Delayed muscle soreness (DOMS) is known as “muscle fever.” and is thought to be due to temporary muscle damage and inflammation. The most common trigger appears to be eccentric exercises.
Exercise-induced muscle injury DOMS is considered a type 1 muscle strain injury with a pain-free period of 12-24 hours with soreness peaks between 24-72 hours.
Pathophysiology
Eccentric muscle contractions result in more significant disruption of the muscle and connective tissue’s structural elements than concentric exercise. This structural disorder has sufficient evidence from histological studies, electron microscopic examinations, and serum enzyme levels that have been performed over the years.
The onset of muscle soreness after exercise is multifaceted. The pain-free period indicates that DOMS is not solely due to myofibrillar disorders but has other underlying causes. The injury model states that after the initial trauma (muscle injury or injury), the following inflammatory cascade may induce secondary injury.
Neutrophils and proinflammatory macrophages are essential for removing cell debris through phagocytosis. Production of reactive oxygen species (ROS) of these inflammatory cells can cause damage to cells that were not involved in the initial trauma.
Prevention
Delayed muscle soreness generally gets better on its own after a few days to a week. However, the range of motion and muscle performance may be reduced during that period. There is evidence that anti-inflammatory drugs, massage, compression garments, rest, and some supplements can reduce DOMS duration.
Implications for physiotherapy
Many physiotherapy patients will start a new exercise program or add new exercises to their current exercise program. These exercises can be intense for the patient, and the patient may experience delayed muscle soreness (DOMS) after starting a physiotherapy or exercise program. DOMS is usually weaker after subsequent training sessions.
The therapist needs to assure the patient that DOMS is a normal part of a new exercise program and help differentiate muscle ulcers from other types of pain.
Massage is an alternative therapy that has shown significant effects in reducing the intensity of the stiffness and pain associated with DOMS. The mechanical pressure reduces the neutrophil migration and thus reduces the inflammatory process in the muscle structure.
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