There has been an extensive amount of research on the origins of DOMS, with factors such as lactate accumulation, tissue damage, and inflammation having been listed as being involved over time.
DOMS is associated with pain and functional impairments, such as restricted range of motion, stiffness, and decreased muscle power. There has also been a massive amount of interventions aiming to reduce DOMS, leading to high heterogeneity between studies.
A total of 121 studies were included in the quantitative analysis. Study quality was assessed using the PEDro scale (0-10). In turn, evidence quality was determined using the GRADE approach. All included studies were randomised controlled trials which compared physiotherapy interventions to no interventions in healthy participants with DOMS.
The average PEDro score of the included studies was 4.7 points; 63 studies were considered to be of low quality and only 16 studies were considered to be of high quality.
Among the interventions that showed significant improvements, massage had the greatest effect on pain. Among physical modalities, the intervention with the best effect was phototherapy.
Conversely, the review found that acupuncture, kinesiotaping, foam rolling, stretching, and electrostimulation had no significant effect on DOMS.
> From: Nahon et al., Phys Ther Sport 52 (2021) 1-12 (Epub ahead of print). All rights reserved to Elsevier Ltd.. Click here for the online summary.
Expert opinion
DOMS is an extremely prevalent issue across all recreational and competitive levels of physical activity. As such, it has been the topic of a massive amount of research regarding the optimal way of decreasing it.
However, the amount of studies has not led to any established method of managing DOMS. This may be due to a fundamental issue also affecting other musculoskeletal conditions, which is the lack of well-fundamented etiological mechanisms.
Without a definite physiological framework to base interventions on, it is less likely that the optimal management will be established. This way, we are left with uncertain effects which are frequently based on subjective sensation and popular trends rather than on objective measures of recovery.
It would probably be more beneficial to establish the physiology behind DOMS in a more solid manner before continuing to pursue multiple avenues of research on more interventions for DOMS.
