8,108
edits
Changes
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 it's a critical part of training. By 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
</gallery>
=Why is DOMS important?=
Because running involves a lot of eccentric stress, DOMS is common in runners, especially after [[Downhill Running]]. The pain that occurs 24-72 hours after exercise can prevent continued training. However, the biggest issue for long distance runners is that although the pain occurs 24-72 hours after exercise, the weakness peaks after 30 minutes <ref name=<ref name="Marginson-2005"/>/>. If you've ever run a long, steep descent, you'll know the strange feeling of weak numbness that pervades your quads as the effect of the downhill builds up. The Boston Marathon or the latter part of Mount Mitchell Challenge have descents that cause this type of weakness. If you've felt a similar weakness in the latter stages of a marathon, this may not be [[Glycogen]] depletion creating 'the wall', but eccentric muscle damage that will later manifest itself as DOMS. It is suggested that this is the reason the Boston Marathon course is relatively slow, even though it is a net decent.
=What does DOMS mean to you?=
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.
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}}
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
| 2xImproved<ref name="TanabeMaeda2015"/><ref name="Davis-2007"/>
|}
==HMB (β-hydroxy-β-methylbutyrate)==
There's limited research on HMB and DOMS which suggests HMB might help reduce DOMS<ref name="van SomerenEdwardsHowatson2005"/><ref name="NunanHowatsonvanSomeren2010"/><ref name="KnitterPantonRathmacher2000"/>. The research isn't great, and the results aren't huge, but given the other benefits of [[HMB|HMB For Runners]], I think it's worthwhile. (As an aside, I was amazed to find one study on HMB and DOMS didn't actually use a product containing HMB<ref name="AbumradRathmacher2011"/><ref name="NunanHowatsonvanSomeren2011Ack"/>!)
==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.
<ref name="ChaffinBerg2011">Morgan E. Chaffin, Kris E. Berg, Jessica R. Meendering, Tamra L. Llewellyn, Jeffrey A. French, Jeremy E. Davis, Interleukin-6 and Delayed Onset Muscle Soreness Do Not Vary During the Menstrual Cycle, Research Quarterly for Exercise and Sport, volume 82, issue 4, 2011, pages 693–701, ISSN [http://www.worldcat.org/issn/0270-1367 0270-1367], doi [http://dx.doi.org/10.1080/02701367.2011.10599806 10.1080/02701367.2011.10599806]</ref>
<ref name="ChenNosaka2008">Trevor C. Chen, Kazunori Nosaka, Chia-Ching Wu, Effects of a 30-min running performed daily after downhill running on recovery of muscle function and running economy, Journal of Science and Medicine in Sport, volume 11, issue 3, 2008, pages 271–279, ISSN [http://www.worldcat.org/issn/14402440 14402440], doi [http://dx.doi.org/10.1016/j.jsams.2007.02.015 10.1016/j.jsams.2007.02.015]</ref>
<ref name="Child-1998"> RB. Child, JM. Saxton, AE. Donnelly, Comparison of eccentric knee extensor muscle actions at two muscle lengths on indices of damage and angle-specific force production in humans., J Sports Sci, volume 16, issue 4, pages 301-8, May 1998, doi [http://dx.doi.org/10.1080/02640419808559358 10.1080/02640419808559358], PMID [http://www.ncbi.nlm.nih.gov/pubmed/9663954 9663954]</ref>
<ref name="Jones-1989"> DA. Jones, DJ. Newham, C. Torgan, Mechanical influences on long-lasting human muscle fatigue and delayed-onset pain., J Physiol, volume 412, pages 415-27, May 1989, PMID [http://www.ncbi.nlm.nih.gov/pubmed/2600839 2600839]</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="AbumradRathmacher2011">Naji N Abumrad, John A Rathmacher, Exercise-Induced Muscle Damage is Not Attenuated by Maximuscle β-Hydroxy-β-Methylbutyrate-1000™ Supplementation, Journal of Strength and Conditioning Research, date July 2011, volume 25, issue 7, pages 1–2, ISSN [http://www.worldcat.org/issn/1064-8011 1064-8011], doi [http://dx.doi.org/10.1519/JSC.0b013e3181f7c3a8 10.1519/JSC.0b013e3181f7c3a8], PMID [http://www.ncbi.nlm.nih.gov/pubmed/21555959 21555959]</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>
<ref name="van SomerenEdwardsHowatson2005">Ken A. van Someren, Adam J. Edwards, Glyn Howatson, Supplementation with β-Hydroxy- β-Methylbutyrate (HMB) and α-Ketoisocaproic Acid (KIC) Reduces Signs and Symptoms of Exercise-Induced Muscle Damage in Man, International Journal of Sport Nutrition and Exercise Metabolism, date August 2005, volume 15, issue 4, pages 413–424, ISSN [http://www.worldcat.org/issn/1526-484X 1526-484X], 1543-2742 !!eissn!!, doi [http://dx.doi.org/10.1123/ijsnem.15.4.413 10.1123/ijsnem.15.4.413], PMID [http://www.ncbi.nlm.nih.gov/pubmed/16286672 16286672]</ref>
<ref name="NunanHowatsonvanSomeren2010">David Nunan, Glyn Howatson, Ken A 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 February 2010, volume 24, issue 2, pages 531–537, ISSN [http://www.worldcat.org/issn/1064-8011 1064-8011], doi [http://dx.doi.org/10.1519/JSC.0b013e3181c4d370 10.1519/JSC.0b013e3181c4d370], PMID [http://www.ncbi.nlm.nih.gov/pubmed/20072045 20072045]</ref>
<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>
</references>