“Beep, Beep, Beep!” Your alarm wakes you from a deep sleep, where you were dreaming about floating blissfully down the river on your paddleboard. As you lift your arm to silence the noise, you notice that your shoulders are aching and stiff. Sitting up, maybe your core is a little stiff, too. After remembering that you were, indeed, paddling around the river yesterday, these sensations start to make sense. You are an avid runner and exercise regularly, but an hour of paddleboarding with your friends yesterday was enough to remind you that even the most practiced athletes still deal with some post-activity soreness.
What is Delayed Onset Muscle Soreness (DOMS)?
This physiological phenomenon is called delayed onset muscle soreness, or DOMS. DOMS is typical after activities that are novel, whether it is moving boxes or completing a hard workout. Symptoms typically appear one to three days after activity and can range from mild discomfort to stiffness and weakness in the affected areas. Discomfort can last 24-48 hours and typically resolves on its own. However, if pain lingers longer than three to five days, it is recommended to reach out to your primary care physician as this may be indicative of a muscle strain.
What causes DOMS?
Our muscles are made of fibrous bundles that contract and relax as we move through our day. When we exercise, small tears form in these fibers. The repair process creates larger, thicker fibers which can stand more load over time (this is called hypertrophy). While you can have a challenging workout without having DOMS, it is usually more prominent with exercise that causes the muscle to contract when it is in its lengthened position.
Compared to concentric motions, these eccentric exercises cause more fibrous tearing, which in turn builds more muscle mass. This is common in sports like throwing, weightlifting, or downhill running and walking where our muscles act as brakes to decelerate a motion.
While you may have heard that lactic acid is the culprit of your soreness, this myth has been scientifically debunked in recent years. Lactic acid is the byproduct of the breakdown of glucose that our body uses for fuel during exercise. Its role with exercise is to help flush excess hydrogen ions from the muscles.
When hydrogen ions interfere with calcium, muscle fibers are not able to contract in a fluid manner. This causes a decrease in the amount of force they are able to exert, and in turn causes the discomfort that we associate with harder efforts. Lactic acid is typically working hard to clear the hydrogen build up to an hour after exercise ends.
Studies have shown that performing a cool down can help expedite the process.
How can you help your body recover from exercise?
While DOMS can be uncomfortable, there are ways to manage it.
Hydration and Nutrition for DOMS Recovery
Staying hydrated while exercising is crucial. While there are no one-size–fits–all recommendations for how much water to consume, a general guideline is to sip often throughout your day. Water is best, but other beverages (such as coffee or electrolytes) count towards this, as well. Eating water–rich foods such as cucumbers and watermelon can help supplement hydration goals. Consuming enough protein and carbohydrates is also beneficial to help aid in repairing your body after exercise.
Using Active Recovery for Muscle Soreness
Gentle stretching, yoga, and walking can help loosen stiff muscles. Because your body is still in the process of repairing itself, be mindful to not push yourself too hard too soon as this can increase your risk of injury.
Increase Blood Flow to Relieve Sore Muscles
Modalities such as heat and ice are tried and true forms of relief. Ice is often recommended when inflammation or pain is present. Heat, such as an Epsom salt bath, can be helpful for stiff muscles. Massage or using a foam roller can be relaxing and encourage increased blood flow to the targeted areas.
Over the counter pain relief may be useful if you are experiencing high levels of discomfort. However, it is typically recommended to avoid using NSAIDS with DOMS. Inflammation is a natural part of the body’s healing process and should resolve on its own within a few days.
An alternative option may be a topical cream, such as lidocaine, which can offer relief without any systemic side effects.
If you are experiencing pain that is sharp, localized swelling, or pain that interferes with sleep, reach out to your healthcare provider for further guidance.
Safely Returning to Your Sport After DOMS
As your muscle soreness begins to fade, you should be able to return to your chosen activity again without issue. However, if you need help reaching your movement goals due to ongoing pain or discomfort, reach out to your local physical therapist. Our expert guidance can help you progressively build a routine to ensure that you can get back to what you love.
Frequently Asked Questions About DOMS
How long does DOMS typically last?
DOMS usually begins 12–24 hours after exercise, peaks between 24 and 48 hours, and typically resolves on its own within three to five days. If you are still experiencing significant pain or stiffness after five days, it may be a sign of a muscle strain or injury that requires professional evaluation.
Is it okay to work out if I am sore?
Yes, you can generally perform light activity—often called “active recovery”—if you have DOMS. Gentle movement like walking, light yoga, or easy cycling can actually help increase blood flow and reduce stiffness. However, avoid high-intensity workouts until the soreness has significantly subsided to prevent further muscle damage.
Should I use ice or heat for muscle soreness?
Both can be effective for different reasons. Ice is often best for managing acute inflammation or pain immediately after an intense session. Heat, such as a warm bath or heating pad, is generally more effective for loosening up stiff muscles and increasing blood flow during the later stages of recovery.
Is DOMS a sign of a good workout?
While muscle soreness is a common result of eccentric exercise and the growth of muscle fibers, it is not a requirement for an effective workout. You can have a highly productive training session without experiencing significant DOMS. In fact, training at an intensity that prevents excessive soreness can often lead to more consistent progress over time.
Need Help Reaching Your Movement Goals?
Don’t let ongoing muscle pain, stiffness, or lingering discomfort keep you from the activities you love. Whether you’re training for an event or just trying to get back to your weekend routine, our expert physical therapists can help you build a personalized plan to recover safely and perform your best.
References:
- https://my.clevelandclinic.org/health/diseases/delayed-onset-muscle-soreness
- https://www.medicalnewstoday.com/articles/eccentric-exercise#vs-concentric
- https://lbsm.co.uk/feeling-the-burn-dont-blame-lactate/
