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-a, 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. Key Points Tart cherry (TC) juice supplementation was associated with significantly improved MVC recovery across time points in the main analysis, although effects showed substantial heterogeneity and some time points were sensitive to single-study removal. TC significantly reduced C-reactive protein (CRP) levels post EIMD up to 48 h post EIMD, supporting a potential anti-inflammatory effect, but CRP effects at 24-48 h were sensitive to removal of an influential study. TC showed a significant improvement in CMJ at 48 h only, with no significant effects post-exercise or at 24 h, and the 48 h effect was sensitive to study removal. No consistent effects were observed on muscle soreness, creatine kinase (CK), interleukin-6 (IL6), tumor necrosis factor-alpha (TNFa), or range of motion (ROM), and subgroup analyses (whole-body vs isolated protocols) suggested model-specific responses without resolving heterogeneity. Overall certainty of evidence ranged from very low to moderate supporting cautious interpretation and emphasizing the need for larger, well-controlled athlete trials with standardized dosing and outcomes.
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