RICE & MICE: The phenomenon of delayed-onset muscle soreness

While not technically an injury, delayed onset muscle soreness (DOMS) is a phenomenon that every athlete experiences and can cause significant discomfort and pain. DOMS occurs in response to increased exertion and can also occur after “new” activities and exercises. The delayed onset peaks in 1-2 days following exertion and the soreness usually will resolve in around 4 days, though full recovery may take a week.

An older school of thought attributed DOMS to a lactic acid build up in muscles. Lactic acid accumulation can cause some discomfort during and immediately after exercise, but only lasts an hour or so. DOMS is often precipitated predominantly by activities like downhill running, plyometrics, and resistance training. We commonly hear about eccentric muscle contractions being a main culprit in development of DOMS. An eccentric muscle contraction happens when a muscle is contracted yet a greater force is causing the muscle to lengthen. It sounds more confusing than it actually is. Simply, an eccentric contraction is used as a means of decelerating a body part or object (think: landing from a jump or hop), or lowering a weight gently rather than letting it drop, such as when doing biceps curls.

After an intense workout, there is damage at the cell level of muscle tissue, which causes an inflammatory response from the body, in order to repair the damaged cell components. The sensation of pain is a result of this process. There may be swelling that also contributes to pain, but it is important to differentiate between DOMS and a muscle strain which is actual tearing of the muscle. One can safely exercise through DOMS, but may aggravate and worsen a muscle strain.

Typical symptoms often associated with DOMS include strength loss, pain, muscle tenderness, stiffness, and swelling. Because of the intense pain and soreness, along with the weakness in the effected muscles, preventing DOMS is always perhaps the best course of action. Weakness and fatigue in muscles can predispose players to a variety of injuries, so the best treatment is aimed at prevention.

Warm-ups and cool-downs play an important role in preventing or at least reducing DOMS. Proper stretching can help keep the muscles loose. Warming up can include riding a stationary bike, doing light footwork exercises, jogging, or like Sergei Bobrovsky, jumping rope. I was at an AHL game last month when the Adirondack Phantoms were in town and there were 2 stationary bikes outside the visiting locker rooms. There were a few rotations of players warming up on the bikes prior to getting dressed for the game. Other players, I am sure, were jogging or doing various warm-up routines behind the scenes.

Equally as important as the warm-up is the cool down for these players. Light aerobic exercise is utilized in active recovery to increase blood flow throughout the body. The increased blood flow helps to reduce and flush the inflammatory components from the muscles and can reduce or lessen the occurrence of DOMS as well as the symptoms should DOMS set in.

The RICE method is a good standby and may help alleviate the symptoms associated with DOMS and may speed recovery time. Ice baths may not sound like any fun, but I can vouch for their effectivenesss in staving off soreness, however they aren’t for everyone. Sitting in a hot tub does not speed recovery or alleviate pain and massage has also been suggested as a treatment for DOMS. There is no evidence that massage will aid in recovery and quite frankly, I think it would be extremely uncomfortable to be on the receiving end of a massage when DOMS has set in. Yoga seems to be a quietly growing in popularity among NHLers and may also help to reduce and alleviate DOMS. Adequate nutrition and hydration also play a vital role in muscle recovery.

Finally, good rest and relaxation are important to every player. We often hear of maintenance days taken by various Flyers throughout the season. Players like Mike Richards, Kimmo Timonen, and Chris Pronger usually have scheduled maintenance days to rest and recover. These are off days that are built into the schedule for different players at different times. Some players will still do a light aerobic workout on their maintenance day, but the goal is to rest both mentally and physically on these days. These days are sometimes used for treatment of nagging aches and pains, but can be especially important for muscle recovery through a long, grueling NHL season.

Disclaimer: Information on found in RICE & MICE on flyersfaithful.com is not intended to be medical advice. Any information or materials posted on the web site are intended for general informational purposes only, and should not be construed as medical advice, medical opinion, diagnosis or treatment. Any information posted on the web site is NOT a substitute for medical attention. See your health-care professional for medical advice and treatment.