Exercise Induced Muscle Soreness: Common and Annoying

Almost every athlete has experienced exercise induced muscle soreness at one time or another. This soreness is often referred to as delayed onset muscle soreness (DOMS) because symptoms usually present 12 to 48 hours after cessation of exercise. Muscle soreness can be extremely annoying as it limits your potential to workout or even move without pain. There is an extreme amount of variation in susceptibility to DOMS, independent of athletic background or even physical condition. Where one person may intensely workout without a tender muscle after months on the couch, another can’t make it up the stairs after introducing a lunge into an existing routine. DOMS is characterized by sore or tender muscles with a reduced range of motion and muscular strength and is often the result of a new activity, introducing new exercises or returning to training after a period of reduced activity. This muscle soreness is directly related to intensity and duration of exercise along with eccentric and dynamic muscular motion. The thigh and tricep muscles are most commonly afflicted. There are several theories for the cause of DOMS including: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness.  1

Nutrition and Muscle Soreness:

It seems intuitive that nutritional status would play a relevant role in susceptibility and severity of DOMS. Although the research is extremely limited, there is evidence that nutritional state before, during and after exercise effect DOMS. It should be pointed out that as of yet, there is no known treatment or preventive measure to eliminate DOMS and that it is simply a consequence of intense physical exercise. This post examines what we do know about nutritional interventions, which may offer some guidance in preventive eating and drinking.

Fluids: There are many good reasons to stay hydrated before, during and after activity and preventing muscle soreness is yet another. It has been proposed that the metabolic by-products of muscular activity contribute to muscle soreness and that optimum hydration results in a large fluid pool at the cellular level diluting harmful waste products and lessening their impact on muscles.2

Unfortunately, there are only two studies that directly measure hydration and muscle soreness. The first such study showed a 44% increase in muscle soreness in dehydrated individuals working out in a hot environment.3  However, when the same researchers conducted a similar study comparing hydrated and dehydrated individuals in a cool environment they were unable to demonstrate significant differences in muscle soreness between groups.4 This would indicate that proper hydration is more important in reducing muscle soreness when working out in the heat.

Protein: At least to some extent, exercise induced muscle soreness is a result of muscle protein breakdown. Providing amino acids (subunits of protein) to worked muscles improves muscle protein turnover and accelerates muscle protein synthesis. There is evidence that resistance exercise (RE) derived biochemical markers of muscle soreness, i.e. creatine kinase (CK), aldolase, and myoglobin, are reduced by providing amino acids pre- and post-workout.5 Additionally, there are two studies that demonstrate protein consumption directly reduces the level of soreness in human subjects. In the first, administration of only five grams of branch-chain amino acids (essential amino acids) significantly reduced muscle soreness after intense squatting exercise.6 The second demonstrated reduction in muscle soreness in male Marine recruits with 10 grams of whey protein, administered post-workout.7

Omega 3-FattyAcids and Vitamin E: There is some evidence that ingestion of Omega-3 Fatty Acids and Vitamin E may reduce muscle soreness as a result of their anti-inflammatory and antioxidant properties.8 However, follow up research on these nutrients has been inconclusive.9 The results of these studies point to only a minor potential in the reduction of DOMS and that consumption of Omega-3 Fatty Acids and Vitamin E work better over an extended period of ingestion compared to bolus administration.

Creatine: Administration of creatine reduces the presence of metabolic markers associated with soreness after sprints.10

Vitamin D: Research has convincingly demonstrated that those who are deficient in Vitamin D will experience much higher and severe delayed onset muscle soreness with decreased muscular strength.11 12

If you work out predominately indoors and are experiencing greater than expected amounts of muscular soreness you may consider having your serum Vitamin D level assessed.

Nutrients that have failed to demonstrate a reduction in DOMS:

Carbohydrate: Inadequate carbohydrate consumption after strenuous exercise coupled with a reduction in muscle glycogen did not increase muscle soreness.13 In other words, there is no reduction in muscle soreness by consuming carbohydrate after a workout.

Vitamin C: Reactive oxygen species (ROS) are a result of strenuous exercise, and although speculative, it has been proposed that ROS may contribute to muscle damage and DOMS. Despite this uncertainty as to the precise role of ROS, attempts to prevent post-exercise ROS production through antioxidant intervention are still common. In light of this, it was a surprise to many that a 2006 study failed to demonstrate a reduction in DOMS with post-workout administration of the antioxidant Ascorbic Acid (Vitamin C). What was even more surprising was that the same research demonstrated that post-workout Vitamin C actually impaired recovery.14 In light of this research, the prudent athlete may choose to avoid supplemental vitamin C post–exercise.

Dealing with DOMS

Even if your nutrition is perfect, it is most likely impossible to eliminate muscle soreness after starting a new intense routine. The best course of action is to listen to your body and gradually increase duration and intensity as your body acclimates. Patience will allow you to avoid injury and over-training, which are two ominous threats to progression and reaching your goals.

Keep in mind: Muscle soreness is an indication that muscles and or connective tissues are compromised and could be ripe for additional joint injuries. Therefore, it is prudent to reduce the intensity or duration of workouts until acclimated to a new routine as muscle soreness will disappear or diminish significantly after a few weeks of consistent training.

Although unpleasant, DOMS should not be considered an indication of muscle damage but rather a sign of the regenerative process, which is well known to contribute to increased muscle mass.15Therefore, muscle soreness should be a little easier to cope with knowing that you are getting stronger and fitter.

Eating recommendations for avoiding muscles soreness:

Although limited, available research provides an athlete with insight on preventive nutritional strategies which could be summarized with the following recommendations:

1. Stay hydrated. Drink fluids before, during and after workouts especially when working out in the heat.
2. Consume protein pre– and post–workout. Even small amounts of protein consumed in conjunction with a workout can reduce DOMS. A recommendation of 10 grams of protein both pre- and post-workout for females and 15 grams for males appears to be more than sufficient for reducing muscle soreness and providing substrate for muscle repair and growth. A quality recovery drink will suffice for the post-workout meal.
3. Regularly consume fatty fish, salmon as an example, as they provide several of the nutrients, such as protein, omega-3 fatty acids, vitamin E, creatine and vitamin D, associated with the prevention or reduction of muscle soreness.