Physical Activity for Delayed Onset Muscle Soreness

(WIO Trial)

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Toronto

Must not be taking: NSAIDs, Oral contraceptives

Disqualifiers: Tobacco use, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 1 week

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if the number of daily steps affects delayed onset muscle soreness (DOMS), the muscle pain and tenderness following new activities or exercises. Participants will be divided into two groups: one taking more than 10,000 steps daily and another taking fewer than 5,000 steps daily. The study, titled "Walk It Off!", seeks healthy, recreationally active individuals who have not engaged in resistance exercises or lower body workouts for at least three months. As an unphased trial, it offers participants the chance to contribute to understanding how daily activity levels influence muscle recovery.

Will I have to stop taking my current medications?

The trial requires that you do not regularly use non-steroidal anti-inflammatory drugs (like Advil) or oral contraceptives if you are a female participant.

What prior data suggests that this protocol is safe for managing delayed onset muscle soreness?

Research has shown that engaging in a lot of physical activity, such as walking more than 10,000 steps a day, can sometimes cause mild muscle and joint aches. This has been observed in nurses who are very active at work. However, these aches are usually not serious and resolve quickly.

In contrast, moderate activity, like walking less than 5,000 steps a day, is generally gentle on the body. Studies indicate that regular moderate activity benefits health and may reduce the risk of certain health problems.

Overall, both high and moderate levels of activity are safe for most people. Any discomfort from increased activity is typically manageable and short-lived. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the "Walk It Off!" trial because it explores how different levels of physical activity can help relieve delayed onset muscle soreness (DOMS) in a more natural and accessible way than current options like anti-inflammatory medications, rest, or massage. Unlike traditional treatments, which often involve medication or passive recovery, this approach emphasizes active recovery through walking, which can be easily integrated into daily routines. The trial investigates whether walking more than 10,000 steps (high activity) or less than 5,000 steps (moderate activity) per day can effectively reduce muscle soreness, potentially offering a simple, drug-free strategy for managing DOMS.

What evidence suggests that increasing daily steps could be effective for delayed onset muscle soreness?

Research shows that physical activity can affect muscle soreness after exercise, known as delayed onset muscle soreness (DOMS). In this trial, participants will follow different activity levels to study these effects. The "High Activity" arm requires more than 10,000 steps per day, which studies have linked to increased muscle aches, including soreness. This suggests that high daily activity might alter the experience of soreness. The "Moderate Activity" arm requires fewer than 5,000 steps per day, associated with health benefits like reduced muscle soreness. This indicates that both high and moderate activity levels can influence DOMS differently, possibly by affecting muscle recovery and inflammation. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for young adults who have experienced muscle pain and tenderness after novel exercise, known as delayed onset muscle soreness (DOMS). Participants should be interested in finding out if their daily physical activity level influences recovery from exercise-induced muscle damage.

Inclusion Criteria

Healthy, recreationally active male and female participants with weekly MET-minutes > 3000 assessed by International Physical Activity Questionnaire

Not having a health condition that would compromise their ability to safely participate in the strenuous physical activity involved in the study screened for by the get active questionnaire

Body mass index (BMI) between 18.5-30

Exclusion Criteria

Self-reported regular tobacco use

I regularly take drugs like Advil for pain or inflammation.

Inability to adhere to any of the compliance rules judged by the principal investigator or medical doctor

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants engage in an unaccustomed bout of resistance exercise followed by daily step count interventions

1 week

Daily assessments (in-person)

Follow-up

Participants are monitored for recovery from exercise-induced muscle damage and DOMS

1 week

Daily assessments (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Walk It Off!

Trial Overview

The study investigates the effect of daily step count on recovery from DOMS. It involves eccentric resistance exercises to induce muscle soreness, followed by monitoring participants' recovery based on their physical activity levels.

How Is the Trial Designed?

Group I: Moderate Activity Experimental Treatment 1 Intervention

Requires completion of less than 5,000 steps per day

Group II: High Activity Experimental Treatment 1 Intervention

Requires completion of greater than 10,000 steps per day

Who Is Running the Clinical Trial?

University of Toronto

Lead Sponsor

Trials

739

Recruited

1,125,000+

Published Research Related to This Trial

The study found that both myelinated Aδ-fibres and unmyelinated C-fibres contribute to mechanical hypersensitivity following lengthening contractions (LC), indicating a complex pain response in delayed onset muscle soreness (DOMS).

Blocking the acid-sensing ion channel ASIC3 with a specific inhibitor (APETx2) significantly reduced mechanical hypersensitivity in muscle, suggesting that ASIC3 could be a promising target for developing new pain relief treatments after exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Thin-fibre receptors expressing acid-sensing ion channel 3 contribute to muscular mechanical hypersensitivity after exercise. Matsubara, T., Hayashi, K., Wakatsuki, K., et al.[2020]

Cold water immersion significantly reduces delayed onset muscle soreness after high-intensity exercise, with notable reductions in pain observed at 24, 48, and 72 hours post-exercise, as indicated by standardized mean differences of -0.55, -0.66, and -0.93, respectively.

The findings support the use of cold water immersion as a reasonable intervention for individuals experiencing muscle soreness from high-intensity sports, despite some methodological limitations in the studies reviewed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Cold-water immersion versus passive therapy to decrease delayed onset muscular soreness: a CAT]. Aguilera Eguía, RA., Ibacache Palma, A.[2019]

Delayed-onset muscle soreness (DOMS) is a common issue that can hinder performance after exercise, typically peaking 1 to 4 days post-activity.

The article highlights that while various strategies exist to alleviate DOMS, their effectiveness and safety are often not well understood.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cochrane review: Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Costello, JT., Baker, PR., Minett, GM., et al.[2019]

Dehydration during exercise in a hot environment significantly increased delayed-onset muscle soreness (DOMS) and perceived pain compared to euhydrated individuals, indicating that proper hydration is crucial for muscle recovery.

Participants who were dehydrated experienced greater muscle microdamage, as evidenced by higher pain levels and tenderness, suggesting that exercising in heat without adequate hydration can worsen muscle injury.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dehydration and symptoms of delayed-onset muscle soreness in hyperthermic males. Cleary, MA., Sweeney, LA., Kendrick, ZV., et al.[2020]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12113665/

High Amount of Physical Activity on Work Days Is ...

Results: Musculoskeletal symptoms and step counts were significantly higher on work days compared to days off. Higher step counts on work days ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4294436/

A review of nutritional intervention on delayed onset muscle ...

This review is focused on the effect of nutritional intervention on delayed onset muscle soreness (DOMS) that occurs after exercise.

3.

frontiersin.org

frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1622377/full

The impact of various post-exercise interventions on ...

Objective: This study aimed to compare the effectiveness of various recovery interventions in alleviating delayed-onset muscle soreness ...

4.

researchgate.net

researchgate.net/publication/317614038_Effect_of_Low-Volume_High-Intensity_Interval_Exercise_and_Continuous_Exercise_on_Delayed-Onset_Muscle_Soreness_in_Untrained_Healthy_Males

Effect of Low-Volume High-Intensity Interval Exercise and ...

The aim of this study was to compare the effect of a single session of a low-volume high-intensity interval exercise (HIIE) and a continuous ...

5.

physio-pedia.com

physio-pedia.com/Delayed_Onset_Muscle_Soreness

Delayed Onset Muscle Soreness

A 2024 systematic review found that magnesium supplementation significantly reduced muscle soreness, rating of perceived exertion of a workout, and improved ...

6.

researchgate.net

researchgate.net/publication/391265128_High_Amount_of_Physical_Activity_on_Work_Days_Is_Associated_with_More_Intense_Musculoskeletal_Symptoms_in_Nurses_Seven-Day_Observational_Study

(PDF) High Amount of Physical Activity on Work Days Is ...

Higher step counts on work days resulted in significantly higher expected MSS ratings than the same number of steps taken on a day off.

7.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11618502/

Intensity and volume of physical exercise influence DOMS and ...

It remains unclear whether exercises leading to different outcomes of delayed onset muscle soreness (DOMS) may also elicit different skin

8.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S0167945721000208

Does delayed onset muscle soreness affect the ...

This study aimed to provide preliminary insight on whether DOMS affects ACL injury risk by investigating whether DOMS affects the biomechanical variables of ...

9.

mdpi.com

mdpi.com/2077-0383/13/7/2006

Physical Therapies for Delayed Onset Muscle Soreness

We will systematically review the current evidence on clinical outcomes (efficacy, safety) of physiotherapy interventions for the treatment of DOMS/EIMD in ...