Delayed Onset Muscle Soreness (DOMS)

You’ve just finished an heroic workout. You felt no problems during and immediately afterward. Now, it’s two days later and your legs are so sore that you can’t walk, let alone go down stairs without severe pain. Welcome to delayed onset muscle soreness.

What is it? Delayed Onset Muscle Soreness (DOMS) is skeletal muscle pain that starts 8 to 24 hours after activity and peaks from 24 to 72 hours after activity. It is not considered to be a true muscle tear or strain.

What are the causes/predisposing factors of DOMS? DOMS is thought to be caused by microscopic damage to the muscle tissue itself. This microtrauma causes disruption to the structure of the muscle fibers leading to inflammation and pain.

Lactic acid accumulation is not believed to play a role in DOMS because blood and muscle lactate levels return to normal 30 to 40 minutes after exercise.

Typical causes of DOMS are eccentric muscle loading (such as downhill running), performing new exercises, or higher-than-normal intensity training.

What are the symptoms? Symptoms include pain and tenderness to the touch in the affected muscles. The pain usually begins 8 to 24 hours after exercise and peaks at 24 to 72 hours post exercise.

There is usually a loss of strength and mobility in the muscle, and it may be swollen. The amount of discomfort seems to be related to the intensity and duration of the activity.

What can be done to prevent or treat this condition? Prevention is done by doing the activity that causes the DOMS in the first place. The thought is that the body will adapt to these stresses and DOMS will no longer occur. Training should focus on building up to the desired intensity and/or duration over time.

Treatment is controversial. Many studies have been done on various treatment modalities ranging from physical therapy to vitamin supplementation and none have been conclusive. The best approach seems to be resuming physical activity. This reduces pain and inflammation leading to a faster recovery.

The good news is that DOMS is self-limiting and most of the pain is gone within 5 to 7 days. Full recovery usually occurs within 2 weeks. Fortunately, DOMS has not been shown to create any long term problems or impairment in performance.