Effects of Tart Cherry Juice Supplementation on Recovery from Exercise-Induced Muscle Damage in Athletes: A Systematic Review and Meta-Analysis

BACKGROUND: Exercise-induced muscle damage (EIMD) is known to impair neuromuscular performance, provoke inflammation, and delay recovery. Tart cherry (TC) juice, a polyphenol-rich nutritional product, has been proposed as a strategy to support recovery in athletes; however, findings across studies remain inconsistent. OBJECTIVE: The aim was to conduct a systematic review combined with a meta-analysis and corroborate the certainty of evidence underpinning the effects of TC juice supplementation on physical, biochemical, and perceptual recovery markers following EIMD in trained athletes. METHODS: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. PubMed, ScienceDirect, Web of Science and SPORTDiscus were searched from inception to 25 December 2025. RESULTS: Nineteen trials were included. Our results revealed TC juice supplementation significantly improved MVC recovery in the main analysis across all time points (post: ES = 0.63; 24 h: ES = 1.12; 48 h: ES = 1.29; 72 h: ES = 2.14; 96 h: ES = 4.82), with substantial heterogeneity (I² 69-93%). CMJ showed no significant effects post-exercise or at 24h but improved at 48 h (ES = 1.41; I² = 72%). TC juice significantly reduced CRP post-exercise and up to 48 h (post: ES = -0.46; 24 h: ES = -0.73; 48 h: ES = -0.68), whereas no significant pooled effects were found for muscle soreness, CK, IL-6, TNF-α, ROM, or most subgroup time points. Subgroup analyses suggested model-specific responses (e.g., MVC improvements at 24-48 h in whole-body protocols and at 72 h in isolated protocols). Sensitivity analyses indicated that statistical significance at selected time points (MVC post and 72 h; CMJ 48 h; CRP 24-48 h) was influenced by individual studies. Certainty of evidence ranged from very low to moderate. CONCLUSIONS: TC juice supplementation may support recovery of selected functional and inflammatory markers following exercise-induced muscle damage in trained athletes; however, findings are heterogeneous and supported by low-to-moderate certainty of evidence, warranting cautious interpretation.