Doms

DOMS, Definition, etiology, pathophysiology, clinical signs and treatment

1. topic ------ goniometer DELAYED ONSET MUSCLE SORENESS PRATIGYA DEUJA

2. DELAYED ONSET MUSCLE SORENESS A particular type of muscle soreness that develops 24-48 hours after unaccustomed physical activity. It appears to be more severe after eccentric exercise (involving muscle contraction while muscle is lengthening), such as downhill running. It is noticeable in the muscle belly or at the musculotendinous junction due to muscular overexertion.

3. ETIOLOGY Lactic acid Muscle spasm Torn tissue Connective tissue Enzyme efflux Tissue fluid theories

4. ETIOLOGY in detail….. Minute tears in muscle tissue or damage to it’s contractile components with accompanying release of creatine kinase , myoglobin , and troponin 1. Osmotic pressure changes that cause fluid retention in the surrounding tissues. Muscle spasms. Overstretching and perhaps tearing of portions of the muscle’s connective tissue harness. Acute inflammation. Alternation in the cells mechanism for calcium regulation. Combination of the above factors.

5. PATHOPHYSIOLOGY Unaccustomed exercise using eccentric muscle actions (downhill running, slowly lowering weights) trigger post-exercise discomfort. High muscle forces damage sarcolemma causing release of cytosolic enzymes and myoglobin . Damage to muscle contractile, myofibrils and non-contractile structures.

6. Continued….. Altered Sarcoplasmic Reticulum : The four factors produce major alterations in sarcoplasmic reticulum structure and function with unaccustomed exercise. Changes in pH Changes in intramuscular high energy phosphates Changes in ionic balance Changes in temperature

7. Continued…. Metabolites ( e.g , calcium) accumulate to abnormal levels in the muscle cell to produce more cell damage and reduced force capacity . Delayed onset muscle soreness, considered to result from inflammation, tenderness, pain. The inflammation process begins; the muscle cell heals; the adaptive process makes the muscle more resistant to damage from subsequent exercise.

8. CLINICAL SIGNS Muscle soreness and aching beginning 12 to 24 hours after exercise, peaking 48 to 72 hours, and subsiding 2 to 3 days. Tenderness with palpation throughout the involved muscle belly or at the myotendinous junction. Increased soreness with passive lengthening or active contraction of the involved muscle. Muscle stiffness reflected by spontaneous muscle shortening before the onset of pain.

9. CLINICAL SIGNS Local edema and warmth . Decreased ROM during the time course of muscle soreness . Decreased muscle strength prior to onset of muscle soreness that persists for up to 1 to 2 weeks after soreness has remitted.

10. PREVENTION & TREATMENT DOMS can be prevented or at least kept to minimum by progressing the intensity and volume of exercise gradually by performing low intensity warm up and cool down activities. Gently stretching the exercised muscles before and after strenuous exercise. P ost event massage. Non weight bearing exercises. Hydrotherapy. Spa baths Vibration therapy

11. PREVENTION & TREATMENT Compression garments Nutritional supplements Hyperbaric oxygen therapy

12. ARTICLE ARTICLE : Foam rolling for delayed onset muscle soreness and recovery of dynamic performance measures. Gregory et al. in their study performed a controlled laboratory study where they took total 8 healthy, physically active males. Participants performed 2 conditions, separated by 4 weeks, involving 10 sets of 10 repetitions of back squats at 60% of their 1 repetition maximum, followed by either no foam rolling or 20 minutes of foam rolling immediately, 24 and 48 hours post-exercise. The outcome measures were Pressure pain threshold, sprint, power, dynamic strength endurance. The study have concluded that Foam rolling effectively reduces DOMS and associated decrements in most dynamic performance measures.

13. REFRENCES THERAPEUTIC EXERCISE–--- CAROLYN KISNER sixth edition ESSENTIALS OF EXERCISE PHYSIOLOGY- ---- KATCH AND KATCH fourth edition JOURNAL OF ATHLETIC TRAINING 50(1), 5-13,2015