How To Eliminate Muscle Pain From Exercise - A New Look At Delayed Onset Muscle Soreness (DOMS) In The Elite Athlete And Weekend Warrior

The reason for this essay is that a high-level health and fitness professional observed the Myoride Exercise Machine function and said to me that this wouldn't cause DOMS. At the time I agreed with him but didn't have any idea what DOMS meant. So I had to research it.

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What I realized is that this is a very common complaint but there just isn't a lot of information on it. So what I did was do a paper research to get a whiff of it and then summarized it. However, I interjected my own thoughts and think you will find this an interesting take on the subject of muscle pain.

The term soreness, like pain, is subjective. The level of sensation DOMS causes seems more like pain than soreness. But let's talk soreness, on the side of pain.

Do you get muscle soreness after a vigorous exercise? Not a soreness in the muscle after a regular workout but a painful soreness after you exercise a muscle that you haven't exercised in a longtime?

The soreness doesn’t hit you until a few days later so you do notice a soreness, like a tightness but then pain several days out. Many people do and this problem has been around for years without much explanation about mechanism of cause, solutions to the problem, or descriptions of prevention.

Let me offer some insights.

The problem is called Delayed Onset Muscle Soreness (DOMS).

It has been related to vigorous muscle exertion and you are going to feel it between one to three days after the exercise - not right away which would be a great indicator that you should stop doing what you're doing, but days later. Like when I foolishly try playing full-court basketball when I haven't done so in years. Ouch! The next day I am very sore and the next day I can hardly walk. I know better but that's the last thing on my mind when there's a great pick-up game. I don't do this anymore but used to.

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This problem doesn't just happen to the legs - DOMS happens to whatever muscles happen to be under heavy use. Do any exercise activity and you're bound to develop DOMS. Doesn't matter what your fitness level is, if you haven't used a muscle group or if you exert more work from a muscle you have a good chance of developing soreness.

Some experts say it's a normal physiological response to increased exertion (I don't think so) and that there may be nothing to be done to prevent this "normal" response from happening (I think there is).

Point #1 The Cause

Firstly there is some consensus that DOMS mostly happens by eccentric exercises, like running downhill - lengthening a muscle under load. According to this explanation, you can have DOMS affect any muscle group that lengthens under a load (which is the opposite of concentric contractions - which is shortening a muscle under load or pulling in toward the body).

If this idea holds up, the first preventative notion is, don't put any muscle through eccentric contractions.

From Treating and Preventing DOMS; Johndavid Maes, and Len Kravitz, Ph.D.; "Connolly et al. (2003) explain that the injury itself is a result of eccentric exercise, causing damage to the muscle cell membrane, which sets off an inflammatory response. This inflammatory response leads to the formation of metabolic waste products, which act as a chemical stimulus to the nerve endings that directly cause a sensation of pain. These metabolic waste products also increase vascular permeability and attract neutrophils (a type of white blood cell) to the site of injury. Once at the site of injury, neutrophils generate free radicals (molecules with unshared electrons), which can further damage the cell membrane. Swelling is also a common occurrence at the site of membrane injury, and can lead to additional sensations of pain."

This is not good for anyone especially the elite athlete who's entire performance is based on muscles functioning; they can't function well at all. Anyone getting DOMS is going to experience  loss of strength, pain, muscle tenderness, stiffness, and swelling and this can last for up to a week. How effective does this make anyone?

There are other caustic mechanisms of DOMS such as problems related to lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. They all may be involved.

Point #2 The Treatment

Secondly, the treatment for the muscle soreness. Again, there is no consensus but actually working the muscle slowly and carefully has been offered as a remedy - performing the actual movement patterns that causes DOMS in the first place.

While it makes sense to take the affected muscles through their ROM while not under load, you're still going to get the hurt all over again. As long as the muscle is affected with the cytokines or metabolites that are contributing to the sensation of muscle soreness.

Even though exercise is the most effective way of reducing pain during DOMS, the analgesic effect is also temporary; the pain comes back. And this is a problem for elite athletes who must train on a daily basis, or you my fellow warrior. Again, taking the muscles gently through their complete ROM under slight resistance may assist in reducing the effects of DOMS as well help shorten the time of recovery.

There seems to be no consensus to the cause of DOMS but it makes sense that there is some connective tissue microtrauma or even muscular microtrauma. If this is the case, treatment may be delayed but I'd certainly utilize low level laser therapy to the affected tissues. As well, there would be nutritive approaches to take.

One of the most interesting discussions of DOMS is the brief reference to the neurological basis of causation. That is that neurotrophic changes take place and substances are secreted by muscles cells that cause nerve growth. Stacking on this issue is the electrolyte idea. According to  "muscle damage" theory of DOMS, ruptures are microscopic lesions at the Z-line of the muscle sarcomere. Following microtrauma, calcium that is normally stored in the sarcoplasmic reticulum accumulates in the damaged muscles.

Now this is interesting. In my blog post, The Cost of Bad Exercise, I wrote: "In response to low intensity exercise there is a loss of calcium and magnesium exchange control.  This is how heart failure patients fatigue. In other words, low intensity, long duration exercise causes the same pathological intracellular chemical imbalances that are found in heart failure patients." How much different is the loss of calcium control than calcium accumulating in the damaged muscles? I don't know.

And in the same article: “In response to high intensity exercise there is gradual muscle cell membrane depolarization due to sodium and potassium membrane exchange."

Might not DOMS be avoided in high intensity training? And this leads us to the final point.

Point #3 Prevention

Why not do everything you can to prevent a problem happening in the first place? Let me summarize and offer my thoughts.

1. DOMS happens more often with eccentric muscle contractions. Don’t do them.

2. One of the greatest reliefs of DOMS is to take the muscle through its range of motion.

3. Be careful of low intensity, long duration training. So as not to upset the calcium magnesium exchange or possible accumulation of calcium in tissues.

4. Do most of your work in high intensity training.

Here's how I would almost completely avoid DOMS.

1. Never do eccentric muscle contractions; there is almost no need to elongate a muscle under load unless you are handing a hot mincemeat pie to your neighbor.

2. Make sure the joints that the muscles are crossing are aligned and removed of any "fixation". If the joint is fixated the muscles are not going to contract through normal ranges of motion or they may be hyper-contracted on one side of the joint and hypo-contracted on the other side.

3. Exercise the muscles through their ENTIRE range of motion. A shoulder joint is at least 180°, a hip joint at least 120° in concentric contractions. Exercising through the entire ROM does two very important things: a) works the muscle in near entirety  b) works the joint in near entirety. The muscle has opportunity to get a complete workload.

4. Workout in high intensity training. The muscle groups involved will increase angiogenesis, oxygenation, and mitochondrial production and efficiency. The muscles will become more efficient and a more efficient muscle will increase its metabolic capacity.

In summary, DOMS can be a nuisance or have a potentially detrimental effect on the elite athlete. But it can be mitigated through careful observance of biomechanics and what I've outlined here today.

References:

https://www.unm.edu/~lkravitz/Article%20folder/domos.html

https://www.painscience.com/articles/delayed-onset-muscle-soreness.php

https://physioworks.com.au/injuries-conditions-1/doms-delayed-onset-muscle-soreness

https://www.ncbi.nlm.nih.gov/pubmed/12617692

https://breakingmuscle.com/fitness/doms-the-good-the-bad-and-what-it-really-means-to-your-training

Peter Lind