Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness is very common and should not be viewed as detrimental to your fitness routine. Previously, DOMS was thought to be due to a build up of lactic acid, but this has been negated. High-intensity exercise can cause tiny, microscopic tears in muscle fibres, and a natural response is for the body to increase levels of inflammation to promote healing. The delayed muscle soreness response of 24-48 hours after exercise explains this notion as the body starts to repair. So, it is the inflammatory process which leads to muscle soreness, not the build-up of metabolites.

The main treatment for DOMS is time, but there are ways of reducing the pain and stiffness whilst your muscles repair.

# Massage: Studies have shown that those who receive a massage 24, 48, or 72 hours after an intense workout reports significantly less soreness than those who do nothing. 48 hours after exercise appears to be most beneficial.

# Menthol-based muscle rubs with arnica have been shown to be beneficial in reducing the pain of DOMS.

# Cold and heat therapy within one-hour after exercise reduces the pain degree of DOMS. Cold water immersion and heat pack therapy appears to be most effective.

Prevention is always better than cure, so make sure you stay on top of your hydration, as well as running through comprehensive warm-up and cool downs. If you are new to exercise, or returning after injury, then be sure to take it slowly to allow your body to adjust to the increased load.

Wang, Y. et al. (2021). Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomised controlled trials. Physical Therapy in Sport. 48: 177-187.