the concentration gradient across the skin. However, in
commercially available topical Mg formulations it is likely that penetration
enhancers would be necessary in order to enhance passage through the
SC layer in normal skin. The role of these enhancers is to penetrate the
skin, reversibly decrease the barrier resistance of the stratum corneum
and to create a water equilibrium between the stratum corneum and
viable epidermis (Williams, 2012).
1.2 Research opportunity
Cycling as a crucial exercise is heavily prone to the loss of energy

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sources and fatigue. Specifically, the presence of post-training fatigue
(PTF) in female cyclists can have an impact on mood and stress
responses. Dehydroepiandrosterone sulphate (DHEA-S) and cortisol can
be negatively impacted by high endurance cycling, contributing to poor
recovery (Bouget et al., 2006). Magnesium has been shown to increase
DHEA and cortisol levels in training. Transdermal methods of delivery are
widely used, as they allow the absorption of minerals directly through the
skin (Sircus, 2011). A recent study undertaken by Piccini et al. (2015)
showed that the administration of transdermal Mg is effective. The
majority of Mg studies are performed by detecting serum Mg
concentrations, which does not consider intracellular uptake (Piccini et
al., 2015). Transdermally applied Mg readily penetrates the skin and
enters the underlying microvasculature producing high concentrations of
Mg in the muscle, while minimizing systemic absorption. Accordingly, the
Mg is delivered directly to the target location, underlying muscle that is in
spasm, to produce localized, immediate relief and not systemic benefits,
since the goal is not to deliver Mg into the circulatory system (Pagliaro,
2013).
In certain situations, when oral supplementation is not an option,
transdermal application of Mg is viable. Transdermal delivery bypasses
the digestive system avoiding any issues of oral Mg side effects (Watkin
et al., 2010), allowing for an increased absorption of Mg to the site of
application. Furthermore, the transdermal application of Mg as a chloride
salt is an effective way to replenish cellular Mg levels since every cell in

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the body bathes in it. In addition, transdermal Mg may also increase
dehydroepiandrosterone (DHEA) levels (Niculescu, 1983).
1.3 Research Aim and Objectives
There have been numerous studies on the role of transdermal Mg in
sports generally. Previous studies have identified that the decrease in
plasma Mg during exercise is due to a transient shift of Mg from
extracellular fluid to skeletal muscle tissue. Based on the findings of prior
studies on the general effectiveness of the transdermal route of
magnesium, the current study aims to investigate if transdermal
application of magnesium can help manage the symptoms of post-
training fatigue in cyclists.
1.4 Research Significance
The current research findings are theoretically significant in
understanding the effects of transdermal application of magnesium in
post-training fatigue. By using primary and secondary data, the study
identifies the major types of fatigue in exercise and training fatigue in
cyclists. Oral magnesium has been used previously for muscular fatigue
in training; however, the role of transdermal magnesium is relatively new,
with little research showing the efficacy of magnesium used topically. The
current research will further the understanding of the application of
magnesium for the treatment of post-training fatigue in cyclists.
1.5 Research Layout
The thesis is divided into five key chapters. Chapter 2 is the literature
review, describing the use of magnesium in topical applications and in

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sports, the role of transdermal magnesium in inflammatory conditions and
the application of transdermal in exercise. Chapter 3 comprises the
methodology, presenting the research design for data collection and
analysis. The study results and analysis are presented in chapter 4 and
chapter 5 offers a comprehensive discussion on the findings of primary
study data in light of the literature reviewed. Finally, the conclusion and
recommendations are outlined in chapter 6.
CHAPTER 2: LITERATURE REVIEW
2.1Introduction
This chapter critically reviews the research findings to develop a
theoretical framework of the research, investigating the aetiology of
muscle cramps during exercise, effects of strenuous exercise and
applications of magnesium in sports.
2.2Aetiology of skeletal muscle cramps during exercise
To understand the application of magnesium for exercise related fatigue,
it is important to first understand the aetiology of skeletal muscle cramps.
This discussion will develop a base for the subsequent literature review.
The aetiology of exercise-associated muscle cramps (EAMC), defined as
‘painful, spasmodic, involuntary contractions of skeletal muscle during or
immediately after physical exercise’ (Schwellnus, Derman, & Noakes,
1997), has not been well investigated and is therefore poorly understood.
It has been associated with heat, humidity, dehydration, and electrolyte
imbalance (Schwellnus et al., 1997).

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A study by Bergaron (2008) showed that there are two distinct and
dissimilar general categories of EAMCs. Skeletal muscle overload and
fatigue can prompt muscle cramping locally in the overworked muscle
fibres, these cramps can be treated effectively with passive stretching
and massage or by modifying the exercise intensity and load. In contrast,
extensive sweating and a consequent significant whole-body
exchangeable sodium deficit caused by insufficient dietary sodium intake
to offset sweat sodium losses can lead to a contracted interstitial fluid
compartment and more widespread skeletal muscle cramping, even
when there is minimal or no muscle overload and fatigue (Bergaron,
2008). Signs of hyperexcitable neuromuscular junctions may appear first
as fasciculation during breaks in activity, which eventually progress to
more severe and debilitating muscle spasms. Notably, affected athletes
often present with normal or somewhat elevated serum electrolyte levels,
even if they are salty sweaters because of hypotonic sweat loss and a fall
in intravascular volume. However, recovery and maintenance of water
and sodium balance with oral or intravenous salt solutions is the proven
effective strategy for resolving and averting EAMCs that are prompted by
extensive sweating and a sodium deficit (Bergaron, 2008). With
exertional heat cramps, an athlete typically has been sweating
extensively with appreciable sweat electrolyte losses as well, particularly
sodium and chloride. Whether during a single long race, match, game or
training session or consequent to multiple same or repeated day exercise
bouts, a sizeable whole-body exchangeable sodium deficit develops
when sweat sodium and chloride losses measurably exceed salt intake

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(Stofan et al., 2005). Electrolytes also are lost in sweat to a much lesser
degree and several of these, namely calcium, magnesium, and
potassium, have been falsely implicated as the cause of muscle cramping
during or after exercise when purported deficiencies are suspected
(Maughan et al., 2004). Nonetheless, exertional heat cramp-prone
athletes characteristically develop a sodium deficit because their sweat
sodium and chloride losses are not offset promptly and sufficiently by
dietary intake (Stofan et al., 2005).
The effect of exercise on the distribution and excretion of magnesium has
been studied extensively. Reviews of these studies found that exercise
resulted in a redistribution of magnesium in the body, with the type of
exercise and magnesium status influencing the nature of this
redistribution (Laires, 2001). Earlier studies indicated that short-term high
intensity exercise transiently increased plasma or serum magnesium
concentrations by 5-15%; the concentrations returned to baseline within a
day. The increase was associated with a decrease in plasma volume.
Earlier studies have also found that sustained moderate physical exercise
(80 km march of 18-hour duration (Stendig-Lindberg, 1999) and short-
term high intensity (anaerobic) exercise increased serum magnesium
concentrations. Instead of decreased plasma volume, muscle breakdown
was suggested as the cause of increased serum magnesium found
shortly after exercise and the finding of a concomitant small increase
supported this suggestion in serum creatine kinase activity. Another
possible contributor to the increased serum or plasma magnesium is the

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transfer of magnesium from muscle to the extracellular fluid during
contraction, similar to that known for potassium (Meludu, 2001).
However, another hypothesis regarding the development of EAMC
suggests skeletal muscle cramp develops because of an abnormal
heightened increase in motor neuron activity during fatigue (Schwellnus,
Drew, & Collins, 2008). This increase is thought to occur due to changes
in muscle receptor activity associated with fatigue and inner range
muscle contraction. Muscle spindle activity has been shown to increase
and Golgi tendon organ activity decreases in a fatiguing muscle.
Furthermore, contraction of a muscle in its inner range between full
flexion and extension is associated with decreased Golgi tendon organ
discharge. Collectively, these changes in muscle receptor activity
potentially result in an imbalance between facilitatory and inhibitory
feedback. This imbalance results in excitation of the motor neurons,
which leads to cramp (Schwellnus, Drew, & Collins, 2008).
From the analysis of muscle cramp aetiology, it becomes clear that
cramps and muscle imbalance caused by fatigue could have a severe
impact on magnesium concentrations. The next section of the literature
focuses on how the past studies have analysed the effects of strenuous
exercise on intramuscular magnesium concentrations.
2.3The effects of strenuous exercise on intramuscular magnesium
concentrations
Numerous studies, such as marathon running, long distance cross-
country skiing, cycle ergometry, swimming and tennis have examined the

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effects of exercise on intracellular blood, urine, sweat and muscle
magnesium levels (Newhouse et al., 2000). Overall, studies have found
that submaximal exercise leads to hypomagnesemia, a transient
decrease in plasma Mg concentrations. Magnesium deficiencies reduce
physical performance and the Mg state may have an effect on exercise
capacity (Newhouse et al., 2000). Cellular levels of ATP and creatine
phosphate appear to become rapidly depleted with Mg deficiency (Bohl et
al., 2002). Approximately half of the total body magnesium is found in the
soft tissue, 7 and 9 mmol of Mg per kilogram of wet tissue is found in
skeletal muscle and liver respectively (Saris et al., 2000), while free Mg
ranges from 0.3 and 3.0 mmol/L. A study found that small changes in the
total cell Mg may affect larger changes in the free Mg (Diler et al., 2015).
Decreases in Mg during exercise have been linked to possible shifts of
Mg from the extracellular fluid to skeletal muscle; the Mg content in
exercising muscles appear to increase slowly, paralleled by a decline in
plasma Mg concentration. This suggests that a reduction in serum Mg
reduction is due to the redistribution into muscle during heightened
metabolic need (Diler et al., 2015).
2.4Applications of magnesium in sports
Studies have shown that magnesium may have an effect on athletic
ability and performance, having a positive effect on sporting performance
(Lukaski, Bolonchuk, Klevay, Milne & Sandstead, 1983; Brilla & Haley,
1992; Brilla & Gunter, 1995). Whilst contradicting literature suggests that
Mg supplementation has no effect or a negative effect on performance
(DeHann et al., 1985; Weight et al., 1988; Ruddell et al., 1990;

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Terblanche et al., 1992; Weller et al., 1998.)
Magnesium has been shown to be essential for a wide variety of cellular
activities and is necessary for maintaining optimal muscle performance
and muscle contraction (Dominguez et al., 1992). It has also been shown
to significantly increase muscle strength in young subjects (Brilla & Haley,
1992). Rodrigues et al. (2003) stated that studying the performance for
different intensities might help understand the behaviour of different
muscle groups and different fitness levels.
Brilla and Gunter (1995) conducted a double blind four-week crossover
design study on 20 females and 12 males (very active). After
consumption of either placebo or Mg supplementation (314 mg/day),
subjects completed an exercise trial, which involved performing
contractions on an isometric leg dynamometer until exhaustion. After
another four weeks of supplementation, subjects returned for a second
isometric leg trial to exhaustion. They reported that there was a
significant increase in time to fatigue when Mg was compared to placebo,
suggesting that Mg is effective in increasing the time to fatigue on a leg
dynamometer. However, Brilla and Gunter (1995) failed to provide
subjects with a washout period between interventions, which may have
had a negative effect on their findings, as Mg levels may not have
returned to baseline for the group taking placebo as their second
intervention (Brilla & Gunter, 1995).
Studies have shown that substantial redistributions within the body may
occur during bouts of exercise, resulting in loss of Mg (Lukaski, 2000).

xxvi

Deuster et al. (1997) concluded that the direction and magnitude of Mg
redistribution in the circulation was influenced by the intensity of the
exercise. They stated that the greater the energy requirement from
anaerobic or glycolytic metabolism, the greater the translocation of Mg
from the serum to the red blood cells. Terblanche et al. (1993) assessed
the effects that Mg supplementation may have on performance in a
marathon race. Twenty athletes were divided equally into two matched
groups and were assessed four weeks prior to the event and six weeks
post event. The trial was double blind with the experimental group
receiving 365 mg of Mg daily. It was reported that Mg supplementation
did not increase either muscle or serum concentrations following blood
samples and muscle biopsies, consequently resulting in no positive effect
on marathon performance. The lack of increase may be related to the
level of Mg provided to subjects; 365 mg daily may have not been
adequate to promote a significant response (Terblanche et al., 1993).
A study by Golf and his co-researchers on female rowers, who were
given magnesium supplements or a placebo for 3 weeks, showed that the
athletes consuming Mg had lower activities of total serum creatine kinase
and creatine kinase isoenzyme from skeletal muscle after training in
comparison to the placebo group. Furthermore, it was also reported that
the Mg supplementation group had lower serum lactate concentrations
and 10% lower oxygen uptake when performing a sub-maximal
performance trial, concluding a positive impact on sports performance
(Golf et al., 1993). Ripari conducted a similar trial in which participants
were given 250 mg of Mg supplement or a placebo. The cardiorespiratory

xxvii

function improved in the Mg during a 30-minute exercise, suggesting that
Mg supplementation improved metabolism and exercise efficiency (Ripari
et al., 1993).
Nutritional supplementation is a well-established method for enhancing
performance in conjunction with training. Micronutrient intake has been
highlighted to gain greater prominence with athletes in relation to the
importance of an adequate nutritional status (Lukasaki, 1995). However,
previous research highlights nutritional inadequacies and thus, an
impaired nutritional status for both the athlete and the general population
(Lukasaki, 1995). This identifies physical activity as increasing the rate at
which micronutrients are utilised, promoting excessive micronutrient loss
via increased catabolism and excretion (sweat and urine). Magnesium is
a mineral required at rest and during exercise (Uzun, 2013).
Kass et al. (2015) determined whether either acute or chronic Mg
supplementation would have an effect on performance (strength and
cardiovascular) and blood pressure with exercise and/or on a second
bout of exercise after a 24 hour recovery period. Acute Mg
supplementation had a positive effect on blood pressure, plyometric
parameters and torque; however, there was no effect on resistance
exercise (Kass et al., 2015). Further chronic loading strategies have not
been investigated with respect to exercise as well as the effect of Mg
supplementation on a second bout of exercise. It was hypothesised that
as acute Mg supplementation has been shown to have beneficial effects
on blood pressure, cardiovascular parameters and peak torque, a longer

xxviii

loading strategy (4 weeks) would enhance these results giving a more
beneficial and greater response. However, this study did not find that
chronic loading of Mg has a cumulative effect on the effect of
supplementation (Kass et al., 2015), perhaps due to saturation of Mg
within the blood or limitations to transporters (Setaro, 2014). The
importance and applications of Mg in exercise and sports further highlight
the need for maintaining the Mg status based on the excretion process
with an underlying aim to avoid cramps and fatigue.
2.5Maintaining magnesium status
To maintain an adequate Mg status, it is said that humans must consume
Mg at regular intervals (Jahnen-Dechent & Ketteler, 2012). There is
confusion regarding the daily allowance of Mg, although values of ≥ 300
mg are usually reported with adjustment dosages for age, sex and
nutritional status (Jahnen-Dechent & Ketteler, 2012). The Committee on
Medical Aspects (COMA) has calculated a RNI of 300 mg/day for adult
males and 270 mg/day for adult females (COMA, 1991). Magnesium can
also be acquired through drinking water; approximately 10% of daily
intake can be achieved in this way (Fawcett 1999). Magnesium is plentiful
in green leafy vegetables, which are rich in magnesium-containing
chlorophyll, cereal, grain, nuts and legumes, with chocolate, vegetables,
fruits, meats and fish having intermediate levels and dairy products being
poor in magnesium (Fawcett, 1999). In general, the intake of magnesium
is directly related to energy intake, except when the majority of the
energy comes from refined sugars or alcohol. Refining or processing of
food may deplete magnesium content by nearly 85%. Furthermore,

xxix

cooking, especially boiling of magnesium-rich foods, will result in a
significant loss of magnesium (Fawcett, 1999).
2.6Magnesium absorption and excretion
The absorption of magnesium commences approximately 1 hour after
consumption and continues at a uniform rate for 2-8 hours. After 12 hours
of ingestion, the material will normally be in the large bowel, which
absorbs very little magnesium. The absorption of magnesium in the small
intestine is inversely related to consumption levels; when a diet low in
magnesium is consumed up to 75% of that ingested magnesium may be
absorbed, whilst when consuming a diet rich in magnesium as little as
25% may be absorbed (Kayne, 1993).
The major excretory pathway for absorbed magnesium is via the kidneys
(Yu, 2001), with a rate of 120 to 140 mg/24 h for a person consuming a
diet adequate in magnesium (Wacker, 1980; Aikawa, 1981).
Consequently, the amount of magnesium absorbed in the small intestine
is similar to the amount excreted by the kidneys.
2.7Role of transdermal magnesium in inflammatory conditions
Transdermal absorption is a potentially important route of transport for
components that are involved in biological processes (Brisson, 1974).
Moreover, the transport of magnesium across skin is a critical
precondition for the function of topical therapeutic compounds in treating
skin and inflammatory diseases. Dead Sea therapy is one of the oldest
forms of therapies to treat inflammatory conditions, including joint disease
and arthritis (Sukenik et al., 2006). Much of the research to date has

xxx

attributed the clinical effects of Dead Sea therapy to its mineral
composition; mostly to magnesium salts (Shani et al., 1991; Proksch,
Nissen, & Bremgartner, 2005). Magnesium salts, such as magnesium
sulphate (Epsom salts), have long been used as a spa product and
therapeutically to manage clinical conditions (Durlach et al., 2005).
Consequently, transdermal magnesium has been shown to be effective in
managing the clinical conditions associated with the exercise-related
cramps, inflammatory conditions and fatigue developed during exercises
and sports. Thus, the literature reviewed substantiates the importance of
current primary investigation of transdermal magnesium for the post-
exercise fatigue in cyclists. The next chapter presents the research
methodology for the current study.
CHAPTER 3: METHODS AND METHODOLOGY
3.1 Introduction
The selection of a suitable and feasible research methodology was very
important for examining the transdermal effects of the magnesium on the
post-exercise fatigue in cyclists. It has been mentioned earlier (chapter
1), that there are range of academic studies which have investigated the
application of transdermal magnesium in sports; the methods and
materials used in this study are adapted from an earlier study conducted
by Waring (2011).

xxxi

3.2 Development of the trial
The purpose of Waring’s research (2011) was to examine if cellular
magnesium levels are increased with the absorption of the magnesium
sulphate through the skin. The methodology critically informed the current
investigation’s design, methods and rationale. In addition, the sampling
process adopted by Waring was also helpful for the quantitative data
design and primary sample selection in the present study. The inclusion
criteria for present study were subjects who do not smoke more than five
cigarettes per day and who not drink more than two units of alcohol daily.
The subjects were aged from 24 to 64 years. The magnesium levels pre-
and post-exercise fatigue in the cyclists’ blood and urine were measured
using the flame photometric method, with magnesium nitrate as a
reference standard.
Subsequent to the initial pilot studies, actual and complete investigation
was carried out. All volunteers bathed in water containing varying
amounts of magnesium sulphate (Epsom salts) in a completely soluble
condition (Waring 2011) for 12 minutes, with a temperature range of 50-
55o
C. Blood samples were collected before the first bath, at 2 hours after
the first bath and at 2 hours after the 7th
consecutive bath. The
experiments lasted for seven days. Participants were asked to take daily
baths at the same time for the seven days of the experiment. Similarly,
urine sample were also taken 24 hours after the last bath. The correction
of all the urine samples was made using the creatinine content (Waring
2011).

xxxii

The findings of Waring (2011) study showed statistically significant
results for the current investigation. She found significant magnesium
levels in the subjects’ blood. Out of the 19 subjects, 16 exhibited an
increase in magnesium concentrations in plasma while three (3)
participants did not show presence of any such concentrations. These
concentrations were presented in small portion. The values collected
before the first bath showed mean of 104.68 ± 20.76 ppm/ml, after the
first bath the mean was 114.08 ± 25.83 in urine ppm/ml. In continuing
bathing for 7 days in all except two (2)participants gave an increase to
the mean of 140.98 ± 17.00ppm/ml. The results reveal that the
statistically significant increase in blood magnesium concentrations was
the consequence of prolonged soaking of skin in Epsom salts (Waring
2011).
Additionally, measurement of the magnesium levels in urine showed an
increase from the control level, mean 94.81 ± 44.26ppm/ml to 198.93 ±
97.52 ppm/ml after the first bath. The results further revealed that those
individuals with results of no increase in magnesium concentration in
blood have shown significant increase in the urinary magnesium levels
(Waring 2011). The experimental results revealed that magnesium ions
crossed the skin barrier. Further, these ions were excreted by way of the
kidney. Such secretion might be the consequence of the optimal blood
levels. In contrary to the blood magnesium levels, urinary magnesium
levels fell after 24 hours the first bath from the initial values found (mean
118.43 ± 51.95). The results suggested the presence of magnesium in
tissues after bathing (Waring 2011). However, measuring magnesium

xxxiii

levels in urine 24 hours after the seventh (7th
) bath returned the values
almost back to the control levels. Thus, Waring (2011) concluded that
magnesium sulphate is capable of increasing the serum magnesium
levels in the body. By using the similar methods and materials, the
procedure for the current investigation was designed. The recruitment
and data collection process in this study is highly consistent with the
previous research. The next section of the chapter presents ethical
considerations taken into account in this study.
3.3 Ethical considerations
For all academic research, it is extremely important to follow the set of
official ethics guidelines to increase the credibility of research. Before
choosing the methods, materials and procedures for the current
investigation, the ethics checklist of the University of Worcester was
considered, such as informed consent, administration of any substances,
invasive procedure, foreseeable risk, collection of, sensitive/confidential
data, deception, testing of animals and others (refer to Master
Dissertation Handbook April, 2013, p. 21).
All the subjects submitted the participants’ information sheet, written
consent form, approved questionnaire and the 3-day food diary of the
University after completion but before entry into the trial. The purpose of
the food diary was to assess the current dietary magnesium levels of the
participants and was necessary to ascertain the participants’ eligibility for
the magnesium oil trial. Additionally, BANT guidelines (British Association
of Nutritional Therapists) were used for assigning participants’ ID
numbers in order to ensure participant confidentiality and anonymity by

xxxiv

assigning numeric identities to the recruits. The participant number, the
questionnaires and the consent forms were collected for each participant
and kept locked in a secured filling cabinet for confidentiality (Data
Protection Act - Worcestor University, 2016).
3.4 Participants
The study sample consisted of 10 participants, of which 6 were males
and 4 were females, recruited from the local cycling club through social
media, contacts and through mutual connections. Sampling was
conducted using one-to-one as well as open discussion forum methods.
All subjects interested in participating in the study were mailed a
participation information sheet after their initial contact.
3.5 Procedure
In order to measure the fatigue levels of the research participants, they
were given consent forms to sign, 3-day food diaries, participation
information sheets and the approved questionnaires for measuring
fatigue levels during the trial. The questionnaire was divided into
response statements, i.e. pre- and post-exercise periods. The
Hecimovich-Peiffer-Harbaugh Exercise Exhaustion Scale (HPHEES) was
used for testing participants’ responses (Payne, 2014). Participants were
also asked to fill in a questionnaire prior to trial entry to determine levels
of post-training fatigue. Subsequently, they were assigned a specific date
for starting the trial after submission of their completed food dairy. During
the process, one female recruit was replaced with a male colleague
because she was unable to participate in the study due to illness. The

xxxv

same procedure for obtaining informed consent and completion of the 3-
day diary was performed for the new recruit.
The food diaries were assessed using the Nutrics database. Diaries have
been shown to be an effective and result-oriented tool for data collection
in nutritional investigations, being highly reliable for investigating activities
or events which are expected to change over time, such as magnesium
level and transdermal absorption (Wiseman et al., 2005). The reliability
and validity of the tool was considered using a test-retest approach and
software was used to analyse the dietary vitamin and mineral intake.
During the assessment, one recruit was excluded due to high dietary
magnesium levels of 320 mg daily. The ethics committee approved the
maximum dietary levels of magnesium and according to their criteria, the
maximum daily dietary levels could not exceed 150 mg (Expert group
vitamins and minerals, 2003). This subject was replaced by another
participant as before. Similarly, another participant quit the study due to
the heavy work pressures. Thus, in total, 8 males and 2 females
participated in this study.
The participants were contacted regularly through emails and by phone to
maintain their interest and encourage their participation. During the trial,
one participant reported a virus, causing their participation to be
postponed for 3 weeks.
3.6 Reflection on the recruitment process
The recruitment process was a unique experience for me due to the
challenges and issues encountered. Prior the start of study, I assumed

xxxvi

the recruitment process to be relatively easy. However, the real
experience was completely different from anticipated; the selection of
appropriate participants to study the post-training fatigue was difficult as
the researcher was required to consider the participants’ expectations
and routine. Similarly, the eligibility criteria of the participants were
difficult to match with the guidelines of the ethical committee.
Measurement of the pre-trial magnesium levels of the participants
consumed much of the time. The challenges faced during this recruitment
process helped in shaping a learning curve for me.
CHAPTER 4: EMPIRICAL RESULTS INTERPRETATION
4.1 Introduction
This chapter presents and interprets the empirical results collected from
five participants to measure the pre- and post-exercise results in order to
assess if the transdermal application of magnesium can help manage the
symptoms of post-training fatigue in cyclists. The primary data was
collected from five cyclists at three different time points within a six week
period, i.e. week 2, week 4 and week 6 for both the pre- and post-
exercise conditions. The data was collected and assessed using the 14
different symptoms of post-training fatigue for the better representation of
the effects of the transdermal application of magnesium in the
management of these 14 symptoms. These symptoms included recovery,
energy, refreshness, easiness, physically drained, replication of last
game event, more training, weak legs and arms, muscle ache, mental
sharpness, relax, mentally drained, easy walk and mentally cloudy. For

xxxvii

each symptom, weekly analysis of the sample group was conducted and
the pre- and post-exercise data used for calculating correlation and
regression for the sample group.
4.2 Weekly results of pre- and post-exercise symptoms
4.2.1 Pre- and post-exercise results: Week 2
Week 2 was the first period when the five cyclists recorded their
individual pre-exercise responses for the fourteen symptoms before using
the magnesium oil (see appendix). Some components of the exercise
fatigue showed a strong negative correlation, such as recovery (-0.702),
easiness (-0.617) and mentally drained (-0.696), while others displayed a
moderate negative correlation, such as post-exercise energy (-0.441),
refreshness (-0.58), replication of last game event (-0.306), muscle ache
(-0.481), and mental sharpness (-0.484). Such negative correlation
shows that despite the use of oil in the post-exercise period, there was an
adverse effect on the cyclists’ fatigue and exhaustion in week 2. These
results are in line with the secondary data literature (DeHann et al., 1985;
Weight et al., 1988; Ruddell et al., 1990; Terblanche et al., 1992; Weller
et al., 1998). The low positive correlation between the use of magnesium
oil and post-exercise fatigue in week 2 can be better understood by the
analysis of secondary literature (Lansdown, 1995; Jahnen-Dechen,
2012). The week 2 results substantiate these findings, highlighting that
the oil is not readily absorbed under normal physiological conditions,
when the skin is intact and healthy.

xxxviii

Additionally, 4 out of the 14 components showed a positive but weak
correlation between the use of oil and post-exercise fatigue. The use of
magnesium oil, to a certain extent (0.189), allowed the participants to
pursue more training and walk easily after cycling.
4.2.1.1 Correlation Analysis
Table 1: Week 2 Correlation Analysis - Pre and Post Exercise
Fatigue
Week 2 Pearson Correlation
Pre-
Exercise
Post-
Exercise
Recovery 1 -0.702
Energy 1 -0.441
Refreshness 1 -0.58
Easiness 1 -0.617
Physically drained 1 0.238
Replication of last game
event 1 -0.306
More training 1 0.189
Weak legs and arms 1 0.358
Muscle Ache 1 -0.481
Mentally Sharpness 1 -0.484
Relax 1 -0.17

xxxix

Mentally Drained 1 -0.696
Easy Walk 1 0.157
Mentally cloudy 1 -0.596


0
1
2
3
4
5
6
7
8
9
10 Week 2: Recovery among all participants
Pre Recovery
Post Recovery
0
2
4
6
8
10 Week 2: Energy among all participants
Pre Energy
Post Energy

xl

Figure 3: Week 2: Refresness among all participants


0
1
2
3
4
5
6
7
8
9
10 Week 2: Refresness among all participants
Pre Refreshness
Post Refreshness
0
1
2
3
4
5
6
7
8
9
10
1 2 3 4 5
Week 2: Easiness among all participants
Pre Easiness
Post Easiness
0
1
2
3
4
5
6
7
8
9 Week 2: Physically drained among all
participants
Pre Physically
drained
Post Physically
drained

xli


Figure 7: Week 2: Increased training among all participants

0
1
2
3
4
5
6
7
8 Week 2: Replication of last game event among
all participants
Pre Replication of
last game event
Post Replication of
last game event
0
1
2
3
4
5
6
7
8
9 Week 2: Increased training among all
participants
Pre Increased
training
Post Increased
training
0
1
2
3
4
5
6
7
8 Week 2: Weak legs and arms among all
participants
Pre Weak legs and
arms
Post Weak legs
and arms

xlii



0
1
2
3
4
5
6
7
8
9 Week 2: Muscle Ache among all participants
Pre Muscle Ache
Post Muscle Ache
0
1
2
3
4
5
6
7
8
9
10 Week 2: Mentally Sharpness among all
participants
Pre Mentally
Sharpness
Post Mentally
Sharpness
0
1
2
3
4
5
6
7
8
9
10 Week 2: Relax among all participants
Pre Relax
Post Relax

xliii

Figure 12: Week 2: Mentally Drained among all participants

Figure 14: Week 2: Mentally cloudy among all participants
0
1
2
3
4
5
6
7
8
9 Week 2: Mentally Drained among all
participants
Pre Mentally
Drained
Post Mentally
Drained
0
2
4
6
8
10
12 Week 2: Easy Walk among all participants
Pre Easy Walk
Post Easy Walk
0
1
2
3
4
5
6
7
8
9
10 Week 2: Mentally cloudy among all
participants
Pre Mentally
cloudy
Post Mentally
cloudy

xliv

4.2.1.2 Regression Analysis
Furthermore, in analyzing the effects of transdermal route of magnesium
in managing the post-exercise fatigue, the regression analysis results
were also calculated. The regression results given in the table below also
confirm the correlation results by highlighting that 10 coefficients are
negative influenced by the use of magnesium oil in the post exercise
fatigue. The negative regression coefficients indicate that with every one
unit (mg level) applied on the cyclists’ skin after the exercise, the post-
exercise fatigue among the cyclists increases significantly. Except ‘mostly
drained’, the regression coefficients of other post-fatigue variables were
insignificant
Table 2: Week 2 Regression Analysis - Pre and Post Exercise
Fatigue
Week 2
Regression
Coefficients
Post-Exercise
Fatigue
Recovery -1.5
Energy -1.188
Refreshness -0.912
Easiness -2.167

xlv

Physically drained 0.625
event -0.278
More training 0.357
Weak legs and arms 0.375
Muscle Ache -0.393
Mentally Sharpness -0.361
Relax -0.25
Mentally Drained -0.705
Easy Walk 0.147
Mentally cloudy -0.465
4.2.2 Pre and Post Exercise Results: Week 4
It is highly astonishing to see that the pre and post-exercise results of the
week 4 (refer to appendix week 4 results) were exactly similar to the
findings of week 2. There was no difference in the pre-exercise and post-
exercise fatigue even after two weeks of the cyclists. Bouget M et al
(2006) in their research have shown that DHEA-S and cortisol can be
negatively impacted by high endurance cycling and therefore decreased
DHEA and cortisol levels can contribute to poor recovery in the cyclists.

xlvi

Fatigue
Pre-
Exercise
Post-
Exercise
Recovery 1 -0.702
Energy 1 -0.441
Refreshness 1 -0.58
Easiness 1 -0.617
event 1 -0.306
More training 1 0.189
Weak legs and arms 1 0.358
Muscle Ache 1 -0.481
Relax 1 -0.17
Easy Walk 1 0.157
Mentally cloudy 1 -0.596

xlvii


0
1
2
3
4
5
6
7
8
9
Pre Recovery
Post Recovery
0
1
2
3
4
5
6
7
8
9
Pre Energy
Post Energy

xlviii


0
1
2
3
4
5
6
7
8
9
10 Week 4: Refreshness among all participants
Pre Refreshness
Post Refreshness
0
1
2
3
4
5
6
7
8
9
10 Week 4: Easiness among all participants
Pre Easiness
Post Easiness

xlix


0
1
2
3
4
5
6
7
8 Week 4: Physically drained among all
participants
Pre Physically
drained
Post Physically
drained
0
1
2
3
4
5
6
7
8
Week 4: Replication of last game event among
all participants
Pre Replication of
last game event
Post Replication of
last game event

l


0
1
2
3
4
5
6
7
8
9
Week 4: More training among all participants
Pre More training
Post More training
0
1
2
3
4
5
6
7
8 Week 4: Weak legs and arms among all participants
Pre Weak legs and
arms
Post Weak legs and
arms

li


0
1
2
3
4
5
6
7
8
9 Week 4: Muscle Ache among all participants
Pre Muscle Ache
Post Muscle Ache
0
1
2
3
4
5
6
7
8
9
10 Week 4: Mentally Sharpness among all
participants
Pre Mentally
Sharpness
Post Mentally
Sharpness

lii


0
1
2
3
4
5
6
7
8
9
Pre Relax
Post Relax
0
1
2
3
4
5
6
7
8
9
Week 4: Mentally drained among all
participants
Pre Mentally
Drained
Post Mentally
Drained

liii



Similarly, like the correlation analysis, the regression analysis showed the
statistically insignificant effect of the magnesium oil on the range of post-
fatigue components. Kayne (1993) pointed out that the absorption
process of the magnesium commences approximately 1 hour after
consumption, continuing at a uniform rate for 2-8 hours. The use of
magnesium in the present study gave contradictory results as the amount
absorbed by the participants returned to normal after two weeks. There is
0
2
4
6
8
10
12 Week 4: Easy walk among all participants
Pre Easy Walk
Post Easy Walk
0
1
2
3
4
5
6
7
8
9
Pre Mentally
cloudy
Post Mentally
cloudy

liv

a possibility that the application of transdermal magnesium oil was not at
the full strength of the oil. Low doses are generally used initially in the
sports industry and subsequently, the dose levels are increased to avoid
any kind of uncomfortable reactions. Therefore, in this context, the results
of the week 6 were crucial in determining whether the transdermal
application of magnesium can help manage the symptoms of post-
training fatigue in cyclists.
Table 4: Week 4 Regression Analysis - Pre and Post Exercise
Fatigue
Week 4
Regression
Coefficients
Post-Exercise
Fatigue
Recovery -1.5
Energy -1.188
Refreshness -0.912
Easiness -2.167
event -0.278
More training 0.357
Weak legs and arms 0.375

lv

Muscle Ache -0.393
Relax -0.25
Easy Walk 0.147
Mentally cloudy -0.465
4.2.3 Pre and Post Exercise Results: Week 6
The correlation analysis results for Week 6 (refer to appendix week 6
results) show remarkable improvements in the components of the post-
exercise fatigue among the individuals. In contrast to the week 4 results,
week 6 results show strong moderate and weak positive correlations
among the dependent and independent variable. These results are in line
with previous studies by Lukaski, Bolonchuk, Klevay, Milne and
Sandstead (1983), Brilla and Haley (1992), and Brilla and Gunter (1995).
Niculescu (1983) also stated that transdermal magnesium may increase
DHEA levels.
By focusing on each of the fourteen components of post-exercise fatigue,
the effects of magnesium oil on managing fatigue in the cyclist can be
examined more effectively. For recovery, week 6 (0.323) results showed
positive and moderate correlation relative to the strong negative
correlation detected in week 2 and week 4 (-1.5). Kass et al. (2015) in
their secondary study also confirmed the effect of transdermal

lvi

magnesium on blood pressure, plyometric parameters and torque within
a 24 hour recovery period. These authors have already justified that a
longer loading strategy is required for gaining beneficial results in the
cumulative recovery of the fatigue effects in the transporters.
Secondly, post-exercise energy (0.312) also showed a moderately
positive correlation in week 6. It means that with the increased application
of the transdermal magnesium oil, the participants were able revive their
energies, similar to that reported by Fawcett (1999). Previous studies
have provided evidence to confirm that that magnesium controls body
energy by positively affecting enzyme function and several biochemical
reactions, therefore a much higher intake of the magnesium can also be
effective after exercise.
Thirdly, the refreshness component showed a strong and positive
correlation in showing the high effects of the magnesium oil on the post-
exercise fatigue. Durlach et al. (2005) confirmed that magnesium salts,
such as magnesium sulphate (Epsom salts) which have long been used
as a spa product and as a therapeutic to manage clinical conditions, can
refresh individuals.
The fourth component, easiness, also showed a strong and positive
correlation (0.699) between the research variables. The participants were
easy going with other tasks after the transdermal application of
magnesium in the post-exercise period. Schwellnus et al. (1997) have
substantiated that exercise associated muscle cramps are common
causes of fatigue and are almost experienced by every exerciser. These

lvii

cramps can lead to the painful, spasmodic, involuntary contraction of
skeletal muscle because of heat, humidity, dehydration, and an
electrolyte imbalance. It becomes difficult for the exerciser to show
easiness due to such cramps.
The fifth component, physically drained, also showed a strong and
moderate correlation in the individual participants (0.327), suggesting that
the level of tiredness among the participants were decreased after the
transdermal application of the magnesium oil. Newhouse et al. (2000)
substantiated that magnesium deficiencies reduce physical performance
and the magnesium state may have an effect on exercise capacity,
causing tiredness. The application of the magnesium oil in the post-
fatigue period appears to be effective in reducing tiredness.
The sixth component, replication of last game event, also demonstrated a
weak but positive correlation between the research variables. In general,
exercise requires the collective working of the different systems in the
human body. There is a very low possibility that in the post-exercise
period, the participants were able to integrate all these functions
effectively to produce the desired results (Bequet et al., 2001). The
systematic changes in the body can only be maintained by meeting the
magnesium dependency of the individuals. Thus, the current research
results have also substantiated that magnesium oil has the capacity to
increase the pre- and post-exercise capacities of the cyclists to replicate
the last game event effectively by utilizing their cognitive and physical
competencies and efficiencies.

lviii

The seventh component, more training, showed a negative and weak
correlation (-0.129) in week 6 in comparison to the positive correlation
reported in weeks 2 and 4. With the passage of time, cyclists have
started showing the sizable whole body exchangeable sodium deficits
developing with the loss of sodium and chlorides through sweat.
Consequently, their salt intake was also increased and participants
showed less training and more rest in order to get a break from the
repeated exercise bouts. Thus, magnesium surplus in the body can also
place severe restrictions on the ability of the participants to revive and
become engaged in a study with repeated cycles (Bohl et al., 2002).
The eighth component of the post-exercise fatigue, weak legs and arms,
has also shown negative correlation in week 6 (-0.477), suggesting that
the transdermal application of the magnesium reduced the cyclists’ level
of weakness or fatigability. Such weaknesses are attributed to the over
exercising or training syndrome. However, despite extensive repeated
weekly exercises, cyclists did not complain of fatigue related with weak
arms and legs in the week 6. Nutritional supplementation is a well-
established method for enhancing performance in conjunction to training.
Like other energy sources in the body, the use of magnesium oil with the
exercising cyclists showed greater improvements in terms of the
improved working muscles to support exercise continuity (Bequet et al.,
2001).
The ninth component, muscle ache, has shown greater improvements in
week 6 with a moderate positive correlation. The results showed that
participants were very confident about their healthy muscle conditions

lix

despite heavy cycling. They did not have any concern with the pain in
their different muscles presented in different target locations. The
application of oil was helpful in considering, controlling and monitoring a
transient shift of magnesium from extracellular fluid to skeletal muscle
tissue.
In contrast, the tenth and eleventh components, mental sharpness and
relax, showed negative weak correlations. In week 6, participants
reported a decline in their mental sharpness. Secondary literature has
already substantiated that magnesium deficiency can lead to the changes
in mental status of the person. In these studies, the authors have
confirmed the brain as the biggest energy consumer in the body and
therefore with the increase in high intensity exercises, there is a decrease
in the brain concentration levels despite the application and use of
different supplementations (Bequet et al., 2001). With the decrease in
mental capacity to control, plan and regulate the actions, individuals are
also unable to relax.
With a decreased level of mental sharpness, ultimately mentally drained
(-0.286) and easy walk (-0.373) components of the post-exercise fatigue
also deteriorated in week 6 (Bequet et al., 2001; Lukaski, 2000). Lastly,
the correlation analysis results for fourteen components, mentally cloudy.
Deuster et al. (1997) stated that the greater the energy requirement from
anaerobic or glycolytic metabolism, the greater the translocation would be
of magnesium from the serum to the red blood cells.

lx

Pre-
Exercise
Post-
Exercise
Recovery 1 0.323
Energy 1 0.312
Refreshness 1 0.634
Easiness 1 0.699
event 1 0.101
More training 1 -0.129
Weak legs and arms 1 -0.477
Muscle Ache 1 0.571
Relax 1 -0.185
Easy Walk 1 -0.373
Mentally cloudy 1 0.156

lxi



0
2
4
6
8
10
Week 6: Recovery among all participants
Pre Recovery
Post Recovery
0
2
4
6
8
Pre Energy
Post Energy
0
1
2
3
4
5
6
7
8
9
10 Week 6: Refreshness among all
participants
Pre Refreshness
Post
Refreshness

lxii



0
2
4
6
8
10 Week 6: Easiness among all participants
Pre Easiness
Post Easiness
0
1
2
3
4
5
6
7
8
Week 6: Physically drained among all
participants
Pre Physically
drained
Post Physically
drained
0
1
2
3
4
5
6 Week 6: Replication of last game event
among all participants
Pre Replication
of last game
event
Post Replication
of last game
event

lxiii



Figure 37: Week 6: Muscle ache among all participants
0
1
2
3
4
5
6
7
8
9 Week 6: More training among all
participants
Pre More
training
Post More
training
0
1
2
3
4
5
6
7
8
9 Week 6: Weak legs and arms among all
participants
Pre Weak legs
and arms
Post Weak legs
and arms
0
1
2
3
4
5
6
7
8
9 Week 6: Muscle ache among all
participants
Pre Muscle Ache
Post Muscle
Ache

lxiv



0
2
4
6
8
10
Week 6: Mentally Sharpness among all
participants
Pre Mentally
Sharpness
Post Mentally
Sharpness
0
2
4
6
8
10
Pre Relax
Post Relax
0
1
2
3
4
5
6
7
8
9
10 Week 6: Mentally drained among all
participants
Pre Mentally
Drained
Post Mentally
Drained

lxv


Regression analysis of the week 6 also showed that transdermal
application of the magnesium oil on the skin of the individuals was helpful
in predicting the effects on the components of the post-fatigue exercise.
Fatigue
Week 6
Regression
Coefficients
Post-Exercise
Fatigue
Recovery 0.417
Energy 0.583
Refreshness 0.75
Easiness 1.346
0
2
4
6
8
10
12 Week 6: Easy walk among all participants
Pre Easy Walk
Post Easy Walk

lxvi

event 0.088
More training -0.196
Weak legs and arms -0.741
Muscle Ache 0.595
Relax -0.375
Easy Walk -0.333
Mentally cloudy 0.105
These results showed that there was significant improvement in the post-
training fatigue of the five participants over 6 weeks. The application of
magnesium oil helped the cyclists to improve their physical, cognitive and
psychological conditions.
4.3 Discussion of results
The aim of the study was to investigate if the transdermal application of
magnesium can help manage the symptoms of post-training fatigue in
cyclists. The study findings further confirmed that the decrease in plasma
magnesium during exercise is due to a transient shift of magnesium from
extracellular fluid to skeletal muscle tissue. The transdermal application
of the magnesium oil can help in controlling the effects of the post-
training fatigue of the cyclists. The most important findings of the

lxvii

research were related with the changes occurring frequently in the post-
fatigue components after the application of oil at different time points.
Week 6 results were more effective compared to the week 2 and 4 results
of post-exercise fatigue. The correlation and regression analyses of the
results showed that magnesium oil after cycling has affected not only the
physically associated muscles cramps but has also significantly
influenced their mental state.
The analysis has shown that transdermal application of magnesium oil is
not effective immediately after application. Week 2 and week 3 results
represent such phenomenon, that the transdermal application helps the
users of the oil in preventing the side effects of the oral supplementation
of magnesium oil, as outlined earlier.
Similarly, the effects of the transdermal application of magnesium oil are
slow due to the barrier function and epidermal integrity of human skin.
The absorption rate and recovery rates are higher in the transdermal
application but the outcomes are long-term, helping the individual cyclists
to relax and revive their energy for the replication and repetition of the
exercise. Since transdermal magnesium as a topical measure has not
been addressed in secondary studies as yet, the current investigation has
informed that topical transdermal applications are much better than the
oral magnesium as the user does not experience the laxative effects
associated with consuming high levels of the oral supplements.
Furthermore, the present study results have confirmed those of Warring
(2011), that magnesium oil shows good and improved results once it is

lxviii

applied on warm skin after bathing. This is in line with previous academic
literature that emphasises that magnesium works best once it is injected
into the body through the skin as transdermal magnesium circumvents
the digestive region. This bioavailable form reduces the risk of over-doing
it, helped the participants to self-regulate, absorbs only what they require.
In addition, the results of five participants further showed that they were
more fatigue-free and energized as soon as became more engaged in
the cycling exercise after two weeks. Proksch (2005) indicated that once
the skin comes into contact with the magnesium oil, it has no effective
barrier in restricting the movement of magnesium ions to epidermal cells
or the nerve endings. In this manner, magnesium oil allows skin recovery
and modulation of the immune nervous system. However, the recovery
time is dependent on the absorption rate. Landsowne (1995) confirmed
that different types of magnesium can have different effects on the
participants; hydrous polysilicate (talc) can restrict and prevent the
performance of the magnesium chloride through the skin. It is important
to highlight here that Warring (2011) has shown the crucial importance of
the type of skin or body region for the application of magnesium, as soft
skin regions such as tummy, armpits or thighs can achieve better results
relative to other body parts.
There was also a greater improvement in mental and physical conditions
of the cyclists in this study. Secondary research has justified such
multidimensional effects of the transdermal application of the magnesium

lxix

oil by emphasizing the temperature control for the cyclists, detoxification
effects and barrier functions.
Magnesium oil in the present study was able to lower post-training or
exercise fatigue in the cyclists. Most of the research participants
demonstrated an extremely difficult response after training, with the
majority of them being emotionally and physically drained after exercise
in week 2. Cycling was a crucial activity for them because it is heavily
prone to the loss of energy sources and fatigue. Specifically, the
presence of post-training fatigue in female cyclists can have an impact on
mood and stress responses. The negative effects of the transdermal
application of magnesium in week 2 and week 4 were due to the
difficulties involved in maintaining the status of magnesium in the body by
the participants (Jahnen-Dechent & Ketteler, 2012). The dosage of the
application is dependent and adjusted according to the age, sex and
nutritional status of the individuals. The participants in the present
research did not show dietary levels lower that 150 mg on a daily basis.
Additionally, the long term and prolonged effects of the magnesium oil via
transdermal application were also confirmed in Waring (2011), where she
has shown the prominent effects of the transdermal magnesium due to
prolonged soaking. The application however does not require any specific
precautions for making transversal application safer for the individuals.
The HPHEES findings and generated correlation and regression results
substantiated earlier sports-related studies. Five participants also showed
effects in the three main causes behind the post-exercise fatigue,

lxx

including medical causes, over performance or overtraining and
psychological stress. In terms of the medical causes, the present study
investigated weak legs, arms, and muscle ache as the key indicators.
The comparative analysis of the three weeks’ post-fatigue symptoms
showed that there was a significant moderate effect of transdermal
magnesium oil on the participants’ medical conditions, such as bone
inflammation, muscle cramps, non-responsiveness of the muscles to the
neural excitations. The body parts, specifically muscles, are more
responsive to the central nervous system during and after cycling.
Therefore, it was extremely important for a muscle to produce power in a
cyclical manner (i.e., cycling, locomotion, etc). McArdle, Katch and Katch
(2001), have reported that there is a neural input from the central nervous
system via alpha motor neurons. The improved correlation and
regression results of the two key indicators suggest the importance of the
magnesium oil in offering adequate speed to the muscles of the five
participants in maintaining maximum power output through recovery of
the body.
Subsequently, the over training aspects in the present study assessed
the participants’ performance using recovery, energy, physically drained,
more training and easy walk measures. The correlation and regression
results showed a greater improvement in terms of the recovery and
refresh the participants for more cycling. The transdermal application of
magnesium oil is effective for the individuals in order to bear the pressure
of over training. It has been suggested that the oil has strengthening

lxxi

effects on the contraction of the muscles after continual exhaustion
exercise (Gotoh et al., 1998).
Lastly, for assessing the third and last cause of fatigue, i.e. psychological
stress, the post-training fatigue included refreshness, easiness, mental
sharpness, easy walk and mentally cloudy as key indicators. Bequet et al.
(2001) suggested that there should be a wider consideration on the
connectivity between the brain and the psychological aspects. Skin is
also exposed to the internal and external psychological stresses that can
influence the physiological and immunological processes of the
individuals. Therefore, with wider consideration, the test conducted on the
cyclists revealed that at the end of week 6, the participants were able to
recover their stress, depression and other psychological components of
the post-training fatigue.
4.4 Conclusion
It can be concluded that transdermal application of magnesium can
strongly, positively and significantly help in managing the symptoms of
post-training fatigue in cyclists. The cross-related analysis of the pre- and
post-exercise fatigue after application of magnesium oil has shown that
there was a significant improvement in components of post-exercise
fatigue. The oil was capable of managing the physical as well as
psychological conditions of the fatigue in the selected participants. The
present study has substantiated the effectiveness of this topical method
of transdermal application of the magnesium oil in stressful training
exercise.

lxxiii

CHAPTER 5: DISCUSSION
This chapter’s main aim is to critique and discuss the findings found in
chapter 4 and their value for research in the future.
5.1Summary of main findings
The main findings of this investigation were in accordance with the aims
and hypotheses of the present study. The aim was to establish if
transdermal magnesium oil would help in the relief of symptoms of post-
training fatigue in cyclists, if applied pre-training or exercise. The
hypothesis for this study was based on the study of Waring (2011), in
which participants were asked to bathe in magnesium salts (12 minutes
in hot salted water) over a 7 day period. Prolonged soaking in Epsom
salts increased magnesium concentrations in blood (for most participants,
140.98 ± 17.00 ppm/ml) and in urine (from 94.81 ± 44.26 ppm/ml to
198.93 ± 97.52 ppm/ml). Those individuals where the blood magnesium
levels were not increased had correspondingly large increases in urinary
magnesium showing that the magnesium ions had crossed the skin
barrier and had been excreted via the kidney, presumably because the
blood levels were already optimal. Generally, urinary magnesium levels
24 hours after the first bath fell from the initial values found after day 1
(118. 43 ± 51.95 ppm/ml) suggesting some retention of magnesium in
tissues after bathing as blood levels were still high. Measurement of
magnesium levels in urine 24 hours after the 7th bath gave values almost
back to control levels (Waring, 2011).

lxxiv

The present study showed decreased symptoms in post-training fatigue
in week 6. The correlation and regression results of week 2 and week 4
showed a strong negative relationship between post-training fatigue
components and transdermal application of magnesium, such as
recovery (-0.702), easiness (-0.617) and mentally drained (-0.696), while
some showed a moderate negative correlation, such as post-exercise
energy (-0.441), refreshness (-0.58), replication of last game event (-
0.306), muscle ache (-0.481), mental sharpness (-0.484). However, week
6 results showed strong positive effects of transdermal magnesium oil on
post-training fatigue in cyclists.
The present study has established that transdermal magnesium can help
decrease symptoms of post-training fatigue. The period of this study was
6 weeks but it would be interesting to extend the study duration. The
dose of the magnesium used in this study was different to Waring’s study,
in which they used Epsom bath Salts (400 g of MgS04 was added to the
bath with 60 litres of hot water, a standard bath size equating to 1 g of
magnesium to 100 ml of water). Epsom salts also contain sulphate and in
the Waring study, blood plasma levels of sulphur also increased.
However, in other studies undertaken by Waring, they showed that
sulphate alone does not absorb through the skin when applied in a patch
to the arm, leading to the conclusion that magnesium acts as a carrier for
sulphate in the bath and on the skin, when applied in a patch (Waring et
al., 2011). The present study used magnesium chloride oil, 10 sprays of
oil applied to the forearms, abdomen and underarms contain 300 mg of

lxxv

elemental magnesium chloride per 10 sprays. After 6 weeks, symptoms
of post-training fatigue were reduced.
5.2Limitations of study
5.2.1 Participants
The number of participants was relatively small, 10 participants of which
7 were males and 3 females were initially recruited for the study and
completed food diaries. However, 1 participant withdrew due to poor
health and was subsequently replaced. After a period of 6 weeks, the
completed HPHEES scale was requested via email and only 5 completed
scales were returned, despite stamped addressed envelopes being
posted out to all the participants. This dropout may have affected the
study findings and future large scale studies are recommended.
5.2.2 Study period
The study was completed over a six week period, relatively shorter than
other studies on transdermal magnesium. The Piccini study showed
increased levels of cellular magnesium (100%) when transdermal
magnesium oil was applied twice a day over a 4 month period (Piccini et
al., 2015). The Watkins study (2010) demonstrated increased levels of
magnesium (89%) applied transdermally over a 12 week period (Watkins,
2010) using hair mineral testing. Hair analysis is routinely used in
occupational, environmental and natural healthcare as a method of
investigation to assist screening and/or diagnosis (Sircus, 2010). The
participants were asked to apply the magnesium oil anywhere on the
body daily and to soak their feet in 100 ml of original foot soak and hot

lxxvi

water (Watkins, 2010). However, a 2015 study by Engen et al.
established that four spays of transdermal magnesium applied to the
limbs twice a day for four weeks helped relieve some of the symptoms of
fibromyalgia (Engen, 2015).
5.3Conclusion
Despite the limitations with this study, the overall results showed that
transdermal magnesium has a positive effect on symptoms of post-
training fatigue. Further research using the same methodology and
addressing limitations discussed previously, such as increasing the
sample size and study duration, are recommended. This study presents
new information regarding the transdermal delivery of magnesium; there
are no previously published studies in this area as the transdermal
delivery of nutrients is relatively new. Currently, there are now other
ongoing studies investigating the effects of transdermal magnesium
underway in conjunction with NHS England (Better you Ltd, 2015). The
present study has shown that transdermal application of magnesium
should be considered in future nutritional therapy practice. Although
research in this area is at an early stage, it is hoped that future research
will show how transdermal magnesium, or even transdermal nutrition, can
be integrated into future nutritional therapy practice.

lxxviii

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