Exercise consisting of predominantly eccentric muscle
actions has the potential to cause greater injury to muscles
than that involving largely isometric or concentric
actions, especially if the exercise is unfamiliar.1–3 Muscle pain
and tenderness generally develop 24 hours after such exercise
and are usually described as delayed-onset muscle soreness
(DOMS).2,4,5 Undoubtedly, DOMS is one of the symptoms of
eccentric-exercise–induced muscle damage; however, DOMS
does not necessarily indicate muscle damage.5 The level of
DOMS does not reflect the extent of muscle damage, and the
course of DOMS does not correspond to the course of changes
in other indicators of muscle damage.5,6 In this context, it is
necessary to separate DOMS from other symptoms of eccentric-
exercise–induced muscle damage, especially when investigating
prophylactic or therapeutic modalities. It may be that
some interventions are effective only for alleviating DOMS,
but others enhance recovery of muscle function without affecting
DOMS. Thus, when a treatment is found to alleviate
DOMS without any effects on recovery of muscle function,
the treatment is still effective if DOMS is the main concern.
A number of prophylactic or therapeutic measures have
been examined for their efficacy in preventing or reducing