Delayed onset muscle soreness
Muscle fever
Signs and symptoms[edit]
The soreness is perceived as a dull, aching pain in the affected muscle, often combined with tenderness and stiffness. The pain is typically felt only when the muscle is stretched, contracted or put under pressure, not when it is at rest.[2]: 63 This tenderness, a characteristic symptom of DOMS, is also referred to as "muscular mechanical hyperalgesia".[3]
Although there is variance among exercises and individuals, the soreness usually increases in intensity in the first 24 hours after exercise. It peaks from 24 to 72 hours, then subsides and disappears up to seven days after exercise.[2]: 63
Cause[edit]
Muscle soreness is caused by eccentric exercise, that is, exercise consisting of eccentric (lengthening) contractions of the muscle. Isometric (static) exercise causes much less soreness, and concentric (shortening) exercise causes none.[2]: 63
Prevention[edit]
Delayed onset muscle soreness can be reduced or prevented by gradually increasing the intensity of a new exercise program,[13]: 112 thereby taking advantage of the repeated-bout effect.[14]
Soreness can theoretically be avoided by limiting exercise to concentric and isometric contractions,[13]: 112 but eccentric contractions in some muscles are normally unavoidable during exercise, especially when muscles are fatigued.[2]: 63 Limiting the length of eccentric muscle extensions during exercise may afford some protection against soreness, but this may also not be practical depending on the mode of exercise.
Physical activity before eccentric exercise helps to prevent delayed-onset muscle soreness.[15] Static stretching or warming up the muscles before or after exercise does not prevent soreness,[16] although there is evidence that whole body vibration therapy performed before exercise may lessen both the soreness and reduced range of motion caused by delayed onset muscle soreness.[17][18]
Other preventative measures with evidence of efficacy based on randomized controlled trials include the consumption of saffron.[19] Wearing compression garments has not been demonstrated to have a significant effect on delayed onset muscle soreness.[20]
Treatment[edit]
The soreness usually disappears within about 72 hours after appearing. If treatment is desired, any measure that increases blood flow to the muscle, such as low-intensity activity, massage, nerve mobilization,[21] hot baths,[22][23] or a sauna visit may help somewhat.[13]: 112
Immersion in cool or icy water, an occasionally recommended remedy, was found to be ineffective in alleviating DOMS in one 2011 study,[24] but effective in another.[25] There is also insufficient evidence to determine whether whole-body cryotherapy—compared with passive rest or no whole-body cryotherapy—reduces DOMS, or improves subjective recovery, after exercise.[1]
Counterintuitively, continued exercise may temporarily suppress the soreness. Exercise increases pain thresholds and pain tolerance. This effect, called exercise-induced analgesia, is known to occur in endurance training (running, cycling, swimming), but little is known about whether it also occurs in resistance training. There are claims in the literature that exercising sore muscles appears to be the best way to reduce or eliminate the soreness, but this has not yet been systematically investigated.[2]: 62–63
Ibuprofen is not an appropriate treatment for delayed onset muscle soreness and damage.[26] It decreases soreness, but does not counteract the reduction in muscular performance caused by delayed onset muscle soreness.[27]