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June 2025

Comparing heat and cold therapy for muscle recovery: insights into delayed onset muscle soreness

Authors: Sebastian Szajkowski 1, Jaroslaw Pasek 2, Witold Woch 3, Grzegorz Cieslar 4

Affiliations:

  1. Faculty of Medical Sciences, Warsaw Medical Academy of Applied Sciences, Warszawa, Poland
  2. Collegium Medicum, Jan Dlugosz University in Czestochowa, Poland
  3. University of Applied Sciences, Faculty of Medicine and Health Sciences in Nowy Sacz, Poland
  4. Department of Internal Medicine, Angiology and Physical Medicine, Medical University of Silesia in Katowice, Bytom, Poland

Journal: Physical Activity Review - May 2025, Volume 13, Issue 2, Pages 57-69 (DOI: 10.16926/par.2025.13.20)

Background: The manifestation of Delayed Onset Muscle Soreness (DOMS) is the consequence of intense work performed by skeletal muscles. An increase in muscle tone and stiffness, concomitant with DOMS, is reflected in the altered values of biomechanical and visco- elastic parameters of muscles.

Methods: The participants of the study (n=60) were divided into three groups: group 1 (n=20) was subjected to infrared radiation, group 2 (n=20) was treated by means of local cryotherapy, and group 3 (n=20) designated as the control group. The gastrocnemius muscle fatigue protocol was performed in order to observe the development of DOMS symptoms in the following days. The participants underwent therapeutic procedures for three consecutive days. The efficacy of the therapeutic intervention was evaluated by measuring the muscle tone using a myotonometer on five occasions: prior to the study, and then thrice during its course, with a final assessment after the study had concluded.

Results: In groups 1 and 2, a statistically significant decrease in tone was observed between day 1 and 2 (median of 18.3 – 16.4 [Hz]; p=0.009 in group 1 and median of 18.8 – 15.7 [Hz]; p= 0.005 in group 2) and stiffness (median of 291 – 271 [N/m]; p=0.005 in group 1 and median of 337 – 268 [N/m]; p=0.026 in group 2). Lower values were observed in group 2. In group 3, the decrease in tone and stiffness occurred later, only after 2 days. Subsequent to day 2, a decrease in tone and stiffness values was observed in all groups. On day 2, significant differences in tone values were identified (p=0.004; group 1 vs group 3 and p=0.004; group 2 vs group 3) and in stiffness (p=0.003; group 1 vs group 3 and p=0.002; group 2 vs group 3). In addition, on day 4, the decrement values in group 2 decreased below the baseline values (median of 1.35 [log] vs. 1.29 [log]), and the differences observed were statistically significant (p=0.006).

Conclusions: It has been demonstrated that local cryotherapy is the most efficacious method for reducing tone and stiffness, and restoring muscle flexibility in the course of delayed onset muscle soreness (DOMS). Beneficial effects were also observed in response to the application of infrared radiation. Both treatment methods were found to be significantly more effective than sham therapy.

 

Keywords: muscle soreness, cryotherapy, infrared, recovery, myotonometry

Treatment procedures using local cryotherapy are effective in restoring the correct biomechanical and viscoelastic parameters of muscles, which are subject to changes in the course of DOMS and DOSS. They shorten the time of symptoms occurrence and eliminate them faster. Similar but less powerful effects were observed after heat treatment with infrared radiation. Both treatments are significantly more effective than placebo using sham therapy.

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