Originally published Dec 1995
James P Doran
You have just increased your mileage as a runner and you find a day or so after upping the mileage you have pain in your legs. Or maybe you worked out at the local gym and you find increasing your weights causes pain in your upper body a day or so after your last work out. Why get the pain so long after the exercise? Well you are probably experiencing delayed onset muscle soreness (D.O.M.S.).
I am sure most readers would have experienced this type of pain at some stage in their life. It may be described as a dull ache or exquisite tenderness depending upon the region of the body affected. Little is known about the exact physiological mechanisms that cause this delayed onset muscle soreness. What is known however, is that the soreness appears anywhere from 24 to 48 hours post exercise. It is also quite common when you change your exercise regime by using different muscle groups.
My experience as a physiotherapist over the years leads me to believe that this is the reason why people develop D.O.M.S. Over use of a new different muscle group causes local tissue damage or micro-trauma and subsequent local swelling. The tissues, in this case invariably the muscles and connective tissues, become tight. This is as a consequence of the over exercise or the unaccustomed exercise of that part. If the tissues become tight, not as much blood flows to that region of the body. Therefore oxygen and the other nutrients are not as easily fed into the exercising region. Also, waste products are not removed. This decreased blood supply leads to local tissue swelling and pain.
D.O.M.S. occurs much less frequently in the regular exercising athlete. It also occurs more commonly in athletes who engage in eccentric muscle contraction (meaning lengthening of a muscle, as opposed to active shortening of a muscle under a load). A particularly potent cause of D.O.M.S. is running down hill. This involves eccentric muscular contractions of the large quadriceps group and the iliotibial band.
D.O.M.S. delays the athlete from further competition. It puts you on hold whilst you are in pain.
The good news about D.O.M.S. though is that it can be lessened if appropriate activities are taken to prevent its occurrence. The main activity is a slow, steady and gentle warm down post exercise. This involves very gentle stretches and very gentle massage techniques. These techniques should be given 15 minutes to two hours after exercise to minimise the amount of soreness that may occur. Gentle massage aids the removal of toxins and waste products that are caused by muscle contraction as well as reducing the subsequent amount of muscle spasm that may also be a contributor to D.O.M.S. Deep or vigorous massage in this case is highly inappropriate and will only result in an increase in the pain experienced by the D.O.M.S. sufferer. In fact deep massage causes microscopic damage which results in a chronic inflammatory stage in the muscle.
Besides gentle massage techniques, soaking in a hot tub may also reduce the amount of pain experienced from D.O.M.S.
Last year I had the privilege of working on the medical team supporting the Hawaiian long distance triathlon. this event involves a 5 kilometre swim, 150 kilometre bike ride and then a marathon. I worked with over 100 massage therapists. Some of the athletes were as old as 75 years of age and one would have expected that the day after such a gruelling event they would be in incredible pain and suffering from D.O.M.S. Yet all of these elite athletes at the completion of their race made a beeline for the massage table. We in fact, worked until 1.00am the following morning massaging athletes as they came across the line, having to complete the race by 12.00 midnight. I was amazed at how important all of those athletes felt post event massage was to prevent the onset of D.O.M.S.
However, massage is not the be all and end all. A satisfactory cool down is very important. Many of us stretch and warm up prior to exercising but how many of us devote as much time to a warm down? The extent of D.O.M.S. can be easily reduced, prevention of D.O.M.S. requires the athlete to understand the reasons by D.O.M.S. occurs (see above) and appropriate advice from trainer and when need be, consultation with physiotherapist and masseur.
James P Doran is a Physiotherapist and Director International College of Massage and Body Work (Australian Division)
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Regards Kym
