With a new year comes, new resolutions. For many that means getting active and hitting the gym. We want you to be successful in this goal, so I want to warn you about something called Delayed Onset of Muscle Soreness or DOMS for short.

So your going to do this great workout, perhaps you even hired a personal trainer to show you a routine. You feel like your accomplishing something as you are working out, you feel good. Then later that day or the next day, you feel like you were run over by a metaphorical bus, although it feels like you actually were. You could feel it in your arms where lifting a feather is a difficult task or maybe you feel it in your legs where you are holding onto the railings while on the stairs because your legs feel like jello. It is at that moment you start to question your decision. “Why am I doing this? Did I hurt myself? Why do I feel so sore, aren’t I suppose to feel good?” And this is usually the point where motivation goes down and people quit their goal. BUT, you’re not going to, because we are going to talk about what it is. So, you wont be surprised by it and will feel confident it will go away and you will continue to exercise as planned.

So DOMS (Delayed Onset of Muscle Soreness): is a post exercise pain or discomfort in the muscles during contractions or to the touch. Most often it starts from a local point then spreads across the muscle (1). Symptoms can range from tenderness to straight out activity limiting pain. Discomfort can start withing a few hours after exercise and peaks between 24-72 hours. Symptoms disappear within 5-7 days (2). If you were to do the same workout that caused the discomfort a few days later it would not feel as bad as the first time (3).

Perhaps you are already active but want to step up your game this year. It is important to state that if you were to change the intensity or type of exercise, you could experience DOMS again. Whether you are an athlete, weekend warrior or someone just trying to get into shape, you can experience DOMS (3).

Muscles are like chemical factories. When they are put through exercise they create chemical by-products, such as lactate (lactic acid) and others with long names. It is the combination of these chemicals that produces the discomfort (3). So, for the body to become better at processing these chemicals you need to continue staying active (3). A key point about DOMS is that the level of DOMS does not accurately reflect extent of muscle damage nor does having DOMS mean you have muscle damage (4).

So, is there any particular treatment that can help get rid of this discomfort?

Looking at the research, many different treatments have been proposed to prevent and treat DOMS, such as ice or ice baths, stretching, anti-inflammatory drugs, ultrasound, massage, electrical stimulation, curcumin and heat. The findings on using ice, shows no significant change in symptoms of DOMS (2). Stretching in some cases can make DOMS worse especially at the peak of symptoms. Anti-inflammatory drugs are also questionable whether they help with DOMS, the side-effects may not out weight the benefits and more research is needed to prove their effectiveness (2, 3). Ultrasound and massage show no added benefits to recovery or prevention (2, 3). Electrical stimulation has mixed reviews. One study found some improvements on signs and symptoms compared to placebo but results were under-whelming (2).

There is some promising results for using curcumin spine (turmeric) for muscle pain, but I will let Dr. Emily Lipinski, Naturopathic Doctor address this topic in her blog post.

Being involved in martial arts myself, when I’ve returned after a break, I’m sore for at least a good 4-5 days. What has helped me is hot showers or baths. Maybe its in my mind, but the heat feels soothing and relaxing. It doesn’t speed up my recovery but makes the duration of my symptoms a bit more tolerable. Once I feel recovered, back to training it is and usually I don’t feel as sore afterwards.

My advice however, is that you take a break from the gym for a few days, allow your muscles to recover then go back. Or at least change up your routine at the gym where you work other muscles or just do cardio. When you do have DOMS, returning to activity too soon or too intensely can increase the risk of injury (2). Walking is a great mild exercise that keeps you moving without over stressing your muscles. Using heat, one study found some improvements with respect to symptoms (3). So you can try heat for yourself, try to move around a bit but take a break from the activity that caused the discomfort for a few days, then get right back to it and stay on track with your new years goal. You can do it!

The advice presented does not substitute medical advice. If something does not feel right see a physiotherapist or family doctor. If the pain does not decrease within 5-7 days, it would be good to seek medical advice. If you notice bruising, excessive swelling, redness, inability to move, seek medical advice..

References:
Lieber, Richard L and Jan Friden. 2002. Morphologic and mechanical basis of delayed-onset of muscle soreness. J Am Acad Orthop Surg. 10: 67-73.
Cheung et al. 2003. Delayed onset of muscle soreness: treatment strategies and performance factors. Sports Med. 33(2): 145-164.
Ingraham, Paul. 2016. Delayed onset of muscle soreness (DOMS): The biological mysteries of “muscle fever”, nature’s little tax on exercise. Accessed on December 5, 2016 from https://www.painscience.com/articles/delayed-onset-muscle-soreness.php
Zainuddin et al. 2005. Effects of massage on delayed-onset muscle soreness, swelling and recovery of muscle function. Journal of Athletic Training. 40(3): 174-180.

Written by: Madelaine Golec PT

Delayed Onset of Muscle Soreness