Gurovich, A. N., Penailillo, L., Reyes, A., & Plaza, P. (2006). What is the best treatment to control Delayed Onset Muscle Soreness: Ultrasound, cryotherapy or both on a combined therapy? Medicine and Science in Sports and Exercise, 38(5), Supplement Abstract 689.

"Rehabilitation protocols for muscle injuries are based mostly on rest and muscular strengthening after the acute phase of the inflammatory process. This option may delayed the healing phase because the installation of a secondary injury elicited by the primary injury. The Delayed Onset Muscle Soreness (DOMS), after an Eccentric Exercise Protocol (EEP), has been proved as a valuable experimental model to study the acute phase of a muscular damage. The main characteristics of DOMS are soreness, muscle injury and functional impairment, where the effects of therapeutic Ultrasound (US) and cryotherapy (CRY) are normally oriented".

This study evaluated the effects of two common therapies for ameliorating DOMS. Healthy men and women (N = 49) were measured 72 hours before and immediately after, and 24, 48, 72, 96 and 192 hours after treatments for pain, with a 20 grs/mm compression, mid arm relaxed girth, maximal isometric voluntary contraction, elbow range of motion, and total plasma creatine kinase activity. The eccentric exercise protocol consisted of flexion at an intensity level of 80% of maximal voluntary contraction of the nondominant elbow. Ss were randomly assigned to one of the following groups: Control-Control (CON-CON) without EEP and any treatment (N = 8), Control-Exercise (CON-EXC) with EEP and no kind of treatment (N = 10), US with EEP and US treatment (N = 10), CRY with EEP and CRY treatment (N = 10), and US+CRY (USC) with EEP and US/CRY combined treatment (N = 11). Cryotherapy lasted 20-minutes with a cold-pack protocol applied immediately after, and at 12, 24, 36, 60, 84 and 108 hours after the EEP; while the 10-minute ultrasound treatment was applied at 36, 60, 84 and 108 hours after the EEP.

Creatine kinase levels were higher in ultrasound group compared to CON-CON group at 72, 96 and 192 hours after EEP and higher in cryotherapy group compared to CON-CON group at 192 hours after EEP. The ultrasound plus cryotherapy group never differed to the CON-CON group. For maximal isometric voluntary contraction, all groups were significantly higher than the CON-CON group at anytime after EEP, except for the USC group at 192 hours.

Implication. The combination of ultrasound and cryotherapy is better than either treatment alone for treating DOMS.

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