Digging into DOMS! What is Delayed Onset Muscle Soreness? Can it be treated or prevented?

If you have ever exercised, you probably have had local muscle soreness that pops up a few hours later and is very annoying. This soreness is commonly called DOMS which stands for Delayed Onset Muscle Soreness. A high school coach may have expressed this as a reward for good performance. I can still hear one of mine in my head saying, “pain is weakness leaving the body.” There is some truth to that, but we will dive into that later.

Before we dive into what DOMS are and look like lets cover what they are not. DOMS should not be highly visible. Bruising, redness, bleeding, tremors, spasm, or other very visible response indicate there is another issue present. DOMS do not present immediately. If you finish lifting and feel the ache right away or within a few minutes it is not DOMS, but DOMS still may occur. DOMS do not radiate into tendons or across joints. This would be symptomatic of a different issue. An experienced, orthopedic Physical Therapist (such as the ones at Absolute Kinetics) can perform tests and analysis to identify what the issue is.

DOMS present hours after activity. Peak soreness and tenderness usually occurs at the 2 day mark from increase in exercise or change in activity. DOMS are local to the muscle group where activity was intensified. If you increased from a usual weight load of 50 lbs on a leg extension machine to 90 lbs at the same reps you have a very high likely hood of DOMS developing in your quadriceps. While present DOMS cause athletic performance to reduce.

DOMS are indicative of tissue adaptation, so in that sense coach was right! Activity that stresses muscle group where DOMS are present needs to be scaled down though until fully resolved. Then when activity is reintroduced size and performance of skeletal muscle should improve. Improved performance and muscle growth can be achieved without DOMS, and often faster! This requires specific dosing of activity to directly correlate to desired outcome. Depending on the trainer (or coach) DOMS may be part of the program for muscle growth that is planned but that style of program should never be in season for an athlete.

So I know I have DOMS, not one of the “what it’s nots.” What do I do now? Pain management and healing are the 2 primary approaches to resolving DOMS in a functional way. Movement and exercise can help flush inflammation and organs. Continue light intensity exercise with no strain on muscles that are experiencing DOMS. Rest the muscle group that has DOMS. NSAIDs (acetametophin and ibuprophen specifically) were found to have no pain management improvement for DOMS symptoms. Heat and/or ice both can help modulate pain response and had no measurable affect in healing time. Gentle stretching and gentle movement of affected muscle can be helpful. Aggressive stretching and deep tissue work can be counter productive and delay DOMS symptom recovery.

Listen to your body and avoid pain! Once DOMS are resolved return to activity, perhaps at a slightly lower intensity or load. Your body should adapt and DOMS that lingered for 10 days should resolve much quicker (yes DOMS can linger for up to 2 weeks, especially if aggressively treated). DOMS are not a serious medical condition and generally resolve without long term consequence.

If you are really interested, check out the references below. The information is fascinating! If you have questions, would like an eval to differentiate what your experiencing, or worried playing through DOMS has lead to bad postures or habits please contact at justin@absolutekineticspt.com or call at 513-208-2257 to schedule.

Blog post written by Dr. Justin Vincent, PT, DPT

References

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