Delayed onset muscle soreness (D.O.M.S) is a medical condition that is characterised by the stiffness, tenderness and pain in muscles several hours after performing a strenuous physical activity. When muscles are stressed, small microscopic tears occur in the ligaments, coupled with the stiffness and inflammation that accompany these tears, causing the pain and fatigue. The soreness is felt most strongly 24 to 72 hours after the exercise. DOMS is most notably experienced after beginning a new exercise program, rapidly altering or upping the work load or pushing the body to the extreme, and for the novice, it can be a quite uncomfortable and off putting outcome of exercise. DOMS certainly does lead to a decline in physical performance, including reduced muscle strength and flexibility as well as reduced joint range of motion. In addition, a deterioration in proprioception, oneís awareness of body position in space, and coordination is found in those suffering from DOMS. These changes can lead to an increased risk of injury if the athlete does not modify their training or exercise routine whilst recovering from a bout of DOMS. † DOMS Management Cryotherapy (cold therapy) A systematic review of 36 papers by Hohenauer and others in 2015 found that cryotherapy (cooling and cold water immersion therapy) significantly reduced the symptoms of DOMS experienced by athletes, with symptoms lasting up to 48 hours, but not having an effect at 96 hours post exhaustive exercise. Stretching A 2011 systematic review in the Cochrane database (Herbert, de Noronha and Kamper) examined the effect that stretching, before or after exercise, had on the development of DOMS and interestingly found that the evidence suggests that muscle stretching before, after, or before &†after exercise, does not produce clinically important reductions in DOMS in healthy adults. Compression garments A 2014 systematic review in the British Journal of Sports Medicine evaluated the effects of compression garments on recovery following intense exercise, with findings indicating compression garments are effective in enhancing recovery from muscle damage. Myofascial release Myofascial release is a popular intervention used to enhance myofascial mobility. According to a 2015 study in the International Journal of Sports Physical Therapy (Cheatham and others), use of a foam roller after intense exercise appears to improve joint range of motion (in the short term) and may help maintain muscle performance and reduce DOMS. Sports massage Massage may facilitate recovery from repetitive muscular contractions, so although sports massage after intense exercise may not improve muscle performance after intense exercise, massage may enhance and speed up recovery as well as reduce the effects of DOMS after intense exercise.