This post was originally published in The Run Experience in a slightly different version.
Today I’m feeling sore. I was fine yesterday, exercised and then I woke up this morning feeling old and grumpy. Dumb DOMS: Delayed Onset Muscle Soreness.
So what is DOMS? There are many theories but nobody knows for sure how it happens. It’s biology so it is probably a mix of things. Among the popular explanations are : connective tissue damage, muscle damage, accumulation of calcium inside the muscle and in between fibers and inflammation. It mostly happens doing eccentric exercises. Basically anytime you lower a weight in a controlled fashion or when running downhill in a races.
What can be done?
In theory DOMS is a minor injury, so RICE (Rest, Ice, Compression, Elevation) should apply here. Rest: It will go away in a couple of days. However you can still exercise and the pain will disappear temporarily but come back shortly after. Ice: The idea is to reduce inflammation and it has definitely mixed results in the literature. It could also blunt the training adaptation, more on this below. I don’t know about you but ice is torture to me. Compression and Elevation: From what I’ve seen it has some potential, and I’ve tried it myself. I love the 2XU pants and I’ll wear them at work sometimes under everything. It removes some of the pain and makes my legs feel lighter.
Nothing works for me better than a hot bath with magnesium salts. And from the literature, it looks like two days before an event would also benefit recovery after. Last but not least: massage. Ouch! My husband always think that I’m having a leisurely relaxing one hour massage. Let me tell you the truth. It hurts like hell and is even more painful than the training. I usually do not like to get a massage when I have DOMS, same reason as ice bath, why create more pain? But after a couple of days, it is always a good idea to remove the remaining knots in your muscle.
What about nutrition?
A lot can be done there too. The key answer: proteins and carbohydrates together. That is how the Got Chocolate Milk campaign was born. It is a bit of a big FAT scam or I should say a big SUGAR scam since most of these studies supporting milk chocolate for recovery were founded by the milk industry…
They are not wrong but try this option with less sugar: blend together milk, whey or plant protein (half a scoop to 1 scoop), a banana and some cocoa powder (of good quality)! Tip: You can add whey or plant protein to your milk to make it higher in protein content, about half a scoop!)
Milk has the advantage of having the electrolytes compared to the whey. None of the sugar and same effect. Plus the chocolate powder might have some good recovery properties because it contains quercetin a potent antioxidant and anti-inflammatory.
But beware, more on this below.
After a hard session, papers report that in general 0.8g/kg of carbs + 0.4g/kg of whey protein works magic or 2:1 ratio carbs to protein to replenish your glycogen stores and keep protein synthesis up and running. That is between 20 and 35g of protein depending on your weight.
Above that amount there is probably no significant impact.
Ideally you’ll want to have this in a meal with real food within 2 hours of your session, but if you can’t, try a protein bar as a snack. (ProBar or Quest as examples) but there are many on the market.
Protein and carbs together work synergistically, as both will increase insulin and promote cellular uptake of nutrients for repair. Instead of whey you can use casein before bed time as it will release more slowly overnight.
Anti-oxidants of course: Vitamin C, E and NAC (N-acetyl-cysteine) are among the most popular anti-oxidants out there. They scavenge free radical (ROS) and help you recover faster. However research is showing that ROS are actually needed for signaling training adaptation. You could totally blunt that response by using too much of them. So use if needed only when no training adaptation is required perhaps during a taper, recovery or the week after a race.
Anti-inflammatory compound are also very useful. Of course, there is the popular over the counter anti-inflammatory Ibuprofen, part of the NSAID category. If I can not sleep, I will go for it since sleep is one of the most proven way to recover.
But do not abuse.
It has a negative effect on muscle growth and therefore could undermine all your efforts a little bit like too much anti-oxidants. Plus it can give you gastrointestinal issues and other nasty side effects.
A more natural compound would be curcumin or turmeric. It has a similar mechanism of action than NSAID but does not cause thinning of the stomach lining. A recent study has shown that ingesting 2.5g of curmumin twice a day a couple of days before and after the exercise bout could be beneficial. But could it impair training adaptation? I don’t think this has been studied yet but since it acts similarly as NSAID I would not be surprised if it did.
Finally, tart cherry juice has also been studied a lot and here is a good paper. Like many fruit and vegetables, tart cherries contains a lot of anti-oxidants and flavonoids which have anti-inflammatory properties. Using around a marathon would not be a bad idea but during training could potentially inhibits training adaptation. We don’t know yet. Be careful with this one though. Tart cherry juice consumed in the quantities that are suggested contains a lot of xylitol a sugar alcohol that can ferment and give you the runs so definitely test beforehand.
Have you heard of HMB? It is a derivative of leucine, one of the most potent amino acid in terms of muscle growth. It has been reported that HMB (Beta-Hydroxy-MethylButyrate free salt) can help alleviate symptoms of DOMS but results are still mitigated. HMB is however safe and worth trying if you know that you will have multiple hard work-outs during the week. It works at reducing protein degradation. A dose of 3 g before exercising would be recommended in that instance.
Then in the same line of thought, amino acids and BCAA, which stands for branched chained amino acid (leucine is one of them) have also shown to reduce DOMS in some instance. Doses vary from 5 to 12g, once or twice per day, 7-10 days before. But since most proteins (in particular whey and casein) contains those, you probably have your grounds covered already.
And then you have Citrulline-malate which at 8g could alleviate DOMS and also L-carnitine, which has to be loaded with 3g/day for 3 weeks for an effect on reducing muscle damage. The good thing about that one is that it also can increase fat metabolism and make you a better fat burner at the same time. Who does not like that?
Beware though, a lot of these studies use muscle damage as a marker which is most likely correlated with muscle soreness but not always and is individual. So see if it works for you.
No Pain No Gain?
Unfortunately, it might be a little bit true.. So my advice go slow and build up, and try some of the strategies listed here. Be aware that some of them could impair training adaptations, so time them carefully.