eMedicine Specialties > Physical Medicine and Rehabilitation > Muscle Pain Syndromes

Postexercise Muscle Soreness: Follow-up

Author: Divakara Kedlaya, MBBS, Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Loma Linda University School of Medicine
Coauthor(s): Timothy Kuang, MD, Pain Management Fellow, Department of Physical Medicine and Rehabilitation, Loma Linda University Medical Center
Contributor Information and Disclosures

Updated: Jun 6, 2008

Follow-up

Further Inpatient Care

  • No inpatient care is needed for individuals with DOMS.

Further Outpatient Care

  • Outpatient care is limited mainly to proper education on specific exercise programs.

Deterrence

  • Armstrong states in his review that there are no preventive measures for DOMS except for previous specific training of the involved muscle.34
  • No study has demonstrated that proper warm-up before and cool-down after exercise will help to prevent DOMS.
  • Johansson and colleagues discovered that preexercise static stretching has no preventive effect on the muscular soreness, tenderness, and force loss that follows heavy eccentric exercise.35
  • Nonsteroidal anti-inflammatory medications are not effective in preventing DOMS.
  • Thompson and coauthors note that oral contraceptive use attenuates soreness following exhaustive stepping activity in women, but no association can be drawn between estrogen ingestion and exercise-induced muscle damage.36
  • Boyle and co-investigators showed that yoga training and a single session of yoga appear to attenuate peak muscle soreness in women following a bout of eccentric exercise.37 These findings have significant implications for coaches, athletes, and the exercising public, who may want to implement yoga training as a preseason regimen or as a supplemental activity to lessen the symptoms associated with muscle soreness.

Prognosis

  • DOMS can temporarily reduce muscle performance. The diminished performance results from reduced voluntary effort due to the sensation of soreness and from the muscle's lowered inherent capacity to produce force.
  • No evidence supports the idea that DOMS is associated with long-term damage or reduced muscle function.
  • Animal studies indicate that injured muscles regenerate during the period following exercise and that the process essentially is completed within 2 weeks.

Patient Education

  • The patient needs to be educated on a specific progressive exercise training program before engaging in a heavy, unaccustomed exercise, particularly one that involves eccentric muscle contractions.
  • For excellent patient education resources, visit eMedicine's Back, Ribs, Neck, and Head Center and Sports Injury Center. Also, see eMedicine's patient education article Muscle Strain.

Miscellaneous

Medicolegal Pitfalls

  • Misdiagnosing DOMS as another pathologic condition of the muscles can have significant medicolegal consequences.
 


More on Postexercise Muscle Soreness

Overview: Postexercise Muscle Soreness
Differential Diagnoses & Workup: Postexercise Muscle Soreness
Treatment & Medication: Postexercise Muscle Soreness
Follow-up: Postexercise Muscle Soreness
References
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Further Reading

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Keywords

postexercise muscle soreness, delayed-onset muscle soreness, DOMS, post-exercise muscle soreness, muscle overuse, rhabdomyolysis, metabolic waste product accumulation, spastic contracture, myofibrillar alterations, cytoskeletal alterations

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Contributor Information and Disclosures

Author

Divakara Kedlaya, MBBS, Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Loma Linda University School of Medicine
Divakara Kedlaya, MBBS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Paraplegia Society, and Colorado Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Timothy Kuang, MD, Pain Management Fellow, Department of Physical Medicine and Rehabilitation, Loma Linda University Medical Center
Timothy Kuang, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Curtis W Slipman, MD, Director, University of Pennsylvania Spine Center, Associate Professor, Department of Physical Medicine and Rehabilitation, University of Pennsylvania Medical Center
Curtis W Slipman, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, International Association for the Study of Pain, and North American Spine Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain (Tailbone Pain, Coccydynia) Service, University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD, FAAPMR, FAAEM is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Lourdes Regional Rehabilitation Center, Our Lady of Lourdes Medical Center
Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD, Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health Care, Immanuel Rehabilitation Center
Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation
Disclosure: Nothing to disclose.

 
 
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