From the Guidelines
The best way to prevent Delayed Onset Muscle Soreness (DOMS) is to consume adequate protein, specifically 20-25g of high-quality protein at 3-4 hour intervals, and maintain a daily carbohydrate intake of 6-8g/kg body weight for up to 48-72 hours after exercise. This approach is supported by the most recent and highest quality study available, which emphasizes the importance of proper nutrition in recovery from exercise 1.
To further reduce the risk of DOMS, it is essential to:
- Gradually progress exercise intensity to allow muscles to adapt
- Perform a proper warm-up routine before exercising
- Stay well-hydrated before, during, and after exercise
- Consider consuming 30-60g of casein protein prior to sleep to enhance overnight protein synthesis, as suggested by emerging evidence 1
It is also important to note that while some studies have reported reductions in muscle soreness with postexercise intake of protein or branched chain amino acids, the overall effects are small 1. Additionally, consuming polyphenol-rich tart cherry juice has not been shown to improve recovery markers of function or subjective soreness in football players 1, and reducing exercise-induced muscle inflammation and free radical production with large doses of individual antioxidant vitamins C and E may interfere with adaptive processes in muscle and is therefore discouraged 1.
From the Research
Prevention Strategies for Delayed Onset Muscle Soreness (DOMS)
To prevent DOMS, several strategies can be employed, including:
- Eccentric exercise introduction: Gradually introducing eccentric exercises or novel activities over a period of 1 or 2 weeks can help reduce the level of physical impairment and/or training disruption 2
- BCAA supplementation: Branched-chain amino acid (BCAA) supplementation has been shown to attenuate exercise-induced muscle damage and DOMS, with repeated BCAA supplementation before exercise having a more beneficial effect than repeated supplementation after exercise 3, 4
- Combination of BCAA and taurine: A combination of 3.2 g BCAA and 2.0 g taurine, three times a day, for two weeks prior to and three days after exercise may be a useful nutritional strategy for attenuating exercise-induced DOMS and muscle damage 5
- Exercise modification: Reducing the intensity and duration of exercise for 1-2 days following intense DOMS-inducing exercise, or targeting less affected body parts, can help alleviate DOMS symptoms 2
Treatment Considerations
Treatment considerations for DOMS focus on:
- Primary prevention of ultrastructural lesions during exercise
- Treatment of the inflammatory response that leads to DOMS
- Recovery strategies for manifest DOMS 6 Nonsteroidal anti-inflammatory drugs, massage, and exercise have demonstrated varying results in alleviating DOMS symptoms, while cryotherapy, stretching, homeopathy, ultrasound, and electrical current modalities have shown no effect 2