Athletic Recovery Strategy - NIH Study
Aug 20th 2025
Abstract
Cherry juice has become a standard component of athlete recovery strategies. This review covers the history of cherry juice as a recovery drink to give context to its current use. Fifteen studies were identified that included a measure of muscle function, soreness, or inflammation on the days following exercise and had an exercise insult sufficient to assess the effectiveness of the tart cherry intervention. Eight studies used a concentrated juice, three used a juice from fresh‐frozen cherries, two used a tart cherry concentrate gel, and two used a tart cherry powder. The effective juice dose was specific to the type of drink (fresh‐frozen versus concentrate) but dose‐response studies are lacking, and thus, the optimal dose for any specific type of cherry juice is not known. Timing of the dosing regimen is a critical factor. Studies have uniformly shown that muscle function will recover faster on the days after exercise if juice is provided for several days prior to exercise. Effects on soreness or systemic inflammation are more equivocal. The available evidence does not support a regimen that begins on the day of exercise or post‐exercise. Tart cherry powder did not enhance any metric of recovery on the days after exercise. In conclusion, the term recovery implies an intervention that is introduced after an exercise insult. The term “precovery” may be preferable to describe interventions that should be introduced on the days prior to exercise to facilitate recovery on the days after exercise. The evidence supports cherry juice as a precovery intervention across a range of athletic activities.
Keywords: antioxidant, inflammation, muscle function, nutrition, tart cherries
1. RATIONAL FOR REVIEW
Cherry juice has been extensively studied for its benefits for exercise recovery (for review, see Hill et al 1 ) and has become a standard component of athlete recovery strategies. In a recent consensus statement on nutrition in elite football, there was a brief mention of the role of cherry juice in a section on recovery from match play. 2 It was noted that cherry juice has become a popular recovery intervention, but it was shown not to be effective in football, with one study cited. 3 The consensus conclusion was that “the available evidence does not support its specific use in football.” This interpretation of the Abbott et al. study 3 and the overall conclusion highlights a misconception of the role of cherry juice in exercise recovery. The athletes in the study by Abbott et al. 3 consumed a tart cherry concentrate gel on the day of the exercise and the subsequent days. Typically, cherry juice is consumed for several days prior to the exercise insult, in addition to the day of exercise and the subsequent days. The problem arises in the interpretation of the term recovery as something one does after an event. In this regard, cherry juice should not be regarded as a recovery drink, and it should be regarded as a “precovery” drink, where the term precovery implies an intervention prior to an athletic event.
The purpose of this review is to provide some historical context for the science behind cherry juice as a recovery intervention in sports and exercise. Understanding the genesis of the dosing regimens employed in the early research will provide a better understanding of the disparate subsequent research. While systematic reviews and meta‐analyses emphasize the application of strict processes and procedures to assimilate disparate studies, this narrative review will emphasize the nuances that explain conflicting findings. The goal is to provide a practical understanding of the role of cherry juice in exercise recovery. The content is specific to situations where the goal is recovery of function to maintain performance and does not address situations where the goal is to optimize training adaptations, in which case a recovery intervention may not be indicated.
2. THE GENESIS OF CHERRY JUICE AS A RECOVERY DRINK
In 2003, Jacob et al. 4 showed that consumption of a bowl of sweet cherries (280 g, approximately 45 cherries) acutely lowered plasma urate and increased indices of antioxidant capacity in healthy women. A subsequent study 5 included men and women and extended the intervention to 280 g of sweet cherries daily for 28 days. The notable new finding was that indices of inflammation were reduced, and specifically, C‐reactive protein was reduced by 25% and nitric oxide production was reduced by 18%. There was no effect on interleukin‐6 or tumor necrosis factor alpha. Based on the anti‐inflammatory and antioxidant effects seen with eating a bowl of 45 sweet cherries daily for 28 days, Connolly et al. 6 examined whether consumption of a cherry juice was effective at reducing indices of exercise‐induced muscle damage. This was the first study in humans showing cherry juice to be effective in exercise recovery. Two 355 ml servings (2x12 fl oz) of cherry juice were given daily for 3 days prior to exercise, on the day of exercise, and on the subsequent 4 days. The drink was made using fresh‐frozen tart cherries. There were approximately 50–60 cherries in each serving. This dosing regimen was based on the findings of Kelley et al. 5 showing that eating 45 sweet cherries a day had systemic antioxidant and anti‐inflammatory effects. It was presumed that there would be degradation of the phytonutrients during processing of a drink and that the end product would not have the potency of 50–60 fresh cherries. Therefore, two 35 ml servings were given each day to achieve a dose that was more than twice the number of cherries given in the prior studies. 4 , 5 Subsequently, the processing of this particular cherry juice drink was refined such that approximately 50–60 cherries could be provided in a 237 ml serving (8 fl oz). A dosing regimen of two 237 ml servings a day was replicated in several subsequent studies, all of which demonstrated efficacy across diverse conditions. 7 , 8 , 9 , 10
3. WHY TART CHERRY JUICE AND NOT SWEET CHERRY JUICE?
Both tart cherries and sweet cherries have been shown to have health benefits when consumed in sufficient amounts (for review, see Kelley et al 11 ). While the phenolic concentration and composition vary between sweet and tart cherries, they also vary between different cultivars of tart or sweet cherries. 11 Generally, both tart and sweet cherries have a range of different phytonutrients that have both antioxidant and anti‐inflammatory effects. 11 In the original studies indicating potential health benefits from cherries, subjects ate bowls of Bing sweet cherries. 4 , 5 In the subsequent studies, on exercise recovery subjects drank commercially available Montmorency tart cherry juice. 2 , 6 , 8 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 The fact that commercial juices are made from tart cherries and not sweet cherries is a matter of cost and availability rather than differences in the phenolic concentrations between them. Pitting and juicing 50–100 sweet cherries are a viable alternative to purchasing a ready‐made tart juice, but this would be costly, time‐consuming, and dependent on the seasonal availability of cherries.
The exclusive use of Montmorency cherries in the exercise recovery studies does not mean that other cultivars are not as effective. Montmorency cherries are grown predominantly in Michigan in the United States. However, Eastern Europe is one of the largest cherry‐growing regions in the world (Turkey, Ukraine, and Poland) with different cultivars of sweet and tart cherries predominating depending on the specific geographic location. To date, there has been no research on exercise recovery examining the potential benefits of cherry juice from these regions and there has only been limited work on the differences in phenolic contents between different cultivars.
4. COMPARISONS OF PHENOLIC CONTENTS OF PRODUCTS USED IN EXERCISE RECOVERY STUDIES
A total of 19 studies have tested the effectiveness of six different tart cherry products for improving exercise recovery in humans. Four of the 19 studies tested juices made from fresh‐frozen cherries, 6 , 8 , 13 , 19 of which three were the same product. 6 , 8 , 13 The juices used in these studies were reported to have a total phenolic content of at least 600 mg and an anthocyanin content of at least 40 mg. Ten of the 19 studies used a juice made from concentrate (all 10 used the same product). 14 , 15 , 16 , 17 , 18 , 20 , 21 , 22 , 23 , 24 The most recent of these studies 24 reported a total phenolic content of 20.2 mg/ml and an anthocyanin content of 7.2 mg/ml. This amounts to 605 mg and 216 mg per 30 ml serving for total phenolic content and anthocyanin content, respectively. The earliest of the studies using this juice 17 reported an anthocyanin content of 9.1 mg/ml (273 mg per 30 ml serving) but did not report a total phenolic content. Three of the 19 studies used a tart cherry powder, with two reporting a phenolic content of 991 mg and an anthocyanin content of 66 mg per serving. 25 , 26 The other reported 773 mg for phenolic content and 64 mg for anthocyanin content. 27 The remaining two studies used a tart cherry concentrate gel 3 , 28 but did not report the phenolic or anthocyanin content. In one of these studies, the gel was diluted to replicate the placebo drink. 3 The gel products are essentially a concentrate with a gel agent added to increase viscosity. Therefore, one might assume that the gel products would have a similar phenolic content to the juice concentrates.
It is unclear how the reported anthocyanin content for the cherry juice concentrate used in most studies is 3.3–6.8 times higher than for either the tart cherry powder or the juice from fresh‐frozen cherries. The skins of Montmorency cherries contain most of the anthocyanins, and the tart cherry powder used in two studies 25 , 26 was exclusively derived from the skins. The total phenolic content per serving was comparable between the juice from fresh‐frozen cherries and the juice concentrate, with 28%–65% higher values for the tart cherry powder.
Besides the type of juice (fresh‐frozen versus concentrate versus powder), the 19 studies differed in exercise mode, study population, dosing regimen, and the number and type of outcome measures. One issue with regard to potential health‐related or exercise recovery benefits comparing a juice concentrate versus a juice using fresh‐frozen cherries is that harsher processing techniques are used in making a concentrate. Degradation of the phytonutrients during the processing is unavoidable and will be greater in the production of a concentrate. In two separate studies, anthocyanin content was shown to be 60% 29 and 57% 30 lower in Montmorency cherry concentrate versus fresh‐frozen Montmorency cherries. In one of these studies, antioxidant activity was 65% lower in concentrate versus fresh‐frozen cherries. 29 However, in the other study the opposite was the case, and antioxidant activity was 60% lower per serving in the fresh‐frozen versus concentrate. 30 Additionally, in that study anti‐inflammatory activity was also lower in fresh‐frozen versus cherry concentrate. 30 The limited and conflicting research in the area makes it difficult to make practical conclusions on potential differences in health or recovery benefits of cherry juice from fresh‐frozen cherries versus cherry concentrate.
An additional consideration, regardless of the type of drink, is that post‐production storage affects degradation of the phytonutrients, with heat, and exposure to sunlight, decreasing the effective shelf life. Thus, refrigeration will be advantageous for maintaining potency of any particular cherry juice. To some extent, the recommended dosing regimens for commercially available concentrate versus fresh‐frozen juices attempt to account for the potential differences in drink potency with the estimated number of cherries per serving substantially higher in the concentrate (see section 5.1 and 6.3).
5. DOSE AND BIOAVAILABILITY
5.1. Dosing regimens in exercise recovery studies
The cherry juice dosing regimens employed in the various studies on exercise recovery have been specific to the actual product being studied. A regimen of two servings a day (355 ml 6 or 237 ml 8 , 13 ) for several days before exercise and for a couple of days after exercise has been employed in studies using a cherry juice made from fresh‐frozen Montmorency tart cherries. In these studies, it was estimated that participants were taking the equivalent of approximately 100 cherries per day. A regimen of two 30 ml servings a day has been employed in exercise recovery studies using a Montmorency cherry juice concentrate. 14 , 15 , 16 , 17 , 18 , 20 , 21 , 22 , 23 , 24 In these studies, it was estimated that participants were taking the equivalent of approximately 180 cherries per day.
5.2. Dose‐response studies
Four of the exercise recovery studies measured total antioxidant status after the pre‐exercise dosing period. 8 , 17 , 25 , 26 In one study, a regimen of two 474 ml a day of cherry juice from fresh‐frozen cherries for 4 days was shown to increase total antioxidant status by 11%. 8 By contrast, total antioxidant status was not different from control after 6 days of 60 ml tart cherry juice concentrate per day 17 or after seven daily ingestions of 480 mg powdered tart cherry capsules. 25 , 26 In a non‐exercise study, a dosing regimen of 30 ml tart cherry juice concentrate per day for 42 days resulted in a 7% increase in antioxidant status. 31 Taken together, these five studies 8 , 17 , 25 , 26 , 31 indicate that cherry juice from fresh‐frozen cherries 8 may more readily affect antioxidant status than juice from cherry concentrate 17 or a tart cherry powder 25 , 26 when the dosing period is 5–7 days. Extending the period of consumption of the cherry juice concentrate to seven weeks can increase antioxidant status. However, an increase in antioxidant status may not be the primary mechanism for improved recovery since indices of recovery were affected despite no change in pre‐exercise antioxidant status. 17 Cherries have been shown to have a potent anti‐inflammatory effect by inhibiting cyclooxygenase enzyme activity. 30 , 32 This effect was shown to be superior to the effect of aspirin but inferior to ibuprofen. 32
One study compared the effects of different doses of the same cherry juice. 33 There were no differences in the responses to a dosing regimen of 30 ml (approximately 90 cherries) versus 60 ml (approximately 180 cherries) of cherry juice concentrate per day for 2 days. Both doses acutely reduced systemic inflammation after the first serving, but values had returned to baseline the next day. Repeating the dose on the second day did result in a sustained reduction in systemic inflammation, with C‐reactive protein (CRP) values approximately 35% below baseline on the third day, with similar effects for each dose. Thus, tart cherry juice concentrate can have systemic effects that could be beneficial for exercise recovery, but it appears to take several days to achieve a sustained effect. By comparison, eating a bowl of sweet cherries each day resulted in a non‐significant 8% decline in CRP after 8 days and a significant 25% decline after 28 days. 5 Since healthy men and women generally have extremely low CRP, it is not appropriate to gauge the effectiveness of cherry juice dosing regimens simply on changes in baseline CRP. Testing the effectiveness of cherry juice dosing regimens on CRP in non‐exercise studies requires populations with elevated CRP. In patients with mild to moderate arthritis, CRP was higher than normal and a dosing regimen of 474 ml per day of cherry juice from fresh‐frozen cherries for six weeks resulted in a 23% reduction in CRP. 10
In a prior review of the health benefits of cherry juice, Bell et al. 34 acknowledged that it was unclear whether the exercise recovery benefits were due to pre‐exercise consumption, post‐exercise consumption, or the combination of both. To date, no study has formally examined this issue but based on changes in antioxidant status 8 , 17 , 25 , 26 and systemic inflammation 5 , 10 , 33 a pre‐exercise dosing period would seem to be needed.
5.3. Bioavailability studies
Data on the bioavailability of the phytonutrients in cherries are very limited. Kirakosyan et al. demonstrated a diverse distribution of tart cherry anthocyanins across different tissues after supplementing rats’ diets with tart cherry powder for seven weeks. 35 Anthocyanin content was highest in the bladder but also evident in liver, kidney, and brain tissue. Unfortunately, there was no measurement of anthocyanin content in muscle. One study in humans showed that plasma levels of phenolic acids increased by 2–3 times baseline within 1–2 h of consuming 30 ml or 60 ml of tart cherry juice concentrate. 36 However, plasma levels were mostly back to baseline by eight hours, indicating a transient acute effect. In a more recent study, 24 consuming 30 ml of tart cherry juice concentrate twice daily for seven days resulted in elevations in plasma levels of some phenolic acids compared to placebo. More importantly, this study 24 showed increased expression of antioxidant genes and proteins in skeletal muscle after seven days of cherry juice consumption. Cherry juice consumption also enhanced recovery from eccentric exercise‐induced muscle damage (see section 6.4 and Table 2).
