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From Fellrnr.com, Running tips
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There is some good news in all of this. While excessive eccentric exercise can cause DOMS, doing some eccentric exercise causes the muscles to adapt and to be able to handle eccentric exercise without DOMS <ref name="Y1"/>. There are two ways then of protecting your muscles from DOMS in running; running greater distances, or running downhill. I believe that downhill running that is greatly underutilized in training regimes. Most hill training workouts focus on the uphill segment, and relegate the downhill to recovery. While uphill can produce some benefits, it is the downhill that can provide the greatest advantage. Adding hills into your workout can make you a much stronger runner, and have benefits even on flat race courses. Don't just use the downhill to recover from the uphill, but work on the downhill.
=How to prevent or treat DOMS?=
There are various approaches to preventing or treating DOMS. The table below is a summary of the approaches showing how likely the strategy is to prevent or treat DOMS combined with the possible significant downsides. At the top are those that are likely to help and have no downsides, then those that have no effects or downsides, then those with little benefit and significant downsides.
{| class="wikitable"
!Strategy!!Timing!!Soreness!!Weakness!!Downsides
|None
|-
|[[Nutrient_Timing|Carbohydrate and/or protein]]
|After
|Some evidence of reduced soreness
|None
|-
|[[Why_compression_clothes|Compression Clothing]]
|After
|Some evidence of reduced soreness
|None
|-
|[[Caffeine]]
|After
|Some evidence of reduced soreness
|Some evidence of reduced weakness
|None<sup>a</sup>
|-
|[[Massage]]
|After
|Some evidence of reduced soreness
|None
|-
|[[Warmup]]
|Immediately before
|Some evidence of reduced soreness
|None
|-
|[[Cryotherapy|Icing]]
|After
|No benefit
|No benefit
|None<sup>b</sup>
|-
|Antioxidents
|Conflicting evidence of reduced endurance adaptations
|-
|[[Stretching]]
|Before and/or After
|No benefit
* Can lead to injury
|-
|[[NSAIDs_and_Running|NSAIDs]]
|Before and/or After
|Most evidence indicates no benefit
|Can impair recovery
|}
Notes
* <sup>a</sup>Caffeine can interfere with sleep
* <sup>b</sup> Only ever use ice in a bag, never a frozen gel pack. Gel packs start too cold and can cause skin or nerve damage.
==Repeated Bout Effect==
The DOMS that follows an initial bout of eccentric exercise is much less on subsequent similar bouts. This is often called the Repeated Bout Effect (RBE)<ref name="Howatson-2008"/><ref name="Cheung-2003"/>. The initial bout does not have to cause significant soreness or damage<ref name="Clarkson-1987"/>. As few as 2-10 maximal eccentric repetitions can protect against a subsequent larger bout (24-50), but the initial bout must be close to maximal effort<ref name="Brown-1997"/>. By contrast, eight weeks of training with 50% of the maximal eccentric load did not provide protection against a subsequent maximal bout<ref name="Nosaka-2002"/>. There is some cross-over of protection between different forms of exercise. For instance, eccentric weight training protects against soreness and weakness in subsequent downhill running<ref name="Eston-1996"/>. The protection from the RBE is long lived. One study showed that while the initial weakness was not reduced by the RBE, the recovery of strength was much faster for up to 9 months, and soreness was less for up to 6 months<ref name="Nosaka-2001"/>. Another study showed that 30 minutes of downhill running provides protection for between 6 and 9 weeks<ref name="Byrnes-1985"/>. There is evidence that the RBE may rapidly start to provide protection from soreness and weakness<ref name="Mair-1995"/>, possibly as soon as 24 hours post exercise<ref name="Chen-2001"/>.
** '''Changed inflammation response. '''The delay in soreness is probably due to a delayed inflammatory response, so changes in that response could reduce the soreness. However, this would not reduce the immediate loss of strength.
** '''Maintenance of Excitation-Contraction coupling'''. One reason for the loss of strength following eccentric exercise is that the nerve impulses (excitation) may result in less contraction. The decoupling could be due to lack of neural drive (perhaps due to pain), physical disruption of the contracting structures of the muscle, or a failure to activate those contracting structures.
=Limitations of the current scientific studies=
While there are a large number of scientific studies available on DOMS, these studies have a number of limitations.
* Most studies use a small number of subjects, limiting their ability to detect the effectiveness of treatments.
* The studies are not consistent in the level of DOMS that is provoked, with some studies having relatively mild soreness.
* Not all studies avoid the confounding effects of the Repeated Bout Effect. This can be where the study has not ensured that subjects have not performed any eccentric exercise in the recent past, or where subjects undergo multiple bouts in the study.
* The studies generally do not establish any dose/response relationship.
* Human studies are limited in their timeframe, so that the longer term effects of the treatments are unclear.
* Studies often focus on how a treatment reduces the symptoms of DOMS without looking at how the treatment might also change the adaptation process. A DOMS treatment that effectively reduces soreness and/or weakness but also prevents any adaptation to the training has limited benefit.
=See Also=
* [[Downhill Running]]
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