It’s that time of year again. The holidays are now officially over and people everywhere are getting back into fitness. For some it’s been a short break, but for others, it’s been years since they’ve dedicated time to improving their fitness.
Regardless, one thing is for certain after an extended break from training…the dreaded ‘D’ word. DOMS!
So what actually is DOMS?
Delayed onset muscle soreness (DOMS) is a symptom of exercise induced muscle damage (EIMD). EIMD is described as an entity of “ultrastructural” muscle damage, caused by eccentric (lengthening) muscle contractions or unaccustomed forms of exercise. For example, going to the gym for the first time this year! Although it is considered a mild type of muscle damage, it often doesn’t feel that way!
Signs include:
impaired muscular force
painful restriction of movement
stiffness
mild swelling
altered biomechanics in adjacent joints (eg. walking down stairs after leg day)
The earliest signs begin 6-12 hours after exercise and increase progressively until reaching a peak pain level at 48-72 hours. Symptoms then begin to disappear and can take up to 5-7 days to subside. Lucky for us, our bodies adapt quite quickly after the initial bout of EIMD and subsequent bouts of similar exercise aren’t half as damaging, or more importantly, painful!
Is there anything we can do about it?
There are a vast array of products and practices out there that claim they can reduce the severity of DOMS. Everything from ice baths, compression gear, supplements, foam rolling, massage guns etc… Despite these claims, what does the scientific research ACTUALLY say?
Let's have a closer look…
Cold water immersion (CWI) is one of the most common recovery strategies used to prevent DOMS. Overall, the research suggests that it seems to be slightly better in the treatment of DOMS compared to passive recovery methods. However, it should be noted that CWI seems to be more effective in reducing DOMS induced by prolonged whole body endurance exercises rather than activities such as weight training. Temperatures between 11-15 degrees Celsius for 11-15 mins were found to achieve the best results. That being said, some studies suggest that CWI is no more effective than active recovery strategies and the effects on performance enhancement still remain unclear.
Compression garments worn during exercise seems to have little effect on performance, recovery or DOMS. However, wearing compression garments after exercise has been shown to be relatively effective to reduce symptoms of DOMS, to accelerate recovery of muscle function, strength and power.
Stretching and low intensity exercise have the longest standing tradition of being two of the most recommended and simple ways to combat the effect of DOMS . Despite them standing the test of time, surprisingly, there is a lack of evidence to support their use.
Foam rolling (FR) has gained huge popularity over the past decade. Research has shown that rolling reduces pressure point tenderness associated with DOMS, but the effect is only temporary. The analgesic effect lasts longer the longer rolling is performed, but that effect isn’t linear. In other words, if you rolled for 10 minutes instead of 5 mins you would get more of a positive effect but it wouldn’t necessarily be twice as effective.
Flossing, which involves wrapping tight bands around limbs, has recently become hugely popular in both competitive and recreational sports, especially CrossFit. Despite its popularity, a recent study showed no effect on symptoms of DOMS or muscle regeneration.
Electrical modalities such as vibration therapy, therapeutic ultrasound, shock wave therapy (ECSWT), electromyostimulation (EMS) and massage guns have limited research and results are quite variable.
Manual therapies such as massage have been used for years for post exercise recovery but uncertainty still exists about the evidence of it’s effectiveness to treat DOMS. The available research has many shortcomings and mixed results.
Medications such as non-steroidal anti-inflammatories (NSAIDS) can offer pain relief and limit inflammation but can also have some negative effects on muscle repair.
Nutritional supplementation with Vitamin D, BCAA's, caffeine, Omega-3 fatty acids and antioxidant supplementation that have shown promising results, but none was found to have groundbreaking effects in the prevention and effects of DOMS.
So, what does all of this mean?
At this stage, there is definitely no silver bullet when it comes to combatting DOMS. CWI and wearing compression garments after exercise seem to be most beneficial according to the current literature. Many of the other aids and therapies that are widely used have been studied to some degree, but the studies themselves are often lacking in various ways. Because of this we really can’t say for sure what our best defence truly is, or if there even is one.
Looking at the above strategies used to reduce the effects of DOMS, they are all fairly low risk if used appropriately. Unless contraindicated, if someone strongly feels that ‘x’ helps their recovery, then I would recommend they simply keep doing it. Even though the evidence isn’t there yet to support much of what we do for DOMS, it doesn’t mean it’s wrong. Especially, if it makes us feel good.
References
Heiss, R., Lutter, C., Freiwald, J., Hoppe, M., Grim, C., Poettgen, K., Forst, R., Bloch, W., Hüttel, M., & Hotfiel, T. (2019). Advances in Delayed-Onset Muscle Soreness (DOMS) – Part II: Treatment and Prevention. Sportverletzung · Sportschaden, 33(01), 21–29.
Hotfiel, T., Freiwald, J., Hoppe, M., Lutter, C., Forst, R., Grim, C., Bloch, W., Hüttel, M., & Heiss, R. (2018). Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletzung · Sportschaden, 32(04), 243–250.
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