Understanding Delayed Onset Muscle Soreness (DOMS)

Man holding shoulder in pain
Pali Rao/Getty Images
Table of Contents
View All
Table of Contents

Delayed onset muscle soreness (DOMS) is a phenomenon in which muscle pain or stiffness develops a day or two after exercise. While it is most common in people who have just started exercising, it can happen to anyone who has increased the duration or intensity of a workout routine.

DOMS is considered a normal response to unusual exertion and is part of the adaptation process by which the muscles recover as they undergo hypertrophy (an increase in muscle size).

Causes

DOMS is not the same thing as muscle pain experienced during exercise or caused by an injury such as a strain or sprain. Rather, it is related to increased stress in muscle fibers as you exert them excessively. This can also occur if you engage in movements your muscles are not accustomed to, such as new exercise.

Eccentric muscle contractions, in which muscle contracts as it lengthens, are the type most associated with DOMS. Examples of this including descending stairs, running downhill, lowering weights, doing deep squats, and lowering yourself during push-ups.

Treatment

There is no one, simple way to treat delayed onset muscle soreness. While gentle stretching, vibration therapy, and even ice-water immersion have all been suggested as reasonable options, most studies have been contradictory as to whether these actually work.

In the end, personal experience will dictate which works best. There are several methods commonly used by athletes to treat DOMS.

Active Recovery

Active recovery is a technique that involves using low-impact aerobic exercise immediately after a workout to increase the blood flow to overworked muscles. The increased blood supply may also help alleviate inflammation.

Ice or Contrast Water Bath

An ice or contrast water bath is something many professional athletes swear by; it provides a "quick fix" cooldown of inflamed or overexerted muscles.

NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, and naproxen, can significantly relieve inflammation and help minimize soreness.

RICE

RICE (rest/ice/compression/elevation) is a technique used to treat acute injuries, but it may be appropriate for DOMS if you feel you have seriously overdone it.

Sports Massage

A regular sports massage is also believed to increase blood flow to the muscles and may lessen the severity of stiffness and swelling.

If all else fails, simple rest and recovery will allow the body to heal itself in its own time. However, if the pain worsens or persists more than seven days, call your doctor and have it checked out.

When to Call a Healthcare Provider

DOMS typically appears 24-72 hours after a workout and goes away after approximately 7 days. If your muscle pain persists for more than a week, reach out to your doctor. If you're noticing swelling, redness, or tenderness around a sore muscle, and at-home remedies have not helped, you should call your healthcare provider.

Prevention

Preventing DOMS demands that you listen to your body and take notice when an exercise moves from stress into pain. That's a sign that you're overdoing it.

Prevention also means starting your workout correctly. One of the reasons why overexertion occurs is because the muscles are tight before you start training. If they are not properly warmed up and you move straight into exercise, your muscles are less able to stretch and can become injured, sometimes seriously.

If in doubt about how to exercise safely and effectively, invest in your health by hiring a personal trainer. Even experienced exercisers can benefit from interacting with a trained professional, who can provide advice on improving form and reaping greater benefits from each workout.

Prevention Tips

  • Follow the 10% rule, increasing your activity no more than 10% per week (this goes for distance, intensity, and time)
  • Progress reasonably, which can help in preventing injury. If you push too hard or use too-heavy weights, you will more likely than not do the exercise incorrectly.
  • Always warm up and cool down. The cool-down helps regulate blood flow and may relieve inflammation and the build-up of lactic acid.


A Word from Verywell

If you're pushing yourself during workouts or changing the movement, duration, or intensity, it's likely you'll experience delayed onset muscle soreness. But as long as you're gradually changing or increasing your exercises, DOMS should pass quickly. Practice safe movements, pay attention to your body, and recognize the difference between soreness and pain to determine how to properly adjust your fitness routine.

Was this page helpful?
6 Sources
Verywell Fit uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Sports Medicine. Delayed Onset Muscle Soreness (DOMS).

  2. Hotfiel T, Freiwald J, Hoppe MW, et al. Advances in delayed-onset muscle soreness (Doms): part i: pathogenesis and diagnostics. Sportverletz Sportschaden. 2018;32(04):243-250. doi:10.1055/a-0753-1884

  3. Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué B. An evidence-based approach for choosing post-exercise recovery techniques to reduce markers of muscle damage, soreness, fatigue, and inflammation: a systematic review with meta-analysis. Front Physiol. 2018;0. doi:10.3389/fphys.2018.00403

  4. Schoenfeld BJ. The use of nonsteroidal anti-inflammatory drugs for exercise-induced muscle damage. Sports Med. 2012;42(12):1017-1028. doi:10.1007/BF03262309

  5. Guo J, Li L, Gong Y, et al. Massage alleviates delayed onset muscle soreness after strenuous exercise: a systematic review and meta-analysis. Front Physiol. 2017;8:747. doi:10.3389/fphys.2017.00747

  6. Mizumura K, Taguchi T. Delayed onset muscle soreness: Involvement of neurotrophic factors. J Physiol Sci. 2016;66(1):43-52. doi:10.1007/s12576-015-0397-0

Additional Reading