The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness

Clin J Sport Med. 2017 Jul;27(4):329-337. doi: 10.1097/JSM.0000000000000375.


Objective: To assess the impact of heat applied for 8 hours immediately after or 24 hours after exercise on delayed-onset muscle soreness (DOMS) in large skeletal muscle groups measured by subjective and objective means.

Design: Cross-sectional repeated measure design study.

Setting: Research laboratory.

Subjects: Three groups of 20 subjects, age range 20 to 40 years.

Intervention: Squats were conducted in three 5-minute bouts to initiate DOMS; 3 minutes of rest separated the bouts. One group had heat applied immediately after exercise, and a second group had heat applied 24 hours after exercise. A third group was the control group where no heat was applied.

Main outcome measures: Visual analog pain scales, muscle strength of quads, range of motion of quads, stiffness of quads (Continuous Passive Motion machine), algometer to measure quadriceps soreness, and blood myoglobin.

Results: The most significant outcome was a reduction in soreness in the group that had low-temperature heat wraps applied immediately after exercise (P < 0.01). There was benefit to applying heat 24 hours after exercise, but to a smaller extent. This was corroborated by myoglobin, algometer, and stiffness data.

Conclusions: Low-level continuous heat wraps left for 8 hours just after heavy exercise reduced DOMS in the population tested as assessed by subjective and objective measures.

Clinical relevance: Although cold is commonly used after heavy exercise to reduce soreness, heat applied just after exercise seems very effective in reducing soreness. Unlike cold, it increases flexibility of tissue and tissue blood flow. For joint, it is still probably better to use cold to reduce swelling.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Exercise
  • Hot Temperature*
  • Humans
  • Muscle Strength
  • Myalgia / therapy*
  • Pain Measurement
  • Quadriceps Muscle / physiopathology
  • Range of Motion, Articular
  • Time Factors
  • Young Adult