Delayed Onset Muscle Soreness

I am writing about Delayed Onset Muscle Soreness (DOMS) while I have Delayed Onset Muscle Soreness. I did some walking lunges up a hill just yesterday evening and as of this afternoon I started to experience some discomfort. I am dreading sitting on the toilet tomorrow. But that's my problem, let's talk about DOMS.

Back in High School as a 14 year old was the first time DOMS was taught to me, but no doubt the “growing pains” that mum had told me about might have been an earlier teaching point that I, like many, missed. We learnt about an American doctor who first wrote about it over 100 years ago (can’t remember the year but I am sure it is over 100 years). The soreness experienced in the days after exercise has since been studied and investigated in more different ways than can be imagined, yet scientists still struggle to pinpoint the cause, the function and whether the phenomenon that is DOMS is positive or negative to training and exercise outcomes.

During my time at The Australian Institute of Sport working in the Physiology department, and more specifically in athlete recovery, Ilearnt quite a bit about DOMS, especially as a guinea pig in a study that induced DOMS in my calf muscles so bad that it was difficult to get up each morning and walk to the bathroom. All of the subjects in DOMS studies get to learn first hand how bad DOMS can get.

Theories about DOMS

Numerous  theories have been proposed for the mechanism of DOMS, but the mechanisms that have been studied the most include muscle spasm, connective tissue damage, muscle damage, enzyme efflux, inflammation and lactic acid accumulation theories (there are bound to be more). But knowing how the body works (knee bone connected to the shin bone) it is more likely that we should consider mechanisms and study a multifactorial and that two or more of the theories, and likely one not mentioned, combined might better explain DOMS.
In simple terms, scientists, coaches and practitioners know that the more unaccustomed the activity and the more it involves eccentric (lengthening a muscle under load) contraction the more likely you are to suffer from DOMS and the more severe it is likely to be. That said, there are some great ways to reduce the severity and length of time you suffer from DOMS. 

Recovering from DOMS

I worked for a brief period with a person with a brilliant mind named Joanna (Jo) Vaile. Jo published articles in the Journal of Strength and Conditioning Research and another in the European Journal of Applied Physiology that investigated the effect of various types of hydrotherapy, including contrast water therapy (hot and cold therapy), cold water therapy and hot water therapy on the physiological and functional symptoms of DOMS. From chatting with Jo and from my interpretation of the studies, I would generally say that contrast water therapy is best followed by cold water therapy. Hot water therapy was best at recovering isometric force, but that doesn’t help too much. So if you have the facilities available then I'd suggest a combination of hot and cold water immersion as a recovery method for 15 to 20 minutes once a day. Jo always had this thing about finishing on cold, so maybe stick to that as well and one other key thing is that the cold water should be 12-15 degrees and not colder than that (it doesn’t need to have ice in it).

Another method that is quite popular is the use of compression garments. Now for every study that says they work there is another study that says compression garments do not help reduce the effects of DOMS. Some of the studies are not that great and the methods can be questionable. In the end we know that wearing compression garments during activity does not help at all but wearing compression garments in the days after the activity can have a significant and positive impact on DOMS and perceived fatigue. So compression garments might be something to consider but they really don’t seem to help too much.

Stretching is another that a lot of people consider but there has not, to my knowledge, ever been a study that has shown a decrease in DOMS from stretching. In fact there are a couple of investigations that indicate that stretching after activity that induces DOMS might actually make it worse. So for now, don’t try stretching after activity to help reduce DOMS.

Active recovery might be the simplest and easiest way to reduce DOMS. Active recovery has a similar outcome to cold water therapy. Some people have probably experienced the effects of active recovery. Have you ever gone and done some activity in the days after DOMS and felt better as a result? That is as basic as it needs to be. So if your legs are sore, head out for a walk or a very light jog and see if the pain is reduced. It is suggested that active recovery might enhance blood flow in muscle tissue, facilitating the removal of metabolic waste, and might contribute to a reduction in muscle lesions and pain. Worth a try. At least it won’t make it any worse.

Now for the best method. Massage. Massage helps reduce the pain associated with DOMS, reduces metabolites present and even helps reduce inflammatory markers present in the muscles. The best part is, the sooner you do the massage after the activity, the better the results, indicating that some of the damage that occurs, actually happens following the activity. Everyone seems to blame lactic acid but the culprit appears more likely to be a creatine kinase. Creatine kinase has several functions in cellular energy metabolism so it is important but following its use, and in high concentrations it appears that it might be a contributor to DOMS. Massage immediately following activity appears to significantly reduce the amount of circulating creatine kinase and subsequently reduce DOMS.

My advice:

If you have the time, the facilities and the willingness, combine a few methods to help reduce DOMS. Get a massage as soon as possible following the activity, and maybe even the day after. Try either cold water therapy or contrast water therapy, Consider some compression garments and do a little bit of active recovery. If you do want some more specific advice for your situation then get in contact and we can have a chat about it and tailor a method that works for you.