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Muscle pain after exercise

Delayed onset muscle soreness (DOMS) is the pain and stiffness felt in muscles after unaccustomed or strenuous exercise. The soreness is felt most strongly 24 to 72 hours after the exercise. Although there is variance among exercises and individuals, the soreness usually increases in intensity in the first 24 hours after exercise. It peaks from 24 to 72 hours, then subsides and disappears up to seven days after exercise. who concluded that this kind of soreness is "fundamentally the result of ruptures within the muscle". The soreness has been attributed to the increased tension force and muscle lengthening from eccentric exercise. This may cause the actin and myosin cross bridges to separate prior to relaxation, ultimately causing greater tension on the remaining active motor units. Another explanation for the pain associated with DOMS is the "enzyme efflux" theory. Following microtrauma, calcium that is normally stored in the sarcoplasmic reticulum accumulates in the damaged muscles. Cellular respiration is inhibited and ATP needed to actively transport calcium back into the sarcoplasmic reticulum is also slowed. This accumulation of calcium may activate proteases and phospholipases which in turn break down and degenerate muscle protein. This causes inflammation, and in turn pain due to the accumulation of histamines, prostaglandins, and potassium. An earlier theory posited that DOMS is connected to the build up of lactic acid in the blood, which was thought to continue being produced following exercise. This build up of lactic acid was thought to be a toxic metabolic waste product that caused the perception of pain at a delayed stage. This theory has been largely rejected, as concentric contractions which also produce lactic acid have been unable to cause DOMS. A recent theory of Sonkodi et al., that incorporates the findings of Mizumura et al., proposes that the microdamage to the muscles is only the secondary phase of DOMS injury mechanism and suggests that the primary damage is the microinjury of the proprioceptive Type Ia sensory fiber terminals within the muscle spindle.

Although delayed onset muscle soreness is a symptom associated with muscle damage, its magnitude does not necessarily reflect the magnitude of muscle damage. As a result of this effect, not only is the soreness reduced the next time the exercise is performed, but other indicators of muscle damage, such as swelling, reduced strength, and reduced range of motion, are also more quickly recovered from. The effect is mostly, but not wholly, specific to the exercised muscle; experiments have shown that some of the protective effects is also conferred on other muscles. Soreness can theoretically be avoided by limiting exercise to concentric and isometric contractions, Static stretching or warming up the muscles before or after exercise does not prevent soreness, although there is evidence that whole body vibration therapy performed before exercise may lessen both the soreness and reduced range of motion caused by delayed onset muscle soreness. Other preventative measures with evidence of efficacy based on randomized controlled trials include the consumption of saffron. Wearing compression garments has not been demonstrated to have a significant effect on delayed onset muscle soreness.

The soreness usually disappears within about 72 hours after appearing. If treatment is desired, any measure that increases blood flow to the muscle, such as low intensity activity, massage, nerve mobilization, hot baths, or a sauna visit may help somewhat. but effective in another. There is also insufficient evidence to determine whether whole body cryotherapy — compared with passive rest or no whole body cryotherapy — reduces DOMS, or improves subjective recovery, after exercise. Counterintuitively, continued exercise may temporarily suppress the soreness. Exercise increases pain thresholds and pain tolerance. This effect, called exercise induced analgesia, is known to occur in endurance training (running, cycling, swimming), but little is known about whether it also occurs in resistance training. There are claims in the literature that exercising sore muscles appears to be the best way to reduce or eliminate the soreness, but this has not yet been systematically investigated. It decreases soreness, but does not counteract the reduction in muscular performance caused by delayed onset muscle soreness.