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==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"! 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"! Scale! Description|-| 0! | An absence of soreness
|-
| 1| A light pain felt only when touched / a vague ache
|-
| 2| A moderate pain felt only when touched / a slight persistent pain
|-
| 3| A light pain when walking up 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"! '''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
==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"/>.
{| class="wikitable"
! Vitamin C
! Vitamin E
{{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.
{| class="wikitable"
! NSAID
! Soreness
<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>
