Document Type

Journal Article


Informa Healthcare


Faculty of Health, Engineering and Science


School of Exercise and Health Sciences/Centre for Exercise and Sports Science Research




This article was originally published as: Lau, W. Y., Muthalib, M. , & Nosaka, K. (2013). Visual analog scale and pressure pain threshold for delayed onset muscle soreness assessment. Journal of Musculoskeletal Pain, 21(4), 320-326. Original article available here


Objectives: To investigate the relationship between two assessments to quantify delayed onset muscle soreness [DOMS]: visual analog scale [VAS] and pressure pain threshold [PPT]. Methods: Thirty-one healthy young men [25.8±5.5 years] performed 10 sets of six maximal eccentric contractions of the elbow flexors with their non-dominant arm. Before and one to four days after the exercise, muscle pain perceived upon palpation of the biceps brachii at three sites [5, 9 and 13cm above the elbow crease] was assessed by VAS with a 100mm line [0=no pain, 100=extremely painful], and PPT of the same sites was determined by an algometer. Changes in VAS and PPT over time were compared amongst three sites by a two-way repeated measures analysis of variance, and the relationship between VAS and PPT was analyzed using a Pearson product-moment correlation. Results: The VAS increased one to four days after exercise and peaked two days post-exercise, while the PPT decreased most one day post-exercise and remained below baseline for four days following exercise [p<0.05]. No significant difference among the three sites was found for VAS [p=0.62] or PPT [p=0.45]. The magnitude of change in VAS did not significantly correlate with that of PPT [r=-0.20, p=0.28]. Conclusion: These results suggest that the level of muscle pain is not region-specific, at least among the three sites investigated in the study, and VAS and PPT provide different information about DOMS, indicating that VAS and PPT represent different aspects of pain.