Search tips
Search criteria 


Logo of jathtrainLink to Publisher's site
J Athl Train. 1992; 27(3): 208, 210, 212, 214, 216-217.
PMCID: PMC1317248

The Effects of Ice Massage, Ice Massage with Exercise, and Exercise on the Prevention and Treatment of Delayed Onset Muscle Soreness


We investigated the effects of ice massage, ice massage with exercise, and exercise on the prevention and treatment of delayed onset muscle soreness (DOMS). Twenty-two subjects were randomly assigned to one of four groups. Preexercise measures were recorded for range of motion (ROM), strength, perceived soreness, and serum creatine kinase (CK) levels. Subjects performed up to 300 concentric/eccentric contractions of the elbow flexors with 90% of their 10 repetition maximum to induce muscle soreness. Dependent variables were assessed at 2, 4, 6, 24, 48, 72, 96, and 120 hours postexercise. Significant differences occurred in all variables with respect to time (ANOVA(p<.05)). However, no significant mode of treatment, or mode of treatment/assessment time interaction was present. Decreases in range of motion and flexion strength correspond with increases in perceived soreness. The nonsignificant mode of treatment/assessment time interaction suggests that the use of ice massage, ice massage with exercise, or exercise alone is not effective in significantly reducing the symptoms of delayed onset muscle soreness. In fact, though not statistically significant, the pattern of the data suggested the use of ice in the treatment of DOMS may be contraindicated. Further investigation is recommended.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Abraham WM. Factors in delayed muscle soreness. Med Sci Sports. 1977 Spring;9(1):11–20. [PubMed]
  • Armstrong RB. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc. 1984 Dec;16(6):529–538. [PubMed]
  • Armstrong RB, Ogilvie RW, Schwane JA. Eccentric exercise-induced injury to rat skeletal muscle. J Appl Physiol Respir Environ Exerc Physiol. 1983 Jan;54(1):80–93. [PubMed]
  • ASMUSSEN E. Observations on experimental muscular soreness. Acta Rheumatol Scand. 1956;2(2):109–116. [PubMed]
  • Berry CB, Moritani T, Tolson H. Electrical activity and soreness in muscles after exercise. Am J Phys Med Rehabil. 1990 Apr;69(2):60–66. [PubMed]
  • Brazeau GA, Fung HL. Physicochemical properties of binary organic cosolvent-water mixtures and their relationships to muscle damage following intramuscular injection. J Parenter Sci Technol. 1989 Jul-Aug;43(4):144–149. [PubMed]
  • BRENDSTRUP P. Late edema after muscular exercise. Arch Phys Med Rehabil. 1962 Aug;43:401–405. [PubMed]
  • Clarkson PM, Tremblay I. Exercise-induced muscle damage, repair, and adaptation in humans. J Appl Physiol (1985) 1988 Jul;65(1):1–6. [PubMed]
  • Davies CT, White MJ. Muscle weakness following eccentric work in man. Pflugers Arch. 1981 Dec;392(2):168–171. [PubMed]
  • Dean E. Physiology and therapeutic implications of negative work. A review. Phys Ther. 1988 Feb;68(2):233–237. [PubMed]
  • De Vries HA. Quantitative electromyographic investigation of the spasm theory of muscle pain. Am J Phys Med. 1966 Jun;45(3):119–134. [PubMed]
  • Donnelly AE, McCormick K, Maughan RJ, Whiting PH, Clarkson PM. Effects of a non-steroidal anti-inflammatory drug on delayed onset muscle soreness and indices of damage. Br J Sports Med. 1988 Mar;22(1):35–38. [PMC free article] [PubMed]
  • Ebbeling CB, Clarkson PM. Muscle adaptation prior to recovery following eccentric exercise. Eur J Appl Physiol Occup Physiol. 1990;60(1):26–31. [PubMed]
  • Francis KT, Hoobler T. Effects of aspirin on delayed muscle soreness. J Sports Med Phys Fitness. 1987 Sep;27(3):333–337. [PubMed]
  • Fridén J, Seger J, Ekblom B. Sublethal muscle fibre injuries after high-tension anaerobic exercise. Eur J Appl Physiol Occup Physiol. 1988;57(3):360–368. [PubMed]
  • Fridén J, Sfakianos PN, Hargens AR. Muscle soreness and intramuscular fluid pressure: comparison between eccentric and concentric load. J Appl Physiol (1985) 1986 Dec;61(6):2175–2179. [PubMed]
  • Fridén J, Sjöström M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. Int J Sports Med. 1983 Aug;4(3):170–176. [PubMed]
  • Fridén J, Sfakianos PN, Hargens AR. Blood indices of muscle injury associated with eccentric muscle contractions. J Orthop Res. 1989;7(1):142–145. [PubMed]
  • Haines J. A study into a report on cold therapy. Physiotherapy. 1970 Nov;56(11):501–502. [PubMed]
  • High DM, Howley ET, Franks BD. The effects of static stretching and warm-up on prevention of delayed-onset muscle soreness. Res Q Exerc Sport. 1989 Dec;60(4):357–361. [PubMed]
  • Howell JN, Falkel J, Chleboun G. Blood flow to skeletal muscle during postexercise muscle soreness in humans. Prog Clin Biol Res. 1990;327:789–793. [PubMed]
  • Jones DA, Newham DJ, Clarkson PM. Skeletal muscle stiffness and pain following eccentric exercise of the elbow flexors. Pain. 1987 Aug;30(2):233–242. [PubMed]
  • Jones DA, Newham DJ, Round JM, Tolfree SE. Experimental human muscle damage: morphological changes in relation to other indices of damage. J Physiol. 1986 Jun;375:435–448. [PubMed]
  • Khazanchi RK, Knight KR, Angel MF, Pederson WC, Coe SA, O'Brien BM. Effect of phosphoenolpyruvate and adenosine triphosphate on rabbit skeletal muscle after ischaemia: preliminary biochemical study. Microsurgery. 1989;10(1):8–14. [PubMed]
  • Knochel JP. Rhabdomyolysis and myoglobinuria. Annu Rev Med. 1982;33:435–443. [PubMed]
  • Komi PV, Buskirk ER. Effect of eccentric and concentric muscle conditioning on tension and electrical activity of human muscle. Ergonomics. 1972 Jul;15(4):417–434. [PubMed]
  • Lehmann JF, Warren CG, Scham SM. Therapeutic heat and cold. Clin Orthop Relat Res. 1974 Mar-Apr;(99):207–245. [PubMed]
  • McGlynn GH, Laughlin NT, Rowe V. Effect of electromyographic feedback and static stretching on artificially induced muscle soreness. Am J Phys Med. 1979 Jun;58(3):139–148. [PubMed]
  • Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(3699):971–979. [PubMed]
  • Newham DJ. The consequences of eccentric contractions and their relationship to delayed onset muscle pain. Eur J Appl Physiol Occup Physiol. 1988;57(3):353–359. [PubMed]
  • Newham DJ, Jones DA, Ghosh G, Aurora P. Muscle fatigue and pain after eccentric contractions at long and short length. Clin Sci (Lond) 1988 May;74(5):553–557. [PubMed]
  • Newham DJ, Jones DA, Tolfree SE, Edwards RH. Skeletal muscle damage: a study of isotope uptake, enzyme efflux and pain after stepping. Eur J Appl Physiol Occup Physiol. 1986;55(1):106–112. [PubMed]
  • Newham DJ, McPhail G, Mills KR, Edwards RH. Ultrastructural changes after concentric and eccentric contractions of human muscle. J Neurol Sci. 1983 Sep;61(1):109–122. [PubMed]
  • Newham DJ, Mills KR, Quigley BM, Edwards RH. Pain and fatigue after concentric and eccentric muscle contractions. Clin Sci (Lond) 1983 Jan;64(1):55–62. [PubMed]
  • O'Reilly KP, Warhol MJ, Fielding RA, Frontera WR, Meredith CN, Evans WJ. Eccentric exercise-induced muscle damage impairs muscle glycogen repletion. J Appl Physiol (1985) 1987 Jul;63(1):252–256. [PubMed]
  • Page S, Jackson MJ, Coakley J, Edwards RH. Isoforms of creatine kinase: MM in the study of skeletal muscle damage. Eur J Clin Invest. 1989 Apr;19(2):185–191. [PubMed]
  • Rippe B, Grega GJ. Effects of isoprenaline and cooling on histamine induced changes of capillary permeability in the rat hindquarter vascular bed. Acta Physiol Scand. 1978 Jul;103(3):252–262. [PubMed]
  • Schwane JA, Johnson SR, Vandenakker CB, Armstrong RB. Delayed-onset muscular soreness and plasma CPK and LDH activities after downhill running. Med Sci Sports Exerc. 1983;15(1):51–56. [PubMed]
  • Schwane JA, Williams JS, Sloan JH. Effects of training on delayed muscle soreness and serum creatine kinase activity after running. Med Sci Sports Exerc. 1987 Dec;19(6):584–590. [PubMed]
  • Talag TS. Residual muscular soreness as influenced by concentric, eccentric, and static contractions. Res Q. 1973 Dec;44(4):458–469. [PubMed]
  • Tiidus PM, Ianuzzo CD. Effects of intensity and duration of muscular exercise on delayed soreness and serum enzyme activities. Med Sci Sports Exerc. 1983;15(6):461–465. [PubMed]
  • Warhol MJ, Siegel AJ, Evans WJ, Silverman LM. Skeletal muscle injury and repair in marathon runners after competition. Am J Pathol. 1985 Feb;118(2):331–339. [PubMed]
  • Wheat MR, McCoy SL, Barton ED, Starcher BM, Schwane JA. Hydroxylysine excretion does not indicate collagen damage with downhill running in young men. Int J Sports Med. 1989 Jun;10(3):155–160. [PubMed]
  • Wolf SL, Knutsson E. Effects of skin cooling on stretch reflex activity in triceps surae of the decerebrate cat. Exp Neurol. 1975 Oct;49(1 Pt 1):22–34. [PubMed]
  • Yackzan L, Adams C, Francis KT. The effects of ice massage on delayed muscle soreness. Am J Sports Med. 1984 Mar-Apr;12(2):159–165. [PubMed]

Articles from Journal of Athletic Training are provided here courtesy of National Athletic Trainers Association