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Getting to the Bottom of Delayed Onset Muscles Soreness
By Katrina Sholeen, PT, DPT
Whether you know it or not, you are probably familiar with the feeling of delayed onset muscle soreness, also known as “DOMS”. To athletes, weekend warriors or even people with physically demanding jobs, sore muscles may seem routine. However, if you’ve only recently started exercising, made changes to the type or intensity of your exercise, or even took up a large gardening project over the summer, it may feel unexpected and unwelcome. This soreness is normal, but knowing what to expect beforehand and how to manage it can help to keep you on track with your fitness goals!
What Causes DOMS?
Delayed Onset Muscle Soreness occurs following starting an exercise program that is new to your body due to microtrauma and irritation to the muscle tissue at the microscopic level, which causes inflammation and soreness that is greatest at 24-48 hours after the exercise before resolving on its own. This results stiffness and can temporarily reduce your strength and flexibility. This initial soreness will get better on its own, usually within 48-72 hours. As your body adapts to the new exercise and becomes stronger, the soreness will also occur less frequently. DOMS has been found to be more common after eccentric exercise, which involves a slow, controlled lowering after the “lift” phase of the exercise. This type of exercise is commonly recommended by physical therapists because of the functional training benefits, which is why you may feel sore even if it didn’t feel like a “hard” workout.
What Can I Do About It?
Time has been shown to be the only cure for DOMS, so it is important to build rest and recovery time into your schedule when starting a new program. In this case, rest does not have to mean lying down or avoiding activity. “Active rest” includes light exercise such as walking or even just exercising a different area of the body. For example, you can work on strengthening your arms when your legs are sore. Other treatments like foam roller exercises, massage therapy and the use of gentle compression garments have been shown to help manage the soreness, but they will not resolve it altogether. The use of heat and ice to improve soreness has also been debated, with many studies showing favor to one, both, or neither to reduce symptoms of DOMS.
Recognizing the difference between soreness and pain is important if you are either recovering from an injury of if DOMS is a new experience for you. Though DOMS causes a dull, achy, sore or stiff sensation, it should never cause sharp, intense pain. If you are currently seeing a physical therapist, DOMS should feel different than the pain that led to you seeking care. If the soreness lasts longer than the typical 48-72 hour recovery period, it may indicate that the exercise was too challenging and needs modification, so be sure to mention lasting soreness to your physical therapist or trainer so they can adjust your exercises to be a good fit for you and your current fitness level!
Unfortunately, delayed onset muscle soreness is a normal part of starting a new exercise routine, but it is also a sign that your body is adapting and getting stronger along the way!
Gregory E. P. Pearcey, David J. Bradbury-Squires, Jon-Erik Kawamoto, Eric J. Drinkwater, David G. Behm, and Duane C. Button (2015) Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures. Journal of Athletic Training: January 2015, Vol. 50, No. 1, pp. 5-13.
Petrofsky, JS, Khowailed, IA, Lee, H, Berk, L, Bains, GS, Akerkar, S, Shah, J, Al-Dabbak, F, and Laymon, MS. Cold vs. heat after exercise—is there a clear winner for muscle soreness. J Strength Cond Res 29(11): 3245–3252, 2015
Petrofsky, Jerrold Scott et al. “The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness.” Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine 27 4 (2017): 329-337 .