Delayed Onset Muscle Soreness: Difference between revisions
Joao Costa (talk | contribs) No edit summary |
Candace Goh (talk | contribs) No edit summary |
||
| (7 intermediate revisions by the same user not shown) | |||
| Line 4: | Line 4: | ||
</div> | </div> | ||
== Introduction == | == Introduction == | ||
[[File:Concentric vs eccentric muscle contraction - Kenhub.png|alt=Overview of concentric vs eccentric muscle contraction | [[File:Concentric vs eccentric muscle contraction - Kenhub.png|alt=Overview of concentric vs eccentric muscle contraction|600x600px|Overview of concentric vs eccentric muscle contraction.<ref>Overview of concentric vs eccentric muscle contraction image - © Kenhub https://www.kenhub.com/en/library/anatomy/eccentric-muscle-contraction</ref>|thumb]] | ||
'''Delayed onset muscle soreness (DOMS)''' also known as 'muscle fever'. It is a sore, aching, painful feeling in the muscles after unfamiliar and unaccustomed intense exercise. This soreness is thought to result from temporary muscle damage and inflammation, commonly triggered by [[Introduction to Therapeutic Exercise|eccentric exercises]] (see [[Exercise Induced Muscle Damage|Exercise induced muscle damage]]). DOMS is considered a type 1 muscle strain injury, with a pain free period of 12-24 hours and peak soreness between 24-72 hours.<ref name=":0">Gulick D, Kimura I. Delayed Onset Muscle Soreness: What Is It and How Do We Treat It?. Journal of Sport Rehabilitation. 1996;5(3):234-243.</ref> When we engage in physical activity, our muscle cells experience minor damage. This is a normal process and isn't as harmful as it might seem. Our bodies then repair the muscle fibres, improving them slightly each time, which is how we progressively become fitter and stronger through exercise. | |||
== Pathophysiology == | == Pathophysiology == | ||
[[File:Skeletal_muscle.jpeg|right|500x500px]]Eccentric muscle contractions result in greater disruption to the structural elements of the muscle and connective tissue than concentric exercise,which is why DOMS is more intense with eccentric than concentric forms of activity<ref>Basham SA, Waldman HS, Krings BM, Lamberth J, Smith JW, McAllister MJ. Effect of Curcumin Supplementation on Exercise-Induced Oxidative Stress, Inflammation, Muscle Damage, and Muscle Soreness. Journal of dietary supplements. 2019 Apr 26:1-4.</ref> | [[File:Skeletal_muscle.jpeg|right|500x500px]]Eccentric muscle contractions result in greater disruption to the structural elements of the muscle and connective tissue than concentric exercise, which is why DOMS is more intense with eccentric than concentric forms of activity.<ref>Basham SA, Waldman HS, Krings BM, Lamberth J, Smith JW, McAllister MJ. Effect of Curcumin Supplementation on Exercise-Induced Oxidative Stress, Inflammation, Muscle Damage, and Muscle Soreness. Journal of dietary supplements. 2019 Apr 26:1-4.</ref> This structural disruption has sufficient evidence by histologic studies, electron microscopic examinations and serum enzyme levels which have been carried out over the years. | ||
Eccentric contractions recruit fewer motor units and thus the force generated is distributed over a smaller cross sectional area of the muscle.This increased tension per unit area causes greater injury to the tissue.However there is still ongoing research to establish a direct causation between the muscle and connective tissue injury to the onset of DOMS<ref>Postexercise Muscle Soreness [Internet]. Sickle Cell Anemia Differential Diagnoses. 2017 [cited 2019Mar1]. Available from: https://emedicine.medscape.com/article/313267-overview#a5</ref> | Eccentric contractions recruit fewer motor units and thus the force generated is distributed over a smaller cross sectional area of the muscle. This increased tension per unit area causes greater injury to the tissue.However there is still ongoing research to establish a direct causation between the muscle and connective tissue injury to the onset of DOMS.<ref>Postexercise Muscle Soreness [Internet]. Sickle Cell Anemia Differential Diagnoses. 2017 [cited 2019Mar1]. Available from: https://emedicine.medscape.com/article/313267-overview#a5</ref> | ||
The onset of muscle soreness following exercise is multifaceted. The pain free period indicates that DOMS isn’t solely due to myofibrillar disruptions but has other underlying causes. The secondary injury model states that after the initial trauma (muscle damage or injury) the inflammatory cascade that follows can induce secondary damage<ref name=":1">Toumi H. The inflammatory response: friend or enemy for muscle injury?. British Journal of Sports Medicine. 2003;37(4):284-286.</ref><ref name=":2">Knight K, Brucker J, Stoneman P, Rubley M. Muscle Injury Management with Cryotherapy. Athletic Therapy Today. 2000;5(4):26-30.</ref> | The onset of muscle soreness following exercise is multifaceted. The pain free period indicates that DOMS isn’t solely due to myofibrillar disruptions but has other underlying causes. The secondary injury model states that after the initial trauma (muscle damage or injury) the inflammatory cascade that follows can induce secondary damage.<ref name=":1">Toumi H. The inflammatory response: friend or enemy for muscle injury?. British Journal of Sports Medicine. 2003;37(4):284-286.</ref><ref name=":2">Knight K, Brucker J, Stoneman P, Rubley M. Muscle Injury Management with Cryotherapy. Athletic Therapy Today. 2000;5(4):26-30.</ref> | ||
Neutrophils and proinflammatory macrophages are important in the removal of cell debris through phagocytosis. However, excess production of reactive oxygen species (ROS) by these inflammatory cells can cause collateral damage to healthy cells that were not involved in the initial trauma by means of denaturing the proteins, lipids and nucleic acids that make up those cells<ref>Bleakley C, Davison G. Cryotherapy and inflammation: evidence beyond the cardinal signs. Physical Therapy Reviews. 2010;15(6):430-435.</ref><ref>Nguyen H, Tidball J. Interactions between neutrophils and macrophages promote macrophage killing of rat muscle cells in vitro. The Journal of Physiology. 2002;547(1):125-132.</ref><ref>Powers S, Jackson M. Exercise-Induced Oxidative Stress: Cellular Mechanisms and Impact on Muscle Force Production. Physiological Reviews. 2008;88(4):1243-1276.</ref> | Neutrophils and proinflammatory macrophages are important in the removal of cell debris through phagocytosis. However, excess production of reactive oxygen species (ROS) by these inflammatory cells can cause collateral damage to healthy cells that were not involved in the initial trauma by means of denaturing the proteins, lipids and nucleic acids that make up those cells.<ref>Bleakley C, Davison G. Cryotherapy and inflammation: evidence beyond the cardinal signs. Physical Therapy Reviews. 2010;15(6):430-435.</ref><ref>Nguyen H, Tidball J. Interactions between neutrophils and macrophages promote macrophage killing of rat muscle cells in vitro. The Journal of Physiology. 2002;547(1):125-132.</ref><ref>Powers S, Jackson M. Exercise-Induced Oxidative Stress: Cellular Mechanisms and Impact on Muscle Force Production. Physiological Reviews. 2008;88(4):1243-1276.</ref> | ||
== Prevention == | == Prevention == | ||
DOMS generally gets better on its own after a few days to a week.However, during that time range of motion and muscle performance can be reduced. | DOMS generally gets better on its own after a few days to a week. However, during that time range of motion and muscle performance can be reduced. Inflammation is crucial for building strength in response to a workout. Research indicates that regularly taking non-steroidal anti-inflammatory drugs (NSAIDs) for DOMS may hinder this process, potentially reducing the muscle strength gains from your training.<ref>Cornu C, Grange C, Regalin A, Munier J, Ounissi S, Reynaud N, Kassai-Koupai B, Sallet P, Nony P. Effect of non-steroidal anti-inflammatory drugs on sport performance indices in healthy people: a meta-analysis of randomized controlled trials. Sports Medicine-Open. 2020 Dec;6:1-1.</ref> Interventions that have proven effective in prevention or recovery of DOMS include: | ||
* Heat and cold therapy<ref>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. Physical Therapy in Sport. 2021 Mar 1;48:177-87.</ref> | |||
* Massage<ref>Guo J, Li L, Gong Y, Zhu R, Xu J, Zou J, Chen X. [https://www.frontiersin.org/articles/10.3389/fphys.2017.00747/full Massage alleviates delayed onset muscle soreness after strenuous exercise: a systematic review and meta-analysis.] Frontiers in physiology. 2017 Sep 27;8:747.</ref> | |||
* Active recovery with timely rest <ref>Song SH. Effects of rest interval following eccentric muscle contraction exercise on circulating substance, parameters related to damage and regeneration in skeletal muscle. The Official Journal of the Korean Academy of Kinesiology. 2013 Oct 31;15(4):107-15.</ref><ref name=":3">Zeng C, Luo G, Xu S, Li Y. The application of DOMS mechanism and prevention in physical education and training. Journal of Healthcare Engineering. 2022 Jan 7;2022.</ref> | |||
* Staying hydrated<ref name=":3" /> | |||
* Foam rolling<ref>La Shier SV. Effect of Therapeutic Treatment on Delayed Onset Muscle Soreness (DOMS).</ref> | |||
* Compression garments<ref>Kim J, Kim J, Lee J. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667600/ Effect of compression garments on delayed-onset muscle soreness and blood inflammatory markers after eccentric exercise: a randomized controlled trial.] Journal of exercise rehabilitation. 2017 Oct;13(5):541.</ref> | |||
* Curcumin supplements<ref>Basham SA, Waldman HS, Krings BM, Lamberth J, Smith JW, McAllister MJ. Effect of Curcumin Supplementation on Exercise-Induced Oxidative Stress, Inflammation, Muscle Damage, and Muscle Soreness. Journal of dietary supplements. 2019 Apr 26:1-4.</ref> | |||
Massage has been proven to show significant effects in reducing the intensity of the stiffness and pain felt associated with DOMS. When administered within 2 hours of activity, the mechanical pressure is believed to decrease the neutrophil migration and thus reduce the inflammatory process within the muscle structure. Massage however was shown to have no effect on muscle performance or strength post exercise when compared to a control group who were not administered the therapy<ref>2. J E Hilbert, G A Sforzo, T Swensen. [https://bjsm.bmj.com/content/bjsports/37/1/72.full.pdf The effects of massage on delayed onset muscle soreness]. ''Br J Sports Med 2003;37:72–75'' ; (): . (accessed 18 February 2018).</ref>. | |||
== Implications for | == Implications for Physiotherapy == | ||
Having DOMS is usually a positive sign post exercise. It indicates that the muscle is healing into a stronger state than it was before the activity and hence it means that the training was indeed effective. | Having DOMS is usually a positive sign post exercise. It indicates that the muscle is healing into a stronger state than it was before the activity and hence it means that the training was indeed effective. | ||
Many | Many physiotherapy clients will be starting a new exercise program or will be adding new exercises to their current exercise program. These exercises may be intense for the client and the client may experience delayed onset muscle soreness (DOMS) after starting physiotherapy or exercise program. DOMS is usually weaker following subsequent exercise sessions but the first bout may be so intense that patients often refuse to continue the exercises. | ||
Therefore, it is important for the therapist to reassure the patient that DOMS is a normal part of a new exercise program and to help the client differentiate muscle soreness from other types of pain. It is also important to note that the severity of the soreness is not related to the extent of the exercise-induced muscle damage.<ref>Nosaka K, Newton M, Sacco P. [https://onlinelibrary.wiley.com/doi/abs/10.1034/j.1600-0838.2002.10178.x Delayed‐onset muscle soreness does not reflect the magnitude of eccentric exercise‐induced muscle damage.] Scandinavian journal of medicine & science in sports. 2002 Dec 1;12(6):337-46.</ref>{{#ev:youtube|PUJpU6Ti5jU}} | |||
{{#ev:youtube|PUJpU6Ti5jU}} | |||
== References == | == References == | ||
Revision as of 05:54, 22 May 2024
Original Editor - Aimee Tow Top Contributors - Candace Goh, Aimee Tow, Shaimaa Eldib, Kim Jackson, Mudra Shah, Joao Costa, Claire Knott, Wanda van Niekerk, Gareth Geoffreys, Lucinda hampton and Saud Alghamdi
Introduction[edit | edit source]
Overview of concentric vs eccentric muscle contraction.[1]
Delayed onset muscle soreness (DOMS) also known as 'muscle fever'. It is a sore, aching, painful feeling in the muscles after unfamiliar and unaccustomed intense exercise. This soreness is thought to result from temporary muscle damage and inflammation, commonly triggered by eccentric exercises (see Exercise induced muscle damage). DOMS is considered a type 1 muscle strain injury, with a pain free period of 12-24 hours and peak soreness between 24-72 hours.[2] When we engage in physical activity, our muscle cells experience minor damage. This is a normal process and isn't as harmful as it might seem. Our bodies then repair the muscle fibres, improving them slightly each time, which is how we progressively become fitter and stronger through exercise.
Pathophysiology[edit | edit source]
Eccentric muscle contractions result in greater disruption to the structural elements of the muscle and connective tissue than concentric exercise, which is why DOMS is more intense with eccentric than concentric forms of activity.[3] This structural disruption has sufficient evidence by histologic studies, electron microscopic examinations and serum enzyme levels which have been carried out over the years.
Eccentric contractions recruit fewer motor units and thus the force generated is distributed over a smaller cross sectional area of the muscle. This increased tension per unit area causes greater injury to the tissue.However there is still ongoing research to establish a direct causation between the muscle and connective tissue injury to the onset of DOMS.[4]
The onset of muscle soreness following exercise is multifaceted. The pain free period indicates that DOMS isn’t solely due to myofibrillar disruptions but has other underlying causes. The secondary injury model states that after the initial trauma (muscle damage or injury) the inflammatory cascade that follows can induce secondary damage.[5][6]
Neutrophils and proinflammatory macrophages are important in the removal of cell debris through phagocytosis. However, excess production of reactive oxygen species (ROS) by these inflammatory cells can cause collateral damage to healthy cells that were not involved in the initial trauma by means of denaturing the proteins, lipids and nucleic acids that make up those cells.[7][8][9]
Prevention[edit | edit source]
DOMS generally gets better on its own after a few days to a week. However, during that time range of motion and muscle performance can be reduced. Inflammation is crucial for building strength in response to a workout. Research indicates that regularly taking non-steroidal anti-inflammatory drugs (NSAIDs) for DOMS may hinder this process, potentially reducing the muscle strength gains from your training.[10] Interventions that have proven effective in prevention or recovery of DOMS include:
- Heat and cold therapy[11]
- Massage[12]
- Active recovery with timely rest [13][14]
- Staying hydrated[14]
- Foam rolling[15]
- Compression garments[16]
- Curcumin supplements[17]
Massage has been proven to show significant effects in reducing the intensity of the stiffness and pain felt associated with DOMS. When administered within 2 hours of activity, the mechanical pressure is believed to decrease the neutrophil migration and thus reduce the inflammatory process within the muscle structure. Massage however was shown to have no effect on muscle performance or strength post exercise when compared to a control group who were not administered the therapy[18].
Implications for Physiotherapy[edit | edit source]
Having DOMS is usually a positive sign post exercise. It indicates that the muscle is healing into a stronger state than it was before the activity and hence it means that the training was indeed effective.
Many physiotherapy clients will be starting a new exercise program or will be adding new exercises to their current exercise program. These exercises may be intense for the client and the client may experience delayed onset muscle soreness (DOMS) after starting physiotherapy or exercise program. DOMS is usually weaker following subsequent exercise sessions but the first bout may be so intense that patients often refuse to continue the exercises.
Therefore, it is important for the therapist to reassure the patient that DOMS is a normal part of a new exercise program and to help the client differentiate muscle soreness from other types of pain. It is also important to note that the severity of the soreness is not related to the extent of the exercise-induced muscle damage.[19]
References[edit | edit source]
- ↑ Overview of concentric vs eccentric muscle contraction image - © Kenhub https://www.kenhub.com/en/library/anatomy/eccentric-muscle-contraction
- ↑ Gulick D, Kimura I. Delayed Onset Muscle Soreness: What Is It and How Do We Treat It?. Journal of Sport Rehabilitation. 1996;5(3):234-243.
- ↑ Basham SA, Waldman HS, Krings BM, Lamberth J, Smith JW, McAllister MJ. Effect of Curcumin Supplementation on Exercise-Induced Oxidative Stress, Inflammation, Muscle Damage, and Muscle Soreness. Journal of dietary supplements. 2019 Apr 26:1-4.
- ↑ Postexercise Muscle Soreness [Internet]. Sickle Cell Anemia Differential Diagnoses. 2017 [cited 2019Mar1]. Available from: https://emedicine.medscape.com/article/313267-overview#a5
- ↑ Toumi H. The inflammatory response: friend or enemy for muscle injury?. British Journal of Sports Medicine. 2003;37(4):284-286.
- ↑ Knight K, Brucker J, Stoneman P, Rubley M. Muscle Injury Management with Cryotherapy. Athletic Therapy Today. 2000;5(4):26-30.
- ↑ Bleakley C, Davison G. Cryotherapy and inflammation: evidence beyond the cardinal signs. Physical Therapy Reviews. 2010;15(6):430-435.
- ↑ Nguyen H, Tidball J. Interactions between neutrophils and macrophages promote macrophage killing of rat muscle cells in vitro. The Journal of Physiology. 2002;547(1):125-132.
- ↑ Powers S, Jackson M. Exercise-Induced Oxidative Stress: Cellular Mechanisms and Impact on Muscle Force Production. Physiological Reviews. 2008;88(4):1243-1276.
- ↑ Cornu C, Grange C, Regalin A, Munier J, Ounissi S, Reynaud N, Kassai-Koupai B, Sallet P, Nony P. Effect of non-steroidal anti-inflammatory drugs on sport performance indices in healthy people: a meta-analysis of randomized controlled trials. Sports Medicine-Open. 2020 Dec;6:1-1.
- ↑ 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. Physical Therapy in Sport. 2021 Mar 1;48:177-87.
- ↑ 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. Frontiers in physiology. 2017 Sep 27;8:747.
- ↑ Song SH. Effects of rest interval following eccentric muscle contraction exercise on circulating substance, parameters related to damage and regeneration in skeletal muscle. The Official Journal of the Korean Academy of Kinesiology. 2013 Oct 31;15(4):107-15.
- ↑ 14.0 14.1 Zeng C, Luo G, Xu S, Li Y. The application of DOMS mechanism and prevention in physical education and training. Journal of Healthcare Engineering. 2022 Jan 7;2022.
- ↑ La Shier SV. Effect of Therapeutic Treatment on Delayed Onset Muscle Soreness (DOMS).
- ↑ Kim J, Kim J, Lee J. Effect of compression garments on delayed-onset muscle soreness and blood inflammatory markers after eccentric exercise: a randomized controlled trial. Journal of exercise rehabilitation. 2017 Oct;13(5):541.
- ↑ Basham SA, Waldman HS, Krings BM, Lamberth J, Smith JW, McAllister MJ. Effect of Curcumin Supplementation on Exercise-Induced Oxidative Stress, Inflammation, Muscle Damage, and Muscle Soreness. Journal of dietary supplements. 2019 Apr 26:1-4.
- ↑ 2. J E Hilbert, G A Sforzo, T Swensen. The effects of massage on delayed onset muscle soreness. Br J Sports Med 2003;37:72–75 ; (): . (accessed 18 February 2018).
- ↑ Nosaka K, Newton M, Sacco P. Delayed‐onset muscle soreness does not reflect the magnitude of eccentric exercise‐induced muscle damage. Scandinavian journal of medicine & science in sports. 2002 Dec 1;12(6):337-46.
