Delayed-Onset DOMS

Immediate treatment is usually an adjunctive therapy of NSAID's and Cold compression therapy. Controlling the inflammation is critical to the healing process. Cold compression therapy acts to reduce swelling and pain by reducing leukocyte extravasation into the injured area. NSAID's such as Ibuprofen/paracetamol work to reduce the immediate inflammation by inhibiting Cox-1 & Cox-2 enzymes, which are the enzymes responsible for converting arachidonic acid into prostaglandin. However, NSAIDs, including aspirin and ibuprofen, affect platelet function and should not be taken during the period when tissue is bleeding because they will tend to increase blood flow, inhibit clotting, and thereby increase bleeding and swelling. After the bleeding has stopped, NSAIDs can be used with some effectiveness to reduce inflammation and pain. A new treatment for acute strains is the use of platelet rich plasma injections which have been shown to accelerate recovery from non surgical muscular injuries. It is recommended that the person injured should consult a medical provider if the injury is accompanied by severe pain, if the limb cannot be used, or if there is noticeable tenderness over an isolated spot. These can be signs of a broken or fractured bone, a sprain, or a complete muscle

Ice pack therapy is a treatment of cold temperatures to an injured area of the body.

The ice will not only numb some of your pain, but it will also decrease swelling and inflammation in the muscles.

Today’s lab was focused on the therapeutic practices of thermotherapy and cryotherapy. Thermotherapy is heat is used in therapy to reduce pain and increase healing. Cryotherapy is much the same, but using cold to promote healing and reduce pain. Both do their jobs by creating physiological changes in the body that is induced by the change of temperature in the areas. For example, and ice pack applied to a swollen arm with reduce the swelling by slowing the blood flow to that area. This also should help with the pain in two ways: one, the cold should numb the nerve endings to any pain, and two, the decrease in swelling should alleviate any discomfort.

This experiment was conducted to see if icing certain muscles in the arm affects grip strength. An electromyogram and dynamometer was used to test this theory. An electromyogram (EMG) is used to record muscles contraction, and a dynamometer is used to test grip strength. The superficial muscles in the forearm that contract when something is being gripped are flexor carpi radialis, brachioradialis, flexor carpi ulnaris, and flexor digitorum superficialis muscles. When muscles are fatigued, often times after sports practice or a game, ice is usually the go to. Some athletes take ice baths to relax their body so the muscles don't get sore. This experiment will prove if ice relaxes the muscles in the forearm and makes the grip weaker as the muscles are cold.

According to a study completed by Wu, 2018 increasing tissue temperature stimulates analgesic mechanisms through inhibition of nociceptors, relaxes skeletal muscle tissue, vasodilation and increased tissue blood flow, which results in substantial pain relief and is thought to promote healing by increasing the supply of nutrients and oxygen to the site of injury. Recent studies prove that thermotherapy has evident therapeutic benefit for both analgesia and promoting healing in low back pain however, as with cryotherapy, more substantial randomised controlled trials of thermotherapy would enhance the body of literature and further establish the effectiveness (Malanga et al., 2015). Additionally, as reported in the 2006 Cochrane Database review, adverse events reported in trials of superficial heat for low back pain were minimal and mainly consisted of skin pinkness (French et al., 2006). However, caution, close monitoring and skin protection is still necessary when practicing thermotherapy and cannot be used on patients with impaired circulation, impaired sensation, open wounds, malignancies and or infections where heat may cause disease progression, burns or increased inflammation (Wu,

The role of exercise in pain perception has been widely researched over a number of years. Koltyn (2000) found that research had been taking place for more than twenty years. Previous studies have identified the significance of exercise in the treatment and rehabilitation for many patients with chronic pain (Naugle, Fillingham, & Riley, 2012). Hypoalgesia was found to occur following resistance and isometric exercise (Koltyn, 2000). However, it was suggested that further examination was required to develop an understanding of hypoalgesic responses following different modes of exercise (Koltyn, 2000). Further studies have provided evidence that healthy individuals demonstrated that sensitivity to painful stimuli is reduced with acute exercise

For many sports with congested fixtures recovery between games is very important to ensure players are at their best for the matches. An example of a period where this is particularly true is the Christmas period with football with most teams facing a high number of games in a short period, sometimes only 2 days between games. Without proper recovery modalities players, can suffer from delayed onset muscle soreness (DOMS) and from a study by Cheung, Hume & Maxwell (2003) it was found that DOMS reduces athletic performance due to the muscle soreness and the damage done to the muscle and caused a decrease in strength and power, with a greater effect on strength and power during eccentric contractions. A study by Byrne, Twist and Eston (2004) discussed the muscle damage caused by high force eccentric exercise. They found that the stretch-shortening cycle(SSC) what occurs during a drop jump, causes muscle damage in the muscle and therefore contributes to DOMS and is similar to the damage done by running.

Ice. This helps in decreasing pain and swelling felt on the injured area. Place cold packs on teh area for 20 minutes, three to four times a day.

DOM’s is when the muscle contracts and a person feels pain during the contraction. With pain there is usually a loss of the range of motion and strength. The symptoms usually set in about six to twelve hours after exercise and increase as time progresses until the peak is reached which is at forty-eight to seventy two hours (Valle, 2013). During the course of the study, male soccer players were used and wore a compression garment over their thigh, leaving the other unprotected in order to act as a control. Athletes performed a submaximal test on a treadmill for three minutes at eight kilometers per hour and at a three percent positive slope. They measure heart rate and oxygen consumption. The next test was an eccentric exercise and consisted of ten minutes of free running and changed to forty minutes of a ten percent downhill slope at seventy three percent of their maximal speed in the test before. An MRI machine was used to measure the thigh its chemical processes and alterations in the muscular group (Valle, 2013). The study concluded that compression garments were not only the effective at treating DOM’s but also maybe could be a preventative measure, but they need further studies to predict that. The garment also can protect against a strength reducing injury (Valle,

Tip: Back off your training and use ice to calm down the inflammation. Ibuprofen is also recommended for their anti-inflammatory properties. But for Ibuprofen to work, it must be present in your system for consecutive days. Taking it only when you have pain will not help with the inflammation.

“For many, it’s second nature to slap an ice pack or bag of frozen peas on an injury”. Furthermore, it’s very likely your doctor recommended RICE (rest, ice, compression, elevation) to you, a go-to prescription of recovery from injuries and muscle damage for nearly 40 years. But does ice or cold actually help the healing process? Despite the countless studies and immense amount of research in the past, there is no clear-cut answer. Evidence to contradict each ‘side’ of the argument has been presented over the years and even proof that the cryotherapy delays recovery.

Osteopathic manipulation (an entire system of evaluation and treatment designed to achieve and maintain health by restoring the body's normal function)

Step 1 – Foundation: Cryokinetics is a combination of cold and exercise. The cold decreases pain so that the patient is able to move. Ice decreases muscle inhibition so that the patient can exercise. Therefore, exercise increases the amount of blood flow to the area, and allows for rebuilds functioning. Because of exercise, the stresses it produces develops fibers that help rebuild tissue. Advantages: Allows exercise much faster than normal, exercise delays atrophy, neuron inhibition, and reduces swelling. Ice is cheap while exercise is priceless. Disadvantages: The cold is painful during first immersion and its messy. Indications: Cryokinetics is most effective on ankle sprains. Contraindications: exercises can cause pain, hypersensitivity

Cryotherapy, or cold therapy, is a treatment that uses cold temperatures to treat an injury or medical condition. It includes using cold packs or ice packs to reduce pain and swelling.