Within clinic we treat a wide range of people from office workers to athletes at international level. We are often asked about DOMS (Delayed Onset of Muscular Soreness) and many of our clients come to us after heavy training loads seeking help with their recovery. Massage is a great tool to help with this but it is equally important to explain to everyone what DOMS actually is
The mildest type of muscle injury due to intrinsic sporting exercise is DOMS, an injury that all active sports people must have experienced at some point in their lives. DOMS is commonly a consequence of an over-training of untrained muscle, which is tolerated while engaged in that activity, but followed by muscle soreness 1–3 days after the exercise. This phenomenon strikes especially if the exercise involves plenty of eccentric work, i.e. lengthening of contracted muscles like in running downhill or more commonly, squatting with weights.
The symptoms of stiffness, soreness and tenderness with palpation develop during the first 1–2 days with a peak on days 2 or 3, and they disappear usually with no treatment by days 5–7. The pain is aggravated by passive stretch of the sore muscle and the strength of the muscle is decreased. This is usually associated with a rise in something called serum creatine kinase (CK), which is usually modest but sometimes up to 20-fold. CK-value peaks around days 3 to 6 and usually returns to normal during the first week after the eccentric exercise. Inflammatory reaction has been reported in both experimental animals and in humans. The pain in DOMS is likely caused by soluble factors released from the inflammatory cells which are sent to the area of damage caused by exercise. Remember, all exercise produces some form of micro-trauma but this is a good thing as the body then repairs itself to make things stronger. People have been told to use non steroidal anti-inflammatory drugs (NSAIDs) in the past to reduce the pain, but the relatively mild inflammation does not actually need any alleviation by treatment with NSAIDs and is actually not doing rhe muscles any good as the inflammation is a good thing to help with repair.
Pathogenesis of DOMS.
In humans, DOMS develops after eccentric work excessive for the fitness level of the muscle. In animal experiments the eccentric muscle contraction is repeated many times. But it has been shown that even a single eccentric stretch in rabbits may be sufficient to result in temporary reduced biomechanical capacity and to stimulate the dormant satellite cells to divide. Such an injury is, however, very mild and can be treated with simple techniques. Active recovery is a well used alternative to massage and involves the athlete/performer undertaking some form of low intensity cross training to help improve blood flow. Massage can also be an effective tool to help with the alignment of muscle fibres and help stimulate repair with tensile and compression loading.
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