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Delayed Onset Muscle Soreness

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Delayed iDelayed 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| 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. 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.
=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 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"/>:
* There are some studies that indicate there are possible changes in muscle fiber recruitment patterns<ref name="Miles-1997"/><ref name="Zhou-1998"/><ref name="Zhou-1996"/>.
=How long does DOMS last?=
It seems likely that exercise characteristics (duration, intensity, etc.) will change the time to recovery<ref name="Vickers-2001"/><ref name="Paschalis-2005"/>. The soreness generally peaks between 24-72 hours after the damaging exercise, but will last at least 4 days<ref name="Paschalis-2005"/>. My personal experience is that DOMS can last for over a week, and I prefer to avoid [[Downhill TrainingRunning]] in the two weeks before a race, though sometimes I will include it as close as 10 days beforehand. 
=The effect of steepness on DOMS=
I have found that steeper descents produce disproportionately severe DOMS. This might be due to the angle of the knee, as most<ref name="Jones-1989"/><ref name="Child-1998"/> (but not all<ref name="Paschalis-2005"/>) studies indicate that the longer a muscle is when being stressed, the greater the DOMS. This effect is most noticeable when using a [[Treadmill]] for downhill training[[Downhill Running]], as small changes in angle can produce a big difference in 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.
<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>