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WHAT IS DOMS?



What is DOMS?


No, it not the name of my friend, as someone asked yesterday! It stands for delayed onset muscle soreness (DOMS). As the name suggests, after you have engaged in performing strenuous exercise, after a day or so, you can get muscle symptoms due to small tears and inflammation in this metabolic tissue organ which can last a few days. The inflammation and tears trigger a bodily response where multiple chemicals are released e.g prostaglandins, leukotrienes etc.


As there has been small tears and inflammation – the hallmark features of inflammation can occur which are

  1. Pain

  2. Swelling

  3. Stiffness


Who gets DOMS?


Anyone of any fitness can suffer with DOMS – so it is not a sign of poor physical fitness. It can occur from many different modalities of exercise; high intensity, weight lifting etc. This is why they UK Chief medical officer advises strength training is done on non-consecutive days but if training if to occur on simultaneous days, that different major muscle groups are used. Recovery of our muscles and soft tissue is just as important as performing the exercise and it is in the recovery phase where all the physiological changes occur in our tissues to then further improve our fitness and muscle capacity.


Interestingly, research has shown significant differences in DOMS at different phases of a woman’s menstrual cycle, suggesting that hormones fluctuations will have an impact on this process. When hormone levels are low in the early phases of the menstrual cycle, lower loads of training and longer recovery is probably more beneficial.


What can you do to help relieve DOMs?

These modalities below can reduce the time of symptoms and how bad they are…

  • Simple painkillers – anti-inflammatory medications can be of some benefit to some people and work to reduce the prostaglandins released that has caused the pain; these can be put on topically or taken orally (if no contraindications)

  • Cold therapy eg cryotherapy chambers, cold water immersion and heat therapies e.g hot baths, saunas; these therapies are becoming more popular in athletes and people who frequently exercise to reduce the DOMS symptoms. Indications from the current evidence is that utilisation of cold or heat therapy within 1 hours after exercise may reduce pain experienced from DOMS.

  • Massage; this can be done at home by yourself with a foam roller but physical therapy from physiotherapists can be done too. The intension is that this will help loosen the myofascial tissues and improve blood supply to the area to improve the healing process of these microtears.

  • Studies have been done to look and see if nutritious foods high in polyphenols can delay and improve symptoms of DOMS but the quality of the studies were low and so conclusions from this will require further testing and studies.

  • As inflammation is the underlying process causing the pain in DOMS, research has been done looking at the effects of omega 3 foods (which are anti-inflammatory) and its effects. No benefits were found from this study, however larger and more robust trials are needed in this area. Anecdotally though, some patients may find benefits from eating nutritious anti-inflammatory foods post exercise. Whether there is science behind this; the verdict is still to be determined.

  • No high-quality evidence for the benefit of acupuncture post exercise on reduction of DOMS currently exists; again, the theory surrounding this may not marry up to the reality of patient’s experience anecdotally, but we must remember this may be a placebo effect, or not!

  • Studies have investigated whether kinaesthetic tape can reduce muscle soreness and research has shown patient experience significantly reduced muscle soreness at 48 h and 72 hours respectively with its use.


What can we do to prevent DOMs?

  • Warming up properly pre-exercise

  • Stretching post exercise – research is ongoing into stretch intensity and position to see how this can benefit DOMS but no clear evidence on this exists at present. Furthermore, there is not clear evidence suggesting stretching to prevent or reduce muscle soreness after exercise is beneficial. Nevertheless, many people still do varying stretching practices after exercise.

 

Drop any comments you have in the box below… Thank you for reading…

 

References:

  1. Cheatham SW, Kolber MJ, Cain M, Lee M. THE EFFECTS OF SELF-MYOFASCIAL RELEASE USING A FOAM ROLL OR ROLLER MASSAGER ON JOINT RANGE OF MOTION, MUSCLE RECOVERY, AND PERFORMANCE: A SYSTEMATIC REVIEW. Int J Sports Phys Ther. 2015 Nov;10(6):827-38. PMID: 26618062; PMCID: PMC4637917.

  2. Machado AF, Ferreira PH, Micheletti JK, de Almeida AC, Lemes ÍR, Vanderlei FM, Netto Junior J, Pastre CM. Can Water Temperature and Immersion Time Influence the Effect of Cold Water Immersion on Muscle Soreness? A Systematic Review and Meta-Analysis. Sports Med. 2016 Apr;46(4):503-14. doi: 10.1007/s40279-015-0431-7. PMID: 26581833; PMCID: PMC4802003.

  3. Guo J, Li L, Gong Y, Zhu R, Xu J, Zou J, Chen X. Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis. Front Physiol. 2017 Sep 27;8:747. doi: 10.3389/fphys.2017.00747. PMID: 29021762; PMCID: PMC5623674.

  4. Petrofsky J, Berk L, Bains G, Khowailed IA, Lee H, Laymon M. The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness. Clin J Sport Med. 2017 Jul;27(4):329-337. doi: 10.1097/JSM.0000000000000375. PMID: 27454218.

  5. Romero-Parra N, Cupeiro R, Alfaro-Magallanes VM, Rael B, Rubio-Arias JÁ, Peinado AB, Benito PJ; IronFEMME Study Group. Exercise-Induced Muscle Damage During the Menstrual Cycle: A Systematic Review and Meta-Analysis. J Strength Cond Res. 2021 Feb 1;35(2):549-561. doi: 10.1519/JSC.0000000000003878. PMID: 33201156.

  6. Rickards L, Lynn A, Harrop D, Barker ME, Russell M, Ranchordas MK. Effect of Polyphenol-Rich Foods, Juices, and Concentrates on Recovery from Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis. Nutrients. 2021 Aug 27;13(9):2988. doi: 10.3390/nu13092988. PMID: 34578866; PMCID: PMC8465563.

  7. Lv ZT, Zhang JM, Zhu WT. Omega-3 Polyunsaturated Fatty Acid Supplementation for Reducing Muscle Soreness after Eccentric Exercise: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biomed Res Int. 2020 Apr 20;2020:8062017. doi: 10.1155/2020/8062017. PMID: 32382573; PMCID: PMC7195643.

  8. Apostolopoulos N, Metsios GS, Flouris AD, Koutedakis Y, Wyon MA. The relevance of stretch intensity and position-a systematic review. Front Psychol. 2015 Aug 18;6:1128. doi: 10.3389/fpsyg.2015.01128. PMID: 26347668; PMCID: PMC4540085.

  9. Ko GWY, Clarkson C. The effectiveness of acupuncture for pain reduction in delayed-onset muscle soreness: a systematic review. Acupunct Med. 2020 Apr;38(2):63-74. doi: 10.1177/0964528419887978. Epub 2019 Dec 3. PMID: 31793352.

  10. Herbert RD, de Noronha M. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD004577. doi: 10.1002/14651858.CD004577.pub2. Update in: Cochrane Database Syst Rev. 2011;(7):CD004577. PMID: 17943822.

  11. Beardsley C, Škarabot J. Effects of self-myofascial release: A systematic review. J Bodyw Mov Ther. 2015 Oct;19(4):747-58. doi: 10.1016/j.jbmt.2015.08.007. Epub 2015 Aug 28. PMID: 26592233.

  12. Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021 Mar;48:177-187. doi: 10.1016/j.ptsp.2021.01.004. Epub 2021 Jan 14. PMID: 33493991.

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