Delayed Onset Muscle Soreness (DOMS): Pain After Exercise

Muscle soreness after physical activity is a familiar experience for many people. Known as delayed onset muscle soreness, or DOMS, this sensation can range from mild to debilitating pain. It can happen after a wide variety of physical activities, such as weight lifting, running, gardening, home improvement projects, and more. In this article, we’ll cover what exactly DOMS is, who it affects, and ways to manage discomfort during your recovery.

DOMS is a type of muscle soreness that typically sets in 12-24 hours after physical activity and peaks at around 24-72 hours post-exertion.1 It’s also sometimes referred to as “muscle fever” due to the sore and achy feelings it can produce.2 DOMS isn’t the same as the acute (and fleeting) feeling of muscle fatigue that happens during strenuous activity. It can be intense, but luckily, DOMS usually gets better on its own within 5-7 days after onset.

DOMS isn’t something that only affects elite athletes — anyone can experience symptoms after participating in a new or intense activity that their body isn’t accustomed to. And while a popular misconception is that lactic acid buildup causes DOMS, this isn’t exactly true. The mechanism behind this phenomenon is still not completely understood, but it’s largely believed to be due to microscopic damage to muscle fibers during exercise and the resulting inflammatory repair process.2 These tiny microtears aren’t all bad; in fact, they are a necessary part of muscle growth.18 So fortunately, with time, your body will adapt to whatever exercise you are participating in and produce less pain and soreness when you work out as you gain strength.

Some typical symptoms of DOMS include:2

• Muscle pain
• Swelling
• Tenderness
• Stiffness
• Joint pain
• Short-term loss of muscle strength
• Reduced range of motion

The type of activities that cause DOMS often involve eccentric muscle action.1 This is where muscles are lengthened while force is applied (stretching under tension). The reverse of this motion is concentric movement, which is where your muscle shortens or contracts. Imagine the lowering motion during a bicep curl or the impact on your quadriceps while jogging downhill — these are eccentric movements. Other types of activities that can result in DOMS include playing a sport for the first time, jumping, push-ups, doing more reps than usual during your workout, or any other physical activity you aren’t accustomed to.1

If your soreness persists beyond the three-day mark and you are experiencing sharp pain, it’s recommended you see a doctor to rule out any serious injuries. The following list contains some other warning signs:1

• Heavy swelling in the limbs
• Dark urine
• Numbness and tingling
• Muscle spasms
• Heat and redness in the affected area

Is DOMS dangerous?

In the majority of cases, DOMS is not dangerous. However, a condition called rhabdomyolysis could occur with a severe case of DOMS. This is where muscle tissues break down and release a large amount of myoglobin into your bloodstream, resulting in kidney damage. Symptoms of rhabdomyolysis include dark urine, muscle pain, and flu-like symptoms.19 If you are experiencing these symptoms after an intense workout, you should consider contacting your doctor to rule out any serious complications.

Exercise during DOMS

If you choose to get in a workout while you recover from DOMS, it’s important to take it easy as best you can. Your muscles may feel weaker than usual, making you more prone to injury. Try to avoid any heavy resistance training or intense work using your sore muscle groups.

Once you’ve determined that you’re suffering from delayed onset muscle soreness, you may be desperate for it to be over — so how can you get some relief? While the most effective treatment for DOMS is time, we’ve broken down several other options that may help alleviate your discomfort and speed up the recovery process.

If you’ve experienced a bout of DOMS, you are likely eager to figure out a way to avoid the discomfort again in the future. The following are some ways you can try to prevent DOMS.

After your body recovers from DOMS, you should find that your new exercise routine doesn’t cause as much soreness as it once did. But building muscle strength takes time, so be kind to yourself as you recover. A good option to consider is finding a personal trainer to help you set your fitness goals safely and in a manageable way; training with a professional may help you to prevent future DOMS episodes.