DOMS When You Workout


Delayed-Onset Muscle Soreness (DOMS) refers to the discomfort, aching or pain that peaks 24-72 hours after performing physical activity or exercise that you are not used to (unaccustomed) or at levels much more than what you usually do (intense). It usually starts 8 hours after physical activity and typically resolves within a week from onset. It increases with passive lengthening or active contraction of muscles. It may also be accompanied by local swelling and warmth of affected muscle. At times, it may be accompanied by loss of function (unable to move) – it is then referred to as Exercise-Induced Muscle Damage (EIMD).

The muscle involvement and severity largely depend on the intensity, duration and type of activity that lead to DOMS. Most of the time, eccentric exercises (those involving repetitive prolongation and shortening of muscles) or performing exercises at >80-100% one’s maximum capacity could lead to this condition.

To lessen the soreness or pain particularly if it limits activity, analgesics and NSAIDs (either topical or oral) may be used. Some sports specialists prefer simple analgesics (i.e. paracetamol) over NSAIDs as the latter may diminish the adaptive response of muscles to exercise. However, recent studies suggest that short term NSAID use may not be that detrimental to muscle adaptation and hypertrophy (enlargement). Performing light exercises that involve concentric actions (varying muscle tension instead of flexing/ extending it) or light dumb bell exercises of the involved muscle may also relieve and lessen DOMS. Presently, there is no strong or very limited evidence on the use of warm-up or stretching exercises, cryotherapy, homeopathy, TENS, laser, or ultrasound to treat DOMS.

Although treatment is available, DOMS is best prevented. The following have been shown useful:

  • Progressing the intensity of exercises (habituation). Start with 40-50% of one’s maximum capacity and gradually increase until you are able to do >100% your limits. This may not be useful for body builders who rely on “shocking” muscle to promote growth.
  • Yoga exercises. Appears that yoga serves as conditioning, preparing one’s muscles for eventual intense exertion. Based on studies, yoga should be started a couple of weeks before other exercises.
  • Compression garments. These compress muscle and provide low level of heat (promotes relaxation) during activity. Appears to lessen the severity of DOMS.
  • Hydration. Maintaining adequate fluid intake during activity lessens DOMS.

Warm-up and stretching exercises do not appear to be effective in preventing DOMS. But these types of exercises have other beneficial effects.

If you experience EIMD (DOMS with loss of function) or if DOMS continue to progress 3 days after onset, it would be best to consult a doctor.


Author: Sids Manahan MD 🇵🇭

Rheumatology. Internal Medicine. Educating Patients and Colleagues. Curating Rheumatology. Bloggero-Wanabe.

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