:: Delayed Onset Muscle Soreness (DOMS) ::

Hello, and welcome to my very first Blogger article! One of the most common questions I am asked as a massage therapist is, "Why are my muscles more sore the 2nd day after I run?" As a massage therapist who counts many triathletes, marathon runners and casual runners amongst her clientele, I have this question posed to me all the time. As such, and seeing that the Sun Herald's "City 2 Surf" 14 km fun-run was held here in Sydney today, I thought that this would make for an appropriate topic with which to begin my regular blog sessions. So, read on if you have ever been curious about this oh-so-common phenomenon!

:: What is DOMS?

We have all been there before: we start a new running program or exercise regime at the gym (or in my personal example, took up Martial Arts for the first time) and all seems to be going well until we awake 48 hours later, barely able to get out of bed without assistance. Seemingly overnight, our muscles have rebelled against us, stiffening up and becoming sore and achy. We then spend the rest of the day - or even several days - hobbling around like we've instantly added another 20 years to our poor bodies... Okay, this may be an extreme example, but the condition of muscular soreness that occurs 12-48 hours after strenuous exercise is very common, and can be annoying or distressing in even its milder forms. Appropriately enough, this "2nd day soreness" is called Delayed Onset Muscle Soreness (or DOMS), and it may be accompanied by muscle stiffness, tenderness and minor swelling. Although its causes are not completely understood, microscopic damage inflicted upon skeletal muscle fibres during strenuous exercise is thought to be a major factor.

:: A Closer Look...

As you exercise, your muscles must continually adapt to the forces placed upon them. During the strenuous activity that accompanies a new exercise program, a change in activities or dramatic increase in exercise intensity or duration, your muscles may not be able to fully adapt, and thus they develop microscopic tears within the actual muscle fibres and fascia, which then heal within a few days. This microscopic tearing and subsequent healing is considered a normal part of the biological process which your body undergoes in order to build muscle strength and stamina. Interestingly, a popular myth that still persists today is that the main cause of DOMS is a build-up of lactic acid within the muscle fibres which causes muscle contraction and irritation. However, although this may be attributable to the "stitch in the side" phenomenon often experienced during exercise, it is no longer believed to be a contributor to DOMS, as the lactic acid is removed from muscle tissue shortly after exercise.

:: How Can DOMS Be Treated?

One of the simplest ways to deal with pain associated with DOMS is to simply rest. DOMS symptoms typically last for only a few days. By the end of the week, your muscles should be healed and ready for more exercise. (Of course, if this is not the case, or if you are experiencing extreme pain, heat within a muscle or joint, bruising/discolouration or noticeable swelling, then you may have an acute injury and you should seek the appropriate medical attention!) Additionally, other steps may be taken that may help to lessen the symptoms of DOMS. These include: 

• RICE (Rest-Ice-Compression-Elevation): also used for acute injuries, this may help alleviate the minor inflammation associated with DOMS;
• Low impact aerobic exercise: this may seem a little counter-intuitive, however there is some indication that this approach may lessen DOMS symptoms by increasing the blood flow to the affected muscle (and thereby increasing the rate of healing), or by increasing the production of certain hormones that create an exercise-induced analgesia;
• Gentle stretching: the emphasis, here, is on gentle. If you stretch too hard, you may cause further injury to the affected muscle. Remember - stretching should be enjoyable, not painful!
• Gentle massage: this may help speed up the healing process by increasing blood flow to the affected muscles. Again, the importance is placed on the word gentle. During post-race/strenuous exercise massage sessions, people often request, "Go as hard as you can!" To which I refuse,  explaining that doing so may cause more harm than good, as heavy massage will likely increase the inflammation within the muscle, and may even cause further damage to the muscle. Additionally, some studies indicate that heavy massage may actually temporarily reduce blood flow to the affected muscle;
• Alternate hot & cold showers: alternating between hot and cold water may simultaneously assist in increasing blood flow to DOMS-affected muscles and reducing the inflammation caused by DOMS.

:: How Can DOMS Be Prevented?

Of course, if you are trying to increase your fitness or are in training for a particular event, completely avoiding DOMS may be impossible or even undesirable as you try to build strength and endurance. However, there may be ways to lessen the intensity of DOMS through some simple preventative measures:

• Avoid activities that involve lots of eccentric muscle contractions (contractions in which the muscle must forcefully contract whilst simultaneously lengthening): studies have indicated that this type of muscle contraction may be responsible for causing the majority of microscopic damage to a muscle. Activities include lowering weights, running downhill, going downstairs, etc.;
• Warm up properly before exercise: this helps to prepare your muscles for activity by increasing blood flow to the muscles and promoting muscle pliability and flexibility;
• Cool down properly after exercise, including gentle stretching: helps return activity-shortened muscles to their resting lengths, and may help to reduce post-exercise inflammation;
• Gradually increase exercise intensity and duration: when beginning a new exercise program or training regime, a gradual increase in the activity may help to lessen the symptoms of DOMS by allowing the muscles to adapt more readily. Most experts suggest a weekly increase in activity of around 10%.

Exercise is an important part of a healthy lifestyle. Don't let the prospect of Delayed Onset Muscle Soreness scare you away from taking part in regular activity and exercise. By understanding what DOMS is and how it occurs, you can make informed decisions about how to treat and prevent this common phenomenon. Happy exercising!

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Photo used under license from iStockphoto.