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=What are the symptoms of DOMS?=
The soreness of DOMS is different to other forms of muscle soreness. With DOMS, large areas of the muscle are tender to the touch and painful when the muscle is used. With other forms of muscle soreness the area of tenderness is usually more localized and the pain of massage is sometimes described as a 'good pain'. The pain of DOMS will normally lessen with light exercise such as walking, which is often described as 'loosening' up. However, the soreness of DOMS is not the best indicator of the muscle damage, and similar levels of soreness can result from differing levels of muscle damage<ref name="NosakaNewton2002"/>. In addition, there are other symptoms, such as:
* Reduction in strength<ref name="Saxton-1995"/><ref name="domsiso"/><ref name="Gulick-1996"/><ref name="Paddon-Jones-1997"/>, typically 30-60%<ref name="Baldwin Lanier-2003"/>. (Note that the reduction in strength starts immediately following the damaging exercise and increases over the next 24-48 hours<ref name="Cheung-2003"/>. The initial reduction in strength can be as much as 40%<ref name="Baldwin Lanier-2003"/>.)
* Increased passive muscle tension<ref name="Howatson-2008"/>. A muscle suffering from DOMS will often be hard to the touch, even when relaxed as much as possible.
* Impaired [[Glycogen]] repletion<ref name="Smith-1992"/><ref name="Braun-2003"/>, though higher carbohydrate intake partly offsets the reduction<ref name="Costill-1990"/>. There is some evidence that Glycogen levels continue to drop after DOMS inducing exercise<ref name="Zehnder-2004"/><ref name="Widrick-1992"/>, and the deficiency in glycogen lasts for over 72 hours<ref name="Widrick-1992"/>.
* 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 Training]]
=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, 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.
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=Menstrual Cycle=
A study has shown that DOMS does not vary with menstrual cycle<ref name="ChaffinBerg2011"/>.
=Mechanisms of DOMS=
The underlying mechanism of DOMS is thought to consist of phases; the initial damage that occurs during the exercise and then secondary damage that occurs subsequently<ref name="Cheung-2003"/><ref name="Howatson-2008"/>:
** '''Increased passive muscle stiffness'''. In contrast, passive stiffness is when the muscles are relaxed. It is unclear if increased passive stiffness protects against eccentric damage or actually exacerbates it.
* '''Cellular adaptation. '''A number of changes at the cellular level may provide protection against eccentric damage.
** '''Increased sarcomeres. '''The sarcomeres are part of the contracting mechanism of the muscles. The contraction of a muscle comes from parts of the sarcomere sliding over each other. One adaptation to eccentric exercise may be that the overlap in these sliding areas becomes larger. A study in rats suggests that the adaptation may include more sarcomeres in series, which produces a greater Range Of Motion and greater force at longer muscle lengths<ref name="Lynn-1998"/>.
** '''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.
=References=
<references>
<ref name="Paschalis-2005">V. Paschalis, Y. Koutedakis, AZ. Jamurtas, V. Mougios, V. Baltzopoulos, Equal volumes of high and low intensity of eccentric exercise in relation to muscle damage and performance., J Strength Cond Res, volume 19, issue 1, pages 184-8, Feb 2005, doi [http://dx.doi.org/10.1519/R-14763.1 10.1519/R-14763.1], PMID [http://www.ncbi.nlm.nih.gov/pubmed/15705032 15705032]</ref>
<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="Paschalis-2005"> V. Paschalis, Y. Koutedakis, V. Baltzopoulos, V. Mougios, AZ. Jamurtas, G. Giakas, Short vs. long length of rectus femoris during eccentric exercise in relation to muscle damage in healthy males., Clin Biomech (Bristol, Avon), volume 20, issue 6, pages 617-22, Jul 2005, doi [http://dx.doi.org/10.1016/j.clinbiomech.2005.02.011 10.1016/j.clinbiomech.2005.02.011], PMID [http://www.ncbi.nlm.nih.gov/pubmed/15927735 15927735]</ref>
<ref name="Derrick-1998"> TR. Derrick, J. Hamill, GE. Caldwell, Energy absorption of impacts during running at various stride lengths., Med Sci Sports Exerc, volume 30, issue 1, pages 128-35, Jan 1998, PMID [http://www.ncbi.nlm.nih.gov/pubmed/9475654 9475654]</ref>
<ref name="Clarke-1985"> TE. Clarke, LB. Cooper, CL. Hamill, DE. Clark, The effect of varied stride rate upon shank deceleration in running., J Sports Sci, volume 3, issue 1, pages 41-9, 1985, doi [http://dx.doi.org/10.1080/02640418508729731 10.1080/02640418508729731], PMID [http://www.ncbi.nlm.nih.gov/pubmed/4094019 4094019]</ref>
<ref name="NosakaNewton2002">Kazunori Nosaka, Mike Newton, Paul Sacco, Delayed-onset muscle soreness does not reflect the magnitude of eccentric exercise-induced muscle damage, Scandinavian Journal of Medicine & Science in Sports, volume 12, issue 6, 2002, pages 337–346, ISSN [http://www.worldcat.org/issn/09057188 09057188], doi [http://dx.doi.org/10.1034/j.1600-0838.2002.10178.x 10.1034/j.1600-0838.2002.10178.x]</ref>
<ref name="Vickers-2001"> AJ. Vickers, Time course of muscle soreness following different types of exercise., BMC Musculoskelet Disord, volume 2, pages 5, 2001, PMID [http://www.ncbi.nlm.nih.gov/pubmed/11701094 11701094]</ref>
<ref name="Lynn-1998">R. Lynn, JA. Talbot, DL. Morgan, Differences in rat skeletal muscles after incline and decline running., J Appl Physiol (1985), volume 85, issue 1, pages 98-104, Jul 1998, PMID [http://www.ncbi.nlm.nih.gov/pubmed/9655761 9655761]</ref>
</references>
