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Interventions for delayed onset muscle soreness

What is the current evidence regarding the physiotherapy management of delayed onset muscle soreness?

Several physiotherapy interventions have a positive impact on delayed onset muscle soreness (DOMS) in comparison to no intervention: among others cryotherapy, vibration, massage, active exercise and compression.

However, it should be taken into account that a large deal of clinical trials demonstrating these differences were of low quality. Furthermore, the ideal application parameters of these modalities also remain to be determined.

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.

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