8,101
edits
Changes
From Fellrnr.com, Running tips
no edit summary
{{DISPLAYTITLE:Delayed Onset Muscle Soreness (DOMS) for Runners}}DOMS is common in of critical importance for runners. Unlike many other types of exercise, runningrequires your muscles to extend under load, absorbing your weight as you land. This extension under load, called eccentric, is a prime cause of DOMS, and while the soreness is delayed, the accompanying weakness is immediate. A This eccentric stress is why marathon runners are often hobbling around the day after a race. The good news is that a bout of DOMS inducing exercise provides protection against future DOMS, and so is it's a critical part of training. This "Repeated Bout Effect" (RBE) is a core aspect of training, and by intentionally inducing DOMS you can prevent the soreness that occurs after long distance races. The less obvious, but more important benefit is that you also prevent some of the weakness that occurs towards the end of longer races. This is a key benefit to [[Downhill Running]] and especially the [[Treadmill Descent]]. I believe that incorporating Treadmill Descents into my training is the reason I've completed 100-mile races with little muscle soreness.
=Introduction =
Delayed Onset Muscle Soreness (DOMS) is a familiar experience to most people who exercise. It affects people who weight train and run particularly, and DOMS can produce anything from mild [[Muscle| muscle]] soreness to debilitating pain and weakness. DOMS is caused by eccentric stress, where the muscles working to resist lengthening, such as lowering a weight or absorbing the landing forces of running. [[Downhill Running]] is a particular source of eccentric stress. DOMS not only produces delayed soreness, but immediate weakness that generally lasts a similar length of time. DOMS also produces swelling, tense muscles, reduced coordination and a limited range of motion. A key benefit of DOMS inducing exercise is that a bout of DOMS can give protection against similar future exercise, and the protection lasts for months. This Repeated Bout Effect (RBE) is a critical part of endurance training. Running with the correct [[Cadence]] can help prevent DOMS, and [[Nutrient Timing| taking protein]] after DOMS inducing exercise ]] is one of the best treatments, though [[Why compression clothes| compression clothing]], [[Caffeine| caffeine]] and [[Massage| massage]] can also help. It seems that [[Vitamin C]] may be critical to the RBE.
=What is DOMS?=
The soreness of DOMS generally peaks between 24 and 72 hours after unusual or severe exercise, though soreness may occur sooner after running<ref name="Vickers2001"/>. DOMS is particularly related to eccentric exercise, which is where the muscle works to resist becoming longer, rather than working to contract. When you your muscles absorb the impact of running, this is eccentric exercise, and [[Downhill Running]] is more eccentric than flat or uphill running. The images below show the damage that occurs from eccentric exercise<ref name="FeassonStockholm2002"/> and marathon running<ref name="Warhol-1985"/>:
<gallery widths=300px heights=200px caption="Muscle damage from eccentric exercise (downhill running)">
File:EccentricA.JPG|Muscle before downhill running
==DOMS Scale==
This is a simplistic scale that I use to evaluate how bad my DOMS symptoms are. This is focused on DOMS of the quads, the most common areas noticed in runners.
{| class="wikitable" style="margin-left: auto; margin-right: auto; border: none;"! DOMS Scale! Stair Test
|-
| 0| You can walk down stairs without discomfort.
|-
| 1| You can walk down stairs with some pain, but there's no need to hold on to the handrail.
|-
| 2| You can walk down stairs with some pain, but you only need to hold on to the handrail for balance.
|-
| 3| You need to put some of your weight on the handrail to descend stairs.
|-
| 4| You need to put nearly all of your weight on the handrail to descend stairs.
|-
| 5| Your quads cannot lower any weight and descending stairs it tricky. Descending stairs involves standing opposite the handrail and locking the leg that is opposite the handrail. Your body is then tilted towards the handrail, using your arms to lower your weight. The leg nearest the handrail is locked straight and once your body is lowered, it takes the weight. Repeat for each step. (Or avoid stairs.)
|}
==Likert Scale Muscle Soreness==
There is a more general scale of muscle soreness that applies to all muscles, but is not focused on DOMS<ref name="Vickers2001"/><ref name="Impellizzeri-2007"/>.
{| class="wikitable" style="margin-left: auto; margin-right: auto; border: none;"! 0Scale! An absence of sorenessDescription
|-
| 10 | A light pain felt only when touched / a vague acheAn absence of soreness
|-
| 21 | A moderate light pain felt only when touched / a slight persistent painvague ache
|-
| 32 | A light moderate pain felt only when walking up or down stairstouched / a slight persistent pain
|-
| 43 | A light pain when walking on a flat surface / painfulup or down stairs
|-
| 4 | A light pain when walking on a flat surface / painful |-| 5
| A moderate pain, stiffness or weakness when walking / very painful
|-
| 6| A severe pain that limits my ability to move
|}
=What are the symptoms of DOMS?=
=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" style="margin-left: auto; margin-right: auto; border: none;"! '''Strategy'''! '''Timing'''! '''Soreness'''! '''Weakness'''! '''Downsides'''
|-
| Repeated Bout Effect| Before (days to months)| Strong evidence of reduced soreness| Some evidence of reduced weakness| None
|-
| [[Nutrient Timing| Carbohydrate and/or protein]]
| After| Some evidence of reduced soreness| Strong evidence of reduced weakness| None
|-
| [[Cadence]]
| During| Some evidence of reduced soreness| Some evidence of reduced soreness| None
|-
| [[Why compression clothes| Compression Clothing]]
| After| Some evidence of reduced soreness| Some evidence of reduced weakness| None
|-
| [[Caffeine]]
| After
| Some evidence of reduced soreness
| Some evidence of reduced weakness| None<sup>a</sup>
|-
| [[Massage]]
| After| Some evidence of reduced soreness| Some evidence of reduced weakness| None
|-
| [[Warmup]]
| Immediately before| Some evidence of reduced soreness| No benefit| None
|-
| Light Exercise
| After
| Transient pain reduction
| No benefit| None<sup>c</sup>
|-
| TENS| After
| Transient pain reduction
| No benefit| None
|-
| [[Cryotherapy| Icing]]
| After| No benefit| No benefit| None<sup>b</sup>
|-
| Antioxidents| Before and/or After| Mixed evidence| Mixed evidence
| Conflicting evidence of reduced [[Endurance Adaptations]]
|-
| [[Stretching]]
| Before and/or After| No benefit| No benefit| * # [[Stretching]] temporarily weakens muscles* # Can induce DOMS* # Can lead to injury
|-
| [[NSAIDs and Running| NSAIDs]]
| Before and/or After| Most evidence indicates no benefit| Most evidence indicates no benefit| Can impair recovery
|}
Notes
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"/>, within 5 days<ref name="Ebbeling-1989"/>, and possibly within 24 hours<ref name="Chen-2001"/>. One study<ref name="Brockett-2001"/> demonstrated a change in the length-tension curve of DOMS trained muscles. As shown on the chart below, 7 days after a bout of DOMS inducing exercise the hamstring is able to generate more force and generate it at a greater angle.
[[File:Length Tension Curve and DOMS.jpg|none|thumb|500px|A chart of a subject before and 7 days after DOMS inducing hamstring exercise. The chart shows the angle and the torque developed, indicating that after training the hamstrings are not only stronger, but are able to generate power at significantly longer length. This may be part of the underlying mechanism for the repeated bout effect.]]
===Repeated Bout and Vitamin C===
I found a single study that looked at how the repeated bout effect changes with [[Vitamin C]]<ref name="HeHockemeyer2015"/>. As described below, most studies have found a small reduction in DOMS with Vitamin C. This 2014 study found that for the first bout, Vitamin C reduced the muscle soreness for the hamstrings, Quads, and Tibialis Anterior (shin), but the soreness of the glutes and calves were similar. However, for the second bout, not only was the soreness was reduced for the placebo, but it was further reduced with the Vitamin C. While this is just one study, it is intriguing with some profound implications. If the protective benefits of the repeated bout effect are dependent on nutritional (or other) factors, some runners may not get the benefit from their training. Personally, I've been taking ~1g/day of Vitamin C for many years due to [[Epidermolysis Bullosa| skin condition]]. However, the evidence that Vitamin C impairs the adaptation to exercise caused me to take a break for about 15 months. During that break from Vitamin C, I found my ability to perform downhill running was quite impaired, and I didn't seem to be able to build up resistance from the repeated bout effect.
[[File:Does Combined Antioxidant Vitamin Supplementation Blunt Repeated Bout Effect.jpg|center|thumb|500px|]]
==Carbohydrate and Protein==
{{Main| Nutrient Timing}}
==Compression Clothing ==
{{Main| Why compression clothes}}
Studies show that wearing [[Why compression clothes| Graduated Compression Clothing]] during the days after DOMS inducing exercise mitigates the soreness<ref name="DaviesThompson2009"/><ref name="Kraemer-2001"/><ref name="Kraemer-2001b"/><ref name="KraemerFlanagan2010"/><ref name="Jakeman-2010"/><ref name="Davies-2009"/><ref name="DuffieldPortus2007"/> and weakness<ref name="Kraemer-2001"/><ref name="KraemerFlanagan2010"/><ref name="Jakeman-2010"/> of DOMS. Relatively few studies showed no benefit from compression clothing<ref name="CarlingFrancis1995"/><ref name="Pearce-2009"/>. However, the results of compression clothing are likely to vary with the particular garment, how well it fits and therefore the pressure that is provided<ref name="MacRae-2011"/>. No I found one studies were found that looked at the effect of wearing compression clothing during DOMS inducing exercise on the subsequent recovery<ref name="McDonnellCooper2018"/>. This study used either or both graduated or uniform compression socks on hiking, a trail run, or calf exercise, with the socks also worn for the following four days. Graduated socks reduced DOMS pain on the hike compared with no compression, the only test with no compression as a control. The uniform compression reduced the pain compared with graduated on the run, and there was no difference between them on the calf exercise. This suggests to me that uniform compression might be better than graduated, or at least, it might not be worth paying extra for graduated compression.
==Caffeine==
{{Main| Caffeine}}
==Massage==
{{Main| Massage}}
[[Massage]] is widely used to prevent and treat injuries. Most meta-analysis suggest that post-exercise massage helps with the soreness of DOMS<ref name="Ernst-1998"/><ref name="Moraska-2005"/>, though the mechanisms are unclear<ref name="Tiidus-1997"/>. Studies that give massage 2-3 hours after DOMS inducing exercise showed reduced soreness<ref name="Smith-1994"/><ref name="Zainuddin-2005"/><ref name="Hilbert2003"/>, but not weakness<ref name="Zainuddin-2005"/><ref name="Hilbert2003"/>. One study that gave massage 2 days after exercise that resulted in reduced soreness and improved muscle function<ref name="MancinelliDavis2006"/>, but other studies that use massage 24 hours or more after exercise showed no benefit<ref name="Hart-"/><ref name="Dawson-2004"/>. A study that used 20 minutes of foam rolling immediately following the DOMS inducing exercise, then again at 24 and 48 hours showed a significant improvement in both pain and muscular performance<ref name="Pearcey-2015"/>. Therefore it seems likely that the timing of the massage is important, though other factors, such as the style of massage and the extent of the DOMS may also change the outcome. My personal experience suggests that massage immediately after the exercise is more effective than when the massage is delayed. (All too often, the muscles are too painful under pressure to allow any form of massage.)
==Warmup==
{{Main| Warmup}}
Performing a [[Warmup]] before exercise may help reduce DOMS pain<ref name="Law-2007"/><ref name="RahnamaRahmani-Nia2005"/>, but not all studies support this<ref name="Evans-2002"/>.
==Light Exercise==
Light training in the days following DOMS inducing exercise generally accepted to be one of the most effective ways of reducing muscle soreness, but unfortunately the reduction in pain is temporary<ref name="Armstrong-1984"/><ref name="Zainuddin-2006"/><ref name="Howatson-2008"/><ref name="Cheung-2003"/>. A study that looked at running 30 minutes/day after DOMS inducing downhill running shows that the extra exercise neither helped nor hindered with soreness, weakness or [[Running Economy]]<ref name="ChenNosaka2008"/>. (The study only looked at the 7 days following the downhill running, and it would be interesting to know if there are any longer -term differences.)One study used cycling at light (30%) or moderate (70%) immediately after DOMS inducing exercise<ref name="TufanoBrown2012"/>. The moderate intensity cycling prevented the loss of strength, and actually increased strength on days 3 and 4. There were no differences between the control and the light exercise, nor between any of the conditions for soreness. This is an interesting suggestion that higher intensity exercise might be beneficial, but the study has a number of flaws, including the use of predicted [[Maximum Heart Rate]] to set exercise intensity.
==TENS==
TENS may reduce the soreness of DOMS<ref name="Denegar-1989"/>, but the effect seems to be transient<ref name="Denegar"/> and the effect is reduced if combined with icing<ref name="Denegar-1992"/>. Not all studies show any pain reduction<ref name="Bonacci-1997"/> and none show a reduction in the weakness.
==Icing==
{{Main| Cryotherapy}}
Sadly, [[Cryotherapy| Icing]] does not helpwith DOMS<ref name="Yackzan-"/><ref name="Shunsuke-2004"/><ref name="Gulick-17"/><ref name="Paddon-Jones-1997"/>, and can make DOMS worse<ref name="TsengLee2012"/><ref name="Isabell-1992"/>. Ice reduces pain slightly, but does not restore strength<ref name="Denegar-1992"/> . (In my experience, ice can be extremely effective at helping heal muscle tears and non-DOMS muscle injuries, but not DOMS.)==Protracted Heat==One study looked at applying heat for 8 hours, either directly after DOMS inducing exercise or 24 hours later<ref name="PetrofskyBerk2017"/>. The study used "ThermaCare" chemically generated heat wraps, and I suspect the study was sponsored by the company. The 60 subjects underwent 5 minutes of squats to induce DOMS, then 20 were controls, 20 had immediate heat for 8 hours and the remainder had heat applied 24 hours after exercise. The immediate heat subjects had little reduction in strength over the follow three days, where the 24-hour delayed heat was no different from the controls. The strength drop was about 24% in controls/delayed-heat, which is a meaningful improvement. There was some reduction in pain over the first two days, with the immediate heat doing better than the delayed heat, which was slightly better than the controls.
==Antioxidants - Vitamin C and E==
The evidence for anti-oxidants is mixed, with some studies showing a benefit but not others. Note that one study below showed an impaired recovery with vitamin C supplementation. In addition, there is mixed evidence that vitamin C and/or vitamin E reduces [[Endurance Adaptations]] from exercise<ref name="Gomez-Cabrera-2008"/><ref name="RistowZarse2009"/><ref name="Strobel-2011"/> or they do not<ref name="Wadley-2010"/><ref name="Higashida-2011"/> <ref name="YfantiAkerstrom2009"/>. A 2019 systematic review of 50 studies covering 1,089 subjects concluded that there was moderate quality evidence that Vitamin C reduced DOMS at 48 and 96 hours, with lower quality evidence for 6 and 24 hours, but the reduction was quite small<ref name="RanchordasRogerson2018"/>.{| class="wikitable" style="margin-left: auto; margin-right: auto; border: none;"
! Vitamin C
! Vitamin E
==Stretching==
{{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==
{{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. 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. 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
! Soreness
| 1xNo Effect<ref name="Stone-2002"/>
|
|-
| Turmeric
| 2xImproved<ref name="Nicol-2015"/><ref name="Drobnic-2014"/>
2xNo Effect<ref name="McFarlinVenable2016"/><ref name="TanabeMaeda2015"/>
| 2xImproved<ref name="TanabeMaeda2015"/><ref name="Davis-2007"/>
|}
==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.
=Menstrual Cycle=
A study has shown that DOMS does not vary with menstrual cycle<ref name="ChaffinBerg2011"/>.
<ref name="Braun-2003"> WA. Braun, DJ. Dutto, The effects of a single bout of downhill running and ensuing delayed onset of muscle soreness on running economy performed 48 h later., Eur J Appl Physiol, volume 90, issue 1-2, pages 29-34, Sep 2003, doi [http://dx.doi.org/10.1007/s00421-003-0857-8 10.1007/s00421-003-0857-8], PMID [http://www.ncbi.nlm.nih.gov/pubmed/12783232 12783232]</ref>
<ref name="Denegar-1992"> CR. Denegar, DH. Perrin, Effect of transcutaneous electrical nerve stimulation, cold, and a combination treatment on pain, decreased range of motion, and strength loss associated with delayed onset muscle soreness., J Athl Train, volume 27, issue 3, pages 200-6, 1992, PMID [http://www.ncbi.nlm.nih.gov/pubmed/16558162 16558162]</ref>
<ref name="Shunsuke-2004">CiNii Articles Articles - EFFECTS OF ICE PACK ON MUSCLE INJURY INDUCED BY ECCENTRIC CONTRACTIONS http://ci.nii.ac.jp/naid/110004787806 </ref>
<ref name="Yackzan-"> L. Yackzan, C. Adams, KT. Francis, The effects of ice massage on delayed muscle soreness., Am J Sports Med, volume 12, issue 2, pages 159-65, PMID [http://www.ncbi.nlm.nih.gov/pubmed/6742292 6742292]</ref>
<ref name="High-1989"> DM. High, ET. Howley, BD. Franks, The effects of static stretching and warm-up on prevention of delayed-onset muscle soreness., Res Q Exerc Sport, volume 60, issue 4, pages 357-61, Dec 1989, PMID [http://www.ncbi.nlm.nih.gov/pubmed/2489863 2489863]</ref>
<ref name="SmithGeorge1995">Lucille Smith, Robert George, Thomas Chenier, Michael McCammon, Joseph Houmard, Richard Israel, R. A. Hoppmann, Susan Smith, Do over-the-counter analgesics reduce delayed onset muscle soreness and serum creatine kinase values?, Research in Sports Medicine, volume 6, issue 2, 1995, pages 81–88, ISSN [http://www.worldcat.org/issn/1543-8627 1543-8627], doi [http://dx.doi.org/10.1080/15438629509512039 10.1080/15438629509512039]</ref>
<ref name="Baldwin-2001"> AC. Baldwin, SW. Stevenson, GA. Dudley, Nonsteroidal anti-inflammatory therapy after eccentric exercise in healthy older individuals., J Gerontol A Biol Sci Med Sci, volume 56, issue 8, pages M510-3, Aug 2001, PMID [http://www.ncbi.nlm.nih.gov/pubmed/11487604 11487604]</ref>
<ref name="pmid12580656">author Tokmakidis SP, Kokkinidis EA, Smilios I, Douda H, The effects of ibuprofen on delayed muscle soreness and muscular performance after eccentric exercise., J Strength Cond Res, 2003, volume 17, issue 1, pages 53-9, PMID [http://www.ncbi.nlm.nih.gov/pubmed/12580656 12580656] </ref>
<ref name="Stone-2002"> MB. Stone, MA. Merrick, CD. Ingersoll, JE. Edwards, Preliminary comparison of bromelain and Ibuprofen for delayed onset muscle soreness management., Clin J Sport Med, volume 12, issue 6, pages 373-8, Nov 2002, PMID [http://www.ncbi.nlm.nih.gov/pubmed/12466693 12466693]</ref>
<ref name="RahnamaRahmani-Nia2005">N Rahnama, F Rahmani-Nia, K Ebrahim, The isolated and combined effects of selected physical activity and ibuprofen on delayed-onset muscle soreness, Journal of Sports Sciences, volume 23, issue 8, 2005, pages 843–850, ISSN [http://www.worldcat.org/issn/0264-0414 0264-0414], doi [http://dx.doi.org/10.1080/02640410400021989 10.1080/02640410400021989]</ref>
<ref name="Impellizzeri-2007">FM. Impellizzeri, NA. Maffiuletti, Convergent evidence for construct validity of a 7-point likert scale of lower limb muscle soreness., Clin J Sport Med, volume 17, issue 6, pages 494-6, Nov 2007, doi [http://dx.doi.org/10.1097/JSM.0b013e31815aed57 10.1097/JSM.0b013e31815aed57], PMID [http://www.ncbi.nlm.nih.gov/pubmed/17993794 17993794]</ref>
<ref name="Pearcey-2015">GE. Pearcey, DJ. Bradbury-Squires, JE. Kawamoto, EJ. Drinkwater, DG. Behm, DC. Button, Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures., J Athl Train, volume 50, issue 1, pages 5-13, Jan 2015, doi [http://dx.doi.org/10.4085/1062-6050-50.1.01 10.4085/1062-6050-50.1.01], PMID [http://www.ncbi.nlm.nih.gov/pubmed/25415413 25415413]</ref>
<ref name="RamsewakDeWitt2000">R.S. Ramsewak, D.L. DeWitt, M.G. Nair, Cytotoxicity, antioxidant and anti-inflammatory activities of Curcumins I–III from Curcuma longa, Phytomedicine, volume 7, issue 4, 2000, pages 303–308, ISSN [http://www.worldcat.org/issn/09447113 09447113], doi [http://dx.doi.org/10.1016/S0944-7113(00)80048-3 10.1016/S0944-7113(00)80048-3]</ref>
<ref name="Nicol-2015">LM. Nicol, DS. Rowlands, R. Fazakerly, J. Kellett, Curcumin supplementation likely attenuates delayed onset muscle soreness (DOMS)., Eur J Appl Physiol, volume 115, issue 8, pages 1769-77, Aug 2015, doi [http://dx.doi.org/10.1007/s00421-015-3152-6 10.1007/s00421-015-3152-6], PMID [http://www.ncbi.nlm.nih.gov/pubmed/25795285 25795285]</ref>
<ref name="Drobnic-2014">F. Drobnic, J. Riera, G. Appendino, S. Togni, F. Franceschi, X. Valle, A. Pons, J. Tur, Reduction of delayed onset muscle soreness by a novel curcumin delivery system (Meriva): a randomised, placebo-controlled trial., J Int Soc Sports Nutr, volume 11, pages 31, 2014, doi [http://dx.doi.org/10.1186/1550-2783-11-31 10.1186/1550-2783-11-31], PMID [http://www.ncbi.nlm.nih.gov/pubmed/24982601 24982601]</ref>
<ref name="McFarlinVenable2016">Brian K. McFarlin, Adam S. Venable, Andrea L. Henning, Jill N. Best Sampson, Kathryn Pennel, Jakob L. Vingren, David W. Hill, Reduced Inflammatory and Muscle Damage Biomarkers following Oral Supplementation with Bioavailable Curcumin, BBA Clinical, 2016, ISSN [http://www.worldcat.org/issn/22146474 22146474], doi [http://dx.doi.org/10.1016/j.bbacli.2016.02.003 10.1016/j.bbacli.2016.02.003]</ref>
<ref name="TanabeMaeda2015">Yoko Tanabe, Seiji Maeda, Nobuhiko Akazawa, Asako Zempo-Miyaki, Youngju Choi, Song-Gyu Ra, Atsushi Imaizumi, Yoshihiko Otsuka, Kazunori Nosaka, Attenuation of indirect markers of eccentric exercise-induced muscle damage by curcumin, European Journal of Applied Physiology, volume 115, issue 9, 2015, pages 1949–1957, ISSN [http://www.worldcat.org/issn/1439-6319 1439-6319], doi [http://dx.doi.org/10.1007/s00421-015-3170-4 10.1007/s00421-015-3170-4]</ref>
<ref name="Davis-2007">JM. Davis, EA. Murphy, MD. Carmichael, MR. Zielinski, CM. Groschwitz, AS. Brown, JD. Gangemi, A. Ghaffar, EP. Mayer, Curcumin effects on inflammation and performance recovery following eccentric exercise-induced muscle damage., Am J Physiol Regul Integr Comp Physiol, volume 292, issue 6, pages R2168-73, Jun 2007, doi [http://dx.doi.org/10.1152/ajpregu.00858.2006 10.1152/ajpregu.00858.2006], PMID [http://www.ncbi.nlm.nih.gov/pubmed/17332159 17332159]</ref>
<ref name="Kawanishi-2013">N. Kawanishi, K. Kato, M. Takahashi, T. Mizokami, Y. Otsuka, A. Imaizumi, D. Shiva, H. Yano, K. Suzuki, Curcumin attenuates oxidative stress following downhill running-induced muscle damage., Biochem Biophys Res Commun, volume 441, issue 3, pages 573-8, Nov 2013, doi [http://dx.doi.org/10.1016/j.bbrc.2013.10.119 10.1016/j.bbrc.2013.10.119], PMID [http://www.ncbi.nlm.nih.gov/pubmed/24184481 24184481]</ref>
<ref name="PetrofskyBerk2017">Jerrold Petrofsky, Lee Berk, Gurinder Bains, Iman Akef Khowailed, Haneul Lee, Michael Laymon, The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness, Clinical Journal of Sport Medicine, volume 27, issue 4, 2017, pages 329–337, ISSN [http://www.worldcat.org/issn/1050-642X 1050-642X], doi [http://dx.doi.org/10.1097/JSM.0000000000000375 10.1097/JSM.0000000000000375]</ref>
<ref name="XieFeng2018">Yanfei Xie, Beibei Feng, Kedi Chen, Lars L. Andersen, Phil Page, Yuling Wang, The Efficacy of Dynamic Contract-Relax Stretching on Delayed-Onset Muscle Soreness Among Healthy Individuals, Clinical Journal of Sport Medicine, volume 28, issue 1, 2018, pages 28–36, ISSN [http://www.worldcat.org/issn/1050-642X 1050-642X], doi [http://dx.doi.org/10.1097/JSM.0000000000000442 10.1097/JSM.0000000000000442]</ref>
<ref name="NicolRowlands2015">Lesley M. Nicol, David S. Rowlands, Ruth Fazakerly, John Kellett, Curcumin supplementation likely attenuates delayed onset muscle soreness (DOMS), European Journal of Applied Physiology, volume 115, issue 8, 2015, pages 1769–1777, ISSN [http://www.worldcat.org/issn/1439-6319 1439-6319], doi [http://dx.doi.org/10.1007/s00421-015-3152-6 10.1007/s00421-015-3152-6]</ref>
<ref name="McDonnellCooper2018">Adam C McDonnell, Diane Cooper, Tinkara Mlinar, Igor B Mekjavic, The effect of post-exercise application of either graduated or uniform compression socks on the mitigation of delayed onset muscle soreness, Textile Research Journal, 2018, pages 004051751878000, ISSN [http://www.worldcat.org/issn/0040-5175 0040-5175], doi [http://dx.doi.org/10.1177/0040517518780002 10.1177/0040517518780002]</ref>
<ref name="TufanoBrown2012">James J. Tufano, Lee E. Brown, Jared W. Coburn, Kavin K.W. Tsang, Vanessa L. Cazas, Joe W. LaPorta, Effect of Aerobic Recovery Intensity on Delayed-Onset Muscle Soreness and Strength, Journal of Strength and Conditioning Research, volume 26, issue 10, 2012, pages 2777–2782, ISSN [http://www.worldcat.org/issn/1064-8011 1064-8011], doi [http://dx.doi.org/10.1519/JSC.0b013e3182651c06 10.1519/JSC.0b013e3182651c06]</ref>
<ref name="RanchordasRogerson2018">Mayur K Ranchordas, David Rogerson, Hora Soltani, Joseph T Costello, Antioxidants for preventing and reducing muscle soreness after exercise: a Cochrane systematic review, British Journal of Sports Medicine, 2018, pages bjsports-2018-099599, ISSN [http://www.worldcat.org/issn/0306-3674 0306-3674], doi [http://dx.doi.org/10.1136/bjsports-2018-099599 10.1136/bjsports-2018-099599]</ref>
<ref name="HeHockemeyer2015">F. He, J. Hockemeyer, D. Sedlock, Does Combined Antioxidant Vitamin Supplementation Blunt Repeated Bout Effect?, International Journal of Sports Medicine, volume 36, issue 05, 2015, pages 407–413, ISSN [http://www.worldcat.org/issn/0172-4622 0172-4622], doi [http://dx.doi.org/10.1055/s-0034-1395630 10.1055/s-0034-1395630]</ref>
</references>
