Delayed Onset Muscle Soreness - AKA DOMS - AKA Post Workout Soreness
What Is It?
Delayed onset muscle soreness, referred to as DOMS in most literature, is a problem that most active individuals experience on a weekly basis. Lifting heavy at the gym, doing a large bout of intense exercise after a long lay-off, or just a light jog downhill can be enough to experience the dull and deep ache in muscles that comes a day or two after. This exercise induced pain and stiffness in muscles can range from a slight discomfort to severely debilitating and usually peaks 24 to 72 hours after exercise and disappears five to seven days later. Our interest in DOMS came after completing the ‘Gambetta Leg Circuit (Check it out here….it’s insane!). Because this condition is so common and can inhibit the athletic performance of a professional or novice athlete or even dissuade a normally sedentary individual from taking up exercise, it is important that an optimum way to prevent and treat DOMS be found.
What Causes DOMS?
Despite the high incidence of DOMS the exact mechanism of what causes the condition remains uncertain. We do know that DOMS is brought on after heavy bouts of eccentric exercise, that is, a voluntary muscle contraction that involves an overall lengthening of the muscle, but the exact intracellular mechanism of what causes the symptoms of DOMS is still unknown. Many theories have been proposed but none has been scientifically proven. These theories include, but are not limited to, an accumulation of lactic acid in muscles that stimulates muscle nociceptors, an isolated muscle spasm, connective tissue damage, muscle damage, inflammation, and increased enzymatic activity in the muscles sarcolemma. Unfortunately the answer is not as simple as these theories suggest and is now thought to be a combination of the theories listed above.
Researchers, for now, suggest that eccentric exercise in muscles results in injury to the cell membrane, which sets off an inflammatory response that leads to prostaglandin and leukotriene synthesis. These prostaglandins sensitize type III and IV pain neurons while the leukotrienes increase vascular permeability and attract neutrophils and monocytes to the damaged muscle. This accumulation of neutrophils as well as histamine, potassium and kinins from phagocytosis by monocytes increases the pressure and temperature of the muscle cells which then activate the sensitized pain afferent neurons and lead to the sensation of DOMS.
In short: Muscle damage leads to inflammation which leads to irritation of our pain receptors.
As one can tell, the exact mechanism of DOMS is complex which in turn has made it difficult to find an appropriate treatment.
Best Treatment Options
- Exercise - It’s been shown that light exercise in the days following eccentric exercise is recommended. One literature reviewer has suggested that light exercise is the most effective treatment for DOMS. So next time you are experiencing muscle soreness, try going for a light jog or rowing session to help decrease the pain.
- Warm Up - Research showed that a proper warm up helped decrease pain levels while a cool down did not. It’s recommended that a warm up emphasizing dynamic stretches be used before all workouts.
- Whole Body Vibration – Whole Body Vibration units are gaining in popularity and have shown to be beneficial in decreasing pain associated with DOMS. If available, these units should be used before or immediately after exercise.
- Massage – Has been shown to help lower pain levels but not help with performance measures (strength or range of motion).
- Stretching – It should be noted thatstatic stretching had no effect on pain levels and may not be beneficial in treating DOMS.
- Supplments - While we're not big on recommending supplements to treat medical issues, if you're desperate, some smaller clinical trials have shown Branch Chain Amino Acids to be helpful in the treatment of DOMS.