vs DELAYED ONSET MUSCLE SORENESS
Fact or Fiction?







vs DELAYED ONSET MUSCLE SORENESS
Fact or Fiction?
Delayed onset muscle soreness (DOMS) can be a common occurrence after vigorous exercising, including unaccustomed resistance training or other types of muscular overexertion, resulting in exercise-induced muscle damage (EIMD). This phenomenon of extreme muscle soreness and discomfort usually occurs within 1-3 days (but can last 1-2 weeks) post working out strenuously, and peaks at about 36-48 hours after performing “forced reps” or eccentric muscle contraction (during the lengthening phase). The severity and distribution of DOMS depends on the exercise type, intensity, and duration. Muscle fibers undergo microscopic tears resulting in inflammation, swelling, and pain. The resulting micro-trauma causes soft tissue breakdown products to be released from the muscles, which eventually accumulate in the blood and/or leaked out in urine. The affected limbs/joints then experience tenderness, stiffness (decreased range of motion-ROM) along with muscle spasm, plus the athlete feels weaker thus is unable to work out for the next few days. These symptoms can become so severe, however, thus may not be completely resolved until several days later after enough relative rest. In other words, it’s recommended that the affected athlete engages in a different type of physical activity i.e. cross training using other muscle groups, in order not to aggravate or traumatize the same muscles.
Different modalities have been used to help prevent and/or treat DOMS, including stretching, compression, massage, supplements, non-steroidal anti-inflammatory medications, vibration therapy, hyperbaric oxygen therapy, ultrasound, superficial heat, hydrotherapy, and electrotherapy. None of these methods, although having widespread use, have had success in complete or long lasting symptomatic relief. Whole body cryotherapy (WBC) is gaining more popularity in the sports medicine arena for treating sore muscles after exercising. The affected athlete is exposed to sub-zero temperature (<100deg C) i.e. liquid nitrogen or extremely cold (refrigerated) dry air for 2-4 minutes. Minimal clothing is worn during these exposures. Usually males wear only shorts and females also add a crop top. To minimize frostbite, hands are protected with gloves and feet with socks/shoes. A woolen headband insulates the ears and a mask covers nose/mouth as well.
Historically, the Japanese built the very first WBC chamber in the late 1970’s, then the Europeans followed suit in the mid 1980’s. Australians and Americans only recently started using WBC about a dozen years ago. The initial usage of WBC was by medical professionals to clinically treat patients with rheumatoid arthritis or multiple sclerosis. Subsequent introduction of WBC into the elite athletic circle for managing DOMS has paved the way for recreational athletes to employ this mode of relieving painful symptoms after vigorous workout sessions as well. Typically, WBC is often utilized within 24 hours after exercising, with treatment repeated again later on the same day or over several days, dependent on the severity and areas of muscle pain.

The mechanism of how WBC is postulated to work involves lowering of both skin and muscle temperature after direct exposure. This extreme freezing application of gaseous air then stimulates the nervous system to send input for constricting vessels, slowing down tissue activity within the affected muscles, thus reducing inflammation and subsequent pain. The resulting effect is to lessen the amount of muscle damage, plus enhances the release of more anti-inflammatory chemicals to involved soft tissue sites. Subsequently, the surrounding muscles can also better contract to assist in the healing, recovery/rehabilitation process. Along the same lines, ice-cold water emersion seems to also psychologically help in reducing the subjective sensation of DOMS after working out vigorously as well.

Historically, the Japanese built the very first WBC chamber in the late 1970’s, then the Europeans followed suit in the mid 1980’s. Australians and Americans only recently started using WBC about a dozen years ago. The initial usage of WBC was by medical professionals to clinically treat patients with rheumatoid arthritis or multiple sclerosis. Subsequent introduction of WBC into the elite athletic circle for managing DOMS has paved the way for recreational athletes to employ this mode of relieving painful symptoms after vigorous workout sessions as well. Typically, WBC is often utilized within 24 hours after exercising, with treatment repeated again later on the same day or over several days, dependent on the severity and areas of muscle pain.

The mechanism of how WBC is postulated to work involves lowering of both skin and muscle temperature after direct exposure. This extreme freezing application of gaseous air then stimulates the nervous system to send input for constricting vessels, slowing down tissue activity within the affected muscles, thus reducing inflammation and subsequent pain. The resulting effect is to lessen the amount of muscle damage, plus enhances the release of more anti-inflammatory chemicals to involved soft tissue sites. Subsequently, the surrounding muscles can also better contract to assist in the healing, recovery/rehabilitation process. Along the same lines, ice-cold water emersion seems to also psychologically help in reducing the subjective sensation of DOMS after working out vigorously as well

In summary, although no current methods exist to prevent delayed onset muscle soreness, whole body cryotherapy appears to be beneficial in treating painful symptoms once they occur. The best time for undergoing WBC treatment is within the first 24 hours after DOMS, which then can be repeated over the next few days if needed. Make sure to wear protective garments over the ears, mask over nose/mouth, gloves for hands and shoes/socks for both feet to prevent thermal injury to these sites on the body. As always, however, prevention is the best method of management so try to avoid extreme, repeated bouts of vigorous intense exercise over a short period of time in the first