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Delayed Onset Muscle Soreness

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Tired handsome bearded manual worker with closed eyes sitting on stack of wooden plank and massaging lower back while feeling pain in back

Many of us have experienced stiff and sore muscles starting a day or two after a workout and have probably wondered what could be going wrong. The good news is that feeling sore after a workout is perfectly normal and in fact is a sign that your body is adapting to your exercise program by increasing its level of physical fitness. The condition is known in sports medicine as delayed onset muscle soreness (DOMS) and it tends to occur after you have started an eccentric muscle exercise program.

DOMS usually starts between 24 and 48 hours after the initial exercise program and may continue for a few days. The correct reaction to this condition is usually not to rest and wait for it to disappear. Instead, you should continue with your workout program with perhaps a temporary diminution in your intensity level. Additional treatment of delayed onset muscle soreness may include a massage and using menthol based topical analgesics to ease the soreness. We discuss possible treatments in detail below.

What Is The Cause Of Delayed Onset Muscle Soreness?

Delayed onset muscle soreness is the result of a muscle undergoing a lengthening (or eccentric) contraction. For example, lowering the weight when performing a bicep curl exercise represents the eccentric phase of that exercise.

Other eccentric muscle exercises that may cause DOMS to appear include running downhill, descending stairs and lowering yourself to the ground while doing push ups.

This contraction usually causes microscopic tearing of the skeletal muscle fibers. The tearing leads in turn to inflammation which in turn causes the pain and stiffness of delayed onset muscle soreness. This is the first part of an adaptation process in which your muscle groups increase in size and strength to handle the greater demands you are now making of them. In sports medicine, this process of increasing in size is known as “muscle hypertrophy”.

Contrary to what some people believe, soreness after exercise is not unique to “weekend warriors” or to individuals who only exercise occasionally. It can happen to anyone, from serious professional athletes to weekend basketball players.

Symptoms Of DOMS

The following is a complete list of the possible symptoms of delayed onset muscle soreness:

  • Pain & stiffness in your joints & muscles;
  • Soreness in your muscles and a “tender to the touch feeling”;
  • Decreased range of motion of your muscles and joints (due to the pain and stiffness you are feeling);
  • Decreased muscle strength;
  • Muscle swelling.

One thing to note is that if you start to experience muscle pain and/or stiffness immediately after exercise (or even while you are still exercising) this is not a symptom of delayed onset muscle soreness.Instead, it may be a completely different condition known as acute muscle soreness.

Acute muscle soreness is due to the accumulation of lactic acid in muscle tissues and will usually disappear shortly after you complete your workout. If it does not, you may have suffered another injury such as a muscle strain.

Treatment Of Delayed Onset Muscle Soreness

There are many alternative ways to reduce the symptoms of delayed onset muscle soreness.

One thing that will not cause them to go away is refraining from your exercise program to give your body a rest. The only thing to do is wait until your DOMS symptoms naturally recede while continuing your workouts.

Mitigating DOMS Symptoms

However, while you are waiting for your DOMS to resolve itself naturally, there are several things you can do to ease your discomfort:

  • Get a massage. It will improve your circulation and this increased blood flow will help to reduce your muscle soreness;
  • If getting a massage is not convenient (probably due to social distancing requirements) you can try a self massage tool such as the Original Tiger Tail;
  • If you are familiar with the use of a foam roller, you can use one to achieve a similar effect to a massage;
  • As mentioned above, topical analgesics can be effective in reducing the discomfort of delayed onset muscle soreness. Try to choose a menthol based analgesic for this purpose. If you can find one that also contains arnica, it will likely be even more effective;
  • Pain killing medications such as Tylenol may also be effective if your symptoms are severe;
  • A warm shower or bath can help to increase your blood circulation and reduce the symptoms of DOMS;
  • Wearing compression sleeves or other garments can also help to increase blood circulation and reduce the symptoms of DOMS;
  • Among professional athletes, there is growing use of ice baths to counter the effects of delayed onset muscle soreness;
  • Consider making changes to what you eat immediately after a workout, especially one that includes eccentric exercise. Increasing your intake of protein right after a workout will help your body to repair those microscopic muscle tears that much more quickly. This in turn can decrease the duration of your delayed onset muscle soreness symptoms.

Prevention Of Delayed Onset Muscle Soreness

Although you are unlikely to be able to completely prevent DOMS, you may have some success in reducing the intensity of its symptoms by gradually increasing the intensity of your exercise program. A sudden significant increase in training intensity will cause greater muscle tearing and more severe DOMS symptoms.

Gradually increasing your exercise intensity will have another, more important, benefit. It will also reduce your risk of getting injured.

Although some believe that stretching before exercise can help to prevent DOMS, there is no evidence to support this. Stretching, like warming up, can of course help to reduce the risk of injuries sprains or strains but it has not been demonstrated to reduce the incidence of DOMS.

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