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What is muscle soreness and how can massage help?

Have you ever wondered why you get sore during or after activities like skiing, biking running, or working out? When our muscles are active they create metabolic wastes such as lactic acid and carbon dioxide. This is a normal process occurring constantly as we move about doing our daily activities. Carrier molecules gather up these waste products and clear them from the muscle cells.

Here’s an analogy: The waste collection center in South Lake Tahoe has hired enough drivers and purchased enough trucks to handle the normal daily flow of garbage. During the Christmas/New Years period there's a sudden influx of vacationers which results in an increased flow of garbage.  It would be helpful to have more drivers and trucks during this period - simple supply and demand dynamics in action. Our bodies, in their infinite wisdom, have enough carrier molecules (trucks and drivers) to clear the flow of metabolic wastes (garbage) produced by our normal daily activities. When our activity suddenly increases, our muscles produce more metabolic wastes while the carrier molecules don’t immediately increase. Why? Our body adds trucks and drivers slowly and carefully over time – it doesn’t take on part-time workers lightly or add trucks to the fleet if it’s only a temporary situation. The excess metabolic wastes we produce on our once-a-year ski trip must wait on the curb (quad muscle) until a truck (carrier molecule) is free to pick it up. In the meantime, its continued presence in the muscle will irritate nerves causing the sensation of pain. Pain is nature’s attention-getting signal that initiates action to correct the situation. It keeps the trucks and drivers moving to clear the area ASAP. Just as garbage sitting on our curb for days is an eye-sore, waste sitting in our muscles is a “nerve-sore”.

How can massage help? It’s like adding a fleet of temporary trucks and drivers to clear the metabolic wastes faster by increasing the circulation rate of blood and lymph. A massage after skiing will often help your legs “feel like new” the next day.

If, however, we have a grace period after strenuous activity, feeling great until the next day when muscle soreness shows up with a vengeance, this is called “delayed onset muscle soreness”, DOMS, and seems to have less to do with buildup of metabolic wastes and more to do with damaged muscle fibers.

Can massage help DOMS? Research conducted at Australia’s Edith Cowan University in 2005 found that “massage, used appropriately, is beneficial in reducing delayed-onset muscle soreness and swelling associated with high-intensity eccentric exercise,” and provides 20-40% reduction in soreness, as well as reducing swelling and plasma CK activity (an inflammation marker).

Prior to this, another study looking at the effects of massage on delayed onset muscle soreness reported in the British Journal of Sports Medicine, 2003, found a decrease in perceived muscle soreness at 48 hours post-exercise, but concluded that “the effects of massage may be more psychological than physiological.” They suggested the benefit of massage may be due to improved sleep patterns, increased endorphin and serotonin levels, and decreased stress hormone levels. “Additionally, massage may activate pressure instead of pain receptors, thereby lowering soreness intensity.”

A study at Cornell showed that a massage twenty minutes after vigorous exercise can help reduce muscle soreness two days later.
In a 2006 article, Postexercise Muscle Soreness by Divakara Kedlaya, MBBS, possible explanations are discussed for why exercise and physical therapy may help DOMS:
• Break-up of adhesions
• increased blood flow to flush accumulations of waste products
• release of endorphins
• attention directed away from the pain
These are also the explanations hypothesized to be the benefits of massage on DOMS.

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