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Strategies for Reducing Delayed-Onset Muscle Soreness

This is an excerpt from Science and Development of Muscle Hypertrophy-2nd Edition by Brad Schoenfeld.

As discussed in chapter 2, delayed-onset muscle soreness (DOMS) manifests 24 to 48 hours after performance of intense exercise and tends to be most prevalent when the stimulus is unaccustomed. While mild DOMS generally is benign from a performance standpoint, moderate to severe levels of soreness can impair subsequent strength capacity, thereby potentially having a detrimental impact on muscular adaptations.

Numerous strategies have been proposed to help alleviate the negative consequences of DOMS (15). A recent meta-analysis on the topic found that massage therapy had the greatest effect on reducing symptoms of DOMS, conceivably by increasing blood flow and diminishing edema. Other strategies shown to have a positive impact include compressive garments, cryotherapy, cold-water immersion, contrast water therapy (i.e., alternating hot- and cold-water baths), and active recovery. Interestingly, evidence did not show a beneficial effect of stretching on DOMS, despite its popular use as a primary treatment.

Recently, foam rolling has been advocated for counteracting DOMS. Drinkwater and colleagues (14) found that 15 minutes of foam rolling for the lower-body musculature performed immediately after a muscle-damaging eccentric bout and 24, 48, and 72 hours post-exercise significantly increased the pressure-pain threshold compared to passive recovery. These findings were associated with a greater recovery from the exercise bout, as determined by an increase in countermovement jump performance. Although speculative, a higher pressure-pain threshold conceivably could be related to a reduction in soreness, thereby raising the possibility that foam rolling may be a viable recovery option.

A potential issue when interpreting research on the topic is the possibility that findings are due to a placebo effect. It is difficult to provide adequate sham treatments as a control for manipulative therapies, and subjects therefore are not adequately blinded to the given treatment. This limits the ability to conclude whether the treatment is actually responsible for beneficial effects or if results are influenced by subjects' perception of treatment.

Importantly, while reducing DOMS potentially can benefit performance, some therapies may interfere with processes beneficial to muscle development. As noted elsewhere in this chapter, evidence shows that cold-water immersion therapy negatively affects anabolic processes (21, 72) and appears to be detrimental to long-term muscle development (72, 90). Caution should therefore be used when deciding whether to use a recovery strategy to optimize hypertrophic adaptations; the potential costs and benefits of adopting a given approach must both be taken into consideration.