DOMS: treatment or prevention?

peer reviewedThe evidence of benefits from eccentric contraction provides compelling rationale for their inclusion in force training and in the reeducation of various locomotor pathologies (i.e., tendinopathies or muscular imbalance). However, intense or unusual eccentric exercise frequently leads to muscle damage associated with prolonged loss in muscle strength and range of motion, a dramatic increase in muscle proteins circulating in blood and the development of muscle soreness. These negative functional consequences, referred to as Delayed Onset Muscle Soreness (DOMS), often disturb the progress of training or reeducation programmes. In an attempt to attenuate signs and symptoms of DOMS, several approaches have been used prophylactically and/or therapeutically. This article focuses on some of the most commonly used modalities, including the nutritionnal and pharmacological strategies, clinical therapies and exercise. Despite a large number of studies, there is little evidence indicating any benefit at the perfomance level of these various approaches. Conversely, there is unequivocal evidence that a bout of eccentric exercise is followed by protection against skeletal muscle damage associated with a subsequent bout of potentially damaging exercise for several weeks to several months. To date, specific submaximal training appears the most efficient prophylactic measure and is recommended to alleviate the prejudiciable consequences associated with DOMS in the athletic or therapeutic programs. Despite the volume of data concerning this protective effect, often called the “repeated bout effect”, the underlying mechanisms of such an adaptation are not fully understood and a better knowledge of these adaptative mechanisms could provide better guidelines for prevention or treatment practice