The morning after.

Most runners recognize Delayed-Onset Muscle Soreness (DOMS)--the morning after aches, stiffness, and muscle pain caused by a strenuous workout--as benevolent pain. It is usually easy for the experienced runner to know the difference between pain that marks progress and pain that waves a warning flag for injury. Delayed-Onset Muscle Soreness is usually felt from about 12 hours after exertion and peaks at about two days (although it may take up to 10 days to go away completely). Some runners might actually welcome the symptoms of DOMS, including stiffness, soreness, and weakness, since they reflect the adaptation process of training. When the soreness goes away, the muscles are stronger. There certainly can be satisfaction in that.

Although not known for certain, it is thought that microscopic tears in the muscle fibers cause DOMS. Eccentric contractions (movements that cause a forceful contraction while a muscle is lengthening) are responsible for the most intense DOMS. Eccentric contractions occur in movements that act like brakes: running down bill and the downward part of squats and pushups are examples.

Even though some runners take a sort of perverse pleasure in DOMS, most of us would like to avoid or lessen the misery. The best way to avoid DOMS is with smart training--don't overdo it--but, no matter how smart you are about your training, DOMS bits every runner at one time or another.

Recent studies have at least shown 'what doesn't work to treat DOMS. In a randomized, double-blind, placebo-controlled study, researchers compared the effects of homeopathic Arnica ointment with a placebo on 400 runners experiencing DOMS after long distance races. They concluded that Arnica was ineffective for muscle soreness (at least at the concentration used in the study). Mother report on the effect of passive stretching following exercise involving eccentric contractions concluded that stretching both before and after eccentric exercise had no significant effect on DOMS. This report is interesting since stretching is traditionally recommended as a method of preventing and treating DOMS.

A third report was more encouraging to those who groan and ache after a workout. A meta-analysis (a study of the studies) suggests that post-exercise massage may alleviate symptoms of DOMS. Unless you have a skillful partner, this can be an expensive treatment, but possibly well worth it.

There are other things you can do to feel better until the misery goes away. You've heard of "the hair of the dog that bit you" to treat the other kind of morning after pain. Well, it works for DOMS too. Not a drink--a light workout. Getting the blood flowing to the painful muscles can at least temporarily make you feel better, and it may help you heal faster and shorten your DOMS. Other tried and true approaches include ice, or a good soak in a tub of epsom salts.

Be sure to wait until DOMS goes away completely before really testing your new strength. In the face of an intense workout, DOMS could set the stage for a more serious muscle injury. Mother warning, if DOMS doesn't pretty much go away in about a week, it may not be DOMS. it could be the symptom of a true injury. call your doctor and get it checked. Remember: moderation prevents both kinds of morning after aches.

(British Journal of Sports Medicine, 1998, Vol. 32, No. 3, pp. 212-214; Scandinavian Journal of Medicine and Science in Sports, 1998, Vol. 8, No. 4, pp. 216-221; Clinical Journal of Pain, 1998, Vol. 14, No. 3, pp. 227-231)