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Everyone has felt immediate muscle soreness during or directly after a workout. No pain, no gain, right? However, if you have ever noticed that your muscles seem to be getting progressively more tender a few days post-workout, it may be something entirely different. Fairly commonly, it could be a phenomenon known as delayed onset muscle soreness (DOMS). Read on for everything you need to know about preventing and treating DOMS at home.
Meet the Expert
- Samantha Smith, MD, is a sports medicine doctor at Yale Medicine and assistant professor of Orthopaedics & Rehabilitation at Yale School of Medicine.
- Bohdanna Zazulak, DPT, OCS, is a physical therapist, orthopedic certified specialist, and researcher at Yale School of Medicine and Yale New Haven Health.
What Is DOMS?
Smith explains that DOMS is the abbreviation for Delayed Onset Muscle Soreness. “If you have ever done a hard or new lifting workout and felt above average muscle soreness a few days later that might have made it hard to do day-to-day activities because of the soreness or muscle stiffness, then you have experienced DOMS," she says.
Smith explains that DOMS symptoms are skeletal muscle soreness with movement or massage/palpation and often stiffness that usually start within 24 hours of a resistance exercise and peak between 24-72 hours afterward. And, it can last up to a week. “This pain and soreness gradually abates about 5-7 days after exercise,” she explains.
What Causes It?
While the exact mechanism of DOMS is not fully understood, there are many theories. “We know from studies that the type of exercise that is most likely to cause DOMS is usually high-force eccentric—muscle is lengthening while the load or resistance is applied—exercise,” Smith explains. The way the muscle fibers are loaded during eccentric exercise makes them more vulnerable to muscle injury and DOMS.
It was thought that DOMS was caused by lactic acid buildup, but experts are now adamant this isn’t the case. “Lactic acid is produced by muscles during anaerobic metabolism and causes that sore, heavy feeling at the end of a hard run or workout when you are approaching your maximum capacity. Although lactic acid can cause this acute muscle soreness during a workout, it usually is cleared rapidly by the body within about an hour of finishing a workout,” Smith says. Since the soreness of DOMS doesn’t start until later, it’s probably not caused solely by lactic acid. “Although the exact mechanism isn’t fully determined, it likely involves some degree of microscopic muscle damage which stimulates pain receptors in the muscle and also creates inflammation necessary for healing which may create swelling and further stimulate pain sensations,” she adds.
Who Experiences DOMS?
DOMS can happen to anyone. “It’s more likely to happen in people who are starting a new resistance exercise or program with an emphasis on eccentric movements with higher loads,” Smith says.
Is DOMS a Sign of a "Good" Workout?
“Although the term DOMS may sound like doom and gloom, it’s actually an indication of effective training that promotes muscle transformation to a stronger state,” adds Bohdanna Zazulak, DPT, OCS, is a physical therapist, orthopedic certified specialist, and researcher at Yale School of Medicine and Yale New Haven Health.
However, Smith maintains that DOMS is not something you should aim for. “Although many resistance workouts will produce some muscle soreness, DOMS represents a level of soreness that is more extreme and requires more recovery,” she explains. While an athlete is recovering from DOMS, experiments show that muscle function is impaired during that time. Studies show that athletes often underestimate how much their performance may be inhibited. “During the recovery period from DOMS, neuromuscular function and coordination is impaired, strength is reduced, and joint range of motion reduced because of muscle stiffness,” she points out. “It may take 4-8 days to recover fully. Exactly when an athlete is fully recovered is often difficult to know for sure.”
How to Treat DOMS at Home
According to Smith, rest is your best bet if you experience DOMS. “The best treatment is time and relative rest,” she says.
Avoid Further Injury
Another tactic you should consider is avoiding injuring the muscle group anymore. “Focusing on other muscle groups in the gym until the soreness is gone is a good strategy. For other workouts, expect a temporary performance decrease and modify your workouts and expectations accordingly. Reducing the intensity of exercise and paying attention to your body more closely is a good idea,” Smith says.
Ice or Stretching
While some people attempt to treat DOMS with ice or even stretching, Smith maintains that “there is no convincing experimental evidence” that either will help improve symptoms.
Try OTC Medication
As for NSAIDs, Smith says the evidence is mixed as to whether or not it will help with muscle soreness, adding “there are potential downsides to routinely taking NSAIDs.”
Indulge in Self-Care
Zazulak urges anyone suffering from DOMS to take care of themself “To minimize the severity and duration of DOMS, be sure to give your body-mind-spirit some love with a healthy holistic diet, plenty of hydration, adequate sleep, healthy breathing, and light exercise for active recovery,” she says.
Try a Low Impact Workout
Zazulak suggests focusing on low-impact workouts while recovering. “Accelerate recovery time with cross-training,” she says. This could be walking, easy running, biking, swimming, or yoga with restorative movements that improve circulation and provide nutrient-rich blood to your aching muscles.
How to Prevent DOMS
The bad news? “Unfortunately, there are no other clear ways to prevent DOMS,” Smith reveals. The good? There are a few things that may improve your chances of avoiding it.
Train Wisely: The best way to prevent DOMS is to avoid large increases in resistance training load—especially for eccentric exercises—says Smith. “For athletes who are training for a specific event, it’s important to keep DOMS in mind when creating a training schedule, to avoid higher risk workouts in the week leading up to an event where optimal performance is needed.”
Warm-Up Before an Intense Workout: You can also try starting with a high-quality warm-up before exercise. However, Smith maintains this will not be fully protected against DOMS.
Try Compression Sleeves: Some individuals wear compression sleeves to prevent DOMS, which may be helpful, “but more research is needed in this area,” Dr. Smith says.
The Final Takeaway
While DOMS doesn’t generally warrant a trip to your doctor’s office, there is an even more extreme form of muscle injury that does, rhabdomyolysis. “In this condition, there is more extensive muscle damage which can release enzymes into the bloodstream that can have an effect on multiple organ systems, especially the kidneys,” says Smith, “Definitely seek medical attention if you have severe muscle pain with weakness that is affecting day-to-day activities, or if you notice other symptoms like dark or brown urine or decreased urination.”