Delayed-Onset Muscle Soreness (DOMS) is exercise-related muscle pain. It develops after excessive and unaccustomed exercise. It is particularly prevalent if that exercise has an eccentric component.
Eccentric exercise is an exercise where the muscles are contracting while lengthening.
- Example: downhill running, plyometric exercises, slowly lowering weights during a bicep curl, and landing drills.
What Causes DOMS?
DOMS is caused by microtrauma (small strains) in the muscle, which results in an inflammatory response. Biochemical markers which are consistent with muscle fiber disruption, such as creatine kinase and lactic dehydrogenase, are found in the blood of DOMS sufferers. Swelling, altered muscle firing patterns, and pain are thought to be the reasons why muscle strength, motions and function are impaired in DOMS sufferers.
What are the Symptoms of DOMS?
The classic DOMS sufferer describes a dull muscle ache that develops 24 to 48 hours after the performance of a new or strenuous exercise. It is localised to the involved muscles and will result in muscle stiffness plus tenderness. Passive stretching will increase your symptoms, which is one of the reasons why you feel stiff. DOMS can also result in a short-term loss of muscle strength, a reduced joint range of motion, and possibly swelling of the affected muscle groups. The good news is that once you start moving your sore muscles they will actually start to feel less sore. But, you will find walking downstairs troublesome if it’s your quadriceps that are suffering!
How is DOMS Diagnosed?
DOMS is a clinical diagnosis. Your physical therapist is an expert in the diagnosis of DOMS and excluding other more significant injuries such as muscle tears, strains or ruptures. An ultrasound scan is unreliable in the diagnosis of DOMS, but may assist in determining if there is a more significant muscle tear.
How is DOMS Treated?
DOMS should be treated initially with active rest and anti-inflammatory measures such as ice. Heat has also been researched on back muscle DOMS with a positive pain reduction.
Gentle pressure garments have been shown in research studies to provide a reduction in the duration and severity of DOMS. Gentle foam rolling has been shown to help ease DOMS symptoms; however, deep tissue massage should be avoided during the first 24 hours. Excessive muscle stretching in this early phase should also be avoided.
You should avoid aggressive exercise during the recovery phase. This is due to your muscles’ reduced capacity to cope with shock absorption, decreased coordination, altered muscle recruitment patterns, reduced strength balance, and contraction intensity. Light cycling has been shown to temporarily ease DOMS pain.
How Can You Prevent DOMS?
To minimize the development of DOMS the following suggestions should be followed:
- Take it slow and gradually build up the amount of exercise you do in your program – remember that Rome wasn’t built in a day.
- Avoid increasing your sets, reps and weights by too much or too quickly.
- Be aware of the amount of eccentric exercise you are including in your workouts.
- Ensure you do a thorough cool down following your workout; many of us have seen athletes doing gentle running and cool down drills after their games – this is one of the reasons why.
What is the Prognosis of DOMS?
The good news is that most cases of DOMS gradually subside and have no lasting effects. Most cases of DOMS will resolve within one to three days.
However if the following applies to you then it is best to seek the advice of your physical therapist:
- The pain is still present and not resolving more than 48 hours post-exercise.
- The pain came on during the exercise (not the day after) and was more sudden in onset.
- The pain is located in and around the joints and not just limited to muscles.
For more specific information, please contact your doctor or physical therapist.