Understanding the pain

CEBU, Philippines - Exercise buffs are all too familiar with it, but I would bet my license that they would never be comfortable if they ever get it.

It goes by different names, depending on which perspective you’re looking at. The uninitiated would call it cramps, the local hilot would say it is pama-ul, for the physical therapist its name is more complicated: delayed onset muscle soreness or DOMS. But all it means is PAIN.

What is DOMS

DOMS is the pain experienced 24 to 48 hours after a new exercise regimen is introduced. This is nothing to be annoyed with because this means that your muscle is adapting to the new load or the new regimen, meaning, it is getting stronger.

The swelling and stiffness usually peaks in three to four days and subsides within ten days. As for strength, weakness would peak in around 48 hours but would recover within five days. Pain, on the other hand, peaks one to three days after exercise, but resolves within seven days. Understand that the symptoms are not dependent of each other and may not occur together.

Eccentric movement (lengthening of the muscle like when you straighten out your elbow, the muscle on the front of your upper arm lengthens) apparently causes the most DOMS.

What causes DOMS

There are several theories on the cause of DOMS ranging from accumulation of toxins like lactic acid in the muscle to micro-tears or trauma to the muscle fibers, which accounts for the swelling and the weakness.

It was also proposed that the lack of oxygen after exercise might cause the muscles to go into a spasm, thus the pain. However, studies show that during the period of DOMS there has been no increase in muscle activity, which means that the muscle is not contracting at all.

So, up until now, DOMS remains to be a mystery. The only certain information is that DOMS brings about the adaptation of the muscle fiber to the more strenuous regimen or load.

How to avoid DOMS

When dealing with DOMS, always remember the age-old adage: “Prevention is better than cure.” So, before you experience anything unpleasant from all those work in the gym try the following recommendations:

1. Take Vitamins C and E supplements. Vitamin C helps in the repair of the connective tissue, and so does Vitamin E, which is found to decrease muscle cell damage.

2. Perform low intensity warm up prior to any exercise, and after, do gentle cool down exercises. Ten minutes of easy aerobic routine or jogging would do wonders.

3. Gentle stretching of the muscles used before and after exercise will break the pain-muscle spasm-pain cycle.

4. Gradually progress the intensity and volume of the exercise. Don’t think that just because today you are able to do 10 reps of biceps curl with a 10-lbs dumbbell you can do 20-lbs tomorrow. Always consult a professional when you are ready to progress your regimen.

5. Continue with your regular routine exercise after your first episode of DOMS as it develops and remits. Amazingly, studies would show that recovery is faster and better if you continue with your regular routine even if you are experiencing the discomfort of DOMS, as compared to those who choose to take a rest while recovering. But don’t expect to perform at your optimum.

Can DOMS be treated?

When it comes to cure, unfortunately, there is none. DOMS, however, is self-limiting, which means it heals on its own. The good news is there are ways to minimize the discomfort that it brings, which includes the following:

1. The basic treatment for any kind of injury is rest, ice, compression and elevation (RICE). Do this after engaging in a new stressful regimen to decrease the chances of swelling.

2. Don’t stop exercising. Light high speed muscle shortening exercises (Rule: Shortening is when the action of the extremity is going towards the muscle being exercised) is reported to reduce muscle soreness and hasten the resolution of DOMS.

3. The relaxing effect of a good deep massage undeniably reduces the associated discomfort of DOMS.

4. Modalities such as electrical stimulation and alternate hot and cold compress or bath (junk the panohot myth!) reduce soreness. Ice massage after a vigorous eccentric exercise is reported to reduce signs of muscle damage.

5. Topical salicylate creams or pads have excellent analgesic effect.