But what actually
aids in relief and recovery?!?
Depending on who you ask, you’ll get different answers from everyone, so we’ve dug into some studies on therapeutic modalities to see what they have found to actually work and what has been shown not to be entirely effective! There is a myriad of supplements on the market claiming to aid recovery, but that’s an entirely different story! Here, we are focused mostly on therapeutic modalities with the exception of non-steroidal anti-inflammatory drugs (like ibuprofen).
To begin, let’s understand what delayed onset muscle soreness (DOMS) actually is! You know when you leave a training session thinking “I feel great! That was an awesome workout!” and then anywhere from a few hours to 48 hours later you go to move and…. “Ahhhhh Help Me! Everything hurts and I’m dying!!” and forget sitting down on the toilet or taking the stairs!! It is caused by exercise-induced muscle damage (EIMD), which is commonly associated with eccentric exercise. Symptoms can range from muscle tenderness and tightness to severe debilitating pain as well as a decrease in muscle function and the ability to produce force!
“Up to six hypothesized 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.”(2)
Some preventative or therapeutic modalities have been found to be effective at only alleviating symptoms of DOMS, whereas others may actually enhance recovery of muscle function.
What studies show are most effective...
Nonsteroidal anti-inflammatory drugs (like ibuprofen)
Data indicates that a preventative (~4 hours before activity) dosage of ibuprofen does not prevent or decrease creatine kinase release from muscle (which may suggest less actual muscle damage), but does show to decrease your perceived amount of muscle soreness. Because you feel less sore, you may be more apt to remain active during the following hours or days and this may assist in restoring muscle function.(3)
Exercise
If you’ve ever complained of severe DOMS to your coach or personal trainer, you've likely heard, “Keep moving! Go for a walk, don’t skip your next workout, try not to sit for long periods of time… just keep your body moving!” They are correct, however, this is only effective for temporarily alleviating the pain associated with DOMS.
Massage
In one study, massage was shown to be effective in reducing swelling and alleviating the pain associated with DOMS by approximately 30%, but it did not show to improve muscle function. They did also find that multiple post-exercise massages may be more effective than a single treatment.(8)
“The hypothesis is that, through its mechanical pressure on muscle tissue, massage treatment leads to enhanced local microcirculatory blood and lymph flow. This, in turn, reduces oedema, ischaemia, or accumulation of substances that directly or indirectly cause pain.”(4)
While some results are promising, researchers state that this requires further testing in carefully designed experiments.
Self Myofascial Release
Self-myofascial release (SMFR) is a type of myofascial release performed by the individual, typically using a specially designed tool like a foam roller or massage stick. Other tools commonly used are lacrosse or tennis balls.
“Acutely, SMFR seems to increase flexibility and reduce muscle soreness but does not impede athletic performance. It may lead to improved arterial function, improved vascular endothelial function, and increased parasympathetic nervous system activity acutely, which could be useful in recovery.” (1)
In addition to DOMS, strenuous exercise can lead to the formation of fibrous adhesions in your soft tissues which results in pain, decrease in soft-tissue extensibility, and can prevent normal joint ROM, muscle length, decreased strength and decreased endurance. This is where SMFR shines!(7)
While there is not much peer-reviewed research on SMFR and the use of this technique has quickly outpaced the actual research, all studies done to date absolutely show the effects of SMFR to be beneficial!
Cold Water Immersion/Cryotherapy (6)
Intense training causes microscopic tears in the muscle fibers and inflammation in the muscle tissue. This is what leads to DOMS. Numerous scientific studies have proven Cold Water Immersion and Whole Body Cryotherapy is successful in the effect of DOMS when done soon after completion of training. Lowering the temperature of the tissues causes vasoconstriction and less localized blood flow (8). The reduction of blood flow around the damaged tissues reduces edema and inflammatory activity.
- Stretching
- Homeopathy
- Ultrasound
- Electrical current
- Compression garments
And there you have it!
If you're interested in reading more, check out the corresponding links located in the text above!
References
1. Beardsley, C, and J Škarabot. “Effects of Self-Myofascial Release: A Systematic Review.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Oct. 2015, www.ncbi.nlm.nih.gov/pubmed/26592233/.
2. Cheung, K, et al. “Delayed Onset Muscle Soreness : Treatment Strategies and Performance Factors.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/pubmed/12617692.
3. “Effect of Ibuprofen Use on Muscle Soreness, Damage, and... : Medicine & Science in Sports & Exercise.” LWW, Oxford University Press, journals.lww.com/acsm-msse/pages/articleviewer.aspx?year=1993&issue=01000&article=00003&type=abstract.
4. Ernst, E. “Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review” British journal of sports medicine vol. 32,3 (1998): 212-4.
5. Heiss, R, et al. “Effect of Compression Garments on the Development of Edema and Soreness in Delayed-Onset Muscle Soreness (DOMS).” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 14 Aug. 2018, www.ncbi.nlm.nih.gov/pubmed/30116112.
6. Hohenauer, Erich et al. “The Effect of Post-Exercise Cryotherapy on Recovery Characteristics: A Systematic Review and Meta-Analysis.” PloS one vol. 10,9 e0139028. 28 Sep. 2015, doi:10.1371/journal.pone.0139028
7. “Is Self Myofascial Release an Effective Preexercise and... : Current Sports Medicine Reports.” LWW, Oxford University Press, journals.lww.com/acsm-csmr/fulltext/2015/05000/Is_Self_Myofascial_Release_an_Effective.16.aspx.
8. Lee, Hoseong et al. “Effects of cryotherapy after contusion using real-time intravital microscopy.” Medicine and science in sports and exercise vol. 37,7 (2005): 1093-8. doi:10.1249/01.mss.0000169611.21671.2e
9. Zainuddin, Z, et al. “Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, www.ncbi.nlm.nih.gov/pubmed/16284637.
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