What is the best way to recover sore muscles? How long should muscle recovery take and can the recovery process be sped up?
In this article we will be taking a look at ways to manipulate the muscle recovery process to alleviate delayed onset muscle soreness (DOMS) faster and more efficiently.
Prerequisite info
DOMS
Contrary to popular belief, lactic acid is not the reason you can hardly walk the day after doing a killer leg workout. The reason is actually DOMS. Delayed Onset Muscle Soreness, or DOMS, is the sensation of aching, stiffness, and general pain in your muscles anywhere from 24 hours - 72 hours after an intense workout. Some workouts create the sensation of DOMS more than others. For example, using a muscle group that hasn't been used in a while, or working a muscle group in a different way commonly results in DOMS. Muscle soreness, including DOMS, is generally created by the physical stress and damage the muscle undergoes when lifting weights. Physical micro-tears occur in the muscle tissue that results in inflammation which then corresponds with the subsequent muscle aches. Although inflammation is typically perceived to be a negative phenomenon, muscular inflammation, when backed by proper nutrition, is a fundamental reaction when increasing lean body mass. Working out muscles that are in a state of DOMS is not recommended due to the greatly increased risk in injury. It is important to allow the recovery process to complete entirely before retargeting the same muscle group.
When a muscle is in a state of DOMS, there are certain characteristics and markers that can be identified such as perceived fatigue, inflammatory [interleukin-6 (IL-6), C-reactive protein (CRP)], and muscle damage markers [creatine kinase (CK)]. We can observe changes in these markers when recovery methods are applied to deduce the level of efficacy of the methods in practice.
Passive Recovery
Rest is the go-to form of recovery for the average weight lifters, primarily due to the anabolic events that take place to promote new muscle growth. Proper sleep, hydration, and nutrition are essential in muscle protein synthesis (the naturally occurring process in which protein is produced to repair muscle damage caused by intense exercise). It is the rest period that is often overlooked, or neglected, when the mindset of "more is better" is adopted as an approach to weight lifting. Generally speaking, more volume, or more frequent workouts WILL produce faster results when building lean mass is the goal. However, working the same muscle group that is experiencing DOMS is never recommended, and can often be counter-productive. For this reason, entire markets exist solely to provide recovery remedies promising "faster recovery" through the use of supplements or other commercial products.
Methods of Recovery
Before we go over the methods of recovery, it is worth noting that many of the findings in published exercise science studies are conclusive enough to properly guide and influence our actions to improve performance or in this case, recovery, yet the underlying causes are greatly unknown. We often observe the effect of our applied stimulus but can rarely be as conclusive in understanding why these reactions take place.
Active Recovery
Active Recovery, or AR, is the process of utilizing short bouts (around 5-7 mins) of low intensity cardio to assist in reducing the symptoms of DOMS and speeding up muscle recovery post-high intensity exercise. Directing blood flow (particularly when the blood is enriched with beneficial nutrients) is thought to be the primary reason AR seems to have any effect on DOMS. (1) When the targeted muscle is under a state of DOMS, the initial phase at the start of low intensity cardio can often feel a bit painful. Surely, after enough blood flow is created the symptoms seem to lessen and performing the action becomes much easier. This increased blood flow also helps facilitate the removal of metabolic toxins post-exercise, which may help reduce DOMS related symptoms and promote muscle further recovery.
Compression Garments
Compression garments are items worn on the body that are tight enough to remain snug on the area it is covering, without being too tight to restrict blood flow and cut off circulation. Compression shirts and leggings have been shown to reduce swelling, allowing better venous return (nutrient rich blood flow). "It has been shown that wearing a whole-body compression garment over a 24-h period after intense heavy resistance training significantly reduces perceived fatigue" (3). Although perceived fatigue is reduced at 96 hours after exercise as a result of wearing compression garments, no significant changes in CK, IL-6, or CRP concentrations are seen, suggesting that compression garments have mixed results when used to combat DOMS>
Cold Water Immersion (CWI)
Cold Water Immersion is the process of immersing the body in very cold water, commonly referred to as ice baths. Many people have see a rise in popularity of this recovery method as it is typically seen being used a recovery method among professional athletes. The benefits of cold water immersion, particularly when the body is exposed to water at 11–15°C over 11–15 min was considered to be the optimal circumstance to obtain a positive impact of CWI after exercise to reduce DOMS (4). Water at or below this temperature is thought to reduce exercise induced inflammation and damage, resulting in a decrease in CK circulation. The results however, were heavily varied depending on the length of time of exposure, and duration and type of exercise performed. For this reason, cold water immersion has shown to have a small effect size when it comes to reducing DOMS as a reliable form of recovery across all markers.
Cryotherapy
Cryotherapy is a method of recovery where the body is placed in a cryostimulation chamber, surrounding the body in an environment far below freezing temperatures for a short period of time (around 3 mins). These temperatures range from -140 to -195 degrees C. Although the reduction of DOMS after exercise using cryotherapy has been demonstrated, the impact varies depending on the cryostimulation method used. When studied, the results of cryotherapy treatments as a method to reducing DOMS vary due to the inconsistencies in the treatments (e.g., exposure in a cold chamber or in a cryo-cabin where the head was not exposed; the timing of the exposure either immediately following or 24 h after exercise; the temperature that ranged from −30 to −195°C; the number of cryostimulation treatments that were used after exercise, and the exhaustive exercises chosen to induce DOMS and fatigue). Most of the benefits received from cryotherapy were mostly present only within 6 hours after exercise. The effect was not present 24 hours after exercise or later. A single session of cryotherapy also has very little effect at all, and more than one treatment was often required to experience any reduction in CK and CRP concentrations in the blood. Therefor, although cryotherapy may be seen as a viable recovery method for other bodily recovery purposes (healing after surgery), it is not a viable method for reducing DOMS.
Stretching / Electrostimulation
Static stretching, in some studies, has been confirmed to have no positive impact on DOMS. Results up to 6 hours after exercise indicated that stretching can even produce DOMS, which was thought to be the case in this study in 1993 (5). Electrostimulation, or, the process of stimulating muscle contractions through the use of external electrical stimulation devices (like the TENS device), has shown to have some positive effects on DOMS in some studies (6), and no effect in others (7).
Massage
As one of the most traditional recovery methods, a 20-30 min massage immediately following or up to 2 hours after exercise has been shown to reduce DOMS for 24 hours after exercise. Even up to 96 hours after exercise, massage has shown to have a significant impact on DOMS. In athletes, massage generated a significant improvement in lowering perceived pain (8). Massage has shown to have the highest impact in reducing perceived fatigue. It is also the best method in decreasing the CK and IL-6 (the above mentioned markers of DOMS and muscle damage) concentration in the blood. Lowering concentrations of these markers is thought to indicate faster recovery and less muscle damage overall.
By increasing blood and lymph flow, massage treatments blunt the response from damaged tissues, thereby preventing fiber necrosis (the death of muscle tissue cells). In a study in 2016 (9), and later confirmed in a meta-analysis in 2017 (10), massage treatments shortly after intense exercise decreased the CK level in male bodybuilders. It seems rather conclusive that current scientific literature suggests post-exercise massage as the most effective way to recover from intense workouts.
Conclusion
The science behind recovery methods appears to be in its infancy stage along with other fields of study relating to exercise science. What we do know is that some recovery techniques are more effective than others across all data points. To put it in practice, massaging the areas of the body that were targeted with progressive overload in mind, within an hour after a workout, will prevent a substantial amount of perceived muscular fatigue, as well as expedite total recovery while alleviating the symptoms related to DOMS, Doing so will also allow you to increase your workout frequency, thus, see results faster and reducing risk of injury.
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