MASSAGE AND DOMS

DELAYED ONSETMUSCLE SORENESS AND SOFT TISSUE THERAPY -

WHAT MAKES GOOD RESEARCH?

By Nina Heymanson and Brad Hiskins, soft tissue practitioners

Delayed onset muscle soreness (DOMS) is defined as the muscular pain and discomfort, often accompanied by movement restric- tions, experienced after bouts of unaccustomed exercise. The type of exercise most likely to result in DOMS is eccentric muscle activity. DOMS often manifests itself in a reduction in flexibility and maximal voluntary force production. The condition peaks 24-48 hours post-activity and gradually dissipates over a period of 5-7 days. Although soft tissue therapy is widely used through- out the sporting world as a form of recovery and although DOMS is one of the primary post-exercise states for which soft tissue therapy is commonly used, the current available research relating to the effects of soft tissue therapy on DOMS is generally poor. There is little consistency in methodologies and the suitable soft tissue therapy treatment required is rarely well defined. This makes it difficult to draw broad conclusions from this body of research. This article sets out to demonstrate using real data, what makes good research and how important this is to developing a good evidence base for soft tissue application.

INTRODUCTION Although the occurrence of DOMS is common the cause/mecha- nism has not been well established. Six main theories of causa- tion are commonly referred to: ■ lactic acid ■ muscle spasm, ■ torn muscle tissue ■ connective tissue damage ■ enzyme efflux ■ and tissue fluid theories

It has also been suggested that neutrophil infiltration and muscle inflammatory response may be contributing factors in DOMS. As the cause is not well understood, establishing a basis for effec- tive treatment and prevention strategies has proven difficult.

Within this review, seven papers relating to soft tissue therapy and its effect on DOMS were considered: 1. The Effects of Therapeutic Massage on Delayed Onset Muscle Soreness and Muscle Function Following Downhill Walking (1) 2. The Effects of Massage on Delayed Onset Muscle Soreness (2) 3. Immediate Postexercise Massage Does Not Attenuate Delayed Onset Muscle Soreness (3) 4. Warm-up, Stretching and Massage Diminish Harmful Effects of Eccentric Exercise (4) 5. The Effects of Athletic Massage on Delayed Onset Muscle Soreness, Creatine Kinase, and Neutrophil Count: A Preliminary Report (5) 6. Effleurage Massage, Muscle Blood Flow and Long-Term Post- Exercise Strength Recovery (6) 7. The Effects of Three Modalities on Delayed Onset Muscle Soreness (7)

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Selection was based, primarily, on the soft tissue therapy being administered by hand. Therefore papers which investigated ice massage, mechanical massage and water jet massage were not included. Also discounted were those publications that were only available in abstract form. This was due to the fact that in such publications the methodology could not be well assessed - a primary objective of this review.

WHAT MAKES DECENT RESEARCH? Good research possesses a number of qualities that contribute to its validity. Some of these include: ■ a well defined methodology ■ controls ■ random trials ■ good statistical analysis ■ reasonable sample size ■ and, where possible, a placebo treatment and blinded studies

Methodology Generally speaking a good study should have a well defined methodology. This means that it should be described in detail so as to make it reproducible. It is important that the study may be validated by others if desired. One of the most common flaws in soft tissue therapy research is poorly defined treatment methods. These methods are commonly described simply as ‘massage’ giving no indication of techniques used or timing of treatment or tech- niques, thereby in no way allowing the study to be replicated.

Of the papers reviewed here, three gave a reasonable description of the soft tissue therapy used (2,4,5), meaning that they described the technique used and the duration of each.

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