THE ROLE OF EXERCISE IN ALTITUDE PAIN

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Abstract
Young men were exposed a total of 390 times to a reduced barometric pressure equivalent to an altitude of 38,000 ft. in order to determine the aspects of muscular exercise that effect the occurrence of altitude joint pain (aviators'' bends). Alveolar O2 was maintained at normal tension by O2 masks. At altitude the men performed one or another of six arm exercises designed to separate factors such as continuous and intermittent strain, total work and angular joint movement. A 63% incidence of pain occurred in the exercised limbs in contrast with 16% in the limbs not intentionally exercised. When half of the total work was done by the arms and half by the legs, pain occurrence was equal in the upper and lower extremities. Incapacitating pain in the arms varied directly with O2 cost and ft. lbs. of work[long dash]380 ft. lbs. yielded 41% incidence, 204 ft. lbs. yielded 28%, 190 ft. lbs. yielded 22% and 101 ft. lbs. yielded 11%. The time of incapacitation also varied systematically with work. The incidence and onset of mild pain showed a similar but less clear relation. Wide variations in muscle strain, mechanical tension and amount of joint movement did not effect the occurrence of pain. The effects of intermittent and continuous strain could not be distinguished. Only work in ft. lbs., or some factor directly related to it, showed a high association with the occurrence of pain. The results suggest that local CO2 production is the responsible agent.

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