Muscle Insider
New member
You crushed your workout on Monday, but by Wednesday, you realized that it was actually your workout that crushed you. That feel-good pump gave way to a bit of stiffness, and you woke up the next day wondering when you got hit by a bus. If you’ve hit the gym hard and found that it hit you back, you’ve likely experienced something called DOMS — delayed-onset muscle soreness.
Credit: Maridav / Shutterstock
DOMS is the source of all those post-leg day memes about not being able to get out of bed, let alone up that flight of stairs. Soreness after working out doesn’t kick in right away. Instead, it can lie in wait anywhere from 24 to 72 hours before knocking you on your butt. But why does it happen that way, and what even is it?
Editor’s note: The content on BarBend is meant to be informative in nature, but it shouldn’t take the place of advice and/or supervision from a medical professional. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. Speak with your physician if you have any concerns.
What Is Delayed-Onset Muscle Soreness?
While pretty much everyone who’s ever conquered a tough training session knows about DOMS firsthand, scientists only have speculations about exactly what it is and why it happens. But a few things seem clear.
Credit: Twinsterphoto / Shutterstock
It’s most common to get hit by a bout of DOMS when you’re coming to physical activity either for the first time or the first time in a long time. (1) You might also be extra prone to post-training soreness after a particularly hard training session where you’ve increased your volume, intensity, and overall time under tension. Eccentric training especially seems to be connected to increased levels of DOMS. (2)(3)
Unfortunately, you may also just be one of those people who seems to just always get sore. You might have done the same exact workout — maybe even with the same exact weights — as your training partner. But don’t be surprised if one of you is hobbling the next day while the other feels fresh and ready to go again. DOMS is highly variable from person-to-person, even if everyone involved performed the same workout. (4)
Why Do I Get Sore?
Strength athletes might know all too well what sparks DOMS — tough training sessions, especially when you haven’t worked out certain muscle groups in a while. But a lot of things happen to your body during a high-intensity workout. So what exactly is the part that causes DOMS?
Just as your workout contains many components, so, it seems, do the stiff aches that follow after. Researchers often recognize that DOMS comes from a combination of factors. It’s theorized that DOMS likely comes from some combination of the following: connective tissue damage, muscle damage, inflammation, lactic acid and free radical buildup, muscle spasms, and enzyme efflux. (5)(6)(7)(8)(9)(1)
Delayed-Onset Muscle Soreness Myths
If you know muscle soreness, you may think you know DOMS. But do you really? Read on for some DOMS myth-busting.
Myth: DOMS Means Muscle Growth
Beginners may not be the only ones crawling up the stairs after leg day, but less experienced strength athletes may also be more likely to experience DOMS than more experienced athletes. (1) Since beginners are also prone to benefit from “newbie gains”, it’s easy to associate that soreness with that sweet, rapid muscle growth.
Credit: MILKXT2 / Shutterstock
But that correlation might be coincidental instead of causative, especially if your case of DOMS is originating more from your connective tissues — your ligaments and tendons — than your muscles themselves. (1)
Myth: You Only Worked Hard if You’re Sore
You worked your butt off — literally, those hip thrusts were tough — but you’re not sore the next day. Did you not go hard enough? If you’re not sore, was it even worth it? Probably, yes.
Beginners and those returning to training after a break are more likely than more experienced and consistent lifters to experience muscle soreness after a training session. (1) Does this mean that you’re not working hard enough if you’re not sore? Not really.
Yes, experienced lifters are likely to get sore after particularly intense sessions — hence all those ice baths. But there doesn’t seem to be any science-based evidence to suggest that DOMS indicates better performance or indicates a threshold of hard work. If anything, working out so hard that you get extremely sore might negatively impact your performance in the days ahead. (10)(1)
Myth: Stretching and Cooling Down Will Prevent DOMS
You’ve just finished a tremendous amount of eccentric training, maybe with some 21s thrown in for good measure. You’re thrilled with how hard you pushed yourself, but you really don’t want to be sore tomorrow. So, you do what they taught you in high school gym, and you cool down and stretch.
Credit: Prostock-studio / Shutterstock
That’s a great habit to get into — but alas, research suggests that cooling down doesn’t defeat DOMS as much as might think. (11)(12) That said, if you love yourself a good post-workout jog and stretch ritual and you believe it will help you recover better, then science is also kind of on your side. Because studies have shown that if you believe cooling down will combat soreness and help recovery, you may in fact perceive less soreness afterwards. (13)(14)(15)
Effects of Delayed-Onset Muscle Soreness
The number one effect of delayed-onset muscle soreness is pretty obvious — that pervasive inability to walk up (or down) stairs after leg day. But all memes aside, here’s what you’re likely to deal with alongside that soreness.
Reduced Muscular Force
DOMS isn’t just something you experience as soreness and stiffness. It’s something that’s happening on the biological, cellular level. The scientific jury is out as to which factors contribute most to that lingering post-exercise pain.
But something that seems clear is that certain biological markers of DOMS — for example, your body’s cytokine response to exercise — can reduce muscular force output by as much as half. (10) This means that as much as you might want to go hard even when you’re sore, your workout might be a lot less effective.
Decreased Range of Motion
It’s not just your muscle performance that may be negatively impacted by DOMS. All that stiffness and soreness can amount to a decreased range of motion that could have potentially nasty impacts on your lifting ability. (1)
Credit: Teerasan Phutthigorn / Shutterstock
Imagine trying to get into a proper overhead squat position when your upper back or hips are sore, for example. When your body’s range of motion is limited, so is your ability to perform lifts that require quite lubricated joints.
Connective Tissue Stress
Your range of motion doesn’t only get limited because of the actual stiffness and soreness of DOMS. It seems that DOMS also impacts your ligaments and tendons directly, which may contribute to soreness and also limit your range of motion. (1)
When your connective tissues are under stress, you might be more prone to injury. (16) So if you’re feeling particularly hammered by DOMS, now might not be the best time to hammer away at those weights.
Should I Worry About Delayed-Onset Muscle Soreness?
It’s reasonable to worry if you’re sore. Especially when it’s meme-level pain. So, when should you actually be concerned?
How Long Should Soreness Last?
If you’re sore between the 24 to 72 hours after a tough training session, there’s generally not a cause for concern. It’s often just part of that training life to have the “real” workout — going about your daily business with all that soreness — begin a day or two after the gym workout.
Credit: Teerasan Phutthigorn / Shutterstock
That said, if your pain is particularly intense or lasts more than a few days, you might want to check in with a doctor. If you’re on the opposite end of the caution spectrum and are eager to get back to the gym, rest assured — you generally can work out while sore.
Can I Work Out With DOMS?
When you go to the gym with DOMS, try to focus on a different muscle group to help maximize your workout effectiveness and recovery time. That way, you can have all the gains with less pain.
If you’re heading back to the gym while you’re still stiff, consider spending extra time warming up. That way, your range of motion won’t be as limited as it might otherwise be while you’re sore. Keep in mind that even if you warm up, DOMS may increase injury risk if you attempt to go back to the gym too soon. (17)(1)(16) So listen to your body and learn when it’s best to pump the breaks versus the gas.
How to Tell the Difference Between Pain and Soreness
If you’re in an uncomfortable amount of pain, checking in with a doctor is generally not a bad idea. But as a general rule of thumb, research suggests that DOMS seems to occupy a middle space between soreness pain and injury pain.
When you’re “just” sore, it sure can hurt a lot — hence all the memes. But DOMS pain often feels generalized (“whoa, going up these three stairs is harder than the actual workout was”) versus injury pain, which is often more specific (“whoa, this one part of my shoulder hurts a lot when I move like this”). (17)
That said, DOMS might have a negative impact on your range of motion and stress out your connective tissue. (1)(16) These factors may increase your risk of training injury — so even if DOMS doesn’t start out as injury pain, sometimes it might end up that way.
How to Treat Delayed-Onset Muscle Soreness
Alas, there is no “cure” for DOMS. But there are some ways to make it less awful.
Rest When You Need To
Technically, there’s nothing stopping you from working out while you’re sore. Unless your entire body is feeling the pain, you can generally work out different muscles than the ones that are sore.
This is where training splits come in handy. If you know you’re prone to get DOMS, you might opt for a muscle group training split so that, for example, while your chest is sore from yesterday, you can work on legs today.
That said, the more intense your pain from DOMS, the less likely you are to have an effective workout. (17)(1)(16) So, rest when you need to. That might mean moving lighter weights, swapping to a different muscle group, having an active recovery day, or taking a day or two off entirely.
Concentric Active Recovery
Performing light, concentric-focused exercise — think sled pushes, for example — can help reduce the soreness you feel from acute DOMS. (18)(19) For that reason, try integrating plenty of concentric work into your active recovery days to help ease that soreness.
That logic seems to apply to the original, DOMS-causing workouts, too. Integrating concentric moves into your eccentric training may have a preventative effect on developing DOMS. (20) So if you’re extra concerned about DOMS — maybe you really can’t be sore during that wedding this weekend — try programming concentric work along with your eccentric training.
Massage Therapy and Foam Rolling
While massage therapy seems to not actually reduce DOMS on a biological level, it can have a positive impact on athletes’ perception of pain. (21) It’s a similar story with foam rolling, which seems to reduce acute pain and soreness perception. (22)
So if massage or foam rolling feel like they’re working to alleviate your post-workout pain, you’re not the only one. And, well, more power to you.
Contrast Therapy
Are you someone who loves heating pads and saunas? Maybe you’re more of a cold plunge or ice pack type of human. Either way, if you’re a fan of temperature contrast therapy — putting something hot or cold on your sore muscles — you’re in luck. Kind of.
Much like massage therapy and foam rolling, hot and cold therapy doesn’t seem to “cure” DOMS on a biological level — but it does seem to improve athletes’ perception of pain. (23) So if you believe in it, it may just work for you.
Supplements
Some supplements may help reduce DOMS in experienced lifters. For example, HMB (hydroxy methylbutyrate) is sometimes found in creatine supplements. It might reduce that sweet after-workout soreness when you’ve got a history of strength training under your belt. (24)
However, over-the-counter pain medications like Ibuprofen — even at high doses — doesn’t necessarily reduce the soreness. (18) Vitamins C and vitamin E also haven’t been found to be effective at reducing that post-workout soreness. (25)
On the other hand, anti-inflammatory dietary supplements and omega-3 supplements have both seemed to be effective at treating the symptoms of DOMS. (26)(27) Similarly, caffeine supplements also seem to reduce DOMS symptoms in elite athletes, though research suggests that this has a bigger impact for men than women. (The study did not note whether nonbinary athletes were considered.) (28)
Fight the Soaring Soreness
If your soreness is soaring to new heights after a workout, odds are you’re new here. Or, maybe you haven’t trained — or focused on a certain muscle group — in a while. That’s not to say that advanced lifters don’t get sore — of course they do. Sometimes, that sweet DOMS sensation is inevitable after a particularly intense session, no matter your experience level.
Researchers might not know exactly why DOMS happens when and how — and to whom — it does. But it seems clear that as long as there are barbells to lift, DOMS will be lurking around the corner. Have your foam rollers and supplements ready for when it strikes.
References
Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64.
Marathamuthu S, Selvanayagam VS, Yusof A. Contralateral Effects of Eccentric Exercise and DOMS of the Plantar Flexors: Evidence of Central Involvement. Res Q Exerc Sport. 2022 Jun;93(2):240-249.
Serravite DH, Perry A, Jacobs KA, Adams JA, Harriell K, Signorile JF. Effect of whole-body periodic acceleration on exercise-induced muscle damage after eccentric exercise. Int J Sports Physiol Perform. 2014 Nov;9(6):985-92.
Chapman DW, Newton MJ, Zainuddin Z, Sacco P, Nosaka K. Work and peak torque during eccentric exercise do not predict changes in markers of muscle damage. Br J Sports Med. 2008 Jul;42(7):585-91.
Wilke J, Behringer M. Is “Delayed Onset Muscle Soreness” a False Friend? The Potential Implication of the Fascial Connective Tissue in Post-Exercise Discomfort. Int J Mol Sci. 2021 Aug 31;22(17):9482.
Sonkodi B, Berkes I, Koltai E. Have We Looked in the Wrong Direction for More Than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage Rather Than Muscle Damage. Antioxidants (Basel). 2020 Mar 5;9(3):212.
Hotfiel T, Freiwald J, Hoppe MW, Lutter C, Forst R, Grim C, Bloch W, Hüttel M, Heiss R. Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletz Sportschaden. 2018 Dec;32(4):243-250.
Lewis PB, Ruby D, Bush-Joseph CA. Muscle soreness and delayed-onset muscle soreness. Clin Sports Med. 2012 Apr;31(2):255-62.
Manojlovi? V, Er?ulj F. Using blood lactate concentration to predict muscle damage and jump performance response to maximal stretch-shortening cycle exercise. J Sports Med Phys Fitness. 2019 Apr;59(4):581-586.
Paulsen G, Mikkelsen UR, Raastad T, Peake JM. Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc Immunol Rev. 2012;18:42-97.
Crowther F, Sealey R, Crowe M, Edwards A, Halson S. Influence of recovery strategies upon performance and perceptions following fatiguing exercise: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2017 Dec 28;9:25.
Rey E, Lago-Peñas C, Casáis L, Lago-Ballesteros J. The effect of immediate post-training active and passive recovery interventions on anaerobic performance and lower limb flexibility in professional soccer players. J Hum Kinet. 2012 Mar;31:121-9.
Cook CJ, Beaven CM. Individual perception of recovery is related to subsequent sprint performance. Br J Sports Med. 2013 Jul;47(11):705-9.
Saw, A. E., Main, L. C., & Gastin, P. B. (2016). Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. British journal of sports medicine, 50(5), 281-291.
Raeder, C., Wiewelhove, T., Schneider, C., Döweling, A., Kellmann, M., Meyer, T., … & Ferrauti, A. (2017). Effects of active recovery on muscle function following high-intensity training sessions in elite Olympic weightlifters. Adv Skelet Muscle Funct Assess, 1(1), 3-12.
Wilke J, Hespanhol L, Behrens M. Is It All About the Fascia? A Systematic Review and Meta-analysis of the Prevalence of Extramuscular Connective Tissue Lesions in Muscle Strain Injury. Orthop J Sports Med. 2019 Dec 24;7(12):2325967119888500.
Zeng C, Luo G, Xu S, Li Y. The Application of DOMS Mechanism and Prevention in Physical Education and Training. J Healthc Eng. 2022 Jan 7;2022:9654919.
Rahnama N, Rahmani-Nia F, Ebrahim K. The isolated and combined effects of selected physical activity and ibuprofen on delayed-onset muscle soreness. J Sports Sci. 2005 Aug;23(8):843-50.
Zainuddin Z, Sacco P, Newton M, Nosaka K. Light concentric exercise has a temporarily analgesic effect on delayed-onset muscle soreness, but no effect on recovery from eccentric exercise. Appl Physiol Nutr Metab. 2006 Apr;31(2):126-34.
Nosaka K, Clarkson PM. Influence of previous concentric exercise on eccentric exercise-induced muscle damage. J Sports Sci. 1997 Oct;15(5):477-83.
Hilbert JE, Sforzo GA, Swensen T. The effects of massage on delayed onset muscle soreness. Br J Sports Med. 2003 Feb;37(1):72-5.
Pearcey GE, Bradbury-Squires DJ, Kawamoto JE, Drinkwater EJ, Behm DG, Button DC. Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Athl Train. 2015 Jan;50(1):5-13.
Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021 Mar;48:177-187.
Wilson JM, Lowery RP, Joy JM, Walters JA, Baier SM, Fuller JC Jr, Stout JR, Norton LE, Sikorski EM, Wilson SM, Duncan NM, Zanchi NE, Rathmacher J. ?-Hydroxy-?-methylbutyrate free acid reduces markers of exercise-induced muscle damage and improves recovery in resistance-trained men. Br J Nutr. 2013 Aug 28;110(3):538-44.
Torre MF, Martinez-Ferran M, Vallecillo N, Jiménez SL, Romero-Morales C, Pareja-Galeano H. Supplementation with Vitamins C and E and Exercise-Induced Delayed-Onset Muscle Soreness: A Systematic Review. Antioxidants (Basel). 2021 Feb 12;10(2):279.
Tanabe Y, Fujii N, Suzuki K. Dietary Supplementation for Attenuating Exercise-Induced Muscle Damage and Delayed-Onset Muscle Soreness in Humans. Nutrients. 2021 Dec 24;14(1):70.
Jouris KB, McDaniel JL, Weiss EP. The Effect of Omega-3 Fatty Acid Supplementation on the Inflammatory Response to eccentric strength exercise. J Sports Sci Med. 2011 Sep 1;10(3):432-8.
Chen HY, Chen YC, Tung K, Chao HH, Wang HS. Effects of caffeine and sex on muscle performance and delayed-onset muscle soreness after exercise-induced muscle damage: a double-blind randomized trial. J Appl Physiol (1985). 2019 Sep 1;127(3):798-805.
Featured Image: Twinsterphoto / Shutterstock
You crushed your workout on Monday, but by Wednesday, you realized that it was actually your workout that crushed you. That feel-good pump gave way to a bit of stiffness, and you woke up the next day wondering when you got hit by a bus. If you’ve hit the gym hard and found that it hit you back, you’ve likely experienced something called DOMS — delayed-onset muscle soreness.
Credit: Maridav / Shutterstock
DOMS is the source of all those post-leg day memes about not being able to get out of bed, let alone up that flight of stairs. Soreness after working out doesn’t kick in right away. Instead, it can lie in wait anywhere from 24 to 72 hours before knocking you on your butt. But why does it happen that way, and what even is it?
Editor’s note: The content on BarBend is meant to be informative in nature, but it shouldn’t take the place of advice and/or supervision from a medical professional. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. Speak with your physician if you have any concerns.
What Is Delayed-Onset Muscle Soreness?
While pretty much everyone who’s ever conquered a tough training session knows about DOMS firsthand, scientists only have speculations about exactly what it is and why it happens. But a few things seem clear.
Credit: Twinsterphoto / Shutterstock
It’s most common to get hit by a bout of DOMS when you’re coming to physical activity either for the first time or the first time in a long time. (1) You might also be extra prone to post-training soreness after a particularly hard training session where you’ve increased your volume, intensity, and overall time under tension. Eccentric training especially seems to be connected to increased levels of DOMS. (2)(3)
Unfortunately, you may also just be one of those people who seems to just always get sore. You might have done the same exact workout — maybe even with the same exact weights — as your training partner. But don’t be surprised if one of you is hobbling the next day while the other feels fresh and ready to go again. DOMS is highly variable from person-to-person, even if everyone involved performed the same workout. (4)
Why Do I Get Sore?
Strength athletes might know all too well what sparks DOMS — tough training sessions, especially when you haven’t worked out certain muscle groups in a while. But a lot of things happen to your body during a high-intensity workout. So what exactly is the part that causes DOMS?
Just as your workout contains many components, so, it seems, do the stiff aches that follow after. Researchers often recognize that DOMS comes from a combination of factors. It’s theorized that DOMS likely comes from some combination of the following: connective tissue damage, muscle damage, inflammation, lactic acid and free radical buildup, muscle spasms, and enzyme efflux. (5)(6)(7)(8)(9)(1)
Delayed-Onset Muscle Soreness Myths
If you know muscle soreness, you may think you know DOMS. But do you really? Read on for some DOMS myth-busting.
Myth: DOMS Means Muscle Growth
Beginners may not be the only ones crawling up the stairs after leg day, but less experienced strength athletes may also be more likely to experience DOMS than more experienced athletes. (1) Since beginners are also prone to benefit from “newbie gains”, it’s easy to associate that soreness with that sweet, rapid muscle growth.
Credit: MILKXT2 / Shutterstock
But that correlation might be coincidental instead of causative, especially if your case of DOMS is originating more from your connective tissues — your ligaments and tendons — than your muscles themselves. (1)
Myth: You Only Worked Hard if You’re Sore
You worked your butt off — literally, those hip thrusts were tough — but you’re not sore the next day. Did you not go hard enough? If you’re not sore, was it even worth it? Probably, yes.
Beginners and those returning to training after a break are more likely than more experienced and consistent lifters to experience muscle soreness after a training session. (1) Does this mean that you’re not working hard enough if you’re not sore? Not really.
Yes, experienced lifters are likely to get sore after particularly intense sessions — hence all those ice baths. But there doesn’t seem to be any science-based evidence to suggest that DOMS indicates better performance or indicates a threshold of hard work. If anything, working out so hard that you get extremely sore might negatively impact your performance in the days ahead. (10)(1)
Myth: Stretching and Cooling Down Will Prevent DOMS
You’ve just finished a tremendous amount of eccentric training, maybe with some 21s thrown in for good measure. You’re thrilled with how hard you pushed yourself, but you really don’t want to be sore tomorrow. So, you do what they taught you in high school gym, and you cool down and stretch.
Credit: Prostock-studio / Shutterstock
That’s a great habit to get into — but alas, research suggests that cooling down doesn’t defeat DOMS as much as might think. (11)(12) That said, if you love yourself a good post-workout jog and stretch ritual and you believe it will help you recover better, then science is also kind of on your side. Because studies have shown that if you believe cooling down will combat soreness and help recovery, you may in fact perceive less soreness afterwards. (13)(14)(15)
Effects of Delayed-Onset Muscle Soreness
The number one effect of delayed-onset muscle soreness is pretty obvious — that pervasive inability to walk up (or down) stairs after leg day. But all memes aside, here’s what you’re likely to deal with alongside that soreness.
Reduced Muscular Force
DOMS isn’t just something you experience as soreness and stiffness. It’s something that’s happening on the biological, cellular level. The scientific jury is out as to which factors contribute most to that lingering post-exercise pain.
But something that seems clear is that certain biological markers of DOMS — for example, your body’s cytokine response to exercise — can reduce muscular force output by as much as half. (10) This means that as much as you might want to go hard even when you’re sore, your workout might be a lot less effective.
Decreased Range of Motion
It’s not just your muscle performance that may be negatively impacted by DOMS. All that stiffness and soreness can amount to a decreased range of motion that could have potentially nasty impacts on your lifting ability. (1)
Credit: Teerasan Phutthigorn / Shutterstock
Imagine trying to get into a proper overhead squat position when your upper back or hips are sore, for example. When your body’s range of motion is limited, so is your ability to perform lifts that require quite lubricated joints.
Connective Tissue Stress
Your range of motion doesn’t only get limited because of the actual stiffness and soreness of DOMS. It seems that DOMS also impacts your ligaments and tendons directly, which may contribute to soreness and also limit your range of motion. (1)
When your connective tissues are under stress, you might be more prone to injury. (16) So if you’re feeling particularly hammered by DOMS, now might not be the best time to hammer away at those weights.
Should I Worry About Delayed-Onset Muscle Soreness?
It’s reasonable to worry if you’re sore. Especially when it’s meme-level pain. So, when should you actually be concerned?
How Long Should Soreness Last?
If you’re sore between the 24 to 72 hours after a tough training session, there’s generally not a cause for concern. It’s often just part of that training life to have the “real” workout — going about your daily business with all that soreness — begin a day or two after the gym workout.
Credit: Teerasan Phutthigorn / Shutterstock
That said, if your pain is particularly intense or lasts more than a few days, you might want to check in with a doctor. If you’re on the opposite end of the caution spectrum and are eager to get back to the gym, rest assured — you generally can work out while sore.
Can I Work Out With DOMS?
When you go to the gym with DOMS, try to focus on a different muscle group to help maximize your workout effectiveness and recovery time. That way, you can have all the gains with less pain.
If you’re heading back to the gym while you’re still stiff, consider spending extra time warming up. That way, your range of motion won’t be as limited as it might otherwise be while you’re sore. Keep in mind that even if you warm up, DOMS may increase injury risk if you attempt to go back to the gym too soon. (17)(1)(16) So listen to your body and learn when it’s best to pump the breaks versus the gas.
How to Tell the Difference Between Pain and Soreness
If you’re in an uncomfortable amount of pain, checking in with a doctor is generally not a bad idea. But as a general rule of thumb, research suggests that DOMS seems to occupy a middle space between soreness pain and injury pain.
When you’re “just” sore, it sure can hurt a lot — hence all the memes. But DOMS pain often feels generalized (“whoa, going up these three stairs is harder than the actual workout was”) versus injury pain, which is often more specific (“whoa, this one part of my shoulder hurts a lot when I move like this”). (17)
That said, DOMS might have a negative impact on your range of motion and stress out your connective tissue. (1)(16) These factors may increase your risk of training injury — so even if DOMS doesn’t start out as injury pain, sometimes it might end up that way.
How to Treat Delayed-Onset Muscle Soreness
Alas, there is no “cure” for DOMS. But there are some ways to make it less awful.
Rest When You Need To
Technically, there’s nothing stopping you from working out while you’re sore. Unless your entire body is feeling the pain, you can generally work out different muscles than the ones that are sore.
This is where training splits come in handy. If you know you’re prone to get DOMS, you might opt for a muscle group training split so that, for example, while your chest is sore from yesterday, you can work on legs today.
That said, the more intense your pain from DOMS, the less likely you are to have an effective workout. (17)(1)(16) So, rest when you need to. That might mean moving lighter weights, swapping to a different muscle group, having an active recovery day, or taking a day or two off entirely.
Concentric Active Recovery
Performing light, concentric-focused exercise — think sled pushes, for example — can help reduce the soreness you feel from acute DOMS. (18)(19) For that reason, try integrating plenty of concentric work into your active recovery days to help ease that soreness.
That logic seems to apply to the original, DOMS-causing workouts, too. Integrating concentric moves into your eccentric training may have a preventative effect on developing DOMS. (20) So if you’re extra concerned about DOMS — maybe you really can’t be sore during that wedding this weekend — try programming concentric work along with your eccentric training.
Massage Therapy and Foam Rolling
While massage therapy seems to not actually reduce DOMS on a biological level, it can have a positive impact on athletes’ perception of pain. (21) It’s a similar story with foam rolling, which seems to reduce acute pain and soreness perception. (22)
So if massage or foam rolling feel like they’re working to alleviate your post-workout pain, you’re not the only one. And, well, more power to you.
Contrast Therapy
Are you someone who loves heating pads and saunas? Maybe you’re more of a cold plunge or ice pack type of human. Either way, if you’re a fan of temperature contrast therapy — putting something hot or cold on your sore muscles — you’re in luck. Kind of.
Much like massage therapy and foam rolling, hot and cold therapy doesn’t seem to “cure” DOMS on a biological level — but it does seem to improve athletes’ perception of pain. (23) So if you believe in it, it may just work for you.
Supplements
Some supplements may help reduce DOMS in experienced lifters. For example, HMB (hydroxy methylbutyrate) is sometimes found in creatine supplements. It might reduce that sweet after-workout soreness when you’ve got a history of strength training under your belt. (24)
However, over-the-counter pain medications like Ibuprofen — even at high doses — doesn’t necessarily reduce the soreness. (18) Vitamins C and vitamin E also haven’t been found to be effective at reducing that post-workout soreness. (25)
On the other hand, anti-inflammatory dietary supplements and omega-3 supplements have both seemed to be effective at treating the symptoms of DOMS. (26)(27) Similarly, caffeine supplements also seem to reduce DOMS symptoms in elite athletes, though research suggests that this has a bigger impact for men than women. (The study did not note whether nonbinary athletes were considered.) (28)
Fight the Soaring Soreness
If your soreness is soaring to new heights after a workout, odds are you’re new here. Or, maybe you haven’t trained — or focused on a certain muscle group — in a while. That’s not to say that advanced lifters don’t get sore — of course they do. Sometimes, that sweet DOMS sensation is inevitable after a particularly intense session, no matter your experience level.
Researchers might not know exactly why DOMS happens when and how — and to whom — it does. But it seems clear that as long as there are barbells to lift, DOMS will be lurking around the corner. Have your foam rollers and supplements ready for when it strikes.
References
[*]Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64.
[*]Marathamuthu S, Selvanayagam VS, Yusof A. Contralateral Effects of Eccentric Exercise and DOMS of the Plantar Flexors: Evidence of Central Involvement. Res Q Exerc Sport. 2022 Jun;93(2):240-249.
[*]Serravite DH, Perry A, Jacobs KA, Adams JA, Harriell K, Signorile JF. Effect of whole-body periodic acceleration on exercise-induced muscle damage after eccentric exercise. Int J Sports Physiol Perform. 2014 Nov;9(6):985-92.
[*]Chapman DW, Newton MJ, Zainuddin Z, Sacco P, Nosaka K. Work and peak torque during eccentric exercise do not predict changes in markers of muscle damage. Br J Sports Med. 2008 Jul;42(7):585-91.
[*]Wilke J, Behringer M. Is “Delayed Onset Muscle Soreness” a False Friend? The Potential Implication of the Fascial Connective Tissue in Post-Exercise Discomfort. Int J Mol Sci. 2021 Aug 31;22(17):9482.
[*]Sonkodi B, Berkes I, Koltai E. Have We Looked in the Wrong Direction for More Than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage Rather Than Muscle Damage. Antioxidants (Basel). 2020 Mar 5;9(3):212.
[*]Hotfiel T, Freiwald J, Hoppe MW, Lutter C, Forst R, Grim C, Bloch W, Hüttel M, Heiss R. Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletz Sportschaden. 2018 Dec;32(4):243-250.
[*]Lewis PB, Ruby D, Bush-Joseph CA. Muscle soreness and delayed-onset muscle soreness. Clin Sports Med. 2012 Apr;31(2):255-62.
[*]Manojlovi? V, Er?ulj F. Using blood lactate concentration to predict muscle damage and jump performance response to maximal stretch-shortening cycle exercise. J Sports Med Phys Fitness. 2019 Apr;59(4):581-586.
[*]Paulsen G, Mikkelsen UR, Raastad T, Peake JM. Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc Immunol Rev. 2012;18:42-97.
[*]Crowther F, Sealey R, Crowe M, Edwards A, Halson S. Influence of recovery strategies upon performance and perceptions following fatiguing exercise: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2017 Dec 28;9:25.
[*]Rey E, Lago-Peñas C, Casáis L, Lago-Ballesteros J. The effect of immediate post-training active and passive recovery interventions on anaerobic performance and lower limb flexibility in professional soccer players. J Hum Kinet. 2012 Mar;31:121-9.
[*]Cook CJ, Beaven CM. Individual perception of recovery is related to subsequent sprint performance. Br J Sports Med. 2013 Jul;47(11):705-9.
[*]Saw, A. E., Main, L. C., & Gastin, P. B. (2016). Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. British journal of sports medicine, 50(5), 281-291.
[*]Raeder, C., Wiewelhove, T., Schneider, C., Döweling, A., Kellmann, M., Meyer, T., … & Ferrauti, A. (2017). Effects of active recovery on muscle function following high-intensity training sessions in elite Olympic weightlifters. Adv Skelet Muscle Funct Assess, 1(1), 3-12.
[*]Wilke J, Hespanhol L, Behrens M. Is It All About the Fascia? A Systematic Review and Meta-analysis of the Prevalence of Extramuscular Connective Tissue Lesions in Muscle Strain Injury. Orthop J Sports Med. 2019 Dec 24;7(12):2325967119888500.
[*]Zeng C, Luo G, Xu S, Li Y. The Application of DOMS Mechanism and Prevention in Physical Education and Training. J Healthc Eng. 2022 Jan 7;2022:9654919.
[*]Rahnama N, Rahmani-Nia F, Ebrahim K. The isolated and combined effects of selected physical activity and ibuprofen on delayed-onset muscle soreness. J Sports Sci. 2005 Aug;23(8):843-50.
[*]Zainuddin Z, Sacco P, Newton M, Nosaka K. Light concentric exercise has a temporarily analgesic effect on delayed-onset muscle soreness, but no effect on recovery from eccentric exercise. Appl Physiol Nutr Metab. 2006 Apr;31(2):126-34.
[*]Nosaka K, Clarkson PM. Influence of previous concentric exercise on eccentric exercise-induced muscle damage. J Sports Sci. 1997 Oct;15(5):477-83.
[*]Hilbert JE, Sforzo GA, Swensen T. The effects of massage on delayed onset muscle soreness. Br J Sports Med. 2003 Feb;37(1):72-5.
[*]Pearcey GE, Bradbury-Squires DJ, Kawamoto JE, Drinkwater EJ, Behm DG, Button DC. Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Athl Train. 2015 Jan;50(1):5-13.
[*]Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021 Mar;48:177-187.
[*]Wilson JM, Lowery RP, Joy JM, Walters JA, Baier SM, Fuller JC Jr, Stout JR, Norton LE, Sikorski EM, Wilson SM, Duncan NM, Zanchi NE, Rathmacher J. ?-Hydroxy-?-methylbutyrate free acid reduces markers of exercise-induced muscle damage and improves recovery in resistance-trained men. Br J Nutr. 2013 Aug 28;110(3):538-44.
[*]Torre MF, Martinez-Ferran M, Vallecillo N, Jiménez SL, Romero-Morales C, Pareja-Galeano H. Supplementation with Vitamins C and E and Exercise-Induced Delayed-Onset Muscle Soreness: A Systematic Review. Antioxidants (Basel). 2021 Feb 12;10(2):279.
[*]Tanabe Y, Fujii N, Suzuki K. Dietary Supplementation for Attenuating Exercise-Induced Muscle Damage and Delayed-Onset Muscle Soreness in Humans. Nutrients. 2021 Dec 24;14(1):70.
[*]Jouris KB, McDaniel JL, Weiss EP. The Effect of Omega-3 Fatty Acid Supplementation on the Inflammatory Response to eccentric strength exercise. J Sports Sci Med. 2011 Sep 1;10(3):432-8.
[*]Chen HY, Chen YC, Tung K, Chao HH, Wang HS. Effects of caffeine and sex on muscle performance and delayed-onset muscle soreness after exercise-induced muscle damage: a double-blind randomized trial. J Appl Physiol (1985). 2019 Sep 1;127(3):798-805.
Featured Image: Twinsterphoto / Shutterstock
Click here to view the article.
Credit: Maridav / Shutterstock
DOMS is the source of all those post-leg day memes about not being able to get out of bed, let alone up that flight of stairs. Soreness after working out doesn’t kick in right away. Instead, it can lie in wait anywhere from 24 to 72 hours before knocking you on your butt. But why does it happen that way, and what even is it?
Editor’s note: The content on BarBend is meant to be informative in nature, but it shouldn’t take the place of advice and/or supervision from a medical professional. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. Speak with your physician if you have any concerns.
What Is Delayed-Onset Muscle Soreness?
While pretty much everyone who’s ever conquered a tough training session knows about DOMS firsthand, scientists only have speculations about exactly what it is and why it happens. But a few things seem clear.
Credit: Twinsterphoto / Shutterstock
It’s most common to get hit by a bout of DOMS when you’re coming to physical activity either for the first time or the first time in a long time. (1) You might also be extra prone to post-training soreness after a particularly hard training session where you’ve increased your volume, intensity, and overall time under tension. Eccentric training especially seems to be connected to increased levels of DOMS. (2)(3)
Unfortunately, you may also just be one of those people who seems to just always get sore. You might have done the same exact workout — maybe even with the same exact weights — as your training partner. But don’t be surprised if one of you is hobbling the next day while the other feels fresh and ready to go again. DOMS is highly variable from person-to-person, even if everyone involved performed the same workout. (4)
Why Do I Get Sore?
Strength athletes might know all too well what sparks DOMS — tough training sessions, especially when you haven’t worked out certain muscle groups in a while. But a lot of things happen to your body during a high-intensity workout. So what exactly is the part that causes DOMS?
Just as your workout contains many components, so, it seems, do the stiff aches that follow after. Researchers often recognize that DOMS comes from a combination of factors. It’s theorized that DOMS likely comes from some combination of the following: connective tissue damage, muscle damage, inflammation, lactic acid and free radical buildup, muscle spasms, and enzyme efflux. (5)(6)(7)(8)(9)(1)
Delayed-Onset Muscle Soreness Myths
If you know muscle soreness, you may think you know DOMS. But do you really? Read on for some DOMS myth-busting.
Myth: DOMS Means Muscle Growth
Beginners may not be the only ones crawling up the stairs after leg day, but less experienced strength athletes may also be more likely to experience DOMS than more experienced athletes. (1) Since beginners are also prone to benefit from “newbie gains”, it’s easy to associate that soreness with that sweet, rapid muscle growth.
Credit: MILKXT2 / Shutterstock
But that correlation might be coincidental instead of causative, especially if your case of DOMS is originating more from your connective tissues — your ligaments and tendons — than your muscles themselves. (1)
Myth: You Only Worked Hard if You’re Sore
You worked your butt off — literally, those hip thrusts were tough — but you’re not sore the next day. Did you not go hard enough? If you’re not sore, was it even worth it? Probably, yes.
Beginners and those returning to training after a break are more likely than more experienced and consistent lifters to experience muscle soreness after a training session. (1) Does this mean that you’re not working hard enough if you’re not sore? Not really.
Yes, experienced lifters are likely to get sore after particularly intense sessions — hence all those ice baths. But there doesn’t seem to be any science-based evidence to suggest that DOMS indicates better performance or indicates a threshold of hard work. If anything, working out so hard that you get extremely sore might negatively impact your performance in the days ahead. (10)(1)
Myth: Stretching and Cooling Down Will Prevent DOMS
You’ve just finished a tremendous amount of eccentric training, maybe with some 21s thrown in for good measure. You’re thrilled with how hard you pushed yourself, but you really don’t want to be sore tomorrow. So, you do what they taught you in high school gym, and you cool down and stretch.
Credit: Prostock-studio / Shutterstock
That’s a great habit to get into — but alas, research suggests that cooling down doesn’t defeat DOMS as much as might think. (11)(12) That said, if you love yourself a good post-workout jog and stretch ritual and you believe it will help you recover better, then science is also kind of on your side. Because studies have shown that if you believe cooling down will combat soreness and help recovery, you may in fact perceive less soreness afterwards. (13)(14)(15)
Effects of Delayed-Onset Muscle Soreness
The number one effect of delayed-onset muscle soreness is pretty obvious — that pervasive inability to walk up (or down) stairs after leg day. But all memes aside, here’s what you’re likely to deal with alongside that soreness.
Reduced Muscular Force
DOMS isn’t just something you experience as soreness and stiffness. It’s something that’s happening on the biological, cellular level. The scientific jury is out as to which factors contribute most to that lingering post-exercise pain.
But something that seems clear is that certain biological markers of DOMS — for example, your body’s cytokine response to exercise — can reduce muscular force output by as much as half. (10) This means that as much as you might want to go hard even when you’re sore, your workout might be a lot less effective.
Decreased Range of Motion
It’s not just your muscle performance that may be negatively impacted by DOMS. All that stiffness and soreness can amount to a decreased range of motion that could have potentially nasty impacts on your lifting ability. (1)
Credit: Teerasan Phutthigorn / Shutterstock
Imagine trying to get into a proper overhead squat position when your upper back or hips are sore, for example. When your body’s range of motion is limited, so is your ability to perform lifts that require quite lubricated joints.
Connective Tissue Stress
Your range of motion doesn’t only get limited because of the actual stiffness and soreness of DOMS. It seems that DOMS also impacts your ligaments and tendons directly, which may contribute to soreness and also limit your range of motion. (1)
When your connective tissues are under stress, you might be more prone to injury. (16) So if you’re feeling particularly hammered by DOMS, now might not be the best time to hammer away at those weights.
Should I Worry About Delayed-Onset Muscle Soreness?
It’s reasonable to worry if you’re sore. Especially when it’s meme-level pain. So, when should you actually be concerned?
How Long Should Soreness Last?
If you’re sore between the 24 to 72 hours after a tough training session, there’s generally not a cause for concern. It’s often just part of that training life to have the “real” workout — going about your daily business with all that soreness — begin a day or two after the gym workout.
Credit: Teerasan Phutthigorn / Shutterstock
That said, if your pain is particularly intense or lasts more than a few days, you might want to check in with a doctor. If you’re on the opposite end of the caution spectrum and are eager to get back to the gym, rest assured — you generally can work out while sore.
Can I Work Out With DOMS?
When you go to the gym with DOMS, try to focus on a different muscle group to help maximize your workout effectiveness and recovery time. That way, you can have all the gains with less pain.
If you’re heading back to the gym while you’re still stiff, consider spending extra time warming up. That way, your range of motion won’t be as limited as it might otherwise be while you’re sore. Keep in mind that even if you warm up, DOMS may increase injury risk if you attempt to go back to the gym too soon. (17)(1)(16) So listen to your body and learn when it’s best to pump the breaks versus the gas.
How to Tell the Difference Between Pain and Soreness
If you’re in an uncomfortable amount of pain, checking in with a doctor is generally not a bad idea. But as a general rule of thumb, research suggests that DOMS seems to occupy a middle space between soreness pain and injury pain.
When you’re “just” sore, it sure can hurt a lot — hence all the memes. But DOMS pain often feels generalized (“whoa, going up these three stairs is harder than the actual workout was”) versus injury pain, which is often more specific (“whoa, this one part of my shoulder hurts a lot when I move like this”). (17)
That said, DOMS might have a negative impact on your range of motion and stress out your connective tissue. (1)(16) These factors may increase your risk of training injury — so even if DOMS doesn’t start out as injury pain, sometimes it might end up that way.
How to Treat Delayed-Onset Muscle Soreness
Alas, there is no “cure” for DOMS. But there are some ways to make it less awful.
Rest When You Need To
Technically, there’s nothing stopping you from working out while you’re sore. Unless your entire body is feeling the pain, you can generally work out different muscles than the ones that are sore.
This is where training splits come in handy. If you know you’re prone to get DOMS, you might opt for a muscle group training split so that, for example, while your chest is sore from yesterday, you can work on legs today.
That said, the more intense your pain from DOMS, the less likely you are to have an effective workout. (17)(1)(16) So, rest when you need to. That might mean moving lighter weights, swapping to a different muscle group, having an active recovery day, or taking a day or two off entirely.
Concentric Active Recovery
Performing light, concentric-focused exercise — think sled pushes, for example — can help reduce the soreness you feel from acute DOMS. (18)(19) For that reason, try integrating plenty of concentric work into your active recovery days to help ease that soreness.
That logic seems to apply to the original, DOMS-causing workouts, too. Integrating concentric moves into your eccentric training may have a preventative effect on developing DOMS. (20) So if you’re extra concerned about DOMS — maybe you really can’t be sore during that wedding this weekend — try programming concentric work along with your eccentric training.
Massage Therapy and Foam Rolling
While massage therapy seems to not actually reduce DOMS on a biological level, it can have a positive impact on athletes’ perception of pain. (21) It’s a similar story with foam rolling, which seems to reduce acute pain and soreness perception. (22)
So if massage or foam rolling feel like they’re working to alleviate your post-workout pain, you’re not the only one. And, well, more power to you.
Contrast Therapy
Are you someone who loves heating pads and saunas? Maybe you’re more of a cold plunge or ice pack type of human. Either way, if you’re a fan of temperature contrast therapy — putting something hot or cold on your sore muscles — you’re in luck. Kind of.
Much like massage therapy and foam rolling, hot and cold therapy doesn’t seem to “cure” DOMS on a biological level — but it does seem to improve athletes’ perception of pain. (23) So if you believe in it, it may just work for you.
Supplements
Some supplements may help reduce DOMS in experienced lifters. For example, HMB (hydroxy methylbutyrate) is sometimes found in creatine supplements. It might reduce that sweet after-workout soreness when you’ve got a history of strength training under your belt. (24)
However, over-the-counter pain medications like Ibuprofen — even at high doses — doesn’t necessarily reduce the soreness. (18) Vitamins C and vitamin E also haven’t been found to be effective at reducing that post-workout soreness. (25)
On the other hand, anti-inflammatory dietary supplements and omega-3 supplements have both seemed to be effective at treating the symptoms of DOMS. (26)(27) Similarly, caffeine supplements also seem to reduce DOMS symptoms in elite athletes, though research suggests that this has a bigger impact for men than women. (The study did not note whether nonbinary athletes were considered.) (28)
Fight the Soaring Soreness
If your soreness is soaring to new heights after a workout, odds are you’re new here. Or, maybe you haven’t trained — or focused on a certain muscle group — in a while. That’s not to say that advanced lifters don’t get sore — of course they do. Sometimes, that sweet DOMS sensation is inevitable after a particularly intense session, no matter your experience level.
Researchers might not know exactly why DOMS happens when and how — and to whom — it does. But it seems clear that as long as there are barbells to lift, DOMS will be lurking around the corner. Have your foam rollers and supplements ready for when it strikes.
References
Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64.
Marathamuthu S, Selvanayagam VS, Yusof A. Contralateral Effects of Eccentric Exercise and DOMS of the Plantar Flexors: Evidence of Central Involvement. Res Q Exerc Sport. 2022 Jun;93(2):240-249.
Serravite DH, Perry A, Jacobs KA, Adams JA, Harriell K, Signorile JF. Effect of whole-body periodic acceleration on exercise-induced muscle damage after eccentric exercise. Int J Sports Physiol Perform. 2014 Nov;9(6):985-92.
Chapman DW, Newton MJ, Zainuddin Z, Sacco P, Nosaka K. Work and peak torque during eccentric exercise do not predict changes in markers of muscle damage. Br J Sports Med. 2008 Jul;42(7):585-91.
Wilke J, Behringer M. Is “Delayed Onset Muscle Soreness” a False Friend? The Potential Implication of the Fascial Connective Tissue in Post-Exercise Discomfort. Int J Mol Sci. 2021 Aug 31;22(17):9482.
Sonkodi B, Berkes I, Koltai E. Have We Looked in the Wrong Direction for More Than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage Rather Than Muscle Damage. Antioxidants (Basel). 2020 Mar 5;9(3):212.
Hotfiel T, Freiwald J, Hoppe MW, Lutter C, Forst R, Grim C, Bloch W, Hüttel M, Heiss R. Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletz Sportschaden. 2018 Dec;32(4):243-250.
Lewis PB, Ruby D, Bush-Joseph CA. Muscle soreness and delayed-onset muscle soreness. Clin Sports Med. 2012 Apr;31(2):255-62.
Manojlovi? V, Er?ulj F. Using blood lactate concentration to predict muscle damage and jump performance response to maximal stretch-shortening cycle exercise. J Sports Med Phys Fitness. 2019 Apr;59(4):581-586.
Paulsen G, Mikkelsen UR, Raastad T, Peake JM. Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc Immunol Rev. 2012;18:42-97.
Crowther F, Sealey R, Crowe M, Edwards A, Halson S. Influence of recovery strategies upon performance and perceptions following fatiguing exercise: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2017 Dec 28;9:25.
Rey E, Lago-Peñas C, Casáis L, Lago-Ballesteros J. The effect of immediate post-training active and passive recovery interventions on anaerobic performance and lower limb flexibility in professional soccer players. J Hum Kinet. 2012 Mar;31:121-9.
Cook CJ, Beaven CM. Individual perception of recovery is related to subsequent sprint performance. Br J Sports Med. 2013 Jul;47(11):705-9.
Saw, A. E., Main, L. C., & Gastin, P. B. (2016). Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. British journal of sports medicine, 50(5), 281-291.
Raeder, C., Wiewelhove, T., Schneider, C., Döweling, A., Kellmann, M., Meyer, T., … & Ferrauti, A. (2017). Effects of active recovery on muscle function following high-intensity training sessions in elite Olympic weightlifters. Adv Skelet Muscle Funct Assess, 1(1), 3-12.
Wilke J, Hespanhol L, Behrens M. Is It All About the Fascia? A Systematic Review and Meta-analysis of the Prevalence of Extramuscular Connective Tissue Lesions in Muscle Strain Injury. Orthop J Sports Med. 2019 Dec 24;7(12):2325967119888500.
Zeng C, Luo G, Xu S, Li Y. The Application of DOMS Mechanism and Prevention in Physical Education and Training. J Healthc Eng. 2022 Jan 7;2022:9654919.
Rahnama N, Rahmani-Nia F, Ebrahim K. The isolated and combined effects of selected physical activity and ibuprofen on delayed-onset muscle soreness. J Sports Sci. 2005 Aug;23(8):843-50.
Zainuddin Z, Sacco P, Newton M, Nosaka K. Light concentric exercise has a temporarily analgesic effect on delayed-onset muscle soreness, but no effect on recovery from eccentric exercise. Appl Physiol Nutr Metab. 2006 Apr;31(2):126-34.
Nosaka K, Clarkson PM. Influence of previous concentric exercise on eccentric exercise-induced muscle damage. J Sports Sci. 1997 Oct;15(5):477-83.
Hilbert JE, Sforzo GA, Swensen T. The effects of massage on delayed onset muscle soreness. Br J Sports Med. 2003 Feb;37(1):72-5.
Pearcey GE, Bradbury-Squires DJ, Kawamoto JE, Drinkwater EJ, Behm DG, Button DC. Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Athl Train. 2015 Jan;50(1):5-13.
Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021 Mar;48:177-187.
Wilson JM, Lowery RP, Joy JM, Walters JA, Baier SM, Fuller JC Jr, Stout JR, Norton LE, Sikorski EM, Wilson SM, Duncan NM, Zanchi NE, Rathmacher J. ?-Hydroxy-?-methylbutyrate free acid reduces markers of exercise-induced muscle damage and improves recovery in resistance-trained men. Br J Nutr. 2013 Aug 28;110(3):538-44.
Torre MF, Martinez-Ferran M, Vallecillo N, Jiménez SL, Romero-Morales C, Pareja-Galeano H. Supplementation with Vitamins C and E and Exercise-Induced Delayed-Onset Muscle Soreness: A Systematic Review. Antioxidants (Basel). 2021 Feb 12;10(2):279.
Tanabe Y, Fujii N, Suzuki K. Dietary Supplementation for Attenuating Exercise-Induced Muscle Damage and Delayed-Onset Muscle Soreness in Humans. Nutrients. 2021 Dec 24;14(1):70.
Jouris KB, McDaniel JL, Weiss EP. The Effect of Omega-3 Fatty Acid Supplementation on the Inflammatory Response to eccentric strength exercise. J Sports Sci Med. 2011 Sep 1;10(3):432-8.
Chen HY, Chen YC, Tung K, Chao HH, Wang HS. Effects of caffeine and sex on muscle performance and delayed-onset muscle soreness after exercise-induced muscle damage: a double-blind randomized trial. J Appl Physiol (1985). 2019 Sep 1;127(3):798-805.
Featured Image: Twinsterphoto / Shutterstock
You crushed your workout on Monday, but by Wednesday, you realized that it was actually your workout that crushed you. That feel-good pump gave way to a bit of stiffness, and you woke up the next day wondering when you got hit by a bus. If you’ve hit the gym hard and found that it hit you back, you’ve likely experienced something called DOMS — delayed-onset muscle soreness.
Credit: Maridav / Shutterstock
DOMS is the source of all those post-leg day memes about not being able to get out of bed, let alone up that flight of stairs. Soreness after working out doesn’t kick in right away. Instead, it can lie in wait anywhere from 24 to 72 hours before knocking you on your butt. But why does it happen that way, and what even is it?
Editor’s note: The content on BarBend is meant to be informative in nature, but it shouldn’t take the place of advice and/or supervision from a medical professional. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. Speak with your physician if you have any concerns.
What Is Delayed-Onset Muscle Soreness?
While pretty much everyone who’s ever conquered a tough training session knows about DOMS firsthand, scientists only have speculations about exactly what it is and why it happens. But a few things seem clear.
It’s most common to get hit by a bout of DOMS when you’re coming to physical activity either for the first time or the first time in a long time. (1) You might also be extra prone to post-training soreness after a particularly hard training session where you’ve increased your volume, intensity, and overall time under tension. Eccentric training especially seems to be connected to increased levels of DOMS. (2)(3)
Unfortunately, you may also just be one of those people who seems to just always get sore. You might have done the same exact workout — maybe even with the same exact weights — as your training partner. But don’t be surprised if one of you is hobbling the next day while the other feels fresh and ready to go again. DOMS is highly variable from person-to-person, even if everyone involved performed the same workout. (4)
Why Do I Get Sore?
Strength athletes might know all too well what sparks DOMS — tough training sessions, especially when you haven’t worked out certain muscle groups in a while. But a lot of things happen to your body during a high-intensity workout. So what exactly is the part that causes DOMS?
Just as your workout contains many components, so, it seems, do the stiff aches that follow after. Researchers often recognize that DOMS comes from a combination of factors. It’s theorized that DOMS likely comes from some combination of the following: connective tissue damage, muscle damage, inflammation, lactic acid and free radical buildup, muscle spasms, and enzyme efflux. (5)(6)(7)(8)(9)(1)
Delayed-Onset Muscle Soreness Myths
If you know muscle soreness, you may think you know DOMS. But do you really? Read on for some DOMS myth-busting.
Myth: DOMS Means Muscle Growth
Beginners may not be the only ones crawling up the stairs after leg day, but less experienced strength athletes may also be more likely to experience DOMS than more experienced athletes. (1) Since beginners are also prone to benefit from “newbie gains”, it’s easy to associate that soreness with that sweet, rapid muscle growth.
But that correlation might be coincidental instead of causative, especially if your case of DOMS is originating more from your connective tissues — your ligaments and tendons — than your muscles themselves. (1)
Myth: You Only Worked Hard if You’re Sore
You worked your butt off — literally, those hip thrusts were tough — but you’re not sore the next day. Did you not go hard enough? If you’re not sore, was it even worth it? Probably, yes.
Beginners and those returning to training after a break are more likely than more experienced and consistent lifters to experience muscle soreness after a training session. (1) Does this mean that you’re not working hard enough if you’re not sore? Not really.
Yes, experienced lifters are likely to get sore after particularly intense sessions — hence all those ice baths. But there doesn’t seem to be any science-based evidence to suggest that DOMS indicates better performance or indicates a threshold of hard work. If anything, working out so hard that you get extremely sore might negatively impact your performance in the days ahead. (10)(1)
Myth: Stretching and Cooling Down Will Prevent DOMS
You’ve just finished a tremendous amount of eccentric training, maybe with some 21s thrown in for good measure. You’re thrilled with how hard you pushed yourself, but you really don’t want to be sore tomorrow. So, you do what they taught you in high school gym, and you cool down and stretch.
That’s a great habit to get into — but alas, research suggests that cooling down doesn’t defeat DOMS as much as might think. (11)(12) That said, if you love yourself a good post-workout jog and stretch ritual and you believe it will help you recover better, then science is also kind of on your side. Because studies have shown that if you believe cooling down will combat soreness and help recovery, you may in fact perceive less soreness afterwards. (13)(14)(15)
Effects of Delayed-Onset Muscle Soreness
The number one effect of delayed-onset muscle soreness is pretty obvious — that pervasive inability to walk up (or down) stairs after leg day. But all memes aside, here’s what you’re likely to deal with alongside that soreness.
Reduced Muscular Force
DOMS isn’t just something you experience as soreness and stiffness. It’s something that’s happening on the biological, cellular level. The scientific jury is out as to which factors contribute most to that lingering post-exercise pain.
But something that seems clear is that certain biological markers of DOMS — for example, your body’s cytokine response to exercise — can reduce muscular force output by as much as half. (10) This means that as much as you might want to go hard even when you’re sore, your workout might be a lot less effective.
Decreased Range of Motion
It’s not just your muscle performance that may be negatively impacted by DOMS. All that stiffness and soreness can amount to a decreased range of motion that could have potentially nasty impacts on your lifting ability. (1)
Imagine trying to get into a proper overhead squat position when your upper back or hips are sore, for example. When your body’s range of motion is limited, so is your ability to perform lifts that require quite lubricated joints.
Connective Tissue Stress
Your range of motion doesn’t only get limited because of the actual stiffness and soreness of DOMS. It seems that DOMS also impacts your ligaments and tendons directly, which may contribute to soreness and also limit your range of motion. (1)
When your connective tissues are under stress, you might be more prone to injury. (16) So if you’re feeling particularly hammered by DOMS, now might not be the best time to hammer away at those weights.
Should I Worry About Delayed-Onset Muscle Soreness?
It’s reasonable to worry if you’re sore. Especially when it’s meme-level pain. So, when should you actually be concerned?
How Long Should Soreness Last?
If you’re sore between the 24 to 72 hours after a tough training session, there’s generally not a cause for concern. It’s often just part of that training life to have the “real” workout — going about your daily business with all that soreness — begin a day or two after the gym workout.
That said, if your pain is particularly intense or lasts more than a few days, you might want to check in with a doctor. If you’re on the opposite end of the caution spectrum and are eager to get back to the gym, rest assured — you generally can work out while sore.
Can I Work Out With DOMS?
When you go to the gym with DOMS, try to focus on a different muscle group to help maximize your workout effectiveness and recovery time. That way, you can have all the gains with less pain.
If you’re heading back to the gym while you’re still stiff, consider spending extra time warming up. That way, your range of motion won’t be as limited as it might otherwise be while you’re sore. Keep in mind that even if you warm up, DOMS may increase injury risk if you attempt to go back to the gym too soon. (17)(1)(16) So listen to your body and learn when it’s best to pump the breaks versus the gas.
How to Tell the Difference Between Pain and Soreness
If you’re in an uncomfortable amount of pain, checking in with a doctor is generally not a bad idea. But as a general rule of thumb, research suggests that DOMS seems to occupy a middle space between soreness pain and injury pain.
When you’re “just” sore, it sure can hurt a lot — hence all the memes. But DOMS pain often feels generalized (“whoa, going up these three stairs is harder than the actual workout was”) versus injury pain, which is often more specific (“whoa, this one part of my shoulder hurts a lot when I move like this”). (17)
That said, DOMS might have a negative impact on your range of motion and stress out your connective tissue. (1)(16) These factors may increase your risk of training injury — so even if DOMS doesn’t start out as injury pain, sometimes it might end up that way.
How to Treat Delayed-Onset Muscle Soreness
Alas, there is no “cure” for DOMS. But there are some ways to make it less awful.
Rest When You Need To
Technically, there’s nothing stopping you from working out while you’re sore. Unless your entire body is feeling the pain, you can generally work out different muscles than the ones that are sore.
This is where training splits come in handy. If you know you’re prone to get DOMS, you might opt for a muscle group training split so that, for example, while your chest is sore from yesterday, you can work on legs today.
That said, the more intense your pain from DOMS, the less likely you are to have an effective workout. (17)(1)(16) So, rest when you need to. That might mean moving lighter weights, swapping to a different muscle group, having an active recovery day, or taking a day or two off entirely.
Concentric Active Recovery
Performing light, concentric-focused exercise — think sled pushes, for example — can help reduce the soreness you feel from acute DOMS. (18)(19) For that reason, try integrating plenty of concentric work into your active recovery days to help ease that soreness.
That logic seems to apply to the original, DOMS-causing workouts, too. Integrating concentric moves into your eccentric training may have a preventative effect on developing DOMS. (20) So if you’re extra concerned about DOMS — maybe you really can’t be sore during that wedding this weekend — try programming concentric work along with your eccentric training.
Massage Therapy and Foam Rolling
While massage therapy seems to not actually reduce DOMS on a biological level, it can have a positive impact on athletes’ perception of pain. (21) It’s a similar story with foam rolling, which seems to reduce acute pain and soreness perception. (22)
So if massage or foam rolling feel like they’re working to alleviate your post-workout pain, you’re not the only one. And, well, more power to you.
Contrast Therapy
Are you someone who loves heating pads and saunas? Maybe you’re more of a cold plunge or ice pack type of human. Either way, if you’re a fan of temperature contrast therapy — putting something hot or cold on your sore muscles — you’re in luck. Kind of.
Much like massage therapy and foam rolling, hot and cold therapy doesn’t seem to “cure” DOMS on a biological level — but it does seem to improve athletes’ perception of pain. (23) So if you believe in it, it may just work for you.
Supplements
Some supplements may help reduce DOMS in experienced lifters. For example, HMB (hydroxy methylbutyrate) is sometimes found in creatine supplements. It might reduce that sweet after-workout soreness when you’ve got a history of strength training under your belt. (24)
However, over-the-counter pain medications like Ibuprofen — even at high doses — doesn’t necessarily reduce the soreness. (18) Vitamins C and vitamin E also haven’t been found to be effective at reducing that post-workout soreness. (25)
On the other hand, anti-inflammatory dietary supplements and omega-3 supplements have both seemed to be effective at treating the symptoms of DOMS. (26)(27) Similarly, caffeine supplements also seem to reduce DOMS symptoms in elite athletes, though research suggests that this has a bigger impact for men than women. (The study did not note whether nonbinary athletes were considered.) (28)
Fight the Soaring Soreness
If your soreness is soaring to new heights after a workout, odds are you’re new here. Or, maybe you haven’t trained — or focused on a certain muscle group — in a while. That’s not to say that advanced lifters don’t get sore — of course they do. Sometimes, that sweet DOMS sensation is inevitable after a particularly intense session, no matter your experience level.
Researchers might not know exactly why DOMS happens when and how — and to whom — it does. But it seems clear that as long as there are barbells to lift, DOMS will be lurking around the corner. Have your foam rollers and supplements ready for when it strikes.
References
[*]Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64.
[*]Marathamuthu S, Selvanayagam VS, Yusof A. Contralateral Effects of Eccentric Exercise and DOMS of the Plantar Flexors: Evidence of Central Involvement. Res Q Exerc Sport. 2022 Jun;93(2):240-249.
[*]Serravite DH, Perry A, Jacobs KA, Adams JA, Harriell K, Signorile JF. Effect of whole-body periodic acceleration on exercise-induced muscle damage after eccentric exercise. Int J Sports Physiol Perform. 2014 Nov;9(6):985-92.
[*]Chapman DW, Newton MJ, Zainuddin Z, Sacco P, Nosaka K. Work and peak torque during eccentric exercise do not predict changes in markers of muscle damage. Br J Sports Med. 2008 Jul;42(7):585-91.
[*]Wilke J, Behringer M. Is “Delayed Onset Muscle Soreness” a False Friend? The Potential Implication of the Fascial Connective Tissue in Post-Exercise Discomfort. Int J Mol Sci. 2021 Aug 31;22(17):9482.
[*]Sonkodi B, Berkes I, Koltai E. Have We Looked in the Wrong Direction for More Than 100 Years? Delayed Onset Muscle Soreness Is, in Fact, Neural Microdamage Rather Than Muscle Damage. Antioxidants (Basel). 2020 Mar 5;9(3):212.
[*]Hotfiel T, Freiwald J, Hoppe MW, Lutter C, Forst R, Grim C, Bloch W, Hüttel M, Heiss R. Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics. Sportverletz Sportschaden. 2018 Dec;32(4):243-250.
[*]Lewis PB, Ruby D, Bush-Joseph CA. Muscle soreness and delayed-onset muscle soreness. Clin Sports Med. 2012 Apr;31(2):255-62.
[*]Manojlovi? V, Er?ulj F. Using blood lactate concentration to predict muscle damage and jump performance response to maximal stretch-shortening cycle exercise. J Sports Med Phys Fitness. 2019 Apr;59(4):581-586.
[*]Paulsen G, Mikkelsen UR, Raastad T, Peake JM. Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc Immunol Rev. 2012;18:42-97.
[*]Crowther F, Sealey R, Crowe M, Edwards A, Halson S. Influence of recovery strategies upon performance and perceptions following fatiguing exercise: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2017 Dec 28;9:25.
[*]Rey E, Lago-Peñas C, Casáis L, Lago-Ballesteros J. The effect of immediate post-training active and passive recovery interventions on anaerobic performance and lower limb flexibility in professional soccer players. J Hum Kinet. 2012 Mar;31:121-9.
[*]Cook CJ, Beaven CM. Individual perception of recovery is related to subsequent sprint performance. Br J Sports Med. 2013 Jul;47(11):705-9.
[*]Saw, A. E., Main, L. C., & Gastin, P. B. (2016). Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. British journal of sports medicine, 50(5), 281-291.
[*]Raeder, C., Wiewelhove, T., Schneider, C., Döweling, A., Kellmann, M., Meyer, T., … & Ferrauti, A. (2017). Effects of active recovery on muscle function following high-intensity training sessions in elite Olympic weightlifters. Adv Skelet Muscle Funct Assess, 1(1), 3-12.
[*]Wilke J, Hespanhol L, Behrens M. Is It All About the Fascia? A Systematic Review and Meta-analysis of the Prevalence of Extramuscular Connective Tissue Lesions in Muscle Strain Injury. Orthop J Sports Med. 2019 Dec 24;7(12):2325967119888500.
[*]Zeng C, Luo G, Xu S, Li Y. The Application of DOMS Mechanism and Prevention in Physical Education and Training. J Healthc Eng. 2022 Jan 7;2022:9654919.
[*]Rahnama N, Rahmani-Nia F, Ebrahim K. The isolated and combined effects of selected physical activity and ibuprofen on delayed-onset muscle soreness. J Sports Sci. 2005 Aug;23(8):843-50.
[*]Zainuddin Z, Sacco P, Newton M, Nosaka K. Light concentric exercise has a temporarily analgesic effect on delayed-onset muscle soreness, but no effect on recovery from eccentric exercise. Appl Physiol Nutr Metab. 2006 Apr;31(2):126-34.
[*]Nosaka K, Clarkson PM. Influence of previous concentric exercise on eccentric exercise-induced muscle damage. J Sports Sci. 1997 Oct;15(5):477-83.
[*]Hilbert JE, Sforzo GA, Swensen T. The effects of massage on delayed onset muscle soreness. Br J Sports Med. 2003 Feb;37(1):72-5.
[*]Pearcey GE, Bradbury-Squires DJ, Kawamoto JE, Drinkwater EJ, Behm DG, Button DC. Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Athl Train. 2015 Jan;50(1):5-13.
[*]Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021 Mar;48:177-187.
[*]Wilson JM, Lowery RP, Joy JM, Walters JA, Baier SM, Fuller JC Jr, Stout JR, Norton LE, Sikorski EM, Wilson SM, Duncan NM, Zanchi NE, Rathmacher J. ?-Hydroxy-?-methylbutyrate free acid reduces markers of exercise-induced muscle damage and improves recovery in resistance-trained men. Br J Nutr. 2013 Aug 28;110(3):538-44.
[*]Torre MF, Martinez-Ferran M, Vallecillo N, Jiménez SL, Romero-Morales C, Pareja-Galeano H. Supplementation with Vitamins C and E and Exercise-Induced Delayed-Onset Muscle Soreness: A Systematic Review. Antioxidants (Basel). 2021 Feb 12;10(2):279.
[*]Tanabe Y, Fujii N, Suzuki K. Dietary Supplementation for Attenuating Exercise-Induced Muscle Damage and Delayed-Onset Muscle Soreness in Humans. Nutrients. 2021 Dec 24;14(1):70.
[*]Jouris KB, McDaniel JL, Weiss EP. The Effect of Omega-3 Fatty Acid Supplementation on the Inflammatory Response to eccentric strength exercise. J Sports Sci Med. 2011 Sep 1;10(3):432-8.
[*]Chen HY, Chen YC, Tung K, Chao HH, Wang HS. Effects of caffeine and sex on muscle performance and delayed-onset muscle soreness after exercise-induced muscle damage: a double-blind randomized trial. J Appl Physiol (1985). 2019 Sep 1;127(3):798-805.
Featured Image: Twinsterphoto / Shutterstock
Click here to view the article.
