MIND and MOTION

The experience of getting an intense workout in, feeling great, and then being left with muscles that feel terribly sore a day or two afterwards is one that is all too familiar to individuals that are just getting into exercising or to athletes that are coming back into the groove after a long break. Inexperienced individuals may wonder why their muscle performance decreases for a few days after these types of workouts. They may look for factors that decrease this painful effect or ways to reduce the occurrence of pain from soreness. Therefore, it is important to inform oneself on muscle damage and muscle soreness that occurs after such high-intensity exercise. An individual who often experiences this muscle soreness should ask: Why does muscle soreness, such as delayed-onset muscle soreness (DOMS), occur after exercise and what are effective treatments for it?

DOMS: Delayed-Onset Muscle Soreness

What is DOMS and Why Does it Occur?

Delayed-onset muscle soreness (DOMS) is a certain type of muscle strain injury where there is mild damage to individual muscle fibers, resulting in tenderness of the muscles or a stiffness in movement (Cheung et al., 2003). It typically occurs after unfamiliar, high-intensity eccentric exercise (Cheung et al., 2003; Hotfiel et al., 2018). Examples of eccentric exercise are running downhill, the downward motion of a squat, push-ups, and pull-ups. Symptoms of DOMS are variable, but predominant ones range from mild muscle soreness to pain accompanied with an inability to move in certain ways (Hotfiel et al., 2018).

There has been extensive research on the reasons why DOMS occurs after eccentric exercise, such as the mechanisms behind the symptoms expressed by individuals. This research has not yet been able to provide a definite explanation of why we experience DOMS after unfamiliar, high-intensity exercise, however Cheung and colleagues (2003) summarize six proposed theories: the lactic acid theory, muscle spasm theory, connective tissue theory, muscle damage theory, inflammation theory, and enzyme efflux theory. Cheung and colleagues (2003) are careful to mention that the likely explanation for DOMS is a combination of two or more of the six proposed theories mentioned above. However, they do suggest a hypothesis for the mechanism of DOMS wherein high forces from eccentric exercise result in muscle and connective tissue damage, which triggers an inflammatory response in the muscle that causes the pain.

How Can This Muscle Soreness Be Attenuated?

Extensive research has provided evidence of several options that can attenuate the muscle soreness experienced after unfamiliar, high-intensity exercise, as well as ways to enhance recovery from it. Several treatments include caffeine ingestion after exercise (Chen et al., 2019), foam rolling of the exercise muscle group (Pearcey et al., 2015), vibration therapy (Cheng et al., 2022; Veqar & Imtiaz, 2014), and supplement intake (Nieman et al., 2020; Ra et al., 2018).

Caffeine Ingestion

Chen and colleagues (2019) decided to look at the influence of caffeine on muscle function after exercise and DOMS. They then had participants ingest a small amount of caffeine (6 mg/kg) 24 hours after eccentric exercise. It was found that when caffeine was ingested 24 hours after eccentric exercise, the effect of DOMS was attenuated. The authors concluded that caffeine ingestion is a factor that is able to improve the recovery of muscle power that was lost following the induced muscle damage from the downhill running and attenuate DOMS.

Foam Rolling

Athletes, who need to have proper muscle function and muscle performance and cannot wait almost a week before using a sore muscle group, need to have quick and efficient methods of treatment for muscle soreness. Pearcey and colleagues (2015) have demonstrated how the implementation of foam rolling after exercise and every 24 hours afterwards can reduce the effects of DOMS. After intense squat exercises, it was reported that the quadriceps felt substantially better 24- and 48-hours post-exercise than in a control condition that did not use any foam rolling technique. This showed that foam rolling reduces muscle tenderness and combats against the decrease in dynamic movement performance for certain joints, thereby enhancing recovery from DOMS.

Vibration Therapy

Vibration therapy has been shown to provide improvements in muscle strength, as well as its range of motion and blood flow (Veqar & Imtiaz, 2014). Cheng and colleagues (2022) sought to evaluate the effect of vertical vibration stimulation of different intensities on DOMS in male athletes. After subjecting athletes to DOMS-inducing eccentric exercises, some were treated with medium-frequency vibration stimulation, whereas others were treated with high-frequency vibration stimulation. This high-frequency vibration training reduced muscle pain more than medium-frequency vibration (Cheung et al., 2022). Therefore, vibration therapy can be one method implemented by individuals as an effective treatment of DOMS that can enhance future performance and reduce risk of injuries (Cheung et al., 2022; Veqar & Imtiaz, 2014).

Supplement Intake

If one is new to the gym and is looking to see consistent results, they may hear regular gym-goers talking about supplements they’ve been taking to aid in their muscle-gaining process. It is a given that individuals who expend more energy, such as active individuals, need to intake more protein than sedentary individuals (Nieman et al., 2020). Therefore, active individuals may turn to supplements. Protein supplements can include branched-chain amino acid supplements, as well as whey and pea protein supplements (Nieman et al., 2020; Ra et al., 2018). However, research has found that, while some supplements may be useful in increasing protein intake, they do not provide any significant effects on the reduction of muscle soreness after unfamiliar, high- intensity exercises (Nieman et al., 2020).

Future Directions

While the current literature on DOMS provides insight into some of the mechanisms that cause it, as well as methods of treatment that can attenuate the experienced muscle soreness, there still seem to be some holes within the literature. Most studies investigating treatments have only evaluated the treatment effects in males, therefore future studies should look to see whether the same treatment effects occur in females. To this extent, a study evaluating the difference between males and females in their symptoms of DOMS should also be conducted.

Citations

Chen, H. Y., Chen, Y. C., Tung, K., Chao, H. H., & Wang, H. S. (2019). Effects of caffeine and sex on muscle performance and delayed-onset muscle soreness after exercise-induced muscle damage: A double-blind randomized trial. Journal of Applied Physiology, 127(3), 798-805.

Cheng, L., Wang, K., He, B., & Yan, Y. (2022). Effect of vertical vibration stimulation at different frequencies on delayed muscle soreness in athletes: A randomized trial. Frontiers in Public Health, 10.

Cheung, K., Hume, P. A., & Maxwell, L. (2003). Delayed Onset Muscle Soreness Treatment Strategies and Performance Factors. 33 (2), 145–164. Sports Medicine. https://doi. org/10.2165/00007256-200333020-00005.

Hotfiel, T., Freiwald, J., Hoppe, M. W., Lutter, C., Forst, R., Grim, C., … & Heiss, R. (2018). Advances in delayed-onset muscle soreness (DOMS): Part I: Pathogenesis and diagnostics. Sportverletzung· Sportschaden, 32(04), 243-250.

Nieman, D. C., Zwetsloot, K. A., Simonson, A. J., Hoyle, A. T., Wang, X., Nelson, H. K., … & Guérin-Deremaux, L. (2020). Effects of whey and pea protein supplementation on post- eccentric exercise muscle damage: A randomized trial. Nutrients, 12(8), 2382.

Pearcey, G. E., Bradbury-Squires, D. J., Kawamoto, J. E., Drinkwater, E. J., Behm, D. G., &
Button, D. C. (2015). Foam rolling for delayed-onset muscle soreness and recovery of
dynamic performance measures. Journal of athletic training, 50(1), 5–13. https://doi-
org.lib-ezproxy.concordia.ca/10.4085/1062-6050-50.1.01

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Ra, S. G., Miyazaki, T., Kojima, R., Komine, S., Ishikura, K., Kawanaka, K., … & Ohmori, H. (2018). Effect of BCAA supplement timing on exercise-induced muscle soreness and damage: a pilot placebo-controlled double-blind study. The Journal of sports medicine and physical fitness, 58(11), 1582-1591.

Veqar, Z., & Imtiyaz, S. (2014). Vibration therapy in management of delayed onset muscle soreness (DOMS). Journal of clinical and diagnostic research: JCDR, 8(6), LE01.