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Journal of Strength and Conditioning Research, 2004, 18(4), 723–729᭧ 2004 National Strength & Conditioning Association

THE EFFECTS OF Y OGA TRAINING AND A SINGLE

BOUT OF Y OGA ON DELAYED ONSET MUSCLE

SORENESS IN THE LOWER E XTREMITY

COLLEEN A. BOYLE,1 STEPHEN P. S AYERS,3 B ARBARA E. JENSEN,2 S AMUEL A. HEADLEY ,1 AND

TINA M. M ANOS1

1 Department of Exercise Science and Sports Studies, Springfield College Allied Health Sciences Complex,Springfield, Massachusetts 01109; 2 Department of Physical Education, Springfield College Allied Health SciencesComplex, Springfield, Massachusetts 01109; 3School of Health Professions Department of Physical Therapy,University of Missouri, Columbia, Missouri 65211.

A BSTRACT. Boyle, C.A., S.P. Sayers, B.E. Jensen, S.A. Headley,and T.M. Manos. The effects of yoga training and a single boutof yoga on delayed onset muscle soreness in the lower extremity.

J. Strength Cond. Res. 18(4):000–000. 2004.—The purpose of thisstudy was to determine the effects of yoga training and a single

bout of yoga on the intensity of delayed onset muscle soreness(DOMS). 24 yoga-trained (YT; n ϭ 12) and non–yoga-trained(CON; n ϭ 12), matched women volunteers were administereda DOMS-inducing bench-stepping exercise. Muscle soreness wasassessed at baseline, 24, 48, 72, 96, and 120 hours after bench-stepping using a Visual Analog Scale (VAS). Groups were alsocompared on body awareness (BA), flexibility using the sit-and-reach test (SR), and perceived exertion (RPE). Statistical signif-icance was accepted at pՅ 0.05. A 2 ϫ 2 mixed factorial ANOVA with repeated measures at 24 and 48 hours revealed a signifi-cant ( p Ͻ 0.05) group main effect with VAS scores greater forCON than YT. Paired t-tests revealed that in YT, VAS scoreswere higher before yoga class than after yoga class at 24 hours(21.4 [Ϯ 6.9] mm vs. 11.1 [Ϯ 4.1] mm; p ϭ 0.02). The SR wasgreater in YT than in CON (65.0 [Ϯ 7.9] cm vs. 33.3 [Ϯ 7.0] cm;

p Ͻ 0.01); however, no differences were found between yoga and

control in BA (94.0 [Ϯ

4.4] units vs. 83.8 [Ϯ

3.7] units; pϭ

0.21)or in RPE at 5-minute intervals (2.9 [Ϯ 0.3], 5.3 [Ϯ 0.8], 5.8 [Ϯ

0.9], and 5.2 [Ϯ 0.8] vs. 2.5 [Ϯ 0.3], 4.0 [Ϯ 0.5], 4.2 [Ϯ 0.3], and4.9 [Ϯ 0.4]. Yoga training and a single bout of yoga appear toattenuate peak muscle soreness in women following a bout of eccentric exercise. These findings have significant implicationsfor coaches, athletes, and the exercising public who may wantto implement yoga training as a preseason regimen or supple-mental activity to lessen the symptoms associated with musclesoreness.

K EY WORDS. muscle damage, eccentric exercise, stretching

INTRODUCTION

Delayed onset muscle soreness (DOMS) is the

sensation of discomfort experienced after un-accustomed physical activity; it ranges fromslight muscle stiffness to severe debilitating pain (39). The overexertion of skeletal muscle

through increased duration or intensity of accustomedforce may lead to DOMS, which has been reported to peakbetween 24–48 hours postexercise and remain for 5–7days (32). DOMS occurs predominantly following activi-ties that emphasize eccentric contractions. Because fewermotor units are recruited during eccentric vs. concentricor isometric contractions, greater mechanical damage tothe muscle occurs, resulting in an increase in the sensa-tion of pain (3).

Muscle pain is considered to be proportional to theamount of physiological and biochemical damage to bodilytissues, as well as to the psychological reaction to thatdamage (4). Although there are no definitive preventionor treatment methods for muscular soreness, yoga maybe a candidate. Nespor (23) hypothesized that yoga prac-tice provides a local relaxation of a painful area throughthe gradual stretching of skeletal muscles, a voluntarychange in respiration, and an increase in self-awarenessthrough meditative techniques. Yoga training has beenshown to decrease low back, shoulder, neck, head, andfacial pain (17), as well as to reduce the pain associatedwith osteoarthritis of the hands (9) and carpal tunnel syndrome (10). Yoga training has never been tested beforeby the scientific community as an intervention to preventor treat DOMS.

The purpose of the present study was to determine theeffects of yoga training and the effects of a single bout ofyoga on DOMS. We hypothesized that the intensity of

muscle soreness would be lower in subjects with yogatraining, compared with those with no yoga training, andthat yoga practitioners would perceive less muscle sore-ness after a single bout of yoga. Because DOMS may re-sult in diminished athletic performance, decreases inphysical activity participation, and difficulty adhering toan exercise regimen (26), finding a prevention and/ortreatment for DOMS is crucial to health promotion facilitators, coaches, and athletes (37). Women especially maybenefit from an effective modality to prevent/treat DOMSbecause they may have a lower pain tolerance comparedwith men (14, 19). A secondary purpose of the study wasto determine whether fundamental differences existed between yoga-trained and non-yoga-trained volunteers, andwhether these factors contributed to differences in the

soreness response to overexertion exercise. We hypothe-sized that a yoga-trained person’s greater purported flex-ibility and body awareness would contribute to lowermuscle soreness after strenuous exercise.

METHODS

Experimental Approach to the Problem

The study was designed to address whether yoga trainingwould attenuate the intensity of muscle soreness afterstrenuous exercise, compared with control, and whethersoreness would be reduced with a single bout of yoga(when muscle soreness is elevated). To test these hypoth



724 BOYLE, S AYERS, JENSEN ET AL.

eses, we used a repeated measures design to assess per-ceived muscle soreness in both yoga-trained and controlwomen over 5 consecutive days following a strenuous ex-ercise protocol designed to increase muscle soreness of thelower extremity. On days when the muscle soreness waselevated (24 and 72 hours postexercise) perceived musclesoreness was assessed in the yoga group alone both priorto and following a yoga training session to determinewhether soreness was acutely diminished by this exer-cise.

Subjects

The effects of yoga training on perceived muscle sorenesswas examined across 2 groups of women: a yoga-trainedgroup (YT; n ϭ 12), and a non-yoga-trained control group(CON; n ϭ 12). The YT group practiced a type of Hathayoga called Kripalu, which consists of asanas, pranaya-ma, and meditation, whereas the CON group had no yogaexperience. Inclusion criteria consisted of the following:volunteers were required to be women, less than 55 yearsof age (according to American College of Sports Medicine[2] criteria for vigorous activity participation), free of medical conditions, and free from the use of any pain-

reducing medications. The YT volunteers were recruitedfrom western Massachusetts and eastern Connecticutyoga centers. Once an adequate number of YT subjectswere obtained, CON subjects who initially matched YTsubjects on age, body mass index (BMI), and physical ac-tivity level (PAL) were recruited. Once a matched controlwas found, subjects were then matched on their durationof bench stepping (DBS) during the eccentric exercise pro-tocol. The CON group consisted of faculty, staff, and stu-dents gathered through an on-campus search at Spring-field College, Springfield, MA. All subjects completed aninformed consent document prior to participating in thestudy. The study was approved by the Springfield CollegeInstitutional Review Board.

Study Design

Each subject’s body mass in kg, height in cm, and limblength in cm (distance from midpatella to the floor) weremeasured immediately upon arriving at the testing site.Next, subjects were asked to complete the Aerobics Lon-gitudinal Study Physical Activity Questionnaire (AL-SPAQ; 18), in conjunction with the Compendium of Phys-ical Activities (1), to determine the PAL for matching pur-poses. Because of the potential influence of body aware-ness (BA) and flexibility (SR) on muscle soreness,differences in these variables were assessed at baselinebetween the groups.

The Body Awareness Questionnaire (BAQ; 31) was ad-ministered to assess BA (or the ability to assess changes

in bodily processes), and a visual analog scale (VAS; 29)was administered to assess muscle soreness. Next, thesubjects were asked to perform a low intensity bench-stepping protocol designed to warm-up the muscle, butnot cause soreness (14). The warm-up consisted of step-ping on a 10-cm high bench (BIG FITNESS, Pawtucket,RI) for 10 minutes at a pace of 64 bpm (via an electricmetronome) to elicit 16 complete cycles per minute. Thelead leg altered every minute. After the warm-up, subjects were asked to perform the sit-and-reach test (SR;35) to assess flexibility. Three trials, with a 30-second restbetween each trial, were obtained, and the best measureof reach (in centimeters) expressed as a percentile rank

(2) was recorded for analysis. If the best reach did notexactly correspond to a percentile rank, the next lowestrank was used. Finally, subjects were asked to begin thebench-stepping exercise designed to induce muscle sore-ness, and the rate of perceived exertion (RPE) was vocal-ized every 5 minutes for the entire duration of the pro-tocol.

The subjects were instructed to complete a VAS every24 hours after the testing session, for a total of 5 days.Muscle soreness was measured at baseline, 24, 48, 72, 96,and 120 hours postexercise. The YT group participated ina 90-minute gentle or moderate Kripalu-style yoga class(at the facility where they normally practice yoga) at 24and 72 hours after the initial testing session. The timeperiods of 24 and 72 hours were chosen, as opposed to 24and 48 hours (when DOMS tends to peak), because most YT subjects practiced yoga every other day, not on con-secutive days. Two additional VAS were provided to YTsubjects to be completed after their participation in theyoga classes, to determine the effect of a single bout of yoga on DOMS. All subjects were instructed not tostretch, to receive massage, to apply thermal modalities,to take medications, or to participate in other structured

physical activity for the duration of their 5-day partici-pation in the study.

Outcome Measures

Matching Criteria. Age was assessed by self-report on aquestionnaire. Height was measured to the nearest cmusing a stadiometer (Detecto Scale, Detecto Scales Inc,Brooklyn, NY). Body mass was measured, with the shoesof the subject removed, to the nearest 0.25 kg with a cal-ibrated scale. BMI was calculated using the following equation: body mass (kg)/height (m)2. Only subjects whohad a BMI of normal (18.5–24.9 kg·mϪ2) or overweight(25.0–29.9 kg·mϪ2) were selected to participate in thisstudy (2). PAL was assessed using the ALSPAQ in conjunction with the Compendium of Physical Activity forthe assignment of metabolic equivalent (MET) levels.

Muscle Soreness. Muscle soreness was obtained using a VAS. The VAS scale is a 100-mm continuum with per-ceived levels of muscle soreness ranging from ‘‘No Pain’’to ‘‘Worst Possible Pain.’’ Volunteers were instructed towalk for 30 seconds and to place a vertical line at a pointalong the continuum that corresponded with their per-ceived level of soreness. VAS soreness/pain scales havebeen found to be valid and reliable instruments for as-sessing muscle pain and soreness (24). The score is ob-tained by measuring the distance in millimeters markedby the respondent from the zero end of the scale.

Body Awareness. Body awareness was determined us-ing the Body Awareness Questionnaire (BAQ) which

quantifies the attentiveness to normal bodily processes.The BAQ consists of 18 questions that assess the abilityto detect changes in bodily processes, bodily reactions,and sleep-wake cycles, as well as to detect the onset of illness. Included in the BAQ is 1 question specific to painperception after overexertion (question number 3, BAQ3)that was analyzed as a part of the set of BA questions, aswell as individually. Scoring of the BAQ (31) consisted of each item being rated on a 7-point Likert scale ranging from ‘‘Not at all true about me’’ to ‘‘Very true about me.’’Higher total scores are indicative of greater body aware-ness. The BAQ has been shown to be internally consistentand reliable (coefficient ␣ ϭ 0.82, r ϭ 0.80; 31).



YOGA AND DOMS 725

Flexibility. Flexibility was assessed using the sit-and-reach test (SR). The SR was administered using a stan-dard preassembled metal 30.48 cm by 53.34 cm SR box(Lafayette Instrument Company, Lafayette, IN). Volun-teers sat on the floor with legs extended and shoulder-width apart, and feet flat against the box. Subjects wereinstructed to place their heels against the edge of the SRbox (where the zero point was set at 23 cm), then placeone hand on top of the other and slowly push their handsalong a ruler positioned on top of the box, without strain-ing or causing pain, until a maximum reach was attained.The SR has been shown to be a valid and reliable measureof flexibility (16, 30).

Perceived Exertion. The CR10 scale was constructedafter the traditional RPE scale to meet the need for acategory (C)-ratio (R) scale. The CR10 scale (5) possessesa simple category rating method for direct estimates andratio scaling for determining ratio relationships betweenperceptual responses. The CR10 scale is a scale labeledfrom zero (‘‘Nothing at all’’) to a dot (‘‘Absolute maxi-mum’’). The following verbal descriptors are placed inter-mittently between 0 and 10: ‘‘Extremely weak,’’ ‘‘Veryweak,’’ ‘‘Weak,’’ ‘‘Moderate,’’ ‘‘Strong,’’ ‘‘Very strong,’’ and

‘‘Extremely strong.’’ Subjects were encouraged to respondusing numbers that were not included on the scale, suchas half values (1.5 or 3.5) or other decimals (0.3 or 2.3),as well as integers beyond 10, yet less than ‘‘Absolutemaximum.’’ The CR10 scale has been shown to be a valid(r ϭ 0.91; 20) and reliable (r ϭ 0.90; 38) measure of per-ceived exertion.

Exercise Protocol

The bench-stepping protocol used in this study was sim-ilar to the protocol used by Buroker and Schwane (6) thatresulted in significant increases in muscle damage. First,a bench was adjusted to equal 110% of the distance fromthe midpatella of the subject to the floor. Plastic steps byReebok (BIG FITNESS, Pawtucket, RI), adjustable in5.08-cm increments, were used. Subjects were assignedstep heights closest to 110% of the distance from theirmidpatella to the floor; however, for safety purposes, thestep height was always rounded down so subjects wouldnot have to step higher than 110% of midpatella to floordistance. The bench-stepping pattern utilized was rightfoot up, left foot up, right foot down, left foot down. Thepattern consisted of raising the body with concentric con-tractions of the right knee extensor and left plantar flexormuscles, and lowering the body with eccentric contrac-tions of the left knee extensor and right plantar flexormuscles. A calibrated metronome was set at 62 bpm toelicit 15.5 stepping cycles per minute.

Statistical Analyses

A 2 ϫ 6 mixed factorial analysis of variance (ANOVA) wasused to compare pain across 2 groups of subjects (YT andCON) for 6 time periods (baseline, 24, 48, 72, 96, and 120hours post eccentric exercise). A 2 ϫ 2 mixed factorial ANOVA was used to compare pain between the yoga andcontrol group for the peak DOMS time periods of 24 and48 hours. Mauchly’s Test of Sphericity was used to deter-mine whether correlations between all possible pairs of measures were similar (sphericity). A correction factor(Greenhouse-Geisser Epsilon) was applied to the degreesof freedom of the error term to calculate the significanceof the F distribution when violations of sphericity oc-

curred. Paired t-tests were used to determine whetherthere were significant differences in pain before and aftera single yoga session performed at 24 and 72 hours post-exercise. To determine differences between YT and CONfor baseline BA, BAQ3, and SR, an independent t-test wasused. A 2 ϫ 4 mixed factorial ANOVA was used to compare RPE at 5, 10, 15, and 20 minutes of bench-steppingacross the 2 groups. Mean group RPE values were sub-stituted for individual missing values at 15 and 20 min-utes (for those subjects who did not complete the entireexercise protocol). Correlation coefficients were computedto determine if a relationship existed between the meanand peak VAS scores and duration (i.e., months) of yogapractice (DYP) and number of times yoga was practicedper week (XYP) for YT. Correlation coefficients were com-puted to determine if a relationship existed between themean and peak VAS scores and BA, BAQ3, and SR forthe entire group (YT and CON). Because of the hypoth-esized directional relationship of these variables to VASscores, we chose a one-tailed test of significance. Statis-tical significance for all tests was accepted at p Յ 0.05.

RESULTS

Outcome Measures

Matching criteria. The mean age (Ϯ SEM ) of the subjectswas 38.0 (Ϯ 2.6) years with a range of 22–53 years. Themean height and body mass of the subjects was 162.3 ( Ϯ

0.7) cm and 57.2 (Ϯ 2.2) kg, respectively. The mean BMIof the subjects was 21.8 (Ϯ 0.7) kg·mϪ2, with 22 of thewomen classified (2) as having a normal BMI and 2 of thewomen classified as overweight. The mean PAL of thesubjects was 40.5 (Ϯ 9.5) MET hours per week. The duration of the bench-stepping exercise was intended to be20 minutes. However, 3 yoga practitioners (and thustheir matched controls) did not complete the full 20 minutes, but completed 10, 11.5, and 15 minutes, respective-ly. Overall, subjects completed an average of 17.9 (Ϯ 1.0minutes of the DOMS-inducing bench-stepping protocolIndependent groups’ t-ratios were computed for thematching variables (see Table 1) and no significant dif-ferences were found between the groups (all; p Ͼ 0.05)We were confident that groups were sufficiently matchedto experience similar effects of the exercise protocol.

Muscular Soreness. Descriptive statistics for VASscores in YT and CON are presented in Table 2. Themean VAS score over the 6 time periods was 11.4 ( Ϯ 3.5mm in YT and 20.2 (Ϯ 3.2) mm in CON. The sphericityassumption was violated according to Mauchley’s test ( pՅ 0.05), therefore, the Greenhouse-Geisser Epsilon cor-rection factor was applied to the degrees of freedom of theerror term to adjust p values. No significant group main

effect ( p ϭ 0.08) or interaction was found ( p ϭ 0.06), butthere was a significant main effect for time ( p Ͻ 0.001effect size ϭ 0.61). The bench-stepping protocol resultedin a significant increase in muscle soreness in the daysfollowing exercise (see Figure 1).

Mean VAS scores between the yoga and control groupsfor the critical DOMS periods (24 and 48 hours) are pre-sented in Table 2. No significant main effect ( p ϭ 0.08or interaction was found for time ( p ϭ 0.55), but therewas a significant main effect for group ( p ϭ 0.05; effectsizeϭ0.17). Yoga subjects demonstrated lower peak muscle soreness than did control subjects (see Figure 1).

Differences in VAS scores before and after yoga class




T ABLE 1. Independent groups t ratios comparing the matching variables of age, body mass index (BMI), physical activity level(PAL), and duration of bench-stepping (DBS) between YT (n ϭ 12) and CON (n ϭ 12).

Groups Means Mean diff. SEM diff. t p ES*

† Age (y)

Control Yoga

37.838.3

0.50 3.73 0.13 0.90 0.05

† BMI (kg·mϪ2)

Control

Yoga

21.7

21.9

0.27 1.03 0.26 0.80 0.13

† PAL (MET hr·wkϪ1)

Control Yoga

39.441.7

2.29 13.7 0.17 0.87 0.10

† DBS (min)

Control Yoga

17.918.0

0.17 1.52 0.11 0.91 0.05

Table t (.05)(22) ϭ Ϯ2.07.* BMI ϭ body mass index; PAL ϭ physical activity level; DBS ϭ duration of bench stepping; ES ϭ effect size.† No significant differences were found in the means for any of the variables between yoga and control subjects.

T ABLE 2. Descriptive statistics for dependent variables in YT(n ϭ 12) and CON (n ϭ 12).

Variable

Control

M SEM

Yoga

M SEM ES*

DOMS (mm)

MeanBaseline

24 h post48 h post72 h post

20.20.8

44.948.817.4

3.20.67.87.25.7

11.40.3

21.429.312.3

3.60.37.08.84.6

0.800.230.870.780.26

96 h post120 h postBAQ (units)BAQ3 (units)SR (cm)

3.50.9

83.84.4

33.3

1.70.53.70.47.0

2.00.6

94.05.1

65.0

1.50.44.40.47.9

0.250.150.790.511.31

DYP

XYP

0.0

0.0

0.0

0.0

53.4

3.2

23.8

0.4

—

—RPE (units)

RPE 5 minRPE 10 min†RPE 15 min‡RPE 20 min

2.54.04.24.9

0.30.50.30.4

2.95.35.85.2

0.30.80.90.8

0.420.821.400.27

* ES ϭ Effect size; DOMS ϭ delayed onset muscle soreness;BAQ ϭ body awareness questionnaire; BAQ3 ϭ Question 3 onBAQ—‘‘I always know when I’ve exerted myself to the pointwhere I’ll be sore the next day.’’; SR ϭ sit-and-reach (Note: 23cm ϭ reach even with bottom of foot); DYP ϭ duration of yogapractice (in months); XYP ϭ times per week yoga was practiced;RPE ϭ rate of perceived exertion.

† Data presented for 10 matched pairs.‡ Data presented for 9 matched pairs.

FIGURE 1. Mean delayed onset muscle soreness (DOMS) inthe control and yoga groups at 6 time periods (baseline, 24, 48,72, 96, and 120 hours post DOMS-inducing exercise).* represents statistically significant group difference.

in YT at 24 and 72 hours postexercise are presented inFigure 2. VAS scores were significantly higher beforeyoga class than after yoga class at 24 hours (21.4 [Ϯ 6.9]mm vs. 11.1 [Ϯ 4.1] mm; p ϭ 0.02; effect size ϭ 0.74) anddemonstrated a strong trend at 72 hours (12.3 [Ϯ 2.5] mmvs. 5.5 [Ϯ 2.2] mm; p ϭ 0.06; effect size ϭ 0.87). Thesefindings suggest that a single bout of yoga may attenuateperceived muscle soreness during elevated periods of muscle soreness.

Body Awareness, Flexibility, and RPE. Descriptive sta-tistics for BA, BAQ3, SR, and RPE scores in YT and CON

are presented in Table 2. No significant difference wasfound between groups in BA ( p ϭ 0.08) or BAQ3 ( p ϭ

0.26). Significant differences were found between groupsin SR ( p Ͻ 0.01; effect sizeϭ1.31), with YT significantlymore flexible than CON. No significant group main effect( p ϭ 0.21) or interaction ( p ϭ 0.31) was found in RPEscores at 5, 10, 15, or 20 minutes, but there was a signif-icant time main effect (p Ͻ 0.001; effect size ϭ 0.72).

No significant correlations were found between 48-hour peak VAS scores and DYP (r ϭ 0.09, p ϭ 0.34), XYP(r ϭ Ϫ0.31, p ϭ 0.07), BA (r ϭ Ϫ0.11, p ϭ 0.31), BAQ3(r ϭ Ϫ0.27, p ϭ 0.10), and SR (r ϭ Ϫ0.16, p ϭ 0.23) orbetween 5-day mean VAS scores and DYP (r ϭ 0.03, p ϭ

0.44), BA (r ϭ Ϫ0.12, p ϭ 0.29), BAQ3 (r ϭ Ϫ0.17, p ϭ

0.21), and SR (r ϭ Ϫ0.24, p ϭ 0.13). A significant rela-tionship was found, however, between 5-day mean VASscore and XYP (r ϭ Ϫ0.37, p ϭ 0.04).

DISCUSSION

Yoga training has been used to treat a multitude of ad-verse physical and psychological conditions; however, it



YOGA AND DOMS 727

FIGURE 2. Mean delayed onset muscle soreness (DOMS)before and after yoga class at 2 time intervals (24 and 72hours after DOMS-inducing exercise). * represents statisticallysignificant difference within time interval.

has never been used to prevent or treat DOMS. The pre-sent study was designed to determine whether (a) the in-tensity of muscle soreness would be lower in those withyoga training compared with those not involved in yogatraining, (b) whether yoga practitioners would experienceless muscle soreness after a single bout (90 minutes) of yoga, and (c) whether fundamental differences in yogapractitioners compared with non-yoga practitioners, con-tributed to differences in perceived muscle soreness afteroverexertion exercise.

The major finding of the study was that yoga practi-tioners had less peak muscle soreness at 24 and 48 hoursin response to a novel, unaccustomed strenuous exercisecompared with their non-yoga counterparts. According toHigh et al. (14), analyses limited to peak muscle sorenessratings of subjects appears to be most appropriate. Peak VAS scores in the present study were comparable to thosereported previously (14, 15). Although the overall differ-ence in VAS scores between the 2 groups over 5 days wasnot statistically significant, there was a strong trend ( pϭ 0.06) to suggest that the pattern of soreness responseto bench-stepping exercise was different between groups(with YT experiencing less perceived muscle sorenessthan did CON). A limitation of this study was that we didnot collect any direct or indirect measures of muscle dam-age other than muscle soreness. However, the bench-step-ping protocol used in this study was nearly identical tothe protocol used by previous researchers (6) who found

significant increases in muscle damage as assessed by re-duced muscle strength and increases in creatine kinaseactivity in the blood. Thus, we are confident that muscledamage was incurred by our subjects using this same pro-tocol.

The challenge inherent in this study was to recruit 2groups who were similar prior to eccentric exercise train-ing. By matching groups according to their age, BMI,PAL, and DBS, we controlled for factors that could poten-tially influence the response to the bench-stepping exer-cise. Because RPE scores were not different betweengroups at any time point during bench-stepping, it is like-ly that YT and CON were similarly stressed by the bench-

stepping protocol. YT may even have had a greater like-lihood for higher VAS scores because they were given thebench-stepping exercise first and exercised until exhaustion, while CON was matched according to the benchstepping duration of YT, independent of exhaustionThus, it is likely that yoga training (and not differencesbetween groups) contributed to the significantly lowersoreness ratings amongst the YT subjects compared withthe CON subjects.

In addition, a single bout of yoga (performed at 24hours postexercise) was successful in attenuating musclesoreness when soreness was significantly elevatedDOMS was higher before yoga class than after yoga clasat 24 hours and showed a strong trend at 72 hours ( p ϭ

0.06), even as muscle soreness was diminished. At 24hours, the magnitude of the significant decrease in VASscores was 49%, which was greater than the magnitudeof decrease in muscle soreness following other reportedtreatment methods, such as high and low electrical nervestimulation (7, 8), high-speed concentric contractions (11)ultrasound (12), and counterirritants (13).

Although merely increasing physical activity when themuscle is sore from overexertion appears to be sufficient

to attenuate muscle soreness (27), the impressive magnitude of decrease in muscle soreness following yoga practice is perhaps due to the unique nature of yoga. Yogaappears to differ from traditional physical activity in that(1) yoga consists of unique, unconventional body positionswhich are held for sufficient durations (ranging from 30seconds to as long as can be tolerated by the practitionerwith typical classes lasting from 60–90 minutes [22, 34])(2) yoga may act as a massage on internal organs, where-by pressing and massaging stimulates circulation (33); (3yoga emphasizes taking each joint through a full rangeof motion (28), whereas many other physical activitymodes emphasize only specific joints and less than fullrange of motion; and (4) yoga emphasizes breathing andmeditative techniques which have been used to reduce

pain (23). Future researchers should examine othermodes of acute activity compared with yoga training tofurther determine the specific impact of a single bout ofyoga on muscle soreness.

The relationship of body awareness and flexibility(prior to strenuous exercise) to the muscular soreness response from strenuous exercise was also assessed. We hypothesized that yoga-trained individuals would experience less soreness after eccentric exercise than non-yogatrained individuals, possibly resulting from greater flex-ibility and/or greater body awareness. A major functionof yoga practice is to increase awareness of the body andmind (25). Techniques designed to specifically increaseself-awareness have been used successfully for pain re-

duction (17). Additionally, yoga training significantly im-proves flexibility (36), and increased flexibility has beenassociated with decreased perception of muscle soreness(21). If yoga practitioners have heightened body aware-ness and greater flexibility than non-yoga practitionersthis might help explain why they experienced lower mus-cle soreness ratings after strenuous exercise.

The measurement used to analyze body awareness inthe current study (the BAQ; 31) was the same as thatused by Rani and Rao (25), who similarly tested the bodyawareness of yoga practitioners. Although Rani and Rao(25) were able to conclude that yoga practitioners hadhigher body awareness than those without yoga training




we did not find significant differences between thegroups. Because our yoga-trained volunteers did not ap-pear to have greater body awareness than the non-yoga-trained group, the decrease in exercise-induced musclesoreness among the yoga-trained practitioners apparentlyis due to other factors.

We believe that one of the mechanisms responsible forthe finding that DOMS was significantly lower with yogatraining was the increased flexibility of YT, comparedwith CON. McHugh et al. (21) reported that flexible in-dividuals are less susceptible to exercise-induced muscledamage than those who are less flexible, and that the lackof flexibility was a risk factor for more severe muscledamage. The yoga practitioners in this study were signif-icantly more flexible than non-yoga practitioners, reach-ing nearly twice as far on the flexibility assessment using the SR. However, a limitation of this study was the useof the SR, which was used as a general indicator of flex-ibility and did not adequately evaluate lower extremityflexibility. Thus, it was not surprising that we did not finda significant association between flexibility and mean andpeak lower extremity VAS scores. Unfortunately, we can-not conclude definitively whether the lower VAS scores

in YT were due to better baseline flexibility in the exer-cise-damaged muscles; however, we believe these findingsprovide an impetus for future research on the mecha-nisms associated with DOMS attenuation in yoga-trainedindividuals.

In conclusion, the practice of Kripalu yoga is effectivein reducing DOMS in 22–53 year-old women who practiceyoga. Yoga practitioners had less soreness between 24and 48 hours postexercise than control subjects, whichmay be related to increased flexibility. A single bout of yoga also appears to attenuate perceived muscle sorenessin the days after strenuous exercise. The magnitude of decrease in soreness following the yoga class at 24 hourspostexercise, when muscle soreness was significantly el-evated, was 49%. In addition to yoga providing a greater

magnitude of decrease in DOMS compared with the otherprevention and treatment methods that have been used(such as nerve stimulation, ultrasound, and counterirri-tants), the practical nature of yoga also makes this treat-ment accessible to most populations. Yoga requires littleor no equipment, it can be practiced almost anywhere,and persons of all different physical abilities can practiceyoga. We would like to emphasize that although a singlebout of yoga was effective in reducing the perception of muscle soreness in trained practitioners of yoga, yogatraining cannot be recommended as a treatment for mus-cle soreness in those who do not have experience with theactivity (due to the nature of unaccustomed physical ac-tivity resulting in soreness; 39).

PRACTICAL A PPLICATIONS

The findings that yoga training and a single bout of yogaappear to lessen DOMS has significant implications forcoaches, athletes, and the exercising public who maywant to implement yoga training as a preseason regimenor a supplemental activity in an attempt to lessen thesymptoms associated with muscle soreness from overex-ertion exercise (such as decreased desire to participateand decreased strength). In addition, it also appears thatincreasing the number of yoga sessions per week may fur-ther attenuate the soreness response. Because the prac-tice of yoga emphasizes the execution of physical pos-

tures, breathing techniques, and meditation, it is un-known which of these components may be most respon-sible for the reduction in pain. Future researchers areencouraged to examine each of these factors to determinewhich is affecting pain to the greatest degree.

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Acknowledgments

The authors would like to extend their sincere appreciation tothe subjects involved with this study and the research grancommittee. This work was supported by the MassachusettGovernor’s Committee on Physical Fitness and Sports.

Address correspondence to Colleen Boyle, cboyle@mcgedu.

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