What Is Delayed-Onset Muscle Soreness (DOMS)?

Delayed-onset muscle soreness (DOMS) is a painful, aching soreness that occurs after new and unfamiliar exercise or strenuous activity. DOMS typically appears a day or two after you complete a vigorous or new workout.

People experiencing DOMS may feel a little sore after a workout, then experience a more intense soreness that peaks a day or two post exercise, when they might normally begin to recover.

While any exercise or activity can cause muscle exhaustion and soreness, DOMS usually happens after doing movements that cause eccentric contractions, such as running or walking down a hill, lowering weights, and the downward motion of squats or push-ups.

Several theories exist as to why these motions cause DOMS and what causes the intense pain. Scientists believe the muscles and connective tissue are involved in the inflammation and muscle cell damage that produces this intense soreness.

In this article you will learn about the symptoms, causes, diagnosis, and treatment of DOMS.

Delayed-Onset Muscle Soreness Symptoms

DOMS symptoms are more intense than the type of muscle soreness you might experience after a typical workout.

People experiencing DOMS may find that their performance in sports or other activities is reduced and that regular movement such as sitting down or walking becomes more difficult.

Signs of DOMS include:

• Feelings of weakness, or a reduction in the amount of weight you can normally lift.
• Increased pain that makes normal day-to-day movements difficult
• Stiffness
• Swelling
• Difficulty bending or straightening your legs or arms, or the areas around the sore spots
• Reduced range of motion

Causes

DOMS is caused by intense exercise and training and performing muscle movements that the body is unaccustomed to doing.

Strenuous or extreme exercise that focuses on eccentric movements (exercises that cause lengthening of the muscle-tendon complex) such as running downhill or squats tend to cause DOMS the most.

When DOMS occurs the muscle fibers become torn and inflamed, which produces soreness, pain, and a reduced range of motion.

DOMS is also believed to affect the connective tissue or fascia (the thin covering of connective tissue) around the muscles. One study found that DOMS not only causes micro tears to the muscles but also causes micro tears to the deep fascia around the muscles. This in turn causes pain and inflammation.

Is DOMS Good for the Body?

While the saying "no pain, no gain" may be a familiar one when it comes to physical and athletic training, pain is not always good for the body.

Soreness from exercise happens because small muscle tears occur that then heal and make the muscle bigger and stronger. Some soreness is a sign that the body is transforming and adapting to the exercise. This is a good effect on the body.

With DOMS, there's a fine line between the benefits of soreness and injury. People with DOMS may see that their performance and strength decrease. While this decrease may be temporary, if training continues at intense levels injury is more likely to occur.

For people who are just beginning to work out or move their body, experiencing DOMS can make you less likely to continue exercising regularly which is important for overall health.

Treatment

Complete recovery from DOMS takes time. Allowing the body to rest after intense exercise can give muscles the space they need to repair themselves.

Rest for DOMS does not always mean stopping movement completely. Active recovery can be an important part of DOMS treatment.

Active recovery is a less intense form of movement and may include activities such as walking, stretching, and other gentle movements that do not put more strain on the sore muscles.

For example, if you’re experiencing DOMS from running downhill, a gentle swim that focuses more on the arms may be a good choice for active recovery. 

Coping With DOMS

While time and recovery are the best treatment for DOMS, there are other things you can do that may alleviate pain and help your muscles recover, such as:

• Cold immersion: Ice baths, cryotherapy, and other forms of cold treatment can bring some symptom relief and may reduce inflammation. While this is a common practice among athletes, it is controversial as to whether it is beneficial for muscle repair.
• Massage: Massage can increase blood flow to the muscles and reduce swelling, helping to reduce pain.
• Vibration therapy: Vibration therapy such as vibrating plates or massage guns can increase blood flow to the muscles. This type of therapy has been shown to help decrease soreness and regain range of motion.
• Acupuncture: While researchers are still studying the effects of acupuncture on DOMS, there is some evidence that it can help reduce muscle soreness and improve recovery rates.
• Analgesics: Ointments and lotions that contain menthol, such as Icy Hot, have been shown to reduce pain levels in DOMS.
• Foam rolling: Rolling on a foam roller has been shown to help reduce pain and aid in the healing of fascia affected by DOMS.

Summary

Delayed-onset muscle soreness is caused by intense exercise that focuses on eccentric movements or challenges muscles in new ways. Signs of DOMS include extreme soreness, reduced range of motion, a temporary decrease in strength, and difficulty performing regular activities such as walking or sitting down.

DOMS causes pain and inflammation in the body and may make you more susceptible to injury. Rest and active recovery are important to the treatment of DOMS. Other modalities such as massage and analgesics can also help you cope with and recover from DOMS. DOMS typically disappears after five to seven days.