To start, it's a good idea to know what causes this pain, more commonly referred to as DOMS (Delayed Onset Muscle Soreness). DOMS is triggered by eccentric muscle loading, where the muscle is stretched while resisting against a load, such as in the lowering phase of a bicep curl or when loading the muscle while running downhill. However any exercise that you are not accustomed to can bring about this muscle pain.
And, as the name suggests, you are unlikely to feel the full brunt of the session until 12-48 hours after the fact, with symptoms subsiding after three to ten days. Symptoms of DOMS include muscle soreness, reduced strength in subsequent sessions, stiffness and mild swelling in the muscle.
On a cellular level, it is believed that DOMS is initiated when the muscle is mechanically stretched in a way that causes damage to the muscle cell, which then initiates a cascade of inflammatory processes that are required to clean up the cellular damage caused. To add further insult to this exercise-induced injury, there is also a secondary layer of muscle damage caused by increased levels of free radical damage, delaying the resolution of the pain and recovery of the muscle.
The obvious question is: can we stop it from occurring? And the sad reality is: after many years of research being undertaken, the most effective way to treat DOMS remains unclear. It is more a matter of managing, rather than eliminating. This is because inflammation, initially thought to be something we should try to combat, is actually a critical part of the adaption and regeneration process that occurs as a result of training and is necessary for remodelling and upgrading muscle. That said, there are a number of approaches that can be utilised to assist and support the body during recovery, while not trying to totally blunt the inflammation response.
The first port of call for many trying to avoid the dreaded DOMS is taking Non-Steroidal Anti-Inflammatory drugs (NSAIDs) in the hours after a session. This is thought to reduce the inflammation associated with muscle damage and assist with reducing pain and sensitivity associated with the muscle damage. However, recently, objections to the use of NSAIDS have been raised, with suggestions they reduce the adaptation response based on animal studies. That being said, a systematic research review in 2017 on NSAID use for muscle soreness deemed them appropriate for use to assist with DOMS, acknowledging further research would be beneficial.
Light swimming and movement in water has been shown to be beneficial in the recovery period, enhancing feelings of wellbeing and reducing the perception of fatigue with the support and pressure of the water taking weight off worked limbs, while assisting with tissue inflammation reduction.
Researchers have found that utilising contrasting temperatures can help flush out accumulated lactate from the worked muscle and reduce recovery time after high intensity exercise. Using two baths, one with water at about 37 degrees for 3 minutes contrasted with a bath at 12-15 degrees across 20-30 minutes saw benefits to recovery and reduction in muscle soreness.
Compression wear is often used in the hours post training by recreation and professional athletes alike. These ultra-tight under layers are thought to work by providing consistent pressure whereby improving blood flow, removal of post exercise waste products such as lactate, improving awareness of joints and running economy and by assisting with the reduction of swelling. They are considered a useful tool within a broad recovery plan that can provide comfort and support to active people in the hours and days after muscle damage is incurred.
Massage is a common go-to for many in a bid to assist with muscle pain and reduced range of motion associated with DOMS. Generally there is seen to be a benefit of massage for relief from DOMS by helping with inflammation and providing psychological comfort in the period after muscle damaging exercise.
When turning to nutrition for reducing the pain and swelling associated with DOMS, generally, we look at foods and supplements for their anti-inflammatory properties and antioxidant traits. As mentioned earlier, inflammation and increased free radicals within the muscle cells is a major component of the progression of DOMS.
Not only does coffee help us roll out of bed and get to a workout with our eyes open, but it turns out it may be beneficial in the aftermath. Adenosine is the molecule that when bound to its receptors in the central nervous system makes us sleepy. Caffeine can also bind to adenosine receptors and has the opposite effect, making us more awake. It appears that via a similar mechanism, taking caffeine post training can assist in reducing pain and fatigue, and is especially effective when combined with light exercise to flush out substances contributing to pain and boosting blood flow.
Doses used in research range greatly from 1mg per kilogram bodyweight up to 10mg per kilo body weight, taken in the hours before training and 12-24 hours after to assist with DOMS. Between 1mg and 3mg of caffeine per kilo body weight in the 12-24 hours is a useful strategy for days when your need to push through the muscle pain, however it should be noted that caffeine taken later in the day may affect sleep which is also critical for recovery, so keep it to the earlier hours of the day to avoid restless sleep.
Fruits and vegetables
Boring yes, but fruits and vegetables provide us not only with fibre to keep our gut healthy (with the gut being critical for a healthy immune system) but they also provide us with crucial antioxidants to help mop up the cellular damage caused. Five 75g serves of vegetables and two serves of fruit per day is the recommendation for longterm good health, although many Australians are nowhere near hitting this target, cutting themselves short when recovering from exercise. Specifically garlic, turmeric, tart cherry juice, ginger, watermelon and pomegranate juice, all of which are know for high antioxidant and beneficial phytochemicals.
A number of supplements are available that provide higher concentrations of the active compounds in these foods which may help boost the body’s defence systems in the days after training, however research is limited on the topic. Supplements include curcumin (the active compound of turmeric), allicin (the active compound of garlic), ginger, tart cherry juice and greens powers that can be useful for people who don’t meet the recommended 5 serves of vegetables per day (which, as mentioned, is most of us).
As amino acids are the building blocks for muscle, protein, which is made up from different amino acids, is critical for the growth and repair of worked muscles. However it is not clear whether acute supplementation of protein, such as a protein shake in the hours after training, actively reduces symptoms associated with DOMS (some research suggests it may help).
Generally speaking, protein intake from a variety of sources spread in meals evenly across the day will help to boost muscle repair. Sources such as lean meats, eggs, dairy and whey protein are readily used to assist with muscle growth, and for those following a vegan or vegetarian diet soy products, pea protein, legumes and wholegrains can all contribute towards daily protein intake. There is some research to suggest essential amino acid supplementation, and more specifically branched chain amino acid drinks can specifically assist with DOMS via stimulation of muscle synthesis, however further research breadth would benefit to clarify the mechanisms for benefit. Body Science has launched a new product combining BCAA containing Branch Amino Acids and EAA’s – complete with all 9 essential Amino Acids – BCEAA Ultra.
Omega 3 Fatty acids
Omega 3 fatty acids, as found in foods like oily fish, nuts and flaxseeds, are well documented to have anti-inflammatory powers within the body. Their use in the reduction and management of DOMS-related inflammation has been tested with some positive benefits record, however the impact appears to be moderate. One study showed that the addition of approximately 1500mg of omega 3 fatty acids (DHA/EPA) to a recovery protein shake of rugby players during a 5-week pre-season was effective at assisting recovery and maintain explosive power of the athletes across the course of the study.