Treatment Of Delayed Onset Muscle Soreness Research Articles

Update: Delayed Onset Muscle Soreness (DOMS) – Muscle Biomechanics, Pathophysiology and Therapeutic Approaches

The term Delayed Onset Muscle Soreness (DOMS) refers to a complex injury entity which is based on ultrastructural injury patterns. The injury is usually harmless and heals within a few days without sequelae. However, at the time of the manifestation there are (sometimes considerable) performance limitations and the risk of possible secondary injuries is increased. Thus, prevention and treatment of DOMS, especially in high-performance sports, are of particular value. Insights into muscle biomechanics are necessary to understand the background and mechanisms of DOMS. The definition and classification of overload-related muscle injuries has not yet been uniformly determined. Fluid transitions between physiological, metabolic and neuromuscular fatigue as well as the actual occurrence of injuries with clinical symptoms make clear delineation difficult. The “Munich Classification” terms Delayed Onset Muscle Soreness (DOMS) as Type 1b muscle injury, “delayed onset muscle pain”. The central target of prevention of DOMS is to prevent or alleviate the onset of the initial damage, known as “Exercise Induced Muscle Damage” (EIMD). In case of manifest DOMS, the intention is both to relieve the attendant symptoms and to promote rapid restoration of muscle function. In clinical practice as in scientific research, diverse procedures and interventions have proven valuable, whereby especially physical therapy procedures like cryotherapy, heat therapy or compression therapy show promising study results.

Optimizing recovery: how PNF stretching and ice massage alleviate markers of DOMS?

Delayed onset muscle soreness (DOMS) is a common problem for both trained or untrained individuals that develop after eccentric or unaccustomed exercise. The large number of cases of DOMS and the varying results of research related to the prevention and treatment of DOMS, imply the importance of research in the effective DOMS prevention. The aim of this research was to investigate the post-exercise effects of combination Proprioceptive Neuromuscular Facilitation (PNF) stretching and ice massage on markers of exercise-induced muscle damage (DOMS). Thirty-nine subjects between the ages of 15 to 17 were randomly assigned to either the experimental or control groups. Subjects performed circuit training exercise-induced DOMS. The experimental group underwent 18 minutes of PNF stretching and 16 minutes of ice massage, which was given 2 hours after exercise. The control group did not receive any treatment. DOMS parameters (muscle soreness, creatine kinase/CK, aspartate aminotransferase/AST, neutrophil) and lower extremity functional scale (LEFS) were assessed at 0 and 24 hours after exercise-induced DOMS. The parametric and non-parametric different tests was used in data analysis. The experimental groups showed a reduction in DOMS symptoms in the form of less muscle soreness and AST, better LEFS compared to control groups (p<0.05), but not for creatine kinase and neutrophils (p>0.05) which is an indicator of tissue damage. In conclusion, the combination of postexercise PNF stretching and ice massage was effective in reducing the severity of DOMS, but it was not able to prevent DOMS. Keywords: PNF Stretching, Ice Massage, DOMS, Creatine Kinase, Muscle Recovery, Exercise-induced Muscle Damage

Mechanisms and Treatment of Delayed Onset Muscle Soreness in Athletes - A Review

Objective: The purpose of this study is to review mechanisms for Delayed Onset Muscle Soreness (DOMS) and the pharmacological treatment options with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Method: Our review of published research literature was based on an appropriate number of subjects included in the study with a statistical power of .80 or higher and an effect size of .30 or higher. In the case of review articles, two cited references from each article where significant data were used to establish the conclusion were examined for type II error using the criteria mentioned above. Our review also includes inflammation, tissue damage, and the treatment of DOMS with both selective and non-selective NSAIDs. Results: Frequently cited mechanisms of DOMS are "mechanical strain" and "metabolic overload" within the muscle structure. The inflammation associated with DOMS is caused by eccentric exercise-induced muscle damage. NSAIDs inhibit prostaglandin synthesis and/or block cyclooxygenase and there by reduce the pain and swelling associated with inflammation. There are both selective and non-selective NSAIDs, the former being the COX-2 inhibitors (e.g., celecoxib) and the later (e.g., ibuprofen, naproxen, and aspirin). Conclusion: For the treatment of DOMS, naproxen taken at anti­inflammation levels for at least 3 days shows the most consistent results for improving the recovery rate of affected muscle.

ANTI-INFLAMMATORIES FOR DELAYED ONSET MUSCLE SORENESS: SYSTEMATIC REVIEW AND META-ANALYSIS

ABSTRACT Objective: To investigate the effectiveness of pharmacological interventions in the treatment of delayed onset muscle soreness (DOMS). Design: A systematic review and meta-analysis of randomized controlled clinical trials (RCTs). Data sources: The PubMed/MEDLINE, EMBASE, SPORTDiscus, Scielo and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for RCTs published prior to August 3, 2020. Eligibility criteria for selecting studies: Studies that 1) used an RCT design; 2) evaluated the effectiveness of steroidal or nonsteroidal anti-inflammatory drugs (NSAIDs) in treating DOMS; and 3) therapeutically used drugs after exercise were included. Results: In total, 26 studies (patients = 934) were eligible for inclusion in the qualitative analysis on the treatment of DOMS. The results of the meta-analysis showed no superiority between the use and non-use of NSAIDs in the improvement of late muscle pain, as no statistically significant differences were verified (21 studies, n= 955; standard mean difference (SMD)= 0.02; 95% confidence interval (CI) −0.58, 0.63; p=0.94; I2=93%). The quality of the synthesized evidence was very low according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and there was significant heterogeneity among the included studies. Conclusion: The results demonstrate that NSAIDs are not superior to controls/placebos in treating DOMS. The inclusion of both studies with dose-response protocols and those with exercise protocols may have influenced the results. In addition, the high risk of bias identified reveals that limitations need to be considered when interpreting the results. Level of evidence I; ystematic review of RCT (Randomized and Controlled Clinical Trials).

Effects of Electrotherapy on Delayed Onset Muscle Soreness (DOMS)

In this article, the reasons for the occurrence of Delayed Onset Muscle Soreness (DOMS) and the effect of electrotherapy on it were discussed. Electrotherapy is a non-invasive and easy method to treat DOMS and muscle fatigue. As a result of intense and abnormal exercise, the creatine phosphokinase enzyme in the muscle increases and DOMS occur. DOMS can be treated with electrotherapy techniques such as micro-current electrotherapy. Micro-currents devices reduce the severity of DOMS symptoms by maintaining intracellular calcium homeostasis. Devices such as Transcutaneous Electrical Nerve Stimulation (TENS) and Micro-Current Electrical Therapy (MET) belong to the category of micro-currents. The number of electrotherapy sessions after the occurrence of DOMS and the frequency of electrotherapy devices are two important factors in the treatment of DOMS. TENS conducts electrical current to the body through electrodes that attach to the skin, and helping to reduce pain by releasing endorphins, a natural painkiller, and blocking the passage of pain to the brain. MET uses resonant frequencies to aid in deeper and longer treatment, increase the body’s production of natural catalysts in the healing process, and is more useful in chronic pain than TENS. Research has shown that electrotherapy has been shown to improve DOMS symptoms.

The effectiveness of natural supplements on prevention and treatment of delayed onset muscle soreness and markers of muscle damage: a review of literature

Objective. Unaccustomed or high-intensity eccentric exercise often leads to delayed onset muscle soreness (DOMS) that presents as pain, soreness, or swelling. Nonsteroidal anti-inflammatory medications (NSAIDs) are often used to treat DOMS. Due to the potential adverse effects of NSAIDs, commerically available supplements have been suggested as a potential alternative treatment of DOMS. The purpose of this review is to examine the effects of commerically available supplements on DOMS and markers of muscle damage and inflammation. Method. Existing publications were examined and summarized regarding the effects of supplements such as curcumin, green tea extract, ginseng, ginger, branch chain amino acids, anatabine, pomegranate juice, and protease on DOMS and markers of both muscle damage and inflammation following eccentric exercise. Results. Consuming branched chain amino acids (BCAA), pomegranate, and curcumin appear to have the greatest effect in preventing and treating DOMS. Anatabine and ginseng do not appear to decrease markers of muscle damage, inflammation, or DOMS. Conclusion. Consuming supplements before or after exercise with anti-inflammatory and analgesia properties may be just as effective as NSAIDs in treating and preventing DOMS. Further studies should be conducted to determine the long-term effects of commerically available supplements and the safest dosage that can be consumed for maximal benefits.

Beneficios del abordaje fisioterapéutico en la recuperación del dolor muscular de aparición tardía y su influencia en el rendimiento deportivo

Introducción: el dolor muscular de aparición tardía (DOMS, por sus siglas en inglés), se encuentra dentro de la categoría de lesiones musculares por sobrecarga, cuando esto sucede el atleta no es capaz de realizar sus sesiones de entrenamiento o incluso puede perder la oportunidad de competir. Se realiza esta revisión narrativa con el fin de establecer los beneficios del abordaje fisioterapéutico en la recuperación del DOMS y su influencia en el rendimiento del deportivo. Metodología: estudio descriptivo de revisión bibliográfica basado en artículos ubicados en PubMed, Academic, Search Ultimate, EBSCOhost, en inglés y español durante 2015-2020, utiliza la combinación de descriptores relacionados a DOMS, recuperación muscular y rendimiento deportivo. Se incluyeron 34 artículos, clasificados según el nivel de evidencia de Sackett como sigue: 8 artículos de nivel 1 (24%), 9 de nivel 2 (27%), 5 de nivel 3 (15%), 8 de nivel 4 (24%) y 4 de nivel 5 (10%). Resultados: las modalidades de crioterapia y terapia compresiva han demostrado evidencia significativa en el tratamiento del DOMS, son efectivos para atenuar el dolor, reducir la inflamación. El estiramiento no ha demostrado ser efectivo, pues sólo provoca analgesia temporal. El masaje ha demostrado flexibilidad, puede utilizarse como técnica preventiva y de tratamiento, pues genera modulación del tono muscular y recuperación del equilibrio metabólico. En estadios subagudos, la aplicación de radio frecuencia se encuentra indicada, al incidir en el aporte de oxígeno y nutrientes necesarios para la recuperación muscular. Conclusiones: un factor crítico que influye en el rendimiento deportivo es la presencia del dolor muscular de aparición tardía; múltiples beneficios se asocian a su abordaje fisioterapéutico. Resulta fundamental ya que, potencia las habilidades físicas e interviene sobre los procesos fisiológicos que se encuentran alterados con la aparición de dicho trastorno.

El masaje en la prevención y tratamiento del dolor muscular tardío: una revisión sistemática actualizada

El masaje es una de las terapias más utilizadas para aliviar el dolor muscular tardío (DMT). El objetivo del presente estudio fue determinar la efectividad del masaje en el tratamiento del DMT, para lo cual se llevó a cabo una revisión sistemática en las bases de datos, Pubmed, Scopus, SportDiscus, Web of Science y el buscador Google académico, usando las palabras clave delayed onset muscle soreness y exercise induced muscle damage combinado con massage. Se incluyeron en el estudio 23 artículos en los cuales el 78% mostró disminución del DMT mientras que en el restante 22% no hubo mejoras o bien empeoró. El análisis de los estudios permite concluir que el masaje es una terapia efectiva en el tratamiento del dolor muscular tardío.

Herbs and natural supplements in the prevention and treatment of delayed-onset muscle soreness.

Unaccustomed and intense eccentric exercise is a common cause of delayed-onset muscle soreness (DOMS). There are multiple remedies for the treatment of DOMS, but its clinical and laboratory pieces of evidence are scarce. Currently, the treatments proposed for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and other alternatives.To find a holistic treatment with effective pain relief and minimum side effects, complementary and alternative medicine, including herbal therapies, plays a main role. In this review, the existing published studies investigating the efficacy of herbal and natural supplementation therapies for the prevention or treatment of side effects, symptoms, and signs of DOMS are summarized. Previous studies have documented the efficacy of herbal therapies to treat pain, inflammation, as well as laboratory and clinical side effects of DOMS. The use of herbs in DOMS seems safer and has lower side effects than pharmacotherapy. However, the potential for side effects and drug interactions should be considered.

No Effect of Acupuncture in the Relief of Delayed-Onset Muscle Soreness: Results of a Randomized Controlled Trial.

Delayed-onset muscle soreness (DOMS) is a common symptom in people participating in exercise, sport, or recreational physical activities. Several remedies have been proposed to prevent and alleviate DOMS. A five-arm randomized controlled study was conducted to examine the effects of acupuncture on eccentric exercise-induced DOMS of the biceps brachii muscle. Participants were recruited through convenience sampling of students and general public. Participants were randomly allocated to needle, laser, sham needle, sham laser acupuncture, and no intervention. Outcome measures included pressure pain threshold (PPT), pain intensity (visual analog scale), and maximum isometric voluntary force. Delayed-onset muscle soreness was induced in 60 participants (22 females, age 23.6 ± 2.8 years, weight 66.1 ± 9.6 kg, and height 171.6 ± 7.9 cm). Neither verum nor sham interventions significantly improved outcomes within 72 hours when compared with no treatment control (P > 0.05). Acupuncture was not effective in the treatment of DOMS. From a mechanistic point of view, these results have implications for further studies: (1) considering the high-threshold mechanosensitive nociceptors of the muscle, the cutoff for PPT (5 kg/cm) chosen to avoid bruising might have led to ceiling effects; (2) the traditional acupuncture regimen, targeting muscle pain, might have been inappropriate as the DOMS mechanisms seem limited to the muscular unit and its innervation. Therefore, a regionally based regimen including an intensified intramuscular needling (dry needling) should be tested in future studies, using a higher cutoff for PPT to avoid ceiling effects.

The effectiveness of ice water immersion in the treatment of delayed onset muscle soreness in the lower leg

Background: The current evidence base pertaining to the use of ice water immersion in the treatment and prevention of delayed onset muscle soreness (DOMS) remains inconsistent and controversial. Although little scientific support exists, many athletes continue to acknowledge it as an important treatment modality in DOMS management. The purpose of this study is to determine the effectiveness of ice water immersion in the treatment of DOMS induced in the lower leg in a group of untrained volunteers. Method: An experimental inter-subject design was employed, using convenience sampling, to recruit 16 untrained volunteers (11 females, 5 males). Each performed a bilateral DOMS inducing protocol, in the plantar flexors, to exhaustion. Each leg was then randomly assigned to a control (no treatment) or intervention (ice immersion) group. The ice protocol consisted of a 10 minute water immersion, superior to the knee joint, at 10˚C. Range of movement (ROM), using a standard plastic goniometer, and soreness, using a Visual Analogue Scale (VAS), were assessed. Measurements were taken prior to, and 48 hours post exercise. Results were analyzed using a related t-test. Results: Statistical analysis of the results was performed using SPSS 14.0, where p <=0.05. The related t-test detected significant differences between the control and intervention group at 48 hours post exercise in both soreness (p=0.007) and ROM (p=0.002) , where p <0.05 Conclusion: The results suggest that a single bout of ice water immersion, immediately after exercise of the Triceps Surae musculature, resulted in significantly less muscle soreness and greater ROM at the ankle, in comparison to a control, 48 hours post exercise. The results offer scientific support to this popular recovery modality.

Whole-Body Vibration and the Prevention and Treatment of Delayed-Onset Muscle Soreness

Numerous recovery strategies have been used in an attempt to minimize the symptoms of delayed-onset muscle soreness (DOMS). Whole-body vibration (WBV) has been suggested as a viable warm-up for athletes. However, scientific evidence to support the protective effects of WBV training (WBVT) on muscle damage is lacking. To investigate the acute effect of WBVT applied before eccentric exercise in the prevention of DOMS. Randomized controlled trial. University laboratory. A total of 32 healthy, untrained volunteers were randomly assigned to either the WBVT (n = 15) or control (n = 17) group. Volunteers performed 6 sets of 10 maximal isokinetic (60°/s) eccentric contractions of the dominant-limb knee extensors on a dynamometer. In the WBVT group, the training was applied using a vibratory platform (35 Hz, 5 mm peak to peak) with 100° of knee flexion for 60 seconds before eccentric exercise. No vibration was applied in the control group. Muscle soreness, thigh circumference, and pressure pain threshold were recorded at baseline and at 1, 2, 3, 4, 7, and 14 days postexercise. Maximal voluntary isometric and isokinetic knee extensor strength were assessed at baseline, immediately after exercise, and at 1, 2, 7, and 14 days postexercise. Serum creatine kinase was measured at baseline and at 1, 2, and 7 days postexercise. The WBVT group showed a reduction in DOMS symptoms in the form of less maximal isometric and isokinetic voluntary strength loss, lower creatine kinase levels, and less pressure pain threshold and muscle soreness (P < .05) compared with the control group. However, no effect on thigh circumference was evident (P < .05). Administered before eccentric exercise, WBVT may reduce DOMS via muscle function improvement. Further investigation should be undertaken to ascertain the effectiveness of WBVT in attenuating DOMS in athletes.

Effectiveness of low-dose pulsed ultrasound for treatment of delayed-onset muscle soreness: A double-blind randomized controlled trial

Purpose: To evaluate the effectiveness of low dose pulsed ultrasound for the treatment of delayed-onset muscle soreness (DOMS). Methods: Ninety female university students participated in a double-blind, placebo-controlled, randomized trial. The subjects were randomly assigned into three equal groups. DOMS was induced in the non-dominant elbow flexors of all subjects with voluntary eccentric contractions on a dynamometer. Group 1 was treated with pulsed ultrasound (spatial average-temporal peak intensity: 0.8 W/cm 2 , spatial average-temporal average: 0.16 W/cm 2 , pulse ratio 1:4 for 10 minutes over 5 consecutive days). Group 2 received sham pulsed ultrasound and the control group received no treatment. The results of therapy were assessed by evaluating perceived muscle soreness, elbow flexor muscle strength, range of motion, and creatine kinase activity. Results: A Friedman's repeated-measures test for muscle soreness results demonstrated a significant change in the mean of perceived muscle soreness in all groups. The first significant decrease in muscle soreness occurred 144 hours after exercise in the experimental and control groups and 120 hours after the exercise in the placebo group. At the end of treatment, there were no significant differences in muscle soreness among the 3 study groups. Conclusion: Low dose pulsed ultrasound therapy did not significantly reduce the effects of DOMS on soreness perception, active-elbow flexion angle, or muscle strength.

Continuous Low-Level Heat Wrap Therapy for the Prevention and Early Phase Treatment of Delayed-Onset Muscle Soreness of the Low Back: A Randomized Controlled Trial

Continuous Low-Level Heat Wrap Therapy for the Prevention and Early Phase Treatment of Delayed-Onset Muscle Soreness of the Low Back: A Randomized Controlled Trial

Continuous Low-Level Heat Wrap Therapy for the Prevention and Early Phase Treatment of Delayed-Onset Muscle Soreness of the Low Back: A Randomized Controlled Trial

Mayer JM, Mooney V, Matheson LN, Erasala GN, Verna JL, Udermann BE, Leggett S. Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Objective To evaluate the effects of continuous low-level heat wrap therapy for the prevention and early phase treatment (ie, 0−48h postexercise) of delayed-onset muscle soreness (DOMS) of the low back. Design Two prospective randomized controlled trials. Setting Outpatient medical facility. Participants Sixty-seven subjects asymptomatic of back pain and in good general health (mean age, 23.5±6.6y). Interventions Participants performed vigorous eccentric exercise to experimentally induce low back DOMS. Participants were assigned to 1 of 2 substudies (prevention and treatment) and randomized to 1 of 2 treatment groups within each substudy: prevention study (heat wrap, n=17; control [nontarget muscle stretch], n=18) and treatment study (heat wrap, n=16; cold pack, n=16). Interventions were administered 4 hours before and 4 hours after exercise in the prevention study and between hours 18 to 42 postexercise in the treatment study. Main Outcome Measures To coincide with the expected occurrence of peak symptoms related to exercise-induced low back DOMS, hour 24 postexercise was considered primary. Pain intensity (prevention) and pain relief (treatment) were primary measures, and self-reported physical function and disability were secondary measures. Results In the prevention study, at hour 24 postexercise, pain intensity, disability, and deficits in self-reported physical function in subjects with the heat wrap were reduced by 47% ( P<.001), 52.3% ( P=.029), and 45% ( P=.013), respectively, compared with the control group. At hour 24 in the treatment study, postexercise, pain relief with the heat wrap was 138% greater ( P=.026) than with the cold pack; there were no differences between the groups in changes in self-reported physical function and disability. Conclusions In this small study, continuous low-level heat wrap therapy was of significant benefit in the prevention and early phase treatment of low back DOMS.

Treatment and Prevention of Delayed Onset Muscle Soreness

Eccentric exercise continues to receive attention as a productive means of exercise. Coupled with this has been the heightened study of the damage that occurs in early stages of exposure to eccentric exercise. This is commonly referred to as delayed onset muscle soreness (DOMS). To date, a sound and consistent treatment for DOMS has not been established. Although multiple practices exist for the treatment of DOMS, few have scientific support. Suggested treatments for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and many more. DOMS is particularly prevalent in resistance training; hence, this article may be of particular interest to the coach, trainer, or physical therapist to aid in selection of efficient treatments. First, we briefly review eccentric exercise and its characteristics and then proceed to a scientific and systematic overview and evaluation of treatments for DOMS. We have classified treatments into 3 sections, namely, pharmacological, conventional rehabilitation approaches, and a third section that collectively evaluates multiple additional practiced treatments. Literature that addresses most directly the question regarding the effectiveness of a particular treatment has been selected. The reader will note that selected treatments such as anti-inflammatory drugs and antioxi-dants appear to have a potential in the treatment of DOMS. Other conventional approaches, such as massage, ultrasound, and stretching appear less promising.

Treatment and Prevention of Delayed Onset Muscle Soreness

Eccentric exercise continues to receive attention as a productive means of exercise. Coupled with this has been the heightened study of the damage that occurs in early stages of exposure to eccentric exercise. This is commonly referred to as delayed onset muscle soreness (DOMS). To date, a sound and consistent treatment for DOMS has not been established. Although multiple practices exist for the treatment of DOMS, few have scientific support. Suggested treatments for DOMS are numerous and include pharmaceuticals, herbal remedies, stretching, massage, nutritional supplements, and many more. DOMS is particularly prevalent in resistance training; hence, this article may be of particular interest to the coach, trainer, or physical therapist to aid in selection of efficient treatments. First, we briefly review eccentric exercise and its characteristics and then proceed to a scientific and systematic overview and evaluation of treatments for DOMS. We have classified treatments into 3 sections, namely, pharmacological, conventional rehabilitation approaches, and a third section that collectively evaluates multiple additional practiced treatments. Literature that addresses most directly the question regarding the effectiveness of a particular treatment has been selected. The reader will note that selected treatments such as anti-inflammatory drugs and antioxidants appear to have a potential in the treatment of DOMS. Other conventional approaches, such as massage, ultrasound, and stretching appear less promising.

Anti-inflammatory treatment of muscular injuries in sport. An update of recent studies.

Stretch-induced muscle injuries or strains, muscle contusions and delayed-onset muscle soreness (DOMS) are common muscle problems in athletes. Anti-inflammatory treatment is often used for the pain and disability associated with these injuries. The most recent studies on nonsteroidal anti-inflammatory drugs (NSAIDs) in strains and contusions suggest that the use of NSAIDs can result in a modest inhibition of the initial inflammatory response and its symptoms. However, this may be associated with some small negative effects later in the healing phase. Corticosteroids have generally been shown to adversely affect the healing of these acute injuries. Animal studies have suggested that anabolic steroids may actually aid in the healing process, but clinical studies are not yet available and the exact role of these drugs has yet to be determined. Studies on anti-inflammatory treatment of DOMS have yielded conflicting results. However, the effect of NSAIDs on DOMS appears small at best. Future research may have to focus on different aspects of these injuries as the emphasis on anti-inflammatory treatment has yielded somewhat disappointing results.

Delayed Onset Muscle Soreness: What Is It and How Do We Treat It?

Muscle soreness, a familiar phenomenon to most athletes, has been differentiated into “acute” and “delayed onset.” The etiology of acute muscle soreness has been attributed to ischemia and the accumulation of metabolic by-products. However, the etiology of delayed onset muscle soreness (DOMS) is not so clear. Six theories have been proposed: lactic acid, muscle spasm, torn tissue, connective tissue, enzyme efflux, and tissue fluid theories. The treatment of DOMS has also been investigated. Studies in which anti-inflammatory medications have been administered have yielded varying results based on the dosage and the time of administration. Submaximal concentric exercise may alleviate soreness but does not restore muscle function. Neither cryotherapy nor stretching abates the symptoms of DOMS. Transcutaneous electrical stimulation has been shown to decrease soreness and increase range of motion, but the effect on the recovery of muscle function is unknown. Therefore, the treatment of DOMS remains an enigma.

Anti-Inflammatory Treatment of Muscular Injuries in Sports

Stretch-induced muscle injuries or strains, muscle contusions and delayed onset muscle soreness (DOMS) are common muscle problems in athletes. Anti-inflammatory treatment is often used for the pain and disability associated with these injuries. The most recent studies on nonsteroidal anti-inflammatory drugs (NSAIDs) in strains and contusions suggest that the use of NSAIDs can result in a modest inhibition of the initial inflammatory response and its symptoms. However, this may be associated with some small negative effects later in the healing phase. Corticosteroids have generally been shown to adversely affect the healing of these acute injuries. Animal studies have suggested that anabolic steroids may actually aid in the healing process, but clinical studies are not yet available and the exact role of these drugs has yet to be determined. Studies on anti-inflammatory treatment of DOMS have yielded conflicting results. However, the effect of NSAIDs on DOMS appears small at best. Future research may have to focus on different aspects of these injuries as the emphasis on anti-inflammatory treatment has yielded somewhat disappointing results.