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Stay Active, Stay Healthy: The Importance of Physiotherapy for Active Individuals

Stay Active, Stay Healthy: The Importance of Physiotherapy for Active Individuals

Oct 3, 2024

Photo by Annie Spratt on Unsplash

Maintaining an active lifestyle is crucial for overall health and well-being in today’s fast-paced world. Whether you’re a seasoned athlete or simply someone who enjoys staying active through sports and exercise, taking care of your body is paramount. However, as you age, changing your approach to fitness is essential to stay active. Proactive preventive approaches such as physiotherapy can prevent injuries, enhance performance, and enable you to continue enjoying the activities you love for years to come.

Who is a physiotherapist? How can a physiotherapist help me?

Physiotherapists, also known as physical therapists, are highly trained healthcare professionals who specialize in assessing, diagnosing, and treating a wide range of musculoskeletal and movement-related conditions. Their primary focus is on optimizing movement, promoting physical well-being, preventing injuries, and rehabilitating individuals who have experienced physical impairments. Here’s an overview of what physiotherapists do and how they can help you stay active:
  • Assessment: Physiotherapists begin by comprehensively assessing the patient’s condition. This involves evaluating their physical function, range of motion, strength, posture, and pain or discomfort. The goal is to identify the underlying issues that may be causing the patient’s problems.
  • Diagnosis: Based on the assessment, physiotherapists diagnose the underlying causes of the patient’s symptoms. They determine the root of the issue, whether it’s a specific injury, a musculoskeletal problem, a neurological condition, or a combination of factors.
  • Treatment Planning: Physiotherapists create personalized treatment plans tailored to the patient’s needs, goals, and condition. These plans often include a combination of various therapeutic techniques and exercises designed to address the identified issues.
  • Exercise Prescription: Physiotherapists prescribe specific exercises and therapeutic activities that target the patient’s condition. These exercises strengthen weak muscles, improve flexibility, enhance balance, and address movement abnormalities.
  • Patient Education: Educating the patient about their condition, proper body mechanics, injury prevention, and self-management techniques is a significant part of a physiotherapist’s role. Patients are empowered to participate in their recovery and long-term health actively.
  • Rehabilitation: Physiotherapists play a crucial role in the rehabilitation process after surgeries, accidents, or injuries. They help patients regain strength, flexibility, and function, guiding them through a structured recovery program.
  • Monitoring Progress: Throughout the treatment process, physiotherapists continually assess the patient’s progress and adjust the treatment plan as needed to ensure optimal results.

Top 5 reasons why physiotherapy is essential for active individuals

Active lifestyles put increased stress on our bodies, making them more susceptible to overuse injuries, muscle imbalances, and joint problems. Physiotherapists at Opus Biological specialize in identifying and addressing these issues before they escalate, thus reducing the risk of injuries. They design personalized exercise plans to strengthen weak areas, improve flexibility, and optimize biomechanics, improving performance and efficiency in sports and activities. Moreover, as individuals age, physiotherapy ensures that they can adapt their exercise routines to maintain mobility, balance, and function, allowing them to enjoy an active lifestyle for life. Here are the top 5 reasons to choose physiotherapy to maintain an active lifestyle:

  • Injury Prevention: Active individuals often engage in high-impact activities that put a strain on muscles, joints, and ligaments. Physiotherapy helps identify areas of weakness, imbalance, or poor biomechanics. Through targeted exercises and corrective techniques, physiotherapists can prevent injuries by strengthening these vulnerable areas, reducing the risk of overuse injuries, strains, and sprains.
  • Improved Performance: Physiotherapy isn’t just about preventing injuries; it’s also about optimizing performance. Physiotherapists can analyse an individual’s movement patterns, identify inefficiencies, and provide tailored exercises to improve form, strength, and flexibility. This optimization leads to better athletic performance and increased endurance.
  • Faster Recovery: If an active individual does experience an injury, physiotherapy is essential for a swift and effective recovery. Physiotherapists employ manual therapy, targeted exercises, and modalities like ultrasound or electrical stimulation to speed up the healing process, restoring function and reducing the risk of complications.
  • Personalized Guidance: Physiotherapy at Opus Biological offers individualized care that aligns with your needs, goals, and physical condition. This personalized approach ensures that active individuals receive tailored advice, exercises, and strategies that address their unique challenges, helping them achieve their fitness objectives while minimizing the risk of setbacks.
  • Staying Active for Life: Physiotherapy helps adapt exercise routines to address age-related changes, such as reduced joint flexibility or muscle strength. This ensures active individuals can continue enjoying their preferred activities as they age, promoting overall health and well-being.

Managing Injuries Better with Physiotherapy

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Preventing injuries is always better than treating them, and that’s where physiotherapy shines. A physiotherapist is a healthcare professional trained to assess and address musculoskeletal issues, identify potential problems, and design personalized prevention plans. By identifying weak areas, poor movement patterns, or imbalances, a physiotherapist can create exercises and strategies to address these issues, reducing the risk of injury.

For active individuals, this proactive approach is a game-changer. It allows you to identify and correct small issues before they become significant problems. It’s like giving your body a regular check-up, ensuring every joint, muscle, and ligament functions optimally. By investing time in physiotherapy, you’re investing in your body’s longevity.

Individualized Care Matters

Photo by Sincerely Media on Unsplash

One of the significant advantages of physiotherapy at Opus Biological is its personalized approach. Every person is unique, and their needs, goals, and physical conditions are distinct. Our physiotherapists work closely with you to understand your specific conditions and design a customized plan that addresses your concerns.
Whether recovering from a sports injury, looking to improve your athletic performance, or seeking guidance on maintaining an active lifestyle as you age, our physiotherapists can provide the tailored care you require. The individualized attention you receive ensures that you’re on the right path, with exercises and strategies that align with your goals, ultimately helping you achieve desired results.

Final Thoughts

Staying active is a beautiful way to maintain your health and enjoy life to the fullest. However, taking a proactive approach is essential to ensure that you can continue being active without unnecessary setbacks. Physiotherapy offers a comprehensive solution, focusing on prevention, performance enhancement, and longevity in your active lifestyle.
By investing in regular physiotherapy sessions at Opus Biological, you’re investing in your body’s well-being. You’re taking steps to prevent injuries, optimize your performance, and adapt your approach to physical activity as you age. With the guidance of a skilled physiotherapist, you can ensure that you’re staying active and healthy for years to come, enabling you to enjoy the activities you love and lead a fulfilling, active life. So, make physiotherapy an integral part of your active lifestyle – your body will thank you for it.
The Effectiveness of Physiotherapy on Subacromial Impingement Syndrome

The Effectiveness of Physiotherapy on Subacromial Impingement Syndrome

Aug 7, 2024

Subacromial impingement syndrome (SAIS) is an umbrella term for a variety of inflammatory pathologies within the subacromial space. These include rotator cuff syndrome, bursitis, tendinopathy and calcific tendinitis. Conservative treatment is used to decrease inflammation, restore range of motion in the shoulder and strengthen the rotator cuff (Gebremariam et. al, 2013). Physiotherapy has shown to be an effective method for treating SAIS and should be considered as the first line of care (Dicken et. al, 2005). However, it is important to understand which therapeutic modalities should be prioritised and considered when treating SAIS.

There is a wealth of research suggesting to focus on scapular stabilization and rotator cuff strengthening when rehabilitating patients with SAIS. For example, Baskurt et. all investigated the effectiveness of scapular stabilization on pain, shoulder range of motion, joint position sense (JPS), scapular dyskinesis and quality of life in patients with SAIS. They discovered the combination of scapular stabilization, shoulder strengthening and stretching is the most effective method in improving JPS and decreasing scapular dyskinesis (Baskurt et. al, 2011).  Michener et. al compared various treatments for SAIS (exercise, joint mobilisations, laser, ultrasound and acupuncture) in a systematic review. The evidence suggested laser therapy is only beneficial when used in isolation and there is no benefit in using ultrasound or acupuncture. However, the most effective treatment for SAIS is the combination of rotator cuff strengthening and scapular stabilisation alongside joint mobilisations (Michener et. al, 2004). Additionally, Celik concluded that patients with SAIS exhibited a lower visual analog scale score when exercises were performed within pain free range of motion (90 degrees and below). Overall research illustrates rotator cuff strengthening, scapular stabilization and joint mobilization are essential when treating SAIS. Furthermore, during the early stages of rehabilitation, prescribing exercises below 90-degree shoulder flexion can aid in pain management (Celik, 2009).

When creating a rehabilitation programme, practitioners should consider a patient-centered approach. It is important to recognize patients’ pain tolerance and threshold when prescribing exercises for SAIS. Vallés- Carrascosa et. al compared painful eccentric exercises (PEE) to pain free eccentric exercises when treating SAIS. Remarkably, PPE was found to provide no additional benefits. Therefore, practitioners should consider prescribing pain free exercises to promote compliance with rehabilitation programmes, especially for patients with a lower pain tolerance (Vallés- Carrascosa et. al,2018).

 

Reference List

 

  • Başkurt, Z., Başkurt, F., Gelecek, N. and Özkan, M.H. (2011). The effectiveness of scapular stabilization exercise in the patients with subacromial impingement syndrome. Journal of Back and Musculoskeletal Rehabilitation, 24(3), pp.173–179. doi:https://doi.org/10.3233/bmr-2011-0291.
  • Celik, D. (2009). Comparison of the effects of two different exercise programs on pain in subacromial impingement syndrome. Acta Orthopaedica et Traumatologica Turcica, 43(6), pp.504–509. doi:https://doi.org/10.3944/aott.2009.504.
  • Dickens, V.A., Williams, J.L. and Bhamra, M.S. (2005). Role of physiotherapy in the treatment of subacromial impingement syndrome: a prospective study. Physiotherapy, 91(3), pp.159–164. doi:https://doi.org/10.1016/j.physio.2004.10.008.
  • Gebremariam, L., Hay, E.M., van der Sande, R., Rinkel, W.D., Koes, B.W. and Huisstede, B.M.A. (2013). Subacromial impingement syndrome—effectiveness of physiotherapy and manual therapy. British Journal of Sports Medicine, 48(16), pp.1202–1208. doi:https://doi.org/10.1136/bjsports-2012-091802.
  • Michener, L.A., Walsworth, M.K. and Burnet, E.N. (2004). Effectiveness of rehabilitation for patients with Subacromial impingement syndrome: a systematic review. Journal of Hand Therapy, 17(2), pp.152–164. doi:https://doi.org/10.1197/j.jht.2004.02.004.
  • Vallés-Carrascosa, E., Gallego-Izquierdo, T., Jiménez-Rejano, J.J., Plaza-Manzano, G., Pecos-Martín, D., Hita-Contreras, F. and Achalandabaso Ochoa, A. (2018). Pain, motion and function comparison of two exercise protocols for the rotator cuff and scapular stabilizers in patients with subacromial syndrome. Journal of Hand Therapy, 31(2), pp.227–237. doi:https://doi.org/10.1016/j.jht.2017.11.041.
Nutrition and Performance: How our Sports Medicine Doctors optimize Diets for Athletes

Nutrition and Performance: How our Sports Medicine Doctors optimize Diets for Athletes

Aug 4, 2024

Photo by Nicolas Hoizey on Unsplash

The world of sports is not just about raw talent and rigorous training; it also hinges on the foundation of optimal nutrition. The dietary choices of athletes play a critical role in determining their performance, recovery, and overall well-being. While athletes often follow disciplined training routines, it is the guidance of Sports Medicine doctors who fine-tune diets, which helps athletes unlock their full potential.

The Role of Nutrition in Athletic Performance

Nutrition forms the cornerstone of athletic performance. An athlete’s diet fuels their body, affecting their energy levels, strength, and endurance. Carbohydrates are essential for providing quick energy, making them vital for athletes engaged in high-intensity sports. On the other hand, proteins aid in muscle repair and growth, while fats act as long-lasting energy provisions during endurance activities.

Moreover, vitamins and minerals are indispensable for various physiological processes, such as metabolism, oxygen transport, and nerve function. Athletes can maximize their performance potential by optimizing their nutrient intake to achieve peak results in their respective sports.

Inadequate nutrition and athletic injuries

High-intensity sports training for athletes demands high functional joint mobility, and a solid musculoskeletal system, making it essential to ensure physical fitness levels and optimal nutrition. Athletes often overexert their bodies and ignore optimal nutrient intake, which can result in athletic injuries that include:

  • Sprains and Strains are injuries to ligaments (sprains) or muscles/tendons (strains) due to overstretching or tearing.
  • Muscle Cramps are painful contractions of muscles caused by dehydration, overuse, or electrolyte imbalances.
  • Tendinitis is an inflammation of a tendon, often caused by repetitive movements or overuse.
  • Stress Fractures are small cracks in bones due to repetitive impact or over training.
  • Concussions are head injuries resulting from a blow to the head, common in contact sports.
  • Shin Splintsis the pain along the shinbone caused by overuse or improper footwear.
  • Knee Injuries include anterior cruciate ligament (ACL) tears, meniscus tears, and patellofemoral pain syndrome.
  • Ankle Sprains are ligament injuries in the ankle, often from twisting or rolling the foot.
  • Groin Strains are strains or tears in the muscles of the inner thigh.
  • Shoulder Injuries  include rotator cuff tears and shoulder impingement and are common in sports involving overhead movements.

Sports Medicine Doctors: The Architects of Athletic Nutrition

Sports Medicine Doctors at specialised clinics such as Opus Biological play a crucial role in athletic success. Their expertise in athletic nutrition, exercise physiology, and injury prevention helps them take a personalized approach, ensuring they meet each athlete’s unique nutritional requirements.

Assessment and Tailoring Dietary Plans

Crafting an athlete’s optimal diet begins with a comprehensive assessment. Sports medicine doctors consider the athlete’s sport, training intensity, body composition, medical history, and specific goals. They may conduct blood tests and other investigations to evaluate nutrient levels and identify any deficiencies that could hinder performance. With this information, the sports medicine doctor develops a tailored dietary plan that addresses the athlete’s needs. These plans encompass appropriate caloric intake, macronutrient ratios, and micronutrient-rich food sources. The goal is to provide the body with the proper nutrients at the right time, optimizing performance and promoting recovery.

Impact of Specific Nutrients on Athletic Performance

Nutrients play vital roles in supporting various physiological processes directly influencing an athlete’s abilities and performance. Here are some key nutrients and their effects on athletic performance:
  • Carbohydrates: As the primary energy source for athletes, carbohydrates are critical for maintaining high-intensity performance and replenishing glycogen stores after intense workouts. Sports medicine doctors work with athletes to determine the optimal carbohydrate intake to sustain energy levels during training and competitions.
  • Proteins: Protein is essential for muscle repair and growth, making it crucial for athletes to support their physical demands. Sports medicine doctors help athletes determine the right amount of protein to include in their diet, considering factors such as training intensity and any injuries requiring additional tissue repair.
  • Fats: While often underrated, fats play a vital role in endurance sports. They serve as an energy reserve, especially during long-distance activities. Sports medicine doctors ensure athletes consume healthy fats to maintain sustained energy and support overall health.
  • Hydration: Proper hydration is paramount for athletes to perform at their best. Sports medicine doctors guide athletes on fluid intake, considering factors like climate, intensity, and duration of activity to prevent dehydration and maintain optimal performance.

Recovery and Injury Prevention

Adequate nutrition is crucial for top-notch athletic performance, post-exercise recovery, and injury prevention. Sports medicine doctors focus on the following aspects:
  • Muscle Recovery: Nutrients such as protein, carbohydrates, and antioxidants aid in muscle repair and reduce inflammation. Sports medicine doctors emphasize post-training meals that facilitate the body’s recovery process.
  • Injury Management: Nutritional support is essential during injury rehabilitation. Sports medicine doctors ensure athletes receive proper nutrition to promote tissue healing and boost their immunity.
  • Bone Health: Calcium and vitamin D are vital for maintaining strong bones, reducing the risk of stress fractures and other bone-related injuries. Sports medicine doctors ensure that athletes’ diets include adequate nutrition.

Conclusion

Nutrition is the bedrock on which athletic performance is built. Sports medicine doctors are pivotal in optimizing athletes’ diets, considering their needs, performance goals, and health conditions. By tailoring dietary plans and emphasizing the importance of specific nutrients, sports medicine doctors can unlock an athlete’s full potential, enhance their performance, aid in recovery, and reduce the risk of injuries. At Opus Biological, we understand your sports nutrition needs. Our sports medicine doctors optimize your nutrient intake, enhance recovery, and boost endurance. Additionally, we provide personalized dietary plans and supplements catering to individualized training regimens, ensuring you receive the right nutrients at the right time. With our support, athletes can maximize their potential, improve overall athletic performance, and maintain their competitive edge in the world of sports.
The Effectiveness of Physiotherapy on Subacromial Impingement Syndrome

Sometimes – less means more

Jul 23, 2024

Unfortunately, sometimes we come face to face with patients who have a rather long road ahead of them when it comes to returning to their pre-injury status. An ACL or Achilles reconstruction for example. This means a longer period for them to be vigilant, compliant and motivated with their session attendance, exercise and management techniques in and away from face-to-face sessions. I for one know that if I was placed in this scenario, I would find it tough to keep the same level of determination to adhere to my programme from beginning to end. So, can we use a little something to aid this lengthy process for our patients which will not negatively impact their progress? In my opinion, yes. Deloading.

Bell et. al (2023) (1) define ‘Deloading’ as a period of reduced training stress designed to mitigate physiological and psychological fatigue, promote recovery, and enhance preparedness for subsequent training.

In the realm of sports rehabilitation, the concept of deload periods has gained significant traction as an approach to managing and enhancing recovery from injuries. Deload periods, often implemented within a structured rehabilitation program, involve a planned reduction in exercise intensity and or volume. This technique is particularly beneficial in long-term recovery processes, offering numerous physiological and psychological benefits that can expedite healing and improve overall outcomes

The primary physiological benefit of deload periods is the mitigation of overtraining and excessive fatigue (Rogerson et.al 2024) (5). During a prolonged rehabilitation process, continuous high-intensity training can lead to increased stress on the injured tissues, potentially exacerbating the injury or slowing down the healing process. By incorporating deload periods, the body is afforded the necessary time to recover and adapt to the rehabilitation exercises without being overwhelmed by continuous strain.

Deload periods can also play a crucial role in preventing the risk of re-injury. As targeted structures are gradually strengthened during rehabilitation, they require adequate rest to fully recover and adapt to the increased loads. Without sufficient recovery, these structures remain vulnerable to further damage. As per Mosewich, Kent and Kowalski (2013) (4) deloading helps ensure that the healing tissues are not subjected to undue stress, thus reducing the likelihood of setbacks.

Additionally, deload periods facilitate metabolic recovery. Intense exercise sessions can deplete glycogen stores, disrupt hormonal balances, and lead to an accumulation of metabolic byproducts. A period of reduced training intensity allows for the replenishment of glycogen stores, normalization of hormone levels, and clearance of metabolic waste, thereby optimizing the body’s readiness for subsequent training phases (Ivy 2004) (3).

Beyond the physiological advantages, deload periods offer substantial psychological benefits that are vital for a successful rehabilitation journey. Long-term injury recovery can be mentally taxing, often leading to feelings of frustration, anxiety, or even burnout. Scheduled deload periods provide individuals with a break, helping to alleviate mental fatigue and maintain motivation throughout the rehabilitation process. It is a well-known fact that within elite sport it is common for a player to be advised to go away to somewhere warm to put their feet up for 7-10 days at a certain stage of their recovery. This gets the player away from the current rehabilitation setting, enabling them to switch off mentally and relax.

The psychological relief afforded by deload periods also promotes adherence to the rehabilitation program (Bell et. al 2022) (2). Consistently high levels of training intensity can lead to a sense of dread or reluctance towards rehabilitation sessions. By incorporating periodic reductions in training demands, individuals are more likely to remain engaged and committed to their recovery plan, ultimately leading to better long-term outcomes

The implementation of deload periods within a rehabilitation program should be tailored to the individual’s specific injury, recovery progress, and overall training load. Generally, deload periods are scheduled every 6-8 weeks, but this can vary based on the intensity and frequency of the rehabilitation exercises. Monitoring the patient’s feedback, progress, and any signs of overtraining or fatigue can help in deciding the optimum time for this process also.  During a deload week, exercise intensity and volume are typically reduced by 50-70%, allowing the body ample time to recover without completely halting progress.

So, I think based on the above, it is safe to say that as therapists we should very much consider the implementation of the deload principle into the rehabilitation plans of those patients who have a longer and slightly more mentally and physically testing battle ahead. It is a big part of our role to support our patient’s and to keep them on the right track. Sometimes that may mean periodically seeing them and doing less to achieve more down the line.

Reference List

 

  • Bell, L., Ben William Strafford, Coleman, M., Patroklos Androulakis-Korakakis and Nolan, D. (2023). Integrating Deloading into Strength and Physique Sports Training Programmes: An International Delphi Consensus Approach. Sports Medicine – Open, 9(1). doi:https://doi.org/10.1186/s40798-023-00633-0.
  • Bell, L., Nolan, D., Immonen, V., Helms, E., Dallamore, J., Wolf, M. and Androulakis Korakakis, P. (2022). ‘You can’t shoot another bullet until you’ve reloaded the gun’: Coaches’ perceptions, practices and experiences of deloading in strength and physique sports. Frontiers in Sports and Active Living, [online] 4. doi:https://doi.org/10.3389/fspor.2022.1073223.
  • Ivy JL. Regulation of muscle glycogen repletion, muscle protein synthesis and repair following exercise. J Sports Sci Med. 2004 Sep 1;3(3):131-8. PMID: 24482590; PMCID: PMC3905295.
  • Amber D. Mosewich , Peter R.E. Crocker & Kent C. Kowalski (2013): Managinginjury and other setbacks in sport: experiences of (and resources for) high-performance women athletes, Qualitative Research in Sport, Exercise and Health, DOI:10.1080/2159676X.2013.766810
  • Rogerson, D., Nolan, D., Korakakis, P.A. et al. Deloading Practices in Strength and Physique Sports: A Cross-sectional Survey. Sports Med – Open 10, 26 (2024). https://doi.org/10.1186/s40798-024-00691-y
The Effectiveness of Physiotherapy on Subacromial Impingement Syndrome

Recovering from Delayed Onset Muscle Soreness

Jun 26, 2024

Delayed onset muscle soreness (DOMS) is defined as ‘ultrastructural damage of muscle cells due to unfamiliar sporting activities or eccentric exercise, which leads to further protein degradation, apoptosis and local inflammatory response’ (Hotfiel et. al 2018) The micro tears caused by eccentric movements can impact performance by reducing joint range of motion and alter muscle recruitment patterns. This can increase risk of a soft tissue injury but treatment strategies for DOMS remain uncertain. Common treatment strategies include anti-inflammatories, massage and cryotherapy. Seidel et. al investigated the optimum treatment for DOMS and found non-steroidal anti-inflammatory drugs did reduce the pain but delayed the recovery.  Other interventions were examined (nutritional and physical) and found that there was a reduction in inflammation but no treatment aided muscle regeneration. (Seidel et. al, 2012)

Massage can be an effective tool to aid recovery from DOMS, however most research states the type and timing of the massage is important.  Hilbert et. al found that there was a reduction in muscle soreness 48 hours post exercise when massage is administered 2 hours after exercise, (Hilbert et. al, 2003). However, Visconti et. al found massage to be an effective tool to reduce DOMS during the onset of symptoms (Visconti et. al, 2015).

Cryotherapy has conflicting research on the effectiveness to alleviate DOMS. For example, Eston and Peters studied the use of cold-water immersion for recovery. They found 2-3 days post exercise, participants who used cold water immersion had increased joint range and reduced creatine kinase activity compared to the control group. However, both groups presented with muscle tenderness, swelling and reduced isometric strength 3 days following exercise. Howaston and Van Someren investigated the impact of ice massage therapy on DOMs, however discovered it is not an effective treatment due to only noticing creatine kinase reduction at 72 hours (Bishop et. al, 2008).

Evidence suggests adapting your exercise programme is the most efficient method to alleviate DOMS however the analgesic effect has been shown to be temporary (Zainuddin et. al, 2011). Cheung et. al suggests when exercising on a daily basis, one should reduce intensity and duration of exercise 1-2 days following DOMS. Training body parts that are less affected by DOMS and progressively overloading eccentric exercises over a 1 to 2 week period are efficient methods to manage DOMS (Cheung et. al 2003).

Reference List

Bishop, P.A., Jones, E. and Woods, A.K. (2008). Recovery From Training: A Brief Review. Journal of Strength and Conditioning Research, [online] 22(3), pp.1015–1024. doi:https://doi.org/10.1519/jsc.0b013e31816eb518.

Cheung, K., Hume, P.A. and Maxwell, L. (2012). Delayed Onset Muscle Soreness. Sports Medicine, [online] 33(2), pp.145–164. doi:https://doi.org/10.2165/00007256-200333020-00005.

Hilbert, J.E., Sforzo, G.A. and Swensen, T. (2003). The effects of massage on delayed onset muscle soreness. British Journal of Sports Medicine, [online] 37(1), pp.72–75. doi:https://doi.org/10.1136/bjsm.37.1.72.

Hotfiel, T., Freiwald, J., Hoppe, M., Lutter, C., Forst, R., Grim, C., Bloch, W., Hüttel, M. and Heiss, R. (2018). Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletzung · Sportschaden, 32(04), pp.243–250. doi:https://doi.org/10.1055/a-0753-1884.

Seidel, E., Rother, M., Hartmann, J., Rother, I., Schaaf, T., Winzer, M., Fischer, A. and Regenspurger, K. (2012). Eccentric Exercise and Delayed Onset of Muscle Soreness (DOMS) – an Overview. Physikalische Medizin, Rehabilitation Medizin, Kurortmedizin, 22(02), pp.57–63. doi:https://doi.org/10.1055/s-0032-1304576.

Visconti, L., Capra, G., Carta, G., Forni, C. and Janin, D. (2015). Effect of massage on DOMS in ultramarathon runners: A pilot study. Journal of Bodywork and Movement Therapies, [online] 19(3), pp.458–463. doi:https://doi.org/10.1016/j.jbmt.2014.11.008.

Zainuddin, Z., Sacco, P., Newton, M. and Nosaka, K. (2006). Light concentric exercise has a temporarily analgesic effect on delayed-onset muscle soreness, but no effect on recovery from eccentric exercise. Applied Physiology, Nutrition, and Metabolism, 31(2), pp.126–134. doi:https://doi.org/10.1139/h05-010.