Treating and Preventing DOMS

Do Antiinflammatories Work?

In a 1993 study of the effect of an over-the-counter antiinflammatory (ibuprofen) on DOMS, researchers compared subjects given ibuprofen four hours before weight lifting (pre-lifting group) to subjects given ibuprofen 24 hours after lifting. Results showed that the pre-lifting ibuprofen group reported 40% to 50% less soreness than the after-lifting group, proving in this study that ibuprofen taken before exercise reduced soreness more than taking it after. A limitation of this study was the lack of a control group of subjects who did not take ibuprofen after working out to compare with subjects who did to see if ibuprofen helps at all after exercise. To answer this question, a study in 2003 investigated subjects who took ibuprofen or sham (placebo) every eight hours for 48 hours after they lifted weights. The ibuprofen group reported less soreness than the sham group, proving that ibuprofen worked when taken after exercise.

From these studies, it appears as if some people will respond to taking antiinflammatories before working out, and others will respond when they take it afterward. How hard you lift, how long you rest, and your level of activity when not working out will factor in to the equation as well.

Does Pre-Stretching Help?

In an interesting study conducted in 1999, subjects were asked to stretch only one of their legs and then perform leg exercises with both legs. Subjects reported afterward that both legs had equal amounts of soreness for at least 48 hours, proving in this study that pre-exercise stretching did not help prevent DOMS. These results, and findings from other similar studies, lead to the conclusion that stretching before exercise does not help prevent DOMS. An intriguing question is what effect stretching after a workout has on DOMS, but I am not aware of any studies that have investigated this. However, I do believe that stretching, and physical activity in general, can help alleviate soreness and offer some suggestions about it at the end of the article.

Does Massage Help?

Massage does help reduce DOMS and a number of studies prove it. In two similarly designed studies where all subjects lifted weights but only half received massages two hours after working out, subjects who received massages reported less muscle soreness than the subjects who did not. In a longer-term study in 2005 in which soreness and swelling were measured, all subjects lifted weights, but only half of them received massages 30 minutes after exercise and then one, two, three, four, seven, 10, and 14 days post-exercise. The subjects who received massages reported 30% less soreness than subjects who were not massaged, and importantly, swelling in the muscle was reduced only in the subjects who received massage. It may be that the pressure of the massage strokes moved fluid out of the muscle and reduced the swelling that causes DOMS. Whatever the mechanism of action, massage after a workout (sometimes lots of it) was effective in reducing DOMS in these studies.

Should You Work Out When You're Sore?

Some studies show that neither aerobic nor resistance exercise helps alleviate soreness. My experience is different. I have observed an alleviation of symptoms in sore individuals if they start their workout with light aerobic (cardio) exercise for 10-15 minutes followed up with stretching. In many of these cases, individuals can go on to do their full cardio and/or resistance exercise workout without a problem. This effect may be similar to the massage effect in that the light cardio and stretching help reduce swelling, perhaps by increasing circulation to and from the muscle.

If you want to work out when you're sore, then I suggest starting with 10-15 minutes of light cardio followed by stretching, then lifting, and/or more cardio. If the soreness resolves or doesn't interfere with your performance, then continue with the workout. But if the soreness worsens or causes too much pain for the workout to be worthwhile (you can only 50% of what you normally do), then you're probably better off either working another muscle group, or taking the day off, because muscles grow during downtime, not when you train, and if your muscles get sorer during your workout, then you need more time to rest, recover, and grow.

In summary, ibuprofen taken before or after a workout, and massage afterward (sometimes a lot of massage), can reduce DOMS, but stretching before a workout doesn't seem to help. Although there is no evidence that stretching after exercise reduces DOMS, I have seen light cardio for eight to 10 minutes followed by stretching reduce DOMS. Everyone responds differently, and so I encourage you to experiment with different routines until you find one that works for you. I also recommend that you speak with your doctor before taking any medication, over-the-counter or prescription, and that includes ibuprofen.