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Lori A. Kuligowski, MS, ATC*; Scott M. Lephart, PhD, ATC^; Frank P. Giannantonio, MS, ATC, CSCS++; Rob 0. Blanc, MS, ATC++
Objective: To determine the efficacy of warm whirlpool, cold whirlpool, and contrast therapy in the treatment of delayedonset muscle soreness.
Design and Setting: Subjects performed eccentric contractions of the elbow flexors and received 4 treatments: immediately postexercise and 24, 48, and 72 hours postexercise. Treatments consisted of 24-minute treatments with warm whirlpool, cold whirlpool, contrast therapy, or no treatment.
Subjects: Fifty-six sex-matched volunteers from the University of Pittsburgh.
Measurements: Measurements were taken at 5 assessment times: pre-exercise (0 hours); prior to treatment at 24, 48, and 72 hours postexercise; and at 96 hours postexercise. Dependent variables were degrees of resting elbow flexion, active elbow flexion, and extension; perceived soreness values on a Graphic Pain Rating Scale; and maximal voluntary isometric
contraction. A repeated-measures analysis of variance (group by time) and Tukey post hoc analysis were used to determine which treatment groups differed significantly in returning subjects to pre-exercise values.
Results: Cold whirlpool and contrast therapy were found to return subjects to baseline values of resting elbow flexion and perceived soreness significantly more than warm whirlpool or no treatment (P < .01). Additionally, warm whirlpool was found to be more effective than no treatment in the return of resting elbow flexion (P < .01).
Conclusions: These results suggest that cold whirlpool and contrast therapy are more effective than warm whirlpool or no treatment in alleviating delayed-onset muscle soreness in the elbow flexors.
Key Words: eccentric exercise, hydrotherapy, contrast therapy
Muscle soreness resulting from physical activity may be classified as acute or delayed in onset. Acute-onset muscle soreness occurs during the activity and dissipates immediately at the end of activity, or within a few hours.1,2 Delayed-onset muscle soreness (DOMS) is the sensation of pain or discomfort that intensifies during the initial 24 hours postexercise, peaking between 24 and 72 hours, and subsiding during the following 5 to 7 days.1-3 The signs and symptoms of DOMS include muscle soreness during palpation or movement of the involved muscles and decreases in range of motion and muscle strength.1,2,4-7 DOMS may have a detrimental impact on athletic performance by reducing endurance performance, reducing strength and power, and...