Hanney, William J.

ABSTRACT Delayed onset muscle soreness (DOMS) is a musculoskeletal condition that typically follows unaccustomed exercise or muscle overload, most common after loaded eccentric contractions. This soreness manifests within 24–48 hours postexercise and can last several days, impacting muscle performance and recovery. Increased levels of anxiety may prolong the perception of soreness and discomfort. Evidence suggests that recovery times for DOMS vary because of multiple factors, which include psychological influences such as anxiety. This manuscript highlights the interplay between psychological states and the DOMS recovery sequelae. Although further studies are needed to fully understand the mechanisms by which anxiety influences DOMS and to confirm the efficacy of anxiety-reducing treatments, a deeper understanding of this relationship could offer strength and conditioning professionals new pathways for optimizing recovery strategies in individuals experiencing DOMS.

Abstract Background Physical therapy is an important treatment option for patients with low back pain (LBP). However, whether to refer patients for physical therapy and the timing of initiation remain controversial. Objective The objective of this study was to evaluate the impact of receiving physical therapy and the timing of physical therapy initiation on downstream health care utilization and costs among patients with acute LBP. Design The design was a retrospective cohort study. Methods Patients who had a new onset of LBP between January 1, 2009, and December 31, 2013, in New York State were identified and grouped into different cohorts on the basis of whether they received physical therapy and the timing of physical therapy initiation. The probability of service use and LBP-related health care costs over a 1-year period were analyzed. Results Among 46,914 patients with acute LBP, 40,246 patients did not receive physical therapy and 6668 patients received physical therapy initiated at different times. After controlling for patient characteristics and adjusting for treatment selection bias, health care utilization and cost measures over the 1-year period were the lowest among patients not receiving physical therapy, followed by patients with immediate physical therapy initiation (within 3 days), with some exceptions. Among patients receiving physical therapy, those receiving physical therapy within 3 days were consistently associated with the lowest health care utilization and cost measures. Limitations This study was based on commercial insurance claims data from 1 state. Conclusions When referral for physical therapy is warranted for patients with acute LBP, immediate referral and initiation (within 3 days) may lead to lower health care utilization and LBP-related costs.