Delayed Onset Muscle Soreness

 What is DOMS?

Delayed onset muscle soreness (DOMS) also known as 'muscle fever', is a sore, aching, painful feeling in the muscles after unfamiliar or unaccustomed intense exercise. This soreness is thought to result from temporary muscle damage and inflammation, commonly triggered by eccentric exercises. Implementing recovery strategies after exercises that cause DOMS may be vital, as preventing and managing DOMS, and subsequently recovering from Exercise induced muscle damage (EIMD), are key for restoring muscular strength and performance levels. DOMS is considered a type 1 muscle strain injury, with a pain-free period of 12 to 24 hours and peak soreness between 24 to 72 hours. 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

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. 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.

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.

Neutrophils and pro-inflammatory 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.

Prevention

·        Heat and cold therapy

·       Massage

·        Compression garments

·        Active recovery with timely rest: low intensity exercise, stretching, foam rolling, flossing

·        Adequate sleep

·         Staying hydrated

·        Nutrition: Vitamin D, omega-3 fatty acids, branched-chain amino acids (BCAAs), antioxidant supplements