By Joseph Cannon M.S.
Delayed onset muscle soreness (DOMS) is a familiar foe for anyone who has pushed their muscles to new limits through intense exercise. This phenomenon, characterized by muscle stiffness, tenderness, and decreased range of motion, typically sets in 12-24 hours after a grueling workout and can last for several days. While DOMS is often seen as a badge of honor among fitness enthusiasts, it can be a significant barrier for clients, especially those new to exercise. As a fitness trainer, understanding the causes, symptoms, and management strategies for DOMS is crucial to creating effective and enjoyable training programs that keep your clients motivated and injury-free. This article will delve into the physiology and causes of DOMS, explore evidence-based techniques to alleviate its discomfort, and provide practical tips for mitigating its impact on your clients’ workout experiences. By mastering the art of managing muscle soreness, you can foster a positive and empowering environment that nurtures long-term commitment to physical fitness.
What is Delayed Onset Muscle Soreness (DOMS) & Why Does It Happen?
Delayed Onset Muscle Soreness (DOMS) is a phenomenon that every fitness enthusiast has likely experienced at some point. It’s that nagging, achy feeling in your muscles that sets in a day or two after a workout, especially if you’ve tried new exercises or significantly increased the intensity of your routine. The phenomenon is complicated, but here is a summary of what happens at the cellular level:
- During intense or unaccustomed exercise, mechanical stress and metabolic fatigue cause microscopic damage to the sarcomeres of muscle fibers as well as connective tissue.
- This micro-damage promotes the release of potassium, calcium, creatine kinase (CK), and myoglobin into the bloodstream.
- At the same time, an inflammatory response is initiated where cells like neutrophils and macrophages infiltrate the damaged area to aid the repair process.
- This response also generates reactive oxygen species (free radicals) that can cause further oxidative damage to muscle cells and surrounding tissues.
This cascade typically peaks 24-48 hours post-exercise, resulting in maximum muscle soreness levels at around 72 hours before gradually subsiding over several days as the regenerative process completes.
DOMS typically kicks in 24-48 hours after a challenging exercise session, which is why it’s called “delayed onset.” It’s important to note that DOMS differs from the immediate muscle soreness you might feel during your workout.
That burning sensation you experience during your exercise routine is caused by lactic acid buildup, which dissipates shortly after you finish exercising. Lactic acid buildup is not the cause of DOMS. Lactic acid (sometimes called lactate) dissipates within 30 to 60 minutes after you stop working out. As such, it is not present in significant amounts when your muscles begin to feel sore.
Causes of Delayed Onset Muscle Soreness
The cause of DOMS is complex and involves not only the often cited microscopic tears in muscle fibers but also microdamage to connective tissues and temporary increases in inflammation and free radicals (oxidative stress). Several theories have been put forth to explain the process, including these:
- Torn muscle tissue theory
- Connective tissue damage theory
- Oxidative stress theory
- Enzyme efflux theory
However, no single theory fully explains this phenomenon. The process is likely multi-factorial and involves aspects of all theories. However, in the real world, this kind of muscle soreness can be traced to:
- Eccentric movements (“negatives”)
- Performing unaccustomed movements
Eccentric muscle actions occur when a muscle lengthens while under tension. For example, if you were performing a biceps curl exercise, the eccentric phase would be when you lowered the barbell to the starting position. These muscle contractions create more substantial muscle damage than concentric contractions (shortening of the muscle). Some exercises that are particularly notorious for causing DOMS include:
- Squats, lunges, and other lower body exercises that involve deep eccentric motions.
- Weightlifting exercises like bicep curls or bench presses, especially if you’re increasing the weight or trying new variations.
- Plyometric exercises, such as jump squats or box jumps, which involve explosive eccentric movements.
- Downhill running or hiking, as the eccentric contractions in your quadriceps are intensified.
For the personal trainer working with a novice client, it’s wise to remember that ALL exercises you prescribe are new and unaccustomed to that person.
This is one reason AAAI-ISMA recommends only one set of a resistance exercise with newbies. The more sets and reps performed, the greater the likelihood of DOMS. Introducing an exercise routine that causes minimal DOMS can also help clients understand that physical activity does not have to hurt to be effective.
Symptoms of DOMS
The telltale signs of DOMS usually appear 12-24 hours after your workout and may last several days, depending on the intensity of the workout and individual recovery rate. Common signs and symptoms of DOMS include:
- Muscle tenderness and stiffness: The affected muscles may feel sore and tender to the touch, making it difficult to perform certain movements.
- Reduced range of motion: Due to the muscle stiffness, you may experience a temporary decrease in your ability to move the affected joints through their ROM.
- Temporary strength decrease: During the peak of DOMS, you may find it challenging to exert the same amount of force or lift the same weights as usual.
One interesting point is that DOMS does not hurt until you move or press on the effected body part. Remembering this may help differentiate this from abnormal conditions such as rhabdomyolysis (rhabdo).
Who is at Risk of Experiencing DOMS?
While DOMS can affect anyone who engages in intense or unfamiliar exercise, there are certain groups of people who are more prone to experiencing this phenomenon:
- Beginners or those returning to exercise after a long break: If you’re new to exercise or haven’t worked out in a while, your muscles are more likely to experience DOMS as they adapt to the increased demand.
- Individuals increasing exercise intensity or duration: Even if you’re a seasoned athlete, a sudden spike in the intensity or duration of your workouts can lead to DOMS as your muscles are pushed beyond their current capabilities.
- Trying new exercises or movements: Introducing novel exercises or movements that your muscles aren’t accustomed to can also trigger DOMS. This is because your muscles are being challenged in new ways.
When to Seek Medical Attention
In most cases, DOMS is a temporary and manageable condition. However, there are instances where you should seek medical attention:
- Severe or persistent pain beyond 5-7 days: If the soreness does not subside within a week or becomes increasingly severe after 3 or 4 days, it could indicate a more serious issue.
- Swelling or bruising in the affected area: While some minor swelling is normal, significant swelling or bruising could be a sign of injury.
- Inability to bear weight or move the affected limb: If you experience extreme difficulty moving or bearing weight on a particular limb, it may be a sign of a more severe injury.
- Pain felt at rest. DOMS does not hurt until you move or press on the affected muscles. Experiencing pain when stationary may be a sign something else is occuring.
If you experience any of these symptoms or have concerns about the severity of your DOMS, it’s best to consult with a healthcare professional for proper evaluation and treatment.
Best Way To Reduce DOMS After It Occurs
While it may seem counter-productive, exercising the muscles experiencing delayed muscle soreness appears to offer some temporary relief. Perform the activity that caused DOMS but at a lesser intensity. For example, if your client developed DOMS after performing 3 sets on a leg press at a resistance of 150 pounds, performing 1 or 2 sets at a lower resistance, such as 85 pounds. This may promote some reductions in pain several hours later. Exercise is thought to work by triggering the release of endocannabinoids and endorphins, temporarily relieving pain. Exercise might also work by inhibiting the transmission of pain signals from nerves.
There is no exact formula to proceed with this, so use your good judgment and remember that sometimes less is more.
Does Stretching Help?
Various investigations have demonstrated that stretching the muscles before exercise begins does not prevent post-activity muscle soreness from occurring. In fact, stretching may actually trigger DOMS in those who are not accustomed to it.
Some data suggest that stretching after workouts may provide short-term reduction, but this may depend on the severity of the pain being experienced.
Can Supplements Help Reduce Muscle Pain After Exercise?
Since at least the 1950s, researchers have investigated the pain-relieving effects of many dietary supplements ranging from vitamin C and tart cherries to ginger, beetroot juice, and even creatine.
If you look deep enough into the research, you will find clinical studies favoring several nutritional strategies. However, not all experts agree that dietary supplements speed the recovery process. As such, it is wise to view positive claims with skepticism until proven otherwise.
Frequently Asked Questions about Delayed Onset Muscle Soreness
- Is DOMS a sign of an effective workout?
- DOMS can be an indicator that you’ve challenged your muscles effectively, but its absence does not necessarily mean an ineffective workout. As your muscles adapt, you may experience less soreness over time. Lack of DOMS does not mean the workout is no longer effective.
- How long does DOMS typically last?
- DOMS usually peaks around 24-48 hours after an intense workout and can last up to 72 hours or more, depending on the individual and the intensity of the exercise. Generally, the pain often begins to subside after the third or fourth day.
- Can DOMS affect daily activities?
- Yes, the muscle soreness and stiffness associated with DOMS can make certain daily activities more challenging, such as climbing or descending stairs or reaching overhead. However, it does not cause any long-term detrimental effects on athletic performance.
- Does massage help?
- Some research suggests massage performed after exercise may help reduce pain levels. However, it might not speed muscle recovery. Additionally, intense, deep-tissue massages may have the opposite effect and trigger DOMS. This is especially true if you are not used to receiving therapeutic massage.
- Does dehydration make DOMS worse?
- At least one study has reported that being dehydrated during exercise does not exacerbate DOMS-related pain; however, a lack of adequate water can negatively impact exercise performance. A 1% to 2% loss of body fluids can trigger clinical dehydration and significantly reduce the ability to exercise at optimum levels.
- Is it safe to exercise with DOMS?
- It is generally safe to exercise with delayed muscle pain, but it’s important to listen to your body and modify your workout accordingly. Avoid exercises that exacerbate the soreness, and focus on active recovery or lighter workouts until the DOMS subsides.
Conclusion
The odds of developing Delayed Muscle Soreness increase when starting a new exercise routine or ramping up the intensity. While the soreness and stiffness can be uncomfortable, it’s important to understand that DOMS does not lead to any long-term muscle damage or reductions in athletic performance. While a little pain a day or two after exercise may not trouble most healthy people, when designing workouts for your clients, consider their overall health and how DOMS might negatively impact their daily activities.
