Wearable monitoring of muscle health across fatigue, injury and recovery in sports

Muscle fatigue and injury are the core issues that restrict the improvement of athletes’ competitive performance and the maintenance of sports health for the general population. The traditional muscle health management paradigm is limited by lagging assessment and single indicators, failing to meet the demands of precise training and individualized rehabilitation. With the advances in wearable sensing technology, muscle health management has the potential to transform from the empirical modality to a new data-driven paradigm. However, existing publications either focus on materials innovation and structure design in sensor development, or solely highlight the overlapping physiological mechanisms inducing muscle fatigue and injury. Thus, a comprehensive review presenting insights on the physiological relevance between biological signals fluctuations and muscle health status, the detection mechanisms and functional layouts of wearable sensors to capture these signals, as well as their real-world applications in competitive sports and public fitness is timely needed. Herein, this article systematically reviews the physiological mechanisms of muscle fatigue, injury and repair, with a focus on elaborating the characteristic change patterns of related bioelectrical, biochemical and biomechanical markers in the process. Sensing mechanisms and working layouts of wearable technology are comprehensively summarized. Importantly, corresponding applications in real-world settings associated with improving professional athletic performance and public fitness are proposed, including load monitoring, fatigue evaluation, personalized nutrition management, as well as AI-enabled multimodal fusion. Based on this, future perspectives are envisioned to better aid sports activities and engineer the development of sports science and sports medicine.