Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness (DOMS) is all too familiar for the elite and novice athlete alike.  DOMS results from intense exercise to which the athlete is unaccustomed, especially at the beginning of the season, after some time away from training.  Although it appears to result more from eccentric (weight lowering, running downhill) movements, the exact cause is unknown.  What is known is that the soreness can be debilitating and can lead to a decrease in peak strength, increased in perceived exertion and pain with movement.

Anti-inflammatory medications (Ibuprofen 400mg every 8 hours, started 4 hours before exercise) and Vitamin C (200mg twice a day for 2 weeks before starting exercise) can help to decrease the pain and soreness, the role of massage is less well known, but appears to have some positive effects on recovery.

Exercise is the most effective modality for decreasing pain from DOMS, but the effect is temporary.  Most DOMS will resolve spontaneously in 2-3 days after exercise.

DOMS should not persist with each exercise session and might underlie more serious problems if it persists.

Reference:

  Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64.
  Farr T, Nottle C, Nosaka K, Sacco P. The effects of therapeutic massage on delayed onset muscle soreness and muscle function following downhill walking. J Sci Med Sport. 2002 Dec;5(4):297-306.

  Hilbert JE, Sforzo GA, Swensen T.The effects of massage on delayed onset muscle soreness. Br J Sports Med. 2003 Feb;37(1):72-5.

  Scott KE, Rozenek R, Russo AC, Crussemeyer JA, Lacourse MG. Effects of delayed onset muscle soreness on selected physiological responses to submaximal running. J Strength Cond Res. 2003 Nov;17(4):652-8.

  Thompson D, Williams C, McGregor SJ, Nicholas CW, McArdle F, Jackson MJ, Powell JR. Prolonged vitamin C supplementation and recovery from demanding exercise. Int J Sport Nutr Exerc Metab. 2001 Dec;11(4):466-81.

  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 Feb;17(1):53-9.

Fluids and Electrolytes in the Heat

It's hot out.  As Eugene Morris Jerome said in Neil Simon's Biloxi Blues:

"It's like Africa hot. Tarzan couldn't take this kind of hot."

How can someone tolerate this heat better?  The right amount of sodium and water.  In a 2012 research study from Scandinavia (when does it ever get that hot in Scandinavia?), water was compared to water and varying amounts of sodium.

Ninety minutes before exercise, participants ingested 10 mL of water/kg body mass either alone or with approximately one or two teaspoons of salt. Participants cycled  for 2 hours at low-moderate intensity immediately followed by a time-trial. 

After 2 hours of exercise, plasma volume dropped by 10% with 2 tsp of sodium, 12% 1 tsp of sodium 16% without sodium. The drop in plasma volume is likely from sweat loss.

Pre-exercise ingestion of salt plus water maintains higher plasma volume during dehydrating exercise. Sodium and water do not keep the cyclist cooler.  However, the sodium smoothie maintains cardiovascular function and improves cycling performance.

To figure out how many milliliters of fluid you need, divide your weight in pounds by 2.2 and multiply by 10.  A large 24 oz water bottle is approximately 700ml.

Add 1 tsp of sodium from regular salt

Ingest 90 minutes before exercise.

Top Marathon Training Mistakes

Not Enough Fluid

We’ve all heard it many times, “Hydrate, hydrate, hydrate.”  Especailly in warm weather, the body can dehydrate quickly.  With even 1-2% of the body weight lost as sweat, performance will suffer.  Training should include hydration so that you will be able to drink during the event.  Practice keeping up with your fluid losses, especially for an event that lasts more than 1 hour.  How much should you drink?  That depends upon how much you are losing.  Weigh yourself before and after a 30 minute training session.  The weight you lost equals how much fluid you lose every 30 minutes (one pound equals 16 fluid ounces)

Too Much Fluid

When you become too focused on hydration, it is possible to drink too much.  Excess fluid will cause you to dilute the electrolytes in your body, possibly causing confusion, cramping and even seizures.  

Not enough carbohydrate

When you combine endurance training with calorie restriction, you create a recipe for disaster.  Prolonged endurance workouts require calories from carbohydrates to keep the muscles fueled to work adequately.  If you don’t eat before a long or intense workout, you set yourself up for muscle fatigue and perhaps injury.  If you cramp after eating, consider taking liquid “meals” before training.  Cool, dilute (5 grams of carbohydrate in every 100ml) liquids

Not enough intensity

Endurance event training relies not only on your slow twitch (Type 1) muscle fibers, but also on your fast twitch (type 2) fibers to provide you with power.  Training at an intensity below which the type 2 fibers are used will leave you out of breath when you hit a hill or when you try to pick up the pace.

Inadequate Taper

Training today will take about six weeks to see an increase in fitness.  Training hard in the week before an important event will only maintain fitness, not improve your fitness for race day.  Over the last week to 10 days prior to an important event, decrease the amount of time you spend training by half while keeping your intensity the same.

Doing what the other guy did

One of the biggest problems with training for any sport is following the training plan of a friend or professional racer.  Every person has a different muscle fiber profile and will respond differently to the same plan.  To truly understand what will work for you, a number of variables need to be taken into account—most of which are only determined through exercise testing.

Too much too soon

If you have never tried a particular food before, you wouldn’t stuff your mouth the first time you tried it.  The same is true with training: take a taste before you sit down for a full meal.  Start out slowly and progress.  Make sure that your shoes are comfortable, that your sunglasses fit, you aren’t developing any injuries and any chafing is addressed before continuing to add miles.

Improper footwear selection

The foot has two arches, one that runs the length of the foot and one that runs across the foot.  Different feet need different support for these arches, some feet even need orthotics whether over the counter or custom.  Be sure your footwear selection matches your feet before undertaking large volume training.  A good running store, sports medicine physician or biomechanist can help find a shoe that is right for you.

Running Through Pain

Ignoring aches and pains and letting them progress to chronic overuse injuries is common.  If you want to be pain free and complete your goals, don’t ignore pains while they are still easily treated.  

Forgetting the rest of the body (core)

Although marathon training should involve lots of running, it should also involve core training.  The core, defined as the muscles that stabilize the trunk so that the arms and legs can do their thing, plays a very important role in increasing speed and limiting injuries.  The hip stabilizer muscles in the butt can be strengthened with side planks and lunges.  Training should be functional and based upon weight-bearing exercises (sitting in a thigh-toning machine won’t necessarily help for running).