Detailed guides to painful problems, treatments & more

Delayed onset muscle soreness — topic summary example

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

I’m continuing to produce carefully crafted article summaries (as announced in a recent blog post). I’m also continuing to find it crazy challenging and satisfying. It’s like taking a crash course in my own content. With each one, I feel more certain that these mini articles-within-articles are genuinely a great service to readers and to me: writing them forces me to refine my overall comprehension of a topic.

Anyhoo, after boasting about the first batch of 40 summaries a couple weeks ago, I started in on some of the trickier ones — with many dozens to go — and I’ll share some of the most interesting ones as I work.

Today’s example is the topic summary for delayed-onset muscle soreness, a topic full of intriguing details, and the hardest yet to condense. There’s a lot more detail (and citations) in the full article — that’s the whole point, of course. This is 232 words summarizing eight thousand. 😃

DELAYED ONSET MUSCLE SORENESS (DOMS), AKA “MUSCLE FEVER,” is the muscle pain and weakness that starts up to a day after unfamiliar exercise, peaking up to two days later. The strongest trigger is a lot of eccentric contraction (e.g. quadriceps while descending). DOMS is much weaker after the next workout, but the first bout can be so fierce that people avoid starting valuable exercise programs, especially strength training. It’s worse for some people due to genetic factors and other biological stresses (especially sleep trouble).

Medical science can’t explain DOMS, let alone treat it. Many athletes believe that massage helps, but that’s not what the evidence shows. And many take ibuprofen as prevention, but that doesn’t work either. Drugs will only take the edge off the pain. The only promising treatments are heat and Indian food (curcumin), but not confirmed.

DOMS is probably not caused by micro-trauma — a popular old idea — although it might be a mild form of “rhabdomyolysis,” which is caused by mucle proteins spilling into the blood. Some kind of “metabolic stress” may be a more likely culprit, and yet there is no clear link between DOMS and any specific biological marker (and definitely not lactic acid). There are even clues that DOMS is neurological. And it appears not to be inflammatory: evidence suggests that inflammation is actually what reduces DOMS as you continue to exercise. Mysterious indeed!

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