Top 5 things you need to know about DOMS (Delayed Onset Muscle Soreness)

DOMS, or Delayed Onset Muscle Soreness, is a really common issue that occurs in people engaging in high-level work-outs or sports. When I say “issue”, I don’t really think it’s an issue. Let’s look into DOMS in more detail.

What causes DOMS?

DOMS is primarily caused by microscopic damage to muscle fibres. Some evidence states that this occurs during the eccentric, or lengthening, phase of the muscle contractions. When you perform exercises like lowering yourself during a squat or extending your arm during a bicep curl, your muscles are undergoing eccentric (lengthening) contractions under load. In my opinion, there is no increased DOMS that occurs from eccentric or concentric contractions.

What I mean by this is, any loading on the muscle can cause DOMS. Not just the eccentric contraction. For example, just bicep curling without lowering the weight back down would cause DOMS too.

Overloading the muscle fibres create small tears in the fibres, leading to inflammation and the characteristic soreness associated with DOMS.

Is DOMS related to a build-up of Lactic Acid?

No, we don’t think so. When I grew up and studied DOMS in GCSE PE (we’re talking 25 years ago), DOMS was very much put down to an accumulation of lactic acid. Lactic acid levels typically return to normal within 30 minutes after exercise, while DOMS can persist for several days. As research has developed, I suspect this is unlikely, and the cause is down to small fibre damage and inflammation.

Contrary to popular belief, DOMS is not caused by an accumulation of lactic acid in the muscles.

When does DOMS occur?

DOMS typically develops 24 to 48 hours after intense exercise or workouts. The pain levels vary depending on how much you pressure you have put through the muscles. The harder you worked out, if you are not used to it, the more likely you are to get DOMS. It typically starts at 24 hours after the workout (when the inflammation has built up) and continues for 2-3 days in most cases, but can be longer.

How painful is DOMS?

The pain is usually a dull deep aching. It can be painful to move the muscle or joint, and in most cases, the pain is very manageable. Although its painful, it won’t really make a serious impact on doing normal day-to-day activities.

When I was a student, we used to work out regularly in the tiny university gym. One lad wanted to start working out. Balla, as we called him, was a nice lad, and he joined in with one of our sessions and he beasted his pecs pretty hard on the smith machine. He was very sore for at least 6-7 days, and we never saw him in the gym again.

Top 5 things you need to know about DOMS:

1. The pain you get is all down to what you do

The harder you push, the more pain you will get. The longer you work out for at a higher intensity, the more pain you will get. The more deconditioned you are, the more pain you will get, if you put the equivalent load through a muscle compared to someone who regularly works out. Stretching doesn’t tend to make much difference to the level of pain you get.

If you want to get less pain, then work out at a lower intensity. Reduce the load.

2. Working out on the same muscle groups with DOMS will cause more pain

If you work out again on the same muscle group while you are still getting the pain from DOMS, then you’ll get more pain. You need to give the muscles time to heal and recover from the first work-out. Don’t keep beasting the muscles repeatedly, they’ll just get really sore. The body needs to heal those fibres and adapt by laying down more sarcomeres. Over time, your muscles become stronger, thicker, and more resilient.

You can still exercise with DOMS, but work on non-sore areas. For example, if you have sore biceps, then work on legs the next day instead. Engaging in low-intensity, low-impact activities like walking, cycling, or swimming can also help reduce DOMS symptoms by increasing blood flow and gently getting the joints moving.

3. What things help DOMS?

Massage – research supports that massage can help, but I suggest go gently with the massage as the muscle can be inflamed/sore. You can try foam roller exercises, like these ones for your legs.

Ice – using ice could definitely help reduce pain. Ice helps to numb low-level pain, and lots of athletes report positive benefits to reduce DOMS, especially with ice baths.

Water intake – keeping hydrated seems to help. We drink the best quality water we can get our hands on, glass-bottled if possible.

Compression – we think its good, and athletes report positive benefits to adding compression to muscles to help reduce DOMS.

Stretching – gentle light stretching may help, but go gently, or just leave and let it heal. More on this later.

Nutrition – an anti-inflammatory diet is generally good. High-protein diets may help muscle building.

Warm downs – they probably do help. Slowly and gradually reducing load on the muscles after a certain degree of intensity could be helpful.

4. Recover quicker from DOMS:

The quickest way to recover is to follow the above advice, but also just to let the body heal and recover. The inflammation needs to reduce. But don’t take anti-inflammatories! You don’t need them. Let the body heal in the normal way. This can take time. Anti-inflammatories are just not necessary, if self-inflicted. Learn how your body responds to exercise and be smart with how you work out.

5. DOMS is good?

DOMS can be good and bad. Overall, I generally think a low-level of DOMS is good. Why? Because it means your muscle fibres can lay down more sarcomeres during the recovery process which very gradually (over months) help muscles grow in size and strength. It is how muscles adapt to load. It’s an adaptive process of the muscle that helps the fibres to become stronger. DOMS is all about muscle recovery. It’s a normal body process.

It is not usually too hard to determine the difference between a muscle injury and DOMS. Muscle injuries tend to happen straight away. That’s where a muscle will strain or tear. This is an acute, sharp-pain injury, and you’ll often feel it specifically. DOMS is different, it’s a more dull and deeper pain that comes on 24 hours after the work-out, not at the time of the work-out.

In conclusion, and in my opinion, DOMS is a normal process that occurs after working out at a high-level of intensity. The harder you work out, the more likely you’ll get DOMS. This is part of the muscle recovery process, and how it adapts to becoming stronger. Finding the sweet spot is key, not causing DOMS too much, but working out with a good enough intensity to create adaptive change in the muscle fibre.

If you'd like help managing your workout sessions or sports activities to avoid injuries, or think you may have sustained an injury, call us on 02086856930 to make an appointment with one of our expert physiotherapists or osteopaths, or book online.