delayed onset muscle soreness

Background Delayed onset muscle soreness (DOMS) commonly follows high-intensity or unaccustomed exercise. Nitric oxide (NO) precursors may reduce DOMS, but their effects remain uncertain. We conducted a systematic review and network meta-analysis to evaluate NO precursor interventions across recovery time points. Methods PubMed, Embase, Web of Science, and CENTRAL were searched to February 2026 for randomized controlled trials in healthy adults. Interventions were classified into four nodes: beetroot-derived nitrate, watermelon-derived citrulline, synthetic or isolated amino acid precursors (L-arginine and citrulline malate), and watermelon plus added citrulline. Random-effects network meta-analyses were conducted separately at 24, 48, and 72 h. Effects were expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs); SUCRA rankings were exploratory. Risk of bias and evidence certainty were assessed using RoB 2 and CINeMA, with subgroup and sensitivity analyses examining robustness. Results Nineteen trials involving 356 participants were included. At 24 h, watermelon plus added citrulline (SMD = −0.97, 95% CI −1.64 to −0.31) and beetroot-derived nitrate (SMD = −0.67, 95% CI −1.14 to −0.20) significantly reduced DOMS vs. placebo. At 48 h, beetroot-derived nitrate was the only intervention with a significant benefit (SMD = −1.18, 95% CI −1.91 to −0.45). No active intervention differed significantly from placebo at 72 h, while evidence for differences between active interventions was limited, with only watermelon plus added citrulline showing a significant advantage over synthetic or isolated amino acid precursors at 24 h. Beetroot-derived nitrate significantly reduced DOMS vs. placebo in the trained subgroup but not in the untrained subgroup. Sensitivity analyses generally supported the findings, although the beetroot-derived nitrate estimate was sensitive to some restrictions related to the exercise-induced muscle damage model. Conclusion NO precursor supplementation may reduce post-exercise DOMS at specific recovery time points, particularly with beetroot-derived nitrate and watermelon plus added citrulline. However, evidence for differences between active interventions remains limited, and the sparse network, substantial heterogeneity, and low certainty of evidence preclude firm clinical conclusions. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261373938 , identifier: CRD420261373938.

matched text: “delayed onset muscle soreness”

Hamstring and Thigh Rehabilitation: 50 Evidence-Based Biomechanics Analyses is an open educational collection from the MMSx Authority Applied Biomechanics Lab (MMSx Authority Institute for Movement Mechanics & Biomechanics Research, Inc.). It contains 50 articles covering hamstring strain, quadriceps and groin injury, return to sprinting and thigh load. Each article pairs a biomechanical analysis of three movements (four 1080 × 1350 analysis slides) with verified research data, a three-step decision pathway (modify, load, track), cautions on when to seek assessment, and APA 7 references with DOIs. Biomechanics is treated as a mechanical decision science: force, direction, dose and tissue tolerance. Files: the full collection as one PDF; all 200 slides with the DOI on each slide; the website edition (HTML articles). Online edition: https://mmsxauthority.org/edu/analysis/hamstring-thigh/ The figures are educational estimates made from illustrated reference figures; they are not measurements of a patient and are not a diagnosis or a substitute for individual clinical assessment. Articles01. Hamstring strain: why it is the most common injury in running sports02. Hamstring pain when sprinting: what happens in the late swing phase03. Pulled hamstring: grade 1, 2 or 3, and what each means for recovery04. Hamstring tear: when a tendon injury needs a surgical opinion05. Proximal hamstring tendinopathy: pain at the sitting bone06. Pain when sitting: when the hamstring tendon is the source07. Hamstring re-injury: why it comes back and how to lower the risk08. Nordic hamstring curl: what the injury-prevention evidence shows09. Eccentric hamstring strength: why lengthening control matters10. Tight hamstrings: stiffness, protective tension or nerve sensitivity?11. Hamstring stretching: does it prevent injury or just change tolerance?12. Return to running after a hamstring strain: criteria, not calendar days13. Hamstring injury in footballers: high-speed running and fatigue14. Hip extension versus knee flexion exercises: training both hamstring roles15. Romanian deadlift for hamstrings: loading the hip hinge safely16. Hamstring pain behind the knee: tendon, nerve or knee joint?17. Sciatic nerve sensitivity: when "tight hamstrings" is a nerve sign18. Slump and straight-leg raise tests: what they tell you about the nerve19. Hamstring cramps: fatigue, hydration and what the evidence supports20. Hamstring muscle bruise versus strain: telling them apart21. Quadriceps strain: the kicking and sprinting injury22. Rectus femoris injury: why the two-joint quadriceps is vulnerable23. Thigh bruise (dead leg): recovery and when it can calcify24. Myositis ossificans: when a thigh bruise turns to bone25. Quadriceps weakness after knee injury: why it lingers26. Quadriceps tendinopathy: pain above the kneecap27. Front-of-thigh pain when squatting: load, depth and knee position28. Groin strain: adductor injury in change-of-direction sports29. Adductor longus pain: the most commonly injured groin muscle30. Copenhagen adduction exercise: preventing groin injury31. Inner thigh pain: muscle, tendon, hip joint or hernia?32. IT band pain: why stretching the band rarely fixes it33. Outer thigh pain: gluteal tendon, IT band or referred pain?34. Meralgia paraesthetica: burning outer-thigh pain from a nerve35. Thigh muscle imbalance: what the hamstring-to-quadriceps ratio means36. Hamstring-to-quadriceps ratio and ACL risk: what is proven37. Single-leg strength differences: when thigh asymmetry matters38. Thigh muscle loss with age: sarcopenia, strength and falls39. Thigh pain in runners: stress reaction, strain or overload?40. Femoral stress fracture: deep thigh pain that should not be ignored41. Thigh pain after a long run: soreness or injury?42. DOMS in the thighs: why eccentric work hurts days later43. Sprinting technique and hamstring load: posture, stride and pelvis44. Pelvic tilt and hamstring strain: does the pelvis matter?45. Glute weakness and hamstring overload: the shared hip-extension job46. Hamstring injuries in older athletes: masters sport and tendon health47. Thigh compartment syndrome: severe swelling after impact or exertion48. Deep vein thrombosis: calf or thigh pain that is not a muscle injury49. Thigh red flags: when thigh pain needs urgent medical care50. Returning to sport after a thigh injury: strength, speed and confidence tests

matched text: “doms”