Covid-19 Research

Review Article

Mechanisms and Treatment of Delayed Onset Muscle Soreness in Athletes - A Review

Journal of Biomedical Research & Environmental Sciences article abstract with citation details, DOI, publication dates, subject areas, full text links, and references.

View DOI Submit Manuscript

Article Details

Publication record, authors, dates, abstract, and full text access.

Open Access
Article Type Review Article
Subject Medicine Group
OCLC JBRES Record
Mark E McKeigue, Michael TC Liang*, Kristen Ulety and Thomas Wesley Allen
Issue: Volume3-Issue7
Pages: 827-832
Received: 2022-06-17
Accepted: 2022-07-29
Published: 2022-07-30

Abstract

Objective: The purpose of this study is to review mechanisms for Delayed Onset Muscle Soreness (DOMS) and the pharmacological treatment options with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).

Method: Our review of published research literature was based on an appropriate number of subjects included in the study with a statistical power of .80 or higher and an effect size of .30 or higher. In the case of review articles, two cited references from each article where significant data were used to establish the conclusion were examined for type II error using the criteria mentioned above. Our review also includes inflammation, tissue damage, and the treatment of DOMS with both selective and non-selective NSAIDs.

Results: Frequently cited mechanisms of DOMS are "mechanical strain" and "metabolic overload" within the muscle structure. The inflammation associated with DOMS is caused by eccentric exercise-induced muscle damage. NSAIDs inhibit prostaglandin synthesis and/or block cyclooxygenase and there by reduce the pain and swelling associated with inflammation. There are both selective and non-selective NSAIDs, the former being the COX-2 inhibitors (e.g., celecoxib) and the later (e.g., ibuprofen, naproxen, and aspirin).

Conclusion: For the treatment of DOMS, naproxen taken at anti­inflammation levels for at least 3 days shows the most consistent results for improving the recovery rate of affected muscle.

FullText HTML FullText PDF DOI: 10.37871/jbres1519 Crossmark

Certificate of Publication

Certificate of Publication

Copyright

© 2022 McKeigue ME, et al. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

McKeigue ME, Michael TCL, Ulety K, Allen TW. Mechanisms and Treatment of Delayed Onset Muscle Soreness in Athletes - A Review. J Biomed Res Environ Sci. 2022 July 30; 3(7): 827-832. doi: 10.37871/jbres1519, Article ID: JBRES1519, Available at: https://www.jelsciences.com/articles/jbres1519.pdf

Subject area(s)

Sports Science

References

  1. Mackey AL, Kjaer M, Dandanell S, Mikkelsen KH, Holm L, Døssing S, Kadi F, Koskinen SO, Jensen CH, Schrøder HD, Langberg H. The influence of anti-inflammatory medication on exercise-induced myogenic precursor cell responses in humans. J Appl Physiol (1985). 2007 Aug;103(2):425-31. doi: 10.1152/japplphysiol.00157.2007. Epub 2007 Apr 26. PMID: 17463304.
  2. Meek IL, Van de Laar MA, E Vonkeman H. Non-Steroidal Anti-Inflammatory Drugs: An Overview of Cardiovascular Risks. Pharmaceuticals (Basel). 2010 Jul 7;3(7):2146-2162. doi: 10.3390/ph3072146. PMID: 27713346; PMCID: PMC4036661.
  3. Bryant AE, Aldape MJ, Bayer CR, Katahira EJ, Bond L, Nicora CD, Fillmore TL, Clauss TR, Metz TO, Webb-Robertson BJ, Stevens DL. Effects of delayed NSAID administration after experimental eccentric contraction injury - A cellular and proteomics study. PLoS One. 2017 Feb 28;12(2):e0172486. doi: 10.1371/journal.pone.0172486. PMID: 28245256; PMCID: PMC5330483.
  4. Liang MT, Allen TW, McKeigue ME, Kotis A, Gierke LW. Effect of cooling on muscular health prior to running a marathon. J Am Osteopath Assoc. 2001 Apr;101(4):219-25. PMID: 11370546.
  5. Newham DJ, Jones DA, Edwards RH. Plasma creatine kinase changes after eccentric and concentric contractions. Muscle Nerve. 1986 Jan;9(1):59-63. doi: 10.1002/mus.880090109. PMID: 3951481.
  6. Sargeant AJ, Dolan P. Human muscle function following prolonged eccentric exercise. Eur J Appl Physiol Occup Physiol. 1987;56(6):704-11. doi: 10.1007/BF00424814. PMID: 3678226.
  7. Sorichter S, Mair J, Koller A, Gebert W, Rama D, Calzolari C, Artner-Dworzak E, Puschendorf B. Skeletal troponin I as a marker of exercise-induced muscle damage. J Appl Physiol (1985). 1997 Oct;83(4):1076-82. doi: 10.1152/jappl.1997.83.4.1076. PMID: 9338413.
  8. Thompson D, Nicholas CW, Williams C. Muscular soreness following prolonged intermittent high-intensity shuttle running. J Sports Sci. 1999 May;17(5):387-95. doi: 10.1080/026404199365902. PMID: 10413266.
  9. Fridén J, Sjöström M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. Int J Sports Med. 1983 Aug;4(3):170-6. doi: 10.1055/s-2008-1026030. PMID: 6629599.
  10. Newham DJ, Jones DA, Edwards RH. Large delayed plasma creatine kinase changes after stepping exercise. Muscle Nerve. 1983 Jun;6(5):380-5. doi: 10.1002/mus.880060507. PMID: 6888416.
  11. Selkow NM, Herman DC, Liu Z, Hertel J, Hart JM, Saliba SA. Blood flow after exercise-induced muscle damage. J Athl Train. 2015 Apr;50(4):400-6. doi: 10.4085/1062-6050-49.6.01. Epub 2015 Feb 6. PMID: 25658816; PMCID: PMC4559999.
  12. Sonkodi B, Berkes I, Koltai E. Have We Looked in the Wrong Direction for More Than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage Rather Than Muscle Damage. Antioxidants (Basel). 2020 Mar 5;9(3):212. doi: 10.3390/antiox9030212. PMID: 32150878; PMCID: PMC7139782.
  13. Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64. doi: 10.2165/00007256-200333020-00005. PMID: 12617692.
  14. Armstrong RB. Muscle damage and endurance events. Sports Med. 1986 Sep-Oct;3(5):370-81. doi: 10.2165/00007256-198603050-00006. PMID: 3529285.
  15. Armstrong RB, Warren GL, Warren JA. Mechanisms of exercise-induced muscle fibre injury. Sports Med. 1991 Sep;12(3):184-207. doi: 10.2165/00007256-199112030-00004. PMID: 1784873.
  16. Nosaka K, Newton M, Sacco P. Muscle damage and soreness after endurance exercise of the elbow flexors. Med Sci Sports Exerc. 2002 Jun;34(6):920-7. doi: 10.1097/00005768-200206000-00003. PMID: 12048316.
  17. Schwane JA, Watrous BG, Johnson SR, Armstrong RB. Is Lactic Acid Related to Delayed-Onset Muscle Soreness? Phys Sportsmed. 1983 Mar;11(3):124-31. doi: 10.1080/00913847.1983.11708485. PMID: 27409551.
  18. Leeuwenburgh C, Hansen PA, Holloszy JO, Heinecke JW. Oxidized amino acids in the urine of aging rats: potential markers for assessing oxidative stress in vivo. Am J Physiol. 1999 Jan;276(1):R128-35. doi: 10.1152/ajpregu.1999.276.1.R128. PMID: 9887186.
  19. Bruunsgaard H, Galbo H, Halkjaer-Kristensen J, Johansen TL, MacLean DA, Pedersen BK. Exercise-induced increase in serum interleukin-6 in humans is related to muscle damage. J Physiol. 1997 Mar 15;499 ( Pt 3)(Pt 3):833-41. doi: 10.1113/jphysiol.1997.sp021972. PMID: 9130176; PMCID: PMC1159298.
  20. MacIntyre DL, Reid WD, McKenzie DC. Delayed muscle soreness. The inflammatory response to muscle injury and its clinical implications. Sports Med. 1995 Jul;20(1):24-40. doi: 10.2165/00007256-199520010-00003. PMID: 7481277.
  21. Faulkner JA, Brooks SV, Opiteck JA. Injury to skeletal muscle fibers during contractions: conditions of occurrence and prevention. Phys Ther. 1993 Dec;73(12):911-21. doi: 10.1093/ptj/73.12.911. PMID: 8248299.
  22. Warren GL, Ingalls CP, Lowe DA, Armstrong RB. Excitation-contraction uncoupling: major role in contraction-induced muscle injury. Exerc Sport Sci Rev. 2001 Apr;29(2):82-7. doi: 10.1097/00003677-200104000-00008. PMID: 11337828.
  23. Nosaka K, Clarkson PM. Changes in indicators of inflammation after eccentric exercise of the elbow flexors. Med Sci Sports Exerc. 1996 Aug;28(8):953-61. doi: 10.1097/00005768-199608000-00003. PMID: 8871903.
  24. Newham DJ, Jones DA, Clarkson PM. Repeated high-force eccentric exercise: effects on muscle pain and damage. J Appl Physiol (1985). 1987 Oct;63(4):1381-6. doi: 10.1152/jappl.1987.63.4.1381. PMID: 3693172.
  25. Sayers SP, Knight CA, Clarkson PM, Van Wegen EH, Kamen G. Effect of ketoprofen on muscle function and sEMG activity after eccentric exercise. Med Sci Sports Exerc. 2001 May;33(5):702-10. doi: 10.1097/00005768-200105000-00004. PMID: 11323536.
  26. Houglum PA. Soft tissue healing and its impact on rehabilitation. J Sport Rehab. 1992;1:19-39.
  27. Prentice W. Rehabilitation techniques in sports medicine. 2nd ed. St. Louis, MO:     Mosby; 1994.
  28. Craig JA, Bradley J, Walsh DM, Baxter GD, Allen JM. Delayed onset muscle soreness: lack of effect of therapeutic ultrasound in humans. Arch Phys Med Rehabil. 1999 Mar;80(3):318-23. doi: 10.1016/s0003-9993(99)90144-2. PMID: 10084441.
  29. Smith LL. Acute inflammation: the underlying mechanism in delayed onset muscle soreness? Med Sci Sports Exerc. 1991 May;23(5):542-51. PMID: 2072832.
  30. Kuipers H, Keizer HA, Verstappen FT, Costill DL. Influence of a prostaglandin-inhibiting drug on muscle soreness after eccentric work. Int J Sports Med. 1985 Dec;6(6):336-9. doi: 10.1055/s-2008-1025866. PMID: 4077362.
  31. Murase S, Terazawa E, Queme F, Ota H, Matsuda T, Hirate K, Kozaki Y, Katanosaka K, Taguchi T, Urai H, Mizumura K. Bradykinin and nerve growth factor play pivotal roles in muscular mechanical hyperalgesia after exercise (delayed-onset muscle soreness). J Neurosci. 2010 Mar 10;30(10):3752-61. doi: 10.1523/JNEUROSCI.3803-09.2010. PMID: 20220009; PMCID: PMC6632252.
  32. Morelli KM, Brown LB, Warren GL. Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Am J Sports Med. 2018 Jan;46(1):224-233. doi: 10.1177/0363546517697957. Epub 2017 Mar 29. PMID: 28355084.
  33. Prescription options for the treatment of osteoarthritis. Triplei Prescribing Guide. 2000;4.p.353.
  34. Clinical pharmacology: Selectively inhibit COX-2 without inhibiting COX-1. 2002.
  35. Lecomte JM, Lacroix VJ, Montgomery DL. A randomized controlled trial of the effect of naproxen on delayed onset muscle soreness and muscle strength. Clin J Sport Med. 1998 Apr;8(2):82-7. doi: 10.1097/00042752-199804000-00003. PMID: 9641434.
  36. What conditions would prevent me from taking Celebrex. 2002.
  37. Lombardino JG editor. Nonsteroidal anti-inflammatory drugs. New York: Wiley; 1985.
  38. Bourgeois J, MacDougall D, MacDonald J, Tamopolsky M. Naproxen does not alter indices of muscle damage in resistance-exercise trained men. Med Sci Sports Exerc. 1999;31:4-9.
  39. Silverman HM. The pill books. Current ed. New York: Bantam Books; 1999. p.519-523.
  40. Riendeau D, Percival MD, Brideau C, Charleson S, Dubé D, Ethier D, Falgueyret JP, Friesen RW, Gordon R, Greig G, Guay J, Mancini J, Ouellet M, Wong E, Xu L, Boyce S, Visco D, Girard Y, Prasit P, Zamboni R, Rodger IW, Gresser M, Ford-Hutchinson AW, Young RN, Chan CC. Etoricoxib (MK-0663): preclinical profile and comparison with other agents that selectively inhibit cyclooxygenase-2. J Pharmacol Exp Ther. 2001 Feb;296(2):558-66. PMID: 11160644.
  41. Lee SH, Soyoola E, Chanmugam P, Hart S, Sun W, Zhong H, Liou S, Simmons D, Hwang D. Selective expression of mitogen-inducible cyclooxygenase in macrophages stimulated with lipopolysaccharide. J Biol Chem. 1992 Dec 25;267(36):25934-8. PMID: 1464605.
  42. Singh G, Triadafilopoulos G. Epidemiology of NSAID induced gastrointestinal complications. J Rheumatol Suppl. 1999 Apr;56:18-24. PMID: 10225536.
  43. Clyman B. Role of non-steroidal anti-inflammatory drugs in sports medicine. Sports Med. 1986 Jul-Aug;3(4):342-6. doi: 10.2165/00007256-198603040-00002. PMID: 3738328.
  44. Rostom A, Moayyedi P, Hunt R; Canadian Association of Gastroenterology Consensus Group. Canadian consensus guidelines on long-term nonsteroidal anti-inflammatory drug therapy and the need for gastroprotection: benefits versus risks. Aliment Pharmacol Ther. 2009 Mar 1;29(5):481-96. doi: 10.1111/j.1365-2036.2008.03905.x. Epub 2008 Nov 27. PMID: 19053986.
  45. Ziltener JL, Leal S, Fournier PE. Non-steroidal anti-inflammatory drugs for athletes: an update. Ann Phys Rehabil Med. 2010 May;53(4):278-82, 282-8. English, French. doi: 10.1016/j.rehab.2010.03.001. Epub 2010 Mar 20. PMID: 20363203.
  46. Hur C, Chan AT, Tramontano AC, Gazelle GS. Coxibs versus combination NSAID and PPI therapy for chronic pain: an exploration of the risks, benefits, and costs. Ann Pharmacother. 2006 Jun;40(6):1052-63. doi: 10.1345/aph.1G493. Epub 2006 May 23. PMID: 16720709.
  47. Mehallo CJ, Drezner JA, Bytomski JR. Practical management: nonsteroidal antiinflammatory drug (NSAID) use in athletic injuries. Clin J Sport Med. 2006 Mar;16(2):170-4. doi: 10.1097/00042752-200603000-00015. PMID: 16603889.
Publish with JBRES — Peer-reviewed, multidisciplinary Open Access with rapid review, DOI, and global visibility.
Double-Blind CrossRef DOI Discoverable
Submit Manuscript Membership