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{{Main| Stretching}}
[[Stretching]] before<ref name="High-1989"/><ref name="Johansson-1999"/> <ref name="Wessel-1994"/>, after <ref name="Johansson-1999"/><ref name="Buroker-1989"/><ref name="Herbert-2007"/>, or both before and after<ref name="Lund-1998"/> exercise does not help with DOMS. In fact, stretching alone can induce DOMS<ref name="Smith-1993"/>. Both static and dynamic stretching are ineffective<ref name="XieFeng2018"/>.
==NSAIDs/Pain Relief==
{{Main|NSAIDs and Running}}
The most common NSAIDs (Ibuprofen, Acetaminophen/Paracetamol, and Aspirin) are unlikely to help with DOMS, but Naproxen may reduce the pain and weakness. (See below for notes on Aspirin and resolvins.) If an NSAID is taken, it should probably be immediately after the damaging exercise rather than waiting until the soreness develops. It seems likely that taking an NSAID for DOMS will reduce the muscular growth that would normally occur as part of the recovery. In one disturbing study, rabbits treated with an NSAID (flurbiprofen) after DOMS inducing exercise initially recovered their strength after 3-7 days, but between days 7 and 28 days the rabbits became weaker while the untreated controls became stronger<ref name="Mishra-1995"/>. I have not included other animal studies, but this is the only one that looks at how NSAIDs impact the longer term recovery from DOMS. There's an emerging belief that NSAIDs suppress inflammation, without actually resolving it<ref name="Markworth Maddipati Cameron-Smith 2016 pp. 110–134"/>. Studies of Turmeric, which acts as a selective COX-2 NSAID<ref name="RamsewakDeWitt2000"/>, are promising. Reduction in soreness is mixed, with some studies showing reduced soreness<ref name="Nicol-2015"/><ref name="Drobnic-2014"/> <ref name="NicolRowlands2015"/>, while others do not<ref name="McFarlinVenable2016"/><ref name="TanabeMaeda2015"/>. However, one study shoes reduced weakness and inflammation markers<ref name="TanabeMaeda2015"/> and an animal study showed less subsequent reduction in running performance in mice<ref name="Davis-2007"/>. Several studies showed reduced markers of damage<ref name="Kawanishi-2013"/><ref name="Davis-2007"/><ref name="TanabeMaeda2015"/><ref name="McFarlinVenable2016"/> <ref name="NicolRowlands2015"/>. However, Turmeric should be treated like any other medication as there are safety concerns; see [[NSAIDs_and_Running#Turmeric_as_an_NSAID| Turmeric as an NSAID]] for details.
{| class="wikitable" style="margin-left: auto; margin-right: auto; border: none;"
! NSAID
==CBD Oil==
I have heard anecdotal suggestions that CBD oil may help with sleep after DOMS inducing exercise, but I've found no supporting research. Note that in 2018, World Anti-Doping Agency (WADA) removed CBD, from its 2018 prohibited substances list, but the legality of CBD is complex.
==Omega-3==
There's some limited evidence that Omega-3 oils might help with DOMS<ref name="Anthony Macartney Peoples 2021 pp. 143–153"/>. The Omega-3 oils need to be long chain, such as fish oil, and include EPA and DHA. There's some evidence that athletes may need more Omega-3, with up to 5g/day of EPA/DHA being recommended<ref name="Thielecke Blannin 2020 p. 3712"/>.
==Omega-3, Aspirin, and Resolvins ==
One interesting possibility is the combination of Omega-3 and low dose Aspirin, because Aspirin triggers the conversion of DHA to resolvins<ref name="Dalli Winkler Colas Arnardottir 2013 pp. 188–201"/>. As the name suggests, these resolvins cause the resolution of inflammation rather than simply suppressing inflammation. (Resolvins are not immunosuppressive<ref name="Gilligan Gartung Sulciner Norris 2019 pp. 6292–6297"/>.) While there's no studies on how resolvins interact with DOMS, there's a compelling hypothesis<ref name="Markworth Maddipati Cameron-Smith 2016 pp. 110–134"/> and some initial research into general muscle recovery from injury<ref name="Markworth Maddipati Cameron-Smith 2016 pp. 110–134"/>. The typical dose used to study aspirin triggered resolvins is 81mg after a study comparing 81/325/650mg doses found that 325mg had a negligible improvement over 81mg<ref name="Chiang Bermudez Ridker Hurwitz 2004 pp. 15178–15183"/>. It's unclear if less than 81mg might be effective, as I couldn't find any research into lower doses. (Anecdotally, a medical researcher suggested to me that much lower doses might be sufficient.)
[[File:Resolvins .jpg|400px|thumb|center|The time course of inflammation.]]
=Menstrual Cycle=
A study has shown that DOMS does not vary with menstrual cycle<ref name="ChaffinBerg2011"/>.
<ref name="KnitterPantonRathmacher2000">A. E. Knitter, L. Panton, J. A. Rathmacher, A. Petersen, R. Sharp, Effects of β-hydroxy-β-methylbutyrate on muscle damage after a prolonged run, Journal of Applied Physiology, date 1 October 2000, volume 89, issue 4, pages 1340–1344, ISSN [http://www.worldcat.org/issn/8750-7587 8750-7587], 1522-1601 !!eissn!!, doi [http://dx.doi.org/10.1152/jappl.2000.89.4.1340 10.1152/jappl.2000.89.4.1340], PMID [http://www.ncbi.nlm.nih.gov/pubmed/11007567 11007567]</ref>
<ref name="NunanHowatsonvanSomeren2011Ack">David Nunan, Glyn Howatson, Ken van Someren, Exercise-induced muscle damage is not attenuated by β-hydroxy-β-methylbutyrate and α-ketoisocaproic acid supplementation'., Journal of Strength and Conditioning Research, date July 2011, volume 25, issue 7, page 2, ISSN [http://www.worldcat.org/issn/1064-8011 1064-8011], doi [http://dx.doi.org/10.1097/01.JSC.0000399726.36961.6c 10.1097/01.JSC.0000399726.36961.6c]</ref>
<ref name="Anthony Macartney Peoples 2021 pp. 143–153">Ryan Anthony, Michael J. Macartney, Gregory E. Peoples, The Influence of Long-Chain Omega-3 Fatty Acids on Eccentric Exercise-Induced Delayed Muscle Soreness: Reported Outcomes Are Compromised by Study Design Issues, International Journal of Sport Nutrition and Exercise Metabolism, volume 31, issue 2, date 2021-03-01, ISSN [http://www.worldcat.org/issn/1526-484X 1526-484X], doi [http://dx.doi.org/10.1123/ijsnem.2020-0238 10.1123/ijsnem.2020-0238], pages 143–153</ref>
<ref name="Thielecke Blannin 2020 p. 3712">Frank Thielecke, Andrew Blannin, Omega-3 Fatty Acids for Sport Performance—Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review, Nutrients, volume 12, issue 12, date 2020-11-30, ISSN [http://www.worldcat.org/issn/2072-6643 2072-6643], PMID [http://www.ncbi.nlm.nih.gov/pubmed/33266318 33266318], 7760705 !!pmc!!, doi [http://dx.doi.org/10.3390/nu12123712 10.3390/nu12123712], free !!doi-access!!, page 3712</ref>
<ref name="Dalli Winkler Colas Arnardottir 2013 pp. 188–201">Jesmond Dalli, Jeremy W. Winkler, Romain A. Colas, Hildur Arnardottir, Chien-Yee C. Cheng, Nan Chiang, Nicos A. Petasis, Charles N. Serhan, Resolvin D3 and Aspirin-Triggered Resolvin D3 Are Potent Immunoresolvents, Chemistry & Biology, volume 20, issue 2, date 2013, PMID [http://www.ncbi.nlm.nih.gov/pubmed/23438748 23438748], 3583372 !!pmc!!, doi [http://dx.doi.org/10.1016/j.chembiol.2012.11.010 10.1016/j.chembiol.2012.11.010], pages 188–201</ref>
<ref name="Gilligan Gartung Sulciner Norris 2019 pp. 6292–6297">Molly M. Gilligan, Allison Gartung, Megan L. Sulciner, Paul C. Norris, Vikas P. Sukhatme, Diane R. Bielenberg, Sui Huang, Mark W. Kieran, Charles N. Serhan, Dipak Panigrahy, Aspirin-triggered proresolving mediators stimulate resolution in cancer, Proceedings of the National Academy of Sciences, volume 116, issue 13, date 2019-03-26, ISSN [http://www.worldcat.org/issn/0027-8424 0027-8424], PMID [http://www.ncbi.nlm.nih.gov/pubmed/30862734 30862734], 6442621 !!pmc!!, doi [http://dx.doi.org/10.1073/pnas.1804000116 10.1073/pnas.1804000116], pages 6292–6297</ref>
<ref name="Chiang Bermudez Ridker Hurwitz 2004 pp. 15178–15183">Nan Chiang, Edmund A. Bermudez, Paul M. Ridker, Shelley Hurwitz, Charles N. Serhan, Aspirin triggers antiinflammatory 15-epi-lipoxin A 4 and inhibits thromboxane in a randomized human trial, Proceedings of the National Academy of Sciences, volume 101, issue 42, date 2004-10-19, ISSN [http://www.worldcat.org/issn/0027-8424 0027-8424], PMID [http://www.ncbi.nlm.nih.gov/pubmed/15471991 15471991], 523452 !!pmc!!, doi [http://dx.doi.org/10.1073/pnas.0405445101 10.1073/pnas.0405445101], pages 15178–15183</ref>
<ref name="Markworth Maddipati Cameron-Smith 2016 pp. 110–134">James F. Markworth, Krishna Rao Maddipati, David Cameron-Smith, Emerging roles of pro-resolving lipid mediators in immunological and adaptive responses to exercise-induced muscle injury, Exercise Immunology Review, volume 22, date 2016, ISSN [http://www.worldcat.org/issn/1077-5552 1077-5552], PMID [http://www.ncbi.nlm.nih.gov/pubmed/26853678 26853678], pages 110–134</ref>
<ref name="Markworth Maddipati Cameron-Smith 2016 pp. 110–134">James F. Markworth, Krishna Rao Maddipati, David Cameron-Smith, Emerging roles of pro-resolving lipid mediators in immunological and adaptive responses to exercise-induced muscle injury, Exercise Immunology Review, volume 22, date 2016, ISSN [http://www.worldcat.org/issn/1077-5552 1077-5552], PMID [http://www.ncbi.nlm.nih.gov/pubmed/26853678 26853678], pages 110–134</ref>
</references>