Delayed Onset of Muscle Soreness: What is
it and how do I treat it?
Written by Chris Mills 29th November 2014
Photo: Liesel Elliott via Flickr
Delayed onset of muscle soreness (Or DOMS as it’s more commonly known) is a pain or
discomfort felt in the muscles which materialises as a result of unfamiliar, extreme or
eccentric exercise.
DOMS can cause reduced muscle power, cause intense pain, reduce an athlete’s muscular
endurance and also reduce the range of motion at a joint. The symptoms of DOMS can last
for up to 10 days so to understand the mechanics of how DOMS can be minimised is
extremely important for any athlete.
There is more than one physiological component to consider when looking at the cause of
DOMS. An inflammatory response is associated with the swelling and the discomfort in the
muscles, mechanical damage to the muscle tendon unit itself has also been shown to cause
reduced muscular strength, proliferation of free radicals also cause injury to the muscle
membrane which in turn causes pain.
This popular ‘injury’ has had a great surge of interest shown in recent years, and there are
now a variety of treatments available to exercisers and athletes alike to help blunt the effects
of DOMS and it’s associated symptoms.
1. Non Steroidal Anti-inflammatory Drugs (e.g. Ibuprofen):
Anti inflammatory drugs such as ibuprofen have been known to reduce the immune
systems response by inhibiting prostaglandin formation, this has led to studies
showing a reduced sensation of soreness and pain in the muscle, but studies from
Trappe et al, Mikkelson et al and Connolly et al have all shown that protein synthesis
in the muscle and crucially the adaption of the body to the training, is blunted by the
use of these anti-inflammatory drugs.
Verdict: Not good for athlete use.
2. Cryotherapy (Such as and cold water immersion):
Ice Baths have gained popularity recently. The effect that cryotherapy has as an
effective agent to diminish the inflammatory response and the sensation of pain in the
body has led to it’s use as a treatment option for DOMS. A study from Eston & Peters
showed that cold water immersion reduced stiffness and also reducing creatine kinase
plasma values.
Verdict: Effective Treatment
3. Anti-oxidant Supplementation:
Supplementation of Vitamin C and E has been studied in the past, The limited
Vitamin C supplementation studies have shown a reduced effect on muscle soreness,
by up to 40%. Vitamin E supplementation has shown inconsistent findings, but some
studies undertaken on downhill running have shown a reduction in various factors
relating to DOMS such as faster recovery and decreased CK concentrations.
Verdict: Potential Effective Treatment
4. Therapuetic Treatment (Massage, Stretching, etc):
Whilst being one of the most practiced treatments, massage, stretching and warm-ups
have revealed a mixed reviews within studies, there has been some evidence of
reduced muscle tenderness and reduced strength loss, but in many cases it is often
hard to attribute these findings to therapeutic treatment. Whilst the psychological
effect of therapeutic treatment has been less studied, it seems fair to state that massage
and stretching methods are a less reliable form of treatment.
Verdict: Unreliable but potentially effective.
5. Protein & Carbohydrate supplementation:
Protein supplementation has been done to death in the literature, the science suggests
that protein synthesis will be heightened by the consumption of protein/amino acid
supplements. Tipton et al has tentatively suggested that this consumption can improve
the adaption and recovery in the athlete, whilst various studies have also noted that
there is a reduced soreness in the muscles in groups who consumed these
supplements.
Verdict: Effective Treatment
It can be gleaned from this article and various pieces of research that there are certainly
options open for athletes in their quest to avoid and reduce DOMS, and whilst there will often
be evidence for and against every type of treatment, it appears from current research that the
best ways of combating DOMS is to consume protein/amino acid supplements, undertake
cold water immersion therapies.
Other therapies offer promising, yet mixed results, such as anti-oxidant supplementation and
therapeutic therapies. Research is extensive on certain treatments, however it is yet to be seen
whether a combination of treatments as opposed to just one is a more effective way of
treating DOMS.