Muscle Soreness and Delayed-Onset Muscle Soreness
Section snippets
Clinical Presentation
Muscle soreness is classified as a type I muscle strain1 and refers to the immediate soreness perceived by the athlete while or immediately after participating in exercises. Muscle soreness presents with muscle stiffness, aching pain, and/or muscular tenderness. These symptoms are experienced for only hours and are relatively transient compared to those of DOMS. The symptomatology of DOMS shares similar quality and intensity to that of immediate exercise-induced muscle soreness but symptom
Cellular Mechanisms
Paralleling the diverse population and clinical presentation of muscle soreness, there are 6 competing theories for the mechanism of DOMS: lactic acid accumulation,19, 20 muscle spasm,21, 22 microtrauma,23, 24, 25 connective tissue damage,25 inflammation,5, 9, 26 and electrolytes and enzyme efflux.19, 27, 28 While these 6 theories were presented independently from one another, the current consensus is that a single theory alone is insufficient to explain the process; instead, they work in
Preventive Measures
Effective prevention of muscle soreness is difficult; it is a physiologic response to activity. The most effective prophylaxis of muscle soreness would be abstaining from prolonged, intense unfamiliar physical exercises. Identifying such activities before participating often carries a commensurate degree of difficulty. When such tasks are identified or anticipated however, there are inherent modalities—physical preparation, demand reduction and nutritional resources—can minimize anticipated
Symptom Management
Completing the physiological mechanism of muscle soreness is the only effective treatment. Each clinician is to approach the most compatible options for the athlete with a sound understanding of existing basic science that supports or refutes the selected modalities. The primary responsibility of the clinician is to prevent the athlete from injuring himself or herself with the chosen management(s).
The outcomes from clinical research on massage are too variable28, 51, 52, 53, 54, 55 to
Summary
Immediate and delayed-onset muscle soreness differ mainly in chronology of presentation. Both conditions share the same quality of pain, eliciting and relieving activities and a varying degree of functional deficits. There is no single mechanism for muscle soreness; instead, it is a culmination of 6 different mechanisms. The developing pathway of DOMS begins with microtrauma to muscles and then surrounding connective tissues. Microtrauma is then followed by an inflammatory process and
References (83)
- et al.
Delayed onset muscle soreness and training
Clin Sports Med
(1986) - et al.
Serum enzyme monitoring in sports medicine
Clin Sports Med
(2008) - et al.
Large-fiber mechanoreceptors contribute to muscle soreness after eccentric exercise
J Pain
(2001) - et al.
Injuries at the myotendinous junction
Clin Sports Med
(1992) - et al.
Function of the long head of the biceps at the shoulder: electromyographic analysis
J Shoulder Elbow Surg
(2001) - et al.
Functional magnetic resonance imaging of muscle
Exerc Sport Sci Rev
(2000) - et al.
Muscle activity in upper and lower rectus abdominus during abdominal exercises
Arch Phys Med Rehabil
(1996) - et al.
Massage reduces pain perception and hyperalgesia in experimental muscle pain: a randomized, controlled trial
J Pain
(2008) - et al.
Vibration-induced afferent activity augments delayed onset muscle allodynia
J Pain
(2011) - et al.
Effects of local pressure and vibration on muscle pain from eccentric exercise and hypertonic saline
Pain
(2003)
The effect of soft tissue release on delayed onset muscle soreness: a pilot study
Phys Ther Sport
Warm-up and muscular injury preventionAn update
Sports Med
Exercise-induced muscle damage and adaptation
Sports Med
Morphologic and mechanical basis of delayed-onset muscle soreness
J Am Acad Orthop Surg
Delayed muscle sorenessThe inflammatory response to muscle injury and its clinical implications
Sports Med
Delayed onset muscle soreness at tendon-bone junction and muscle tissue is associated with facilitated referred pain
Exp Brain Res
Injury to skeletal muscle fibers during contractions: conditions of occurrence and prevention
Phys Ther
Presence of WBC, decreased strength, and delayed soreness in muscle after eccentric exercise
J Appl Physiol
Time course of leukocyte accumulation in human muscle after eccentric exercise
Med Sci Sports Exerc
Recovery of skeletal muscle contractility after high- and moderate-intensity strength exercise
Eur J Appl Physiol
Temporal relation between leukocyte accumulation in muscles and halted recovery 10-20 h after strength exercise
J Appl Physiol
E-C coupling failure in mouse EDL muscle after in vivo eccentric contractions
J Appl Physiol
Time course of proteolytic, cytokine, and myostatin gene expression after acute exercise in human skeletal muscle
J Appl Physiol
Uncoupling of in vivo torque production from EMG in mouse muscles injured by eccentric contractions
J Physiol
Delayed onset muscle soreness following repeated bouts of downhill running
J Appl Physiol
Causes of delayed onset muscle soreness and the impact on athletic performance: a review
J Appl Sport Sci Res
Theoretical basis for patterning EMG amplitudes to assess muscle dysfunction
Med Sci Sports Exerc
Mechanisms of exercise-induced delayed onset muscular soreness: a brief review
Med Sci Sports Exerc
Delayed onset muscle soreness: treatment strategies and performance factors
Sports Med
Neuromuscular tension and its relief
J Assoc Phys Ment Rehabil
Quantitative electromyographic investigation of the spasm theory of muscle pain
Am J Phys Med
Factors in delayed onset muscular soreness of man
Med Sci Sports Exerc
Sublethal muscle fibre injuries after high-tension anaerobic exercise
Eur J Appl Physiol Occup Physiol
Ergographic studies in muscular fatigue and soreness
J Boston Soc Med Sci
Different effects of strenuous eccentric exercise on the accumulation of neutrophils in muscle in women and men
Eur J Appl Physiol
Delayed onset muscle soreness: what is it and how do we treat it?
J Sport Rehab
Various treatment techniques on signs and symptoms of delayed onset muscle soreness
J Athl Train
Initial events in exercise-induced muscular injury
Med Sci Sports Exerc
Acute inflammation: the underlying mechanism in delayed onset muscle soreness?
Med Sci Sports Exerc
Clinical significance of skeletal muscle architecture
Clin Orthop Relat Res
Functional and clinical significance of skeletal muscle architecture
Muscle Nerve
Cited by (128)
Skin temperature normalizes faster than pressure pain thresholds, pain intensity, and pain distribution during recovery from eccentric exercise
2023, Journal of Thermal BiologyCitation Excerpt :Additionally, given the difficulty of directly assessing the extent of muscle damage, such modeling enables contrasting the utility of different potential indirect markers such as skin temperature, pain distribution, pain intensity, and pain sensitivity. Exercise-induced delayed-onset muscle soreness (DOMS) his associated with symptoms similar to musculoskeletal injuries, such as pain during movement or local swelling (Kim and Lee, 2014; Lewis et al., 2012). The overloading of muscle tissue by unaccustomed exercise (e.g., eccentric exercise) produces ultrastructural damage (Hotfiel et al., 2018), which prompts the release of inflammatory sensitizing substances such as nerve growth factor and bradykinin (Murase et al., 2010).
Is Electrical Stimulation Effective in Preventing or Treating Delayed-onset Muscle Soreness (DOMS) in Athletes and Untrained Adults? A Systematic Review With Meta-Analysis
2022, Journal of PainCitation Excerpt :Delayed-onset muscle soreness (DOMS) is commonly reported by athletes or untrained individuals after high-intensity eccentric exercise or by unfamiliar exercises.33,48
Ankle muscle fatigability impairs body sway for more than 24 h
2022, Journal of BiomechanicsLocal Heat Applications as a Treatment of Physical and Functional Parameters in Acute and Chronic Musculoskeletal Disorders or Pain
2022, Archives of Physical Medicine and RehabilitationCitation Excerpt :The investigated pathologies included knee osteoarthritis,27,28,45 low back pain,2 and frozen shoulder.50 Three studies2,45,50 performed follow-up assessments at 48 hours where LHA continued to show a beneficial effect on physical function. These results suggest that LHA is effective in improving physical function.
The authors have nothing to disclose.