Capabilities of RSL sculpting procedure in Delayed Onset Muscle Soreness (DOMS) treatment

Introduction

One of the crucial problems of professional and amateur sport nowadays is the problem of recovery from physical exertion. Therefore, the issues of the training process management and body recovery by introduction of evidence based means into professionals’ and amateurs’ training and rehabilitation is currently relevant. It is apparent that the required effect can be achieved only by application of an integrated approach utilizing various means of recovery, and modern mechanical stimulation methods takes a special place among them ^[1-5].

Mechanism of RSL sculpting procedure

RSL sculpting procedure is based on a combined application of vibrocompression with rotating silicone spheres and high-brightness red light (LED).

Vibrocompression normalizes blood and nerve supply in tissues. Blood vessels and capillaries expand, blood flow increases, and nutrients and oxygen are supplied to cells in the area of vibration application. Lymphatic ducts also expand, and metabolic waste gets removed via them ^{[6, 7]}. It has been proven that even local subtle change of atmospheric pressure leads to change in hydrostatic and osmotic pressure gradients and related direction of liquid filtration through a capillary wall. This results in increased speed of liquid filtration from interstitium to blood channels and lymphatic vessels, increased intercellular space drainage, better tissue respiration and lower hypoxia ^[8-10]. Local barotherapy leads to change in hydrostatic and oncotic pressure gradient ratio in underlying blood and lymphatic vessels. Augmentation of carbon dioxide and oxygen concentration gradients in the microcirculation area leads to augmentation of their transcapillary diffusion speed and speeds up metabolism in underlying tissues ^[11].

In its turn, light exposure improves skin elasticity by 19% owing to stimulation of fibroblasts and production of TGF-β, which results in increase of collagen production. Under the influence of LED radiation, chromophores of the body (water, melanin and hemoglobin proteins) transform absorbed energy producing biologically active agents, such as serotonin, histamine etc. It has positive effect on the processes related to repair of connective tissue, microcirculation, and neuroendocrine system, thus demonstrating anti-inflammatory, lipolytic, and regenerating effects ^[12-15].

Hereby, based on understanding of the mechanism of RSL sculpting effect on the body, the procedure is indicated for:

• correction of local fat accumulation, including those in the projection of С7,
• treatment of gynoid lipodystrophy, including that of grades 3 and 4,
• improvement of skin and muscle tone,
• elimination of edema, including pitting edema, and congestive phenomena,
• decrease of soreness,
• preparation and rehabilitation before and after plastic surgery procedures.

Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness is usually abbreviated as DOMS. Relevance of the problem of prevention of the Delayed Onset Muscle Soreness and its treatment methods has to do with the fact that recovery is an important aspect of training process of professional and amateur athletes of any sex and age. It is considered that lactate may trigger further consecutive homeostatic changes that lead to immediate micro-injuries of skeletal muscles and inflammation and then to development of the delayed onset muscle soreness syndrome. Increase of vascular permeability (bradykinin release), activation of cyclooxygenase- 2 (COX-2) and lipoxygenase enzymes with the formation of thromboxanes, prostaglandins and leukotrienes (pain triggers) play an important role in the cascade of triggered biochemical reactions and lead to the development of pain syndrome, as well as to sensitization of group III and IV nerve fibers with increase in sensitivity to chemical and mechanical stimuli. The release of fluid from the vascular lumen into the tissues and the accumulation of immune cells lead to edema development, which also adds up to the pain ^[16-23].

However, muscle pain syndrome is not common, therefore it can be assumed that other triggers are also involved in the mechanisms of its development. For example, fluctuations of antioxidant system activity in its enzymatic (glutathione peroxidase, glutathione reductase, superoxide dismutase) and nonenzymatic (reduced glutathione) components may be more important for the DOMS development than lactate accumulation ^{[24, 25]}. Thus, in 2002 Lenn J. et al. suggested that it might be possible to reduce the DOMS symptoms by modulating inflammatory response. According to the authors, natural antioxidants based on fish oil reduce the inflammatory response by changing eicosanoid pathways and may level off intensity of the delayed onset muscle soreness ^[24]. In the work by R. Deminice, it was demonstrated that antioxidants reduce the intensity of oxidative stress manifestations and homeostasis disorders mediated by it. A positive effect of vitamin D3 supplement in a daily dose of 800 IU on reduction of DOMS intensity was also reported ^[24].

Taking into account the knowledge on the mechanisms of the development the delayed onset muscle soreness accumulated to date, a conclusion can be drawn that individualized nutrition and mechanical stimulation methods, including simultaneous application of vibration, compression, and massage elements, may serve as the DOMS prevention and treatment methods. Independent studies by different authors indicate that application of vibration to tissues is the most effective method of soreness relief ^{[26, 27]}. J. Guo, L. Li, Y. Gong, R. Zhu & al. in their systematic review conducted in 2017, which included 7 databases and 11 experimental articles with the total of 504 participants, concluded that performing a massage after intensive exercises might be an effective therapy for reducing the DOMS symptoms and improving effectiveness of muscle functions ^[28]. The Beautylizer Therapy Cosmospheres device belongs to the known devices that simultaneously apply all of the treatment factors mentioned. It is used to perform RSL sculpting procedure, which effects on tissues and the whole body are described above. It is worth noticing, that the device also has an inbuilt LED lamp with red light that further improves microcirculation, lymph flow, tissue regeneration, and demonstrates an anti-inflammatory action ^{[12-15, 28, 29]}. It occurs because the tissues that has absorbed this radiating energy start to generate heat. A pronounced heat effect increases metabolic processes, improves nerve supply in tissues, stimulates ATP synthesis ^[30].

Regarding nutrition, it is recommended to pay attention to sufficient intake of vitamins, especially vitamin D3 together wit calcium ions, polyunsaturated omega-3 fatty acids, plant-derived antioxidants. In case of their deficiency in the diet nutritional supplements can be used.