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Delayed Onset Muscle Soreness

Treatment Strategies and Performance Factors

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Abstract

Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted.

A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of muscle soreness or other DOMS symptoms. Exercise is the most effective means of alleviating pain during DOMS, however the analgesic effect is also temporary. Athletes who must train on a daily basis should be encouraged to reduce the intensity and duration of exercise for 1–2 days following intense DOMS-inducing exercise. Alternatively, exercises targeting less affected body parts should be encouraged in order to allow the most affected muscle groups to recover. Eccentric exercises or novel activities should be introduced progressively over a period of 1 or 2 weeks at the beginning of, or during, the sporting season in order to reduce the level of physical impairment and/or training disruption. There are still many unanswered questions relating to DOMS, and many potential areas for future research.

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References

  1. Talag T. Residual muscle soreness as influenced by concentric, eccentric, and static contractions. Res Q 1973; 44: 458–69

    PubMed  CAS  Google Scholar 

  2. Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc 1984, 16 (6): 529–38

    PubMed  CAS  Google Scholar 

  3. Byrnes WC, Clarkson PM. Delayed onset muscle soreness and training. Clin Sports Med 1986; 5 (3): 605–14

    PubMed  CAS  Google Scholar 

  4. Jones DA, Newham DJ, Round JM, et al. Experimental human muscle damage: morphological changes in relation to other indices of damage. J Physiol 1986; 375: 435–48

    PubMed  CAS  Google Scholar 

  5. Cleak MJ, Eston RG. Delayed onset muscle soreness: mechanisms and management. J Sports Sci 1992; 10 (4): 325–41

    PubMed  CAS  Google Scholar 

  6. Willoughby DS. Delayed onset muscle soreness: a possible physiological etiology and practical implications for coaches. Texas Coach 1990; 35 (1): 34–6

    Google Scholar 

  7. High DM, Howley ET. The effects of static stretching and warm up on prevention of delayed onset muscle soreness. Res Q Exerc Sport 1989; 60 (4): 357–61

    PubMed  CAS  Google Scholar 

  8. Maxwell S, Kohl S, Watson A, et al. Is stretching effective in the prevention of or amelioration of delayed onset muscle soreness? Aust J Sci Med Sport 1988; 20 (4): 22

    Google Scholar 

  9. Claps F. Soothe the burn: 11 ways to extinguish post-workout pain. Men’s Fitness 2000; 16 (5): 104–7

    Google Scholar 

  10. Nessel EH. Even my eyebrows hurt. American Swimming 1999; (3): 2

    Google Scholar 

  11. Fell JW, Brown RB, Gaffney PT. Ibuprofin and creatine intervention does not reduce the effect of exercise induced muscle damage or delayed onset muscle soreness. Fifth IOC World Congress on Sport Sciences; 1999 Oct 31-Nov 5; Sydney. Sydney: Sports Medicine Australia, 1999

    Google Scholar 

  12. Brown RB, Fell JW, Gaffney PT. The influence of previous aerobic activity levels on morphological and biochemical indicators of exercise induced muscle damage [abstract]. Fifth IOC World Congress on Sport Sciences; 1999 Oct 31-Nov 5; Sydney. Sydney: Sports Medicine Australia, 1999

    Google Scholar 

  13. Birk TJ. Preventive interventions can minimize delayed onset muscle soreness. Sports Med Alert 1999; 5 (6): 47–9

    Google Scholar 

  14. Lightfoot IT, Char D, McDermott J, et al. Immediate postexercise massage does not attenuate delayed onset muscle soreness. J Strength Cond Research 1997; 11 (2): 119–24

    Google Scholar 

  15. Paddon-Jones DJ, Quigley BM. Effect of cryotherapy on muscle soreness and strength following eccentric exercise. Int J Sports Med 1997; 18: 588–93

    PubMed  CAS  Google Scholar 

  16. Vickers AJ, Fisher P, Smith C, et al. Homeopathy for delayed onset muscle soreness: a randomised double blind placebo controlled trial. Br J Sports Med 1997; 31: 304–7

    PubMed  CAS  Google Scholar 

  17. Gulick DT, Kimura IF. Delayed onset muscle soreness: what is it and how do we treat it? J Sport Rehab 1996; 5: 234–43

    Google Scholar 

  18. Sharkey J. Delayed onset muscle soreness. Ultrafit 1995; 5 (7): 3

    Google Scholar 

  19. Cleary MA. The time course of the repeated bout effect of eccentric exercise on delayed onset muscle soreness. Philadelphia (PA): Temple University, 1995

    Google Scholar 

  20. Rodenburg JB, Steenbeek D, Schiereck P, et al. Warm-up, stretching and massage diminish harmful effects of eccentric exercise. Int J Sports Med 1994; 15 (7): 414–9

    PubMed  CAS  Google Scholar 

  21. Isabell WK, Durrant E, Myrer W, et al. The effects of ice massage, ice massage with exercise, and exercise on the prevention and treatment of delayed onset muscle soreness. J Athletic Train 1992; 27 (3): 208, 210, 212, 214, 216–7

    CAS  Google Scholar 

  22. Francis KT, Hoobler T. Effects of aspirin on delayed muscle soreness. J Sports Med Phys Fitness 1987; 27 (3): 333–7

    PubMed  CAS  Google Scholar 

  23. Portero P, Maisetti O. A new treatment technique on delayed onset muscle soreness recovery: preliminary study on physiological mechanisms. 2000 Pre-Olympic Congress; 2000 Sep 7–12; Brisbane, 58

  24. MacIntyre DL, Reid WD, McKenzie DC. Delayed muscle soreness: the inflammatory response to muscle injury and its clinical implications. Sports Med 1995; 20 (1): 24–40

    PubMed  CAS  Google Scholar 

  25. Abraham WM. Factors in delayed muscle soreness. Med Sci Sport Exerc 1977; 9 (1): 11–20

    CAS  Google Scholar 

  26. Safran MR, Seaber AV, Garrett JWE. Warm-up and muscular injury prevention, an update. Sports Med 1989; 8 (4): 239–49

    PubMed  CAS  Google Scholar 

  27. Armstrong RB, Warren III GL. Strain-induced skeletal muscle fibre injury. In: Macleod D, editor. Intermittent high intensity exercise: preparation, stresses and damage limitation. London: E & FN Spon, 1993: 275–85

    Google Scholar 

  28. Garrett JWE. Muscle strain injuries: clinical and basic aspects. Med Sci Sports Exerc 1990; 22 (4): 436–43

    PubMed  Google Scholar 

  29. Noonan TJ, Garrett Jr WE. Injuries at the myotendinous junction. Clin Sports Med 1992; 11 (4): 783–806

    PubMed  CAS  Google Scholar 

  30. Garrett J. Muscle strain injuries. Am J Sports Med 1996; 24 (6): S2–8

    Google Scholar 

  31. Newham DJ, Mills KR, Quigley R, et al. Muscle pain and tenderness after exercise. Aust J Sports Med Exerc Sci 1982; 14: 129–31

    Google Scholar 

  32. Friden J, Sfakianos PN, Hargens AR. Muscle soreness and intramuscular fluid pressure: comparison between eccentric and concentric load. J Appl Physiol 1986; 61 (6): 2175–9

    PubMed  CAS  Google Scholar 

  33. Tidball JG. Myotendinous junction injury in relation to junction structure and molecular composition. Exerc Sport Science Rev 1991; 19: 419–45

    CAS  Google Scholar 

  34. Stauber WT. Eccentric action of muscles: physiology, injury and adaptation. In: Pandolf KP, editor. Exercise and sport science reviews. Baltimore (MD): Williams and Wilkins, 1989: 157–86

    Google Scholar 

  35. Eston RG, Lemmey AB, McHugh P, et al. Effect of stride length on symptoms of exercise-induced muscle damage during a repeated bout of downhill running. Scand J Med Sci Sports 2000; 10 (4): 199–204

    PubMed  CAS  Google Scholar 

  36. Eston RG, Critchley N, Balzopoulos V. Delayed onset muscle soreness, strength loss characteristics and creatine kinase activity following uphill and downhill running. UK sport: partners in performance. The contribution of sport science, sports medicine and coaching to performance and excellence. Manchester: Sports Council, 1993: 10–11

    Google Scholar 

  37. Donnelly AW, Maughan RJ, Whiting PH. Effects of ibuprofen on exercise-induced muscle soreness and indices of muscle damage. Br J Sports Med 1990; 24 (3): 191–5

    PubMed  CAS  Google Scholar 

  38. Webber LM, Byrnes WC, Rowlands TW, et al. Serum creatine kinase activity and delayed onset muscle soreness in prepubescent children: a preliminary study. Pediatr Exerc Sci 1989; 1 (4): 351–9

    Google Scholar 

  39. Newham DJ, Jones DA, Edwards RHT. Plasma creatine kinase changes after eccentric and concentric contractions. Muscle Nerve 1986; 9: 59–63

    PubMed  CAS  Google Scholar 

  40. Byrnes WC, Clarkson PM, White IS, et al. Delayed onset muscle soreness following repeated bouts of downhill running. J Appl Physiol 1985; 59 (3): 710–5

    PubMed  CAS  Google Scholar 

  41. Schwane JA, Johnson SR, Vandenakker CB, et al. Delayed-onset muscular soreness and plasma CPK and LDH activities after downhill running. Med Sci Sports Exerc 1983; 15 (1): 51–6

    PubMed  CAS  Google Scholar 

  42. Schwane JA, Hatrous BG, Johnson SR, et al. Is lactic acid related to delayed-onset muscle soreness? Phys Sports Med 1983; 11 (3): 124–7, 130–1

    Google Scholar 

  43. Walsh B, Tonkonogi M, Malm C, et al. Effect of eccentric exercise on muscle oxidative metabolism in humans. Med Sci Sports Exerc 2001; 33 (3): 436–41

    PubMed  CAS  Google Scholar 

  44. Johansson PH, Lindstrom L, Sundelin G, et al. The effects of preexercise stretching on muscular soreness, tenderness and force loss following heavy eccentric exercise. Scand J Med Sci Sports 1999; 9 (4): 219–25

    PubMed  CAS  Google Scholar 

  45. Evans WJ, Meredit CN, Cannon JG, et al. Metabolic changes following eccentric exercise in trained and untrained men. J Appl Physiol 1986; 61 (5): 1864–8

    PubMed  CAS  Google Scholar 

  46. Janssen E, Kuipers H, Vertsappen F, et al. Influence of anti-inflammatory drugs on muscle soreness. Med Sci Sport Exerc 1983; 15: 165

    Google Scholar 

  47. Smith LL. Causes of delayed onset muscle soreness and the impact on athletic performance: a review. J Appl Sport Sci Res 1992; 6 (3): 135–41

    Google Scholar 

  48. Lund H, Vestergaard-Poulsen P, Kanstrup IL, et al. Isokinetic eccentric exercise as a model to induce and reproduce pathophysiological alterations related to delayed onset muscle soreness. Scand J Med Sci Sports 1998; 8 (4): 208–15

    PubMed  CAS  Google Scholar 

  49. Brown SJ, Child RB, Day SH, et al. Exercise-induced skeletal muscle damage. J Sports Sci 1997; 15 (2): 215–22

    PubMed  CAS  Google Scholar 

  50. Housh TJ, Housh DJ, Weir JO, et al. Effects of eccentric-only resistance training and detraining. Int J Sports Med 1996; 17 (2): 145–8

    PubMed  CAS  Google Scholar 

  51. Sorichter S, Koller A, Haid C, et al. Light concentric exercise and heavy eccentric muscle loading: effects on CK, MRI and Markers of Inflammation. Int J Sports Med 1995; 16: 288–92

    PubMed  CAS  Google Scholar 

  52. Teague BN, Schwane JA. Effect of intermittent eccentric contractions on symptoms of muscle microinjury. Med Sci Sports Exerc 1995; 27 (10): 1378–84

    PubMed  CAS  Google Scholar 

  53. Wessel J, Wan A. Effect of stretching on the intensity of delayed-onset muscle soreness. Clin J Sports Med 1994; 4 (2): 83–7

    Google Scholar 

  54. Clarkson PM, Ebbeling C. Investigation of serum creatine kinase variability after muscle damaging exercise. Clin Sci 1988; 75: 257–61

    PubMed  CAS  Google Scholar 

  55. Francis K, Hoobler T. Delayed onset muscle soreness and decreased isokinetic strength. J Appl Sport Sci Res 1988; 2 (2): 20–3

    Google Scholar 

  56. Horswill CA, Layman DK, Boileau RA, et al. Excretion of 3-methylhistidine and hydroxyproline following acute weight-training exercise. Int J Sports Med 1988; 9 (4): 245–8

    PubMed  CAS  Google Scholar 

  57. Newham DJ, Jones DA, Gosh G, et al. Muscle fatigue and pain after eccentric contractions at long and short length. Clin Sci (Lond) 1988; 74: 553–7

    CAS  Google Scholar 

  58. Newham DJ, Jones DA, Clarkson PM. Repeated high-force eccentric exercise: effects on muscle pain and damage. J Appl Physiol 1987; 63 (4): 1381–6

    PubMed  CAS  Google Scholar 

  59. Jones DA, Newham DJ. The effect of training on human muscle pain and damage. J Physiol 1985; 365: 76

    Google Scholar 

  60. Tiidus PM, Ianuzzo CD. Effects of intensity and duration of muscular exercise on delayed soreness and serum enzyme activities. Med Sci Sports Exerc 1983; 15 (6): 461–5

    PubMed  CAS  Google Scholar 

  61. Wilson RW. A review of methods used in research to induce, measure, and treat exercise induced delayed onset muscle soreness. Foil 1992; Fall: 11–4

  62. Hasson SM, Daniels JC, Divine JG, et al., Effect of ibuprofen use on muscle soreness, damage, and performance: a preliminary investigation. Med Sci Sports Exerc 1993; 25 (1): 9–17

    PubMed  CAS  Google Scholar 

  63. Hasson SM, Wible CL, Reich M, et al. Dexamethasone iontophoresis: effect on delayed muscle soreness and muscle function. Can J Sport Sci 1992; 17 (1): 8–13

    PubMed  CAS  Google Scholar 

  64. Buroker KC, Schwane JA. Does postexercise stretching alleviate delayed muscle soreness? Phys Sports Med 1989; 17 (6): 65–83

    Google Scholar 

  65. Asmussen E. Observations on experimental muscle soreness. Acta Rheumatol Scand 1956; 2: 109–16

    PubMed  CAS  Google Scholar 

  66. Cazorla G, Petibois C, Bosquet L, et al. Lactate et exercice: mythes et realites. Rev Sci Tech Activ Phys Sport (Grenoble) 2001; 22 (54): 63–76

    Google Scholar 

  67. de Vries HA. Electromyographic observations of the effects of static stretching upon muscular distress. Res Q 1961; 32: 468–79

    Google Scholar 

  68. Bobbert ME Hollander AP, Huijing PA. Factors in delayed onset muscular soreness of man. Med Sci Sports Exerc 1986; 18 (1): 75–81

    PubMed  CAS  Google Scholar 

  69. Cleak MJ, Eston RG. Muscle soreness, swelling, stiffness and strength loss after intense eccentric exercise. Br J Sports Med 1992; 26 (4): 267–72

    PubMed  CAS  Google Scholar 

  70. de Vries HA. Quantitative EMG investigation of the spasm theory of muscle pain. Am J Phys Med 1966; 45: 119–34

    PubMed  Google Scholar 

  71. Newham DJ, Mills KR, Edwards RHT. Large delayed plasma creatine kinase changes after stepping exercise. Muscle Nerve 1983; 6: 380–5

    PubMed  CAS  Google Scholar 

  72. de Vries HA. Prevention of muscular distress after exercise. Res Q 1960; 32 (2): 177–85

    Google Scholar 

  73. Hough T. Ergographic studies in muscular soreness. Am J Physiol 1902; 7: 76–92

    Google Scholar 

  74. Sydney-Smith M, Quigley B. Delayed onset muscle soreness: evidence of connective tissue damage, liquid peroxidation and altered renal function after exercise. Report to the Australian Sports Commission’s Applied Sport Research. Canberra: Australian Sports Commission, 1992: 77

    Google Scholar 

  75. Friden J, Seger J, Ekblom B. Sublethal muscle fibre injuries after high-tension anaerobic exercise. Fur J Appl Physiol 1988; 57: 360–8

    CAS  Google Scholar 

  76. Friden J, Kjorell U, Thornell LE. Delayed muscle soreness and cytoskeletal alterations: an immunocytological study in man. Int J Sports Med 1984; 5: 15–8

    PubMed  CAS  Google Scholar 

  77. Friden J, Sjostrom M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. Int J Sports Med 1983; 4: 170–6

    PubMed  CAS  Google Scholar 

  78. Friden J, Sjostrom M, Ekblom B. A morphological study of delayed onset muscle soreness. Experentia 1981; 37: 506–7

    CAS  Google Scholar 

  79. Friden J, Lieber RL. Structural and mechanical basis of exercise induced muscle injury. Med Sci Sports Exerc 1992; 24 (5): 521–30

    PubMed  CAS  Google Scholar 

  80. Brown SJ, Child RB, Day SH, et al. Indices of skeletal muscle damage and connective tissue breakdown following eccentric muscle contractions. Fur J Appl Physiol Occup Physiol 1997; 75 (4): 369–74

    CAS  Google Scholar 

  81. Armstrong R. Initial events in exercise-induced muscular injury. Med Sci Sports Exerc 1990; 22 (4): 429–35

    PubMed  CAS  Google Scholar 

  82. Clarkson PM, Byrnes WC, McCormick KM, et al. Muscle soreness and serum creatine kinase activity following isometric, eccentric and concentric exercise. Int J Sports Med 1986; 7: 152–5

    PubMed  CAS  Google Scholar 

  83. Clarkson PM, Apple FS, Byrnes WC, et al. Creatine kinase isoforms following isometic exercise. Muscle Nerve 1986; 10 (1): 41–4

    Google Scholar 

  84. Smith LL. Acute inflammation: the underlying mechanism in delayed onset muscle soreness? Med Sci Sports Exerc 1991; 23 (5): 542–51

    PubMed  CAS  Google Scholar 

  85. Smith ME, Jackson CGR. Delayed onset muscle soreness (DOMS), serum creatine kinase (SCK) and creatine kinase-MB (%CK-MB) related to performance measurements in football [abstract]. Med Sci Sport Exerc 1990; 22 Suppl. 2: S34

    Google Scholar 

  86. Rowlands AV, Eston RG, Tilzey C. Effect of stride length manipulation on symptoms of exercise-induced muscle damage and the repeated bout effect. J Sports Sci 2001; 19 (5): 333–40

    PubMed  CAS  Google Scholar 

  87. Weber MD, Servedio FJ, Woodall WR. The effects of three modalities on delayed onset muscle soreness. J Sports Phys Ther 1994; 20 (5): 236–42

    CAS  Google Scholar 

  88. Harris C, Wilcox A, Smith G, et al. The effect of delayed onset muscle soreness (DOMS) on running kinematics. Med Sci Sport Exerc 1990; 22 (2): S34

    Google Scholar 

  89. Vasudevan SV. Impairment, disability and functional capacity assessment. In: Turk DC, Melzack RM, editors. Handbook of pain assessment. New York: The Guilford Press, 1993: 100–1

    Google Scholar 

  90. Saxton JM, Clarkson PM, James R, et al. Neuromuscular dysfunction following eccentric exercise. Med Sci Sports Exere 1995; 27 (8): 1185–93

    CAS  Google Scholar 

  91. Hamill J, Freedson PS, Clarkson PN, et al. Muscle soreness during running: biomechanical and physiological considerations. Int J Sport Biomech 1991; 7 (2): 125–37

    Google Scholar 

  92. Goff DA, Hamill J, Clarkson PM. Biomechanical and biochemical changes after downhill running [abstract]. Med Sci Sport Exerc 1998; 30 Suppl. 5: S101

    Google Scholar 

  93. Gulick DT, Kimura IF, Sider M, et al. Various treatment techniques on signs and symptoms of delayed onset muscle soreness. J Athletic Train 1996; 31 (2): 145–52

    CAS  Google Scholar 

  94. Nosaka K, Clarkson PM. Variability in serum creatine kinase response after eccentric exercise of the elbow flexors. Int J Sports Med (Stuttgart) 1996; 17 (2): 120–7

    CAS  Google Scholar 

  95. Saxton JM, Donnelly AE. Light concentric exercise during recovery from exercise-induced muscle damage. Int J Sports Med 1995; 16 (6): 347–51

    PubMed  CAS  Google Scholar 

  96. Howell IN, Chila AGA, Ford G, et al. An electromyographic study of elbow motion during postexercise muscle soreness. J Appl Physiol 1985; 58 (5): 1713–8

    PubMed  CAS  Google Scholar 

  97. Jones DA, Newham DJ, Clarkson PM. Skeletal muscle stiffness and pain following eccentric exercise of the elbow flexors. Pain 1987; 30: 233–42

    PubMed  CAS  Google Scholar 

  98. Eston RG, Finney S, Baker S, et al. Muscle tenderness and peak torque changes after downhill running following a prior bout of isokinetic eccentric exercise. J Sports Sci (London) 1996; 14 (4): 291–9

    CAS  Google Scholar 

  99. Nosaka K, Clarkson PM. Changes in indicators of inflammation after eccentric exercise of the elbow. Med Sci Sports Exerc 1996; 28 (8): 953–61

    PubMed  CAS  Google Scholar 

  100. Yates JW, Armbruster WJ. Concentric and eccentric strength loss and recovery following exercise induced muscle soreness [abstract]. Int J Sports Med 1990; 11: 403

    Google Scholar 

  101. Ebbeling CB, Clarkson PM. Exercise-induced muscle damage and adaptation. Sports Med 1989; 7 (4): 207–34

    PubMed  CAS  Google Scholar 

  102. Evans DT, Smith LL, Chenier TC, et al. Changes in peak torque, limb volume and delayed onset muscle soreness following repetitive eccentric contractions. Int J Sports Med 1990; 11: 403

    Google Scholar 

  103. Orchard J, Marsden J, Lord S, et al. Pre-season hamstring muscle weakness associated with hamstring muscle injury in Australian footballers. Am J Sports Med 1997; 25 (1): 81–5

    PubMed  CAS  Google Scholar 

  104. Edgerton VR, Wolf SL, Levendowski DJ, et al. Theoretical basis for patterning EMG amplitudes to assess muscle dysfunction. Med Sci Sports Exerc 1996; 28 (6): 744–51

    PubMed  CAS  Google Scholar 

  105. Miles MP, Ives JC, Vincent KR. Neuromuscular control following maximal eccentric exercise. Fur J Appl Physiol 1997; 76: 368–74

    CAS  Google Scholar 

  106. Zhou S, Carey MF, Snow RJ, et al. Effects of muscle fatigue and temperature on electromechanical delay. Electromyogr Clin Neurophysiol 1998; 38: 67–73

    PubMed  CAS  Google Scholar 

  107. Zhou S. Acute effect of repeated maximal isometric contraction on electromechanical delay of knee extensor muscle. J Electromyogr Kinesiol 1996; 6: 117–1127

    PubMed  CAS  Google Scholar 

  108. Boucher JP, Pepin A, Lefebvre R. Using the vastus medialis to vastus lateralis IEMG ration as a neuromuscular imbalance index for the diagnosis of patello-femoral syndrome. Med Sci Sport Exerc 1989; 24: 531–6

    Google Scholar 

  109. Brukner P, Khan K. Clinical sports medicine. Sydney: McGraw-Hill Book Company Australia Pty Limited, 1993

    Google Scholar 

  110. Verducci FM. Interval cryotherapy decreases fatigue during repeated weight lifting. J Athletic Train 2000; 35 (4): 422–6

    CAS  Google Scholar 

  111. Kokkinidis E, Tsamourtas A, Bruckenmeyer P, et al. The effect of static stretching and cryotherapy on the recovery of delayed muscle soreness. Exerc Soc J Sport Sci 1998; 19: 9

    Google Scholar 

  112. Gulick DT. Effects of various treatment techniques on the signs and symptoms of delayed onset muscle soreness. Philadelphia (PA): Temple University, 1995

    Google Scholar 

  113. Denegar CR, Perrin DH. Effect of transcutaneous electrical nerve stimulation, cold, and a combination treatment on pain, decreased range of motion, and strength loss associated with delayed onset muscle soreness. J Athletic Train 1992; 27 (3): 200, 202, 204–6

    CAS  Google Scholar 

  114. Yackzan L, Adams C, Francis KT. The effects of ice massage on delayed muscle soreness. Am J Sports Med 1984; 12: 159–65

    PubMed  CAS  Google Scholar 

  115. Braun B, Clarkson PM. Effect of cold treatment during eccentric exercise [abstract]. Med Sci Sports Exerc 1989; 21 Suppl.: S32

    Google Scholar 

  116. Meussen R, Lievens I. The use of cryotherapy in sports injuries. Sports Med 1986; 3: 398–414

    Google Scholar 

  117. Magnusson SP, Simonsen EB, Aagaard P, et al. Viscoelastic response to repeated static stretching in the human hamstring muscle. Scand J Med Sci Sports 1995; 5: 342–7

    PubMed  CAS  Google Scholar 

  118. Smith LL, Brunetz MH, Chenier TC, et al. The effects of static and ballistic stretching on delayed onset muscle soreness and creatine kinase. Res Q Exerc Sport 1993; 64 (1): 103–7

    PubMed  CAS  Google Scholar 

  119. Lin WH. The effects of massage, stretch and meloxicam on delayed onset muscle soreness. Taoyuan: National College of Physical Education and Sports, 1999

    Google Scholar 

  120. Lund H, Vestergaard-Poulsen P, Kanstrup IL, et al. The effect of passive stretching on delayed onset muscle soreness, and other detrimental effects following eccentric exercise. Scand J Med Sci Sports 1998; 8 (4): 216–21

    PubMed  CAS  Google Scholar 

  121. Shellock FG, Prentice WE. Warming-up and stretching for improved physical performance and prevention of sports-related injuries. Sports Med 1985; 2: 267–78

    PubMed  CAS  Google Scholar 

  122. Hertel J. The role of nonsteroidal anti-inflammatory drugs in the treatment of acute soft tissue injuries. J Athletic Train 1997; 32 (4): 350–8

    CAS  Google Scholar 

  123. Kuipers H, Keizer HA, Verstappen FT, et al. Influence of a prostaglandin-inhibiting drug on muscle soreness after eccentric work. Int J Sports Med 1985; 6 (6): 336–9

    PubMed  CAS  Google Scholar 

  124. Donnelly AE, McCormick K, Maughan RJ, et al. Effects of a non-steroidal anti-inflammatory drug on delayed onset muscle soreness and indices of damage. Br J Sports Med 1988; 22 (1): 35–8

    PubMed  CAS  Google Scholar 

  125. Adams SS, Bough RG, Cliffe EE, et al. Absorption, distribution, and toxicity of ibuprofen. Toxicol Appl Pharmacol 1989; 15: 1310–30

    Google Scholar 

  126. Hasson SM, Mundorf R, Barnes WS, et al. Effect of ultrasound on muscle soreness and performance. Med Sci Sports Exerc 1989; 21: S36

    Google Scholar 

  127. Ciccone CD, Leggin BG, Callamaro JJ. Effects of ultrasound and trolamine salicylate phonopheresis on delayed onset muscle soreness. Phys Ther 1991; 71 (9): 666–78

    PubMed  CAS  Google Scholar 

  128. Stay JC, Richard MD, Draper DO, et al. Pulsed ultrasound fails to diminish delayed-onset muscle soreness symptoms. J Athletic Train 1998; 33 (4): 341–6

    CAS  Google Scholar 

  129. Allen JD, Mattacola CG, Perrin DH. Effect of microcurrent stimulation on delayed-onset muscle soreness: a double-blind comparison. J Athletic Train 1999; 34 (4): 334–7

    CAS  Google Scholar 

  130. Butterfield DL, Draper DO, Richard MD, et al. The effects of high-volt pulsed current electrical stimulation on delayed-onset muscle soreness. J Athletic Train 1997; 32 (1): 15–20

    CAS  Google Scholar 

  131. Denegar CR, Perrin DH, Rogol AS, et al. Influence of transcutaneous electrical nerve stimulation on pain, range of motion, and serum cortisol concentration in females experiencing delayed onset muscle soreness. J Orthop Sports Phys Ther 1989; 11 (3): 100–3

    PubMed  CAS  Google Scholar 

  132. Denegar CR, Yoho AP, Borowicz AJ, et al. The effects of low-volt, microamperage stimulation on delayed onset muscle soreness. J Sport Rehab 1992; 1 (2): 95–102

    Google Scholar 

  133. Denegar CR, Huff CB. High and low frequency TENS in the treatment of induced musculoskeletal pain: a comparison study. Athletic Train 1988; 23 (3): 235–7, 258

    Google Scholar 

  134. Schmitz RJ, Martin DE, Perrin DH, et al. Effect of interferential current on perceived pain and serum cortisol associated with delayed onset muscle soreness. J Sport Rehabil 1997; 6: 30–7

    Google Scholar 

  135. Baxter JD. Glucocortoid hormone action. In: Gill GN, editor. Pharmacology of adrenal cortical hormones. Oxford: Pergamon Press Ltd., 1979: 93–103

    Google Scholar 

  136. Kloth L. Electrotherapeutic alternative for the treatment of pain. In: Gersh M, editor. Electrotherapy in rehabilitation. Philadelphia (PA): Davis, 1992: 197–217

    Google Scholar 

  137. Lambert MI, Marcus P, Burgess T, et al. Electro-membrane microcurrent therapy reduces signs and symptoms of muscle damage. Med Sci Sports Exerc 2002 Apr; 34 (4): 602–7

    PubMed  Google Scholar 

  138. Castro M. The complete homeopathy handbook. New York: St Martin’s Press, 1991

    Google Scholar 

  139. Smith LL, Keating MN, Holbert D, et al. The effects of athletic massage on delayed onset muscle soreness, creatine kinase and neutrophil count: a preliminary report. J Orthop Sports Phys Ther 1994; 19 (2): 93–9

    PubMed  CAS  Google Scholar 

  140. Hovind H, Nielsen ST. Effect of massage on blood flow in skeletal muscle. Scand J Rehabil Med 1974; 6: 74–7

    PubMed  CAS  Google Scholar 

  141. Cafarelli E, Flint F. The role of massage in preparation for and recovery from exercise. Sports Med 1992; 14: 1–9

    PubMed  CAS  Google Scholar 

  142. Tiidus PM. Manual massage and recovery of muscle function following exercise: a literature review. J Sports Phys Ther 1997; 25 (2): 107–12

    CAS  Google Scholar 

  143. Ernst E. Does post-exercise massage treatment reduce delayed onset muscle soreness: a systematic review. Br J Sports Med 1998; 32 (3): 212–4

    PubMed  CAS  Google Scholar 

  144. Kraemer WJ, Bush JA, Wickham R, et al. Continuous compression as an effective therapeutic intervention in treating eccentric-exercise-induced muscle soreness. J Sport Rehabil 2001; 10 (1): 11–23

    Google Scholar 

  145. Harrison BC, Robinson D, Davison BJ, et al. Treatment of exercise-induced muscle injury via hyperbaric oxygen therapy. Med Sci Sports Exerc 2001; 33 (1): 36–42

    PubMed  CAS  Google Scholar 

  146. Babul S. Hyperbaric oxygen therapy to enhance recovery from delayed onset muscle soreness [commentary]. Clin J Sport Med 2000; 10 (4): 308

    PubMed  CAS  Google Scholar 

  147. Mekjavic IB, Exner JA, Tesch PA, et al. Hyperbaric oxygen therapy does not affect recovery from delayed onset muscle soreness. Med Sci Sports Exerc 2000; 32 (3): 558–63

    PubMed  CAS  Google Scholar 

  148. Staples JR, Clement DB, Taunton JE, et al. Effects of hyperbaric oxygen on a human model of injury. Am J Sports Med 1999; 27 (5): 600–5

    PubMed  CAS  Google Scholar 

  149. Carlsson CA, Pellettieri L. A clinical view on pain physiology. Acta Chir Scand 1982; 148: 305–13

    PubMed  CAS  Google Scholar 

  150. Donnelly AE, Clarkson PM, Maughan RJ. Exercise-induced muscle damage: effects of light exercise on damaged muscle. Eur J Appl Physiol 1992; 64 (4): 350–3

    CAS  Google Scholar 

  151. Hasson SM, Williams III, Signorile IF. Fatigue-induced changes in myoelectric signal characteristics and perceived exertion. Can J Sport Sci 1989; 14 (2): 99–102

    PubMed  CAS  Google Scholar 

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Acknowledgements

The authors would like to acknowledge Sport Science New Zealand for funding assistance in the preparation of this manuscript. The authors have provided no information on conflicts of interest directly relevant to the content of this review.

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Correspondence to Patria A. Hume.

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Cheung, K., Hume, P.A. & Maxwell, L. Delayed Onset Muscle Soreness. Sports Med 33, 145–164 (2003). https://doi.org/10.2165/00007256-200333020-00005

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