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Relieving Muscle Pain and Delayed Onset Muscle Soreness (DOMS)

Engaging in regular physical activity is essential for maintaining overall health and fitness. However, intense workouts can sometimes leave us with muscle pain and DOMS, which put our body under discomfort and affect our daily routine. DOMS is not an injury. 

Muscle Injury VS. DOMS 

What is muscle injury? What is DOMS? Muscle injury and delayed onset muscle soreness (DOMS) are two different experiences related to physical activity. Here's a breakdown of the key differences: 

 

Muscle Injury 

Delayed Onset Muscle Soreness (DOMS) 

Timing 

Muscle pain can occur during or immediately after exercise 

DOMS typically develops 24 to 48 hours after intense or unfamiliar exercise 

Sensation 

It is often described as a sharp or acute pain 

A dull, aching soreness in the muscles characterises it 

Onset 

Muscle pain is immediate and does not typically develop gradually 

A dull, aching soreness in the muscles characterises it 

Causes 

Muscle pain can result from various factors like muscle strains, sprains, or injuries 

DOMS is primarily caused by microscopic damage to muscle fibers during eccentric movements (lengthening of the muscle under tension) or high-intensity exercise 

Duration 

It can persist beyond 48 hours and may require medical attention if severe or debilitating 

DOMS usually subsides within 3 to 7 days without medical intervention 

It's important to note that while both muscle pain and DOMS can be uncomfortable, DOMS is a normal response to exercise and indicates that your muscles are adapting and getting stronger.  

Symptoms of DOMS

Soreness and Stiffness

Muscles may feel sore, tender, or stiff to the touch. Movement and stretching may exacerbate the discomfort

Limited Range of Motion

Muscle pain can restrict movement, making it challenging to perform daily activities or exercise

Muscle Weakness

Pain in the muscles can be accompanied by weakness or difficulty performing tasks requiring strength

Fatigue

Muscle pain can be accompanied by a feeling of overall fatigue or exhaustion

Disrupted Sleep

Severe muscle pain can interfere with sleep quality, leading to sleep disturbances and daytime fatigue 

Causes of DOMS

DOMS causes muscular discomfort and pain that arises after engaging in intense physical activity or exercise. While the exact cause of DOMS is not fully understood, it is believed to be a result of several factors working together. Here are some of the proposed mechanisms contributing to the development of DOMS: 

Microscopic muscle damage

During strenuous exercise, particularly activities that involve eccentric muscle contractions (lengthening of the muscle under tension), microscopic damage occurs in the muscle fibers. This damage triggers an inflammatory response in the body, leading to pain and soreness.

Inflammation

The inflammatory response triggered by muscle damage plays a significant role in DOMS. It releases various chemicals and immune system cells, resulting in swelling, pain, and tenderness.

Metabolic waste accumulation: Intense exercise can cause a collection of metabolic waste products, such as lactic acid, within the muscles. While lactic acid does not directly cause DOMS, it may contribute to the discomfort and pain experienced.

Muscle swelling

The inflammatory response and fluid accumulation in the muscles can cause swelling, putting pressure on pain receptors and contributing to the soreness associated with DOMS.

 

It's important to note that DOMS is a normal response to exercise, especially when starting a new activity or increasing the intensity or duration of your workouts. The severity and duration of DOMS can vary depending on factors such as individual fitness level, the type of exercise performed, and the intensity of the workout. DOMS resolves independently within a few days to a week as the muscles recover and adapt to the new stimuli.

Here are some general advice on self-help for DOMS:

Gradual Progression: When engaging in physical activities that may lead to delayed onset muscle soreness (DOMS), such as intense exercise or strength training, gradually increase the intensity and duration of your workouts. This allows your muscles to adapt and minimises the risk of excessive soreness.

Proper Warm-Up and Cool-Down: Always include a thorough warm-up before your workout and a cool-down afterwards. An introduction helps prepare your muscles for exercise by increasing blood flow and flexibility, while a cool-down allows for a gradual recovery and helps prevent stiffness.

Stretching and Flexibility Exercises: Incorporate regular stretching and flexibility exercises into your routine. This can help improve muscle elasticity, reduce muscle tension, and alleviate soreness. Focus on major muscle groups and hold each stretch for 15-30 seconds without bouncing.

Hydration and Nutrition: Stay hydrated before, during, and after workouts. Drinking enough water helps maintain muscle function and aids in recovery. Additionally, ensure you have a balanced diet that includes adequate protein, as it plays a crucial role in muscle repair and growth.

Rest and Recovery: Allow your body sufficient time to recover between workouts. Rest is essential for muscle repair and rebuilding. Adequate sleep, typically 7-9 hours per night, is also crucial for overall recovery and muscle regeneration.

Active Recovery: Engage in light exercises or activities on rest days to promote blood flow and alleviate muscle soreness. Low-impact activities like walking, cycling, or swimming can help reduce DOMS symptoms.

Massage and Foam Rolling: Consider using a foam roller or a massage to help alleviate muscle soreness. These techniques can help improve circulation, reduce muscle tension, and promote relaxation.

Pain Management: If you experience significant discomfort from DOMS, over-the-counter pain relievers like ibuprofen or acetaminophen can provide temporary relief. However, consulting a doctor or physiotherapist before taking any medication is essential.

Listen to Your Body: Pay attention to your body's signals. If you feel excessive pain or discomfort during exercise, it's essential to modify or scale back your workouts to prevent further injury or exacerbation of DOMS.

Consistency and Long-Term Approach: Consistency is critical when managing DOMS. Regular exercise and gradually increasing intensity over time can help your muscles adapt and reduce the severity of soreness. Adopt a long-term approach to your fitness journey, focusing on progressive improvement rather than immediate results. 

Remember, while these self-help tips can alleviate DOMS symptoms, it's important to differentiate between normal muscle soreness and acute injury pain. If you experience severe pain, persistent discomfort, or any concerns, it is advisable to consult with a doctor or a physiotherapist for proper evaluation and guidance. 

Is Muscle Soreness a Good Thing or a Bad Thing?

Muscle soreness can be good or bad, depending on the context and severity. Let's examine both perspectives:

Good Thing

Indication of Progress: Muscle soreness, particularly after exercise or physical activity, can be a positive sign of progress and adaptation. It often occurs when muscles are subjected to new or increased stress levels, such as starting a new workout routine or increasing the intensity of your exercises. Soreness suggests that your muscles are being challenged and stimulated, which can lead to strength and endurance gains over time 

Muscle Hypertrophy: Soreness can be associated with muscle growth and hypertrophy. When muscles are stressed through resistance training, microscopic damage occurs in the muscle fibres. This damage triggers a repair and rebuilding process, leading to more substantial muscles 

Motivation and Achievement: Feeling sore after a workout can provide a sense of accomplishment and motivation. It serves as a reminder that you've put in the effort and challenged your body, which can be rewarding and encourage you to continue progressing towards your fitness goals

Bad Thing

Excessive or Prolonged Soreness: If muscle soreness persists for an extended period or becomes severe, it can be a negative sign. Extreme soreness may indicate that you have pushed your muscles too hard, leading to overtraining or potential injury. It's essential to listen to your body and allow for proper rest and recovery, especially if the soreness hinders your ability to perform daily activities or interferes with your training routine. 

Impaired Function: Intense muscle soreness can limit your range of motion and temporarily impair your ability to perform specific movements or activities. If the soreness significantly affects your daily functioning or prevents you from exercising regularly, it can be considered a disadvantage. 

Potential Injury Risk: While mild to moderate muscle soreness is generally considered normal, extremely intense or localised soreness may indicate an injury or strain. It's important to differentiate between regular post-exercise soreness and acute pain that may require medical attention. 

Always listen to your body, adjust your workout intensity, and prioritise rest and recovery. With these practices in place, you'll enjoy the benefits of exercise while minimising muscle pain and maximising your overall well-being. 

 

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References

Delayed Onset Muscle Soreness (DOMS), American College of Sports Medicine, Retrieved 12 Jan. 2024, https://www.acsm.org/docs/default-source/files-for-resource-library/delayed-onset-muscle-soreness-(doms).pdf?sfvrsn=8f430e18_2#:~:text=This%20type%20of%20soreness%20is,the%20exercise%20has%20been%20performed. 

American College of Sports Medicine. (2011). Delayed Onset Muscle Soreness (DOMS). Retrieved January 12, 2024, from https://www.acsm.org/docs/default-source/files-for-resource-library/delayed-onset-muscle-soreness-(doms).pdf?sfvrsn=8f430e18_2

Cheung, K., Hume, P., & Maxwell, L. (2003). Delayed Onset Muscle Soreness: Treatment Strategies and Performance Factors. Sports Medicine, 33(2), 145–164. doi:10.2165/00007256-200333020-00005

Clarkson, P. M., & Hubal, M. J. (2002). Exercise-Induced Muscle Damage in Humans. American Journal of Physical Medicine & Rehabilitation, 81(11 Suppl), S52–S69. doi:10.1097/00002060-200211001-00007

Hotfiel, T., Freiwald, J., Hoppe, M. W., Lutter, C., Forst, R., Grim, C., & Bloch, W. (2018). Advances in Delayed-Onset Muscle Soreness (DOMS) – Part I: Pathogenesis and Diagnostics. Sportverletz Sportschaden, 32(4), 243–250. doi:10.1055/a-0753-1884

Topics: Physiotherapy, BodyWorX

Mark Cameron

Mark Cameron

Physiotherapist, TPI Certified Instructor

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