Muscle soreness, DOMS, damaged muscles – how to cope with it?

Micro-injuries in muscles are common, but, against popular belief, lactic acid, which is created during unaerobic work, does not cause pain of skeletal muscles. Why? Because even after the hardest gym workout lactates are removed from muscles, often within 1 hour. Only in extreme cases, when people do very hard interval training VO2 max – this process may take a bit longer. But at the moment when the DOMS start (delayed onset muscle soreness) – which is 24, 36 or 48 hours after the session, there is only the memory of lactates.

In one of the latest studies removing lactates from blood after maximal training took 70 minutes. This study was published on 13th January 2016. There were 20 participants of this study. They did the maximal running test until exhaustion, then they relaxed lying on the back for 120 minutes. Blood samples were gathered before and after the test, and heart was also checked at that time. 70 minutes after finishing work the level of lactates was equal to that from the beginning [2].

What can be done to speed up the recovery of sore muscles?

You should plan wisely the progress and volume of the training. If you had training after 4-week break (on purpose, or e.g. holiday), finish the sets at 50-60% of your normal load. You can do at most 3 sets of each exercise. If you start a new training program, don't do the maximal volume at once, e.g. in the 10 x 10 model (sets x repetitions). You can do 3-4 sets of 10 repetitions, add one set every week.

Massage after workout. In one of the studies [1], 30 experienced bodybuilders did the same kind of work in 5 sets with 75-77% of their maximal load of the erectors and flexors of the knee. Right after the workout one group of volunteers was massaged for 30 minutes, the others relaxed passively – there was the increase of creatine kinasis and muscle soreness. The measurements were taken: right after, 24, 48 and 72 hours after training. However, the bodybuilders, who had the massage, recovered faster.

Proper warm-up and cool down are of huge influence on: muscle damage, decreasing the risk of injury, increasing efficiency, muscle strength and power. This subject was widely described here: Muscle soreness - fast aid.

Contrast water therapy (CWT) – e.g. by soaking in cold and warm water. Unfortunately, metanalysis of this method [3] brings ambiguous results. If you use other methods of wellness – the efficiency is similar.

Compression clothes, pressure – it may matter for speeding up the after-workout recovery. Many studies prove that cooling and heating, as well as compression have similar resuls for perceiving muscle soreness during less than: 6, 24 and 48 hours after finishing training [3, 4]. When it comes to the creatine kinases, the CWT therapy seems more advantagous.

Stretching – according to some studies it may matter for decreasing after-workout muscle soreness.

Ginger. According to a study done on 36 women [8], consuming ginger 1 hour before training is more efficient in decreasing muscle soreness 24 and 48 hours after finishing exercising, compared to a dose of ginger right after the workout. Training – it was going up and down the 46-centimetre step for 20 minutes, 15 steps up per minute of work [8]. Conclusion: 2 grams of ginger before training may decrease muscle soreness. However, it should be added, that other studies do not necessarily confirm those conclusions – in the following experiment 48 hours after finishing training, strength increased faster among people who used 4 g of ginger [9].

Arnica – it decreases the perception of soreness [11]. Unfortunately, it has minute or none influence on IL-1 beta, tumour necrosis factor-alpha, C-reactive protein (they evidence inflammation); creatine kinasis and myoglobin (the measurements of breakdown and skeletal muscle damage).

BCAA – according to some studies the branch-chained amino acids may reduce the feeling of pain in muscles, but... I underline it, that it happens in case of untrained people [12]. Whereas, other studies suggest decreasing muscle soreness among long-distance runners when using 2.5l of solution with 0.8% BCAA [14].

Bad ideas for fighting against DOMS are following:

Drinking alcohol. Alcohol speeds up nothing but headache or other symptoms of disease connected with its overdose. It helps with nothing. Physiologically speaking, ethanol is a sophisticalted poison. When drinking, you slow down the repair of micro-injuries in muscles, and it doesn't matter if it's beer, wine or vodka. The bigger amount of alcohol, the worse – it dehydrates more.

Painkillers and anti-inflammatory products from the NSAID group (non-steroidal anti-inflammatory drugs), e.g. aspirin, ketoprofen, naproxen, ibuprofen, sodium diclofenac – for many reasons it's a very bad choice. These are products, which are harmful for health (“using any kind of NSAID, except for the acetylsalicilic acid, is connected with increasing the cardiovascular risk”), whereas, when used chronically, these products kill many thousands of people annually in Poland (according to estimates – 3,000 people). Because of the complications after using such products in the USA, 16,500 people die during each year [6]. But... For a sports person there is the other side – these products block the results of training [5]. It probably happens because of blocking the conversion of the arachidonic acid into prostaglandins. NSAID are the inhibitors of prostaglandins synthesis by their influence on the cyclooxygenaze: constructive cyclooxygenaze (COX-1) and induced cyclooxygenaze (COX-2) [6, 7].

Ginseng – according to studies, it has minute influence on DOMS, e.g. 4 g used before running on treadmill – a kind of workout, which is supposed to cause DOMS [10].

Glutamine – according to research, it has almost no influence on human body. Leave it in a shop. 17 healthy men at the age of 22.35 +/- 2.27, weight: 69.91 +/- 9.78 kg, height: 177.08 +/- 4.32 cm, were divided into the group with glutamine (0.1 g/kg of body mass) and placebo. They consumed glutamine or placebo for 4 weeks (3 x a week). They did 6 sets until exhaustion – the excentric phase in leg extensions with the load of 75% of the maximal load. Between the sets they had 3-minute breaks. The delayed onset muscle soreness was checked (DOMS), as well as the range of motion and the activity of muscles with the EMG method – 24 and 48 hours after finishing the session. There were no differences between the groups of placebo and glutamine [13].

Sources: J Sports Sci. 2015 Sep 3:1-7. [Epub ahead of print] “Efficacy of massage on muscle soreness, perceived recovery, physiological restoration and physical performance in male bodybuilders.” http://www.ncbi.nlm.nih.gov/pubmed/26334128 2. Clin Physiol Funct Imaging. 2016 Jan 13. doi: 10.1111/cpf.12339. [Epub ahead of print] Temporal sequence of recovery-related events following maximal exercise assessed by heart rate variability and blood lactate concentration. http://www.ncbi.nlm.nih.gov/pubmed/26762787 3. Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis François Bieuzen,1,* Chris M. Bleakley,2 and Joseph Thomas Costello3,4 François Hug, Editor http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633882/ 4. The effects of contrast bathing and compression therapy on muscular performance. French DN, Thompson KG, Garland SW, Barnes CA, Portas MD, Hood PE, Wilkes G Med Sci Sports Exerc. 2008 Jul; 40(7):1297-306. 5. Do Pain Pills Impair Muscle Growth? by Brad Schoenfeld, PhD | 11/13/12 https://www.t-nation.com/training/do-pain-pills-impair-muscle-growth 6. http://www.czytelniamedyczna.pl/504,przewlekle-stosowanie-nlpz-zagrozenia-potencjalne-powiklania.html 7. Racjonalne stosowanie niesteroidowych leków przeciwzapalnych w terapii bólu dr Jarosław Woroń, Zakład Farmakologii Klinicznej Katedry Farmakologii UJ CM, Klinika Leczenia Bólu i Opieki Paliatywnej UJ CM w Krakowie http://www.mp.pl/bol/wytyczne/show.html?id=90989 8. Med J Islam Repub Iran. 2015 Sep 12;29:261. eCollection 2015. Acute effects of ginger extract on biochemical and functional symptoms of delayed onset muscle soreness. http://www.ncbi.nlm.nih.gov/pubmed/26793652 9. Phytother Res. 2015 Jun;29(6):887-93. doi: 10.1002/ptr.5328. Epub 2015 Mar 18. The Effects of Pre-Exercise Ginger Supplementation on Muscle Damage and Delayed Onset Muscle Soreness. http://www.ncbi.nlm.nih.gov/pubmed/25787877 10. Complement Ther Med. 2013 Jun;21(3):131-40. doi: 10.1016/j.ctim.2012.12.007. Epub 2013 Jan 5. The effects of Panax notoginseng on delayed onset muscle soreness and muscle damage in well-trained males: a double blind randomised controlled trial. 11. Eur J Sport Sci. 2014;14(3):294-300. doi: 10.1080/17461391.2013.829126. Epub 2013 Aug 16. The effects of topical Arnica on performance, pain and muscle damage after intense eccentric exercise. http://www.ncbi.nlm.nih.gov/pubmed/23947690 12. „Branched-chain amino acid supplementation before squat exercise and delayed-onset muscle soreness.” Int J Sport Nutr Exerc Metab. 2010 Jun;20(3):236-44. http://www.ncbi.nlm.nih.gov/pubmed/20601741 13. Effect of L-glutamine supplementation on electromyographic activity of the quadriceps muscle injured by eccentric exercise http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3758038/ 14. J Sports Med Phys Fitness. 2009 Dec;49(4):424-31. Branched-chain amino acid supplementation attenuates muscle soreness, muscle damage and inflammation during an intensive training program http://www.ncbi.nlm.nih.gov/pubmed/20087302