Delayed onset muscle soreness (DOMS) is the muscle pain and stiffness that develops 24 to 72 hours after intense exercise, especially after eccentric movements during weightlifting or running downhill. Unlike acute muscle soreness, which happens during or right after a workout, DOMS is delayed muscle soreness after exercise that occurs later and can last for several days.
The soreness is caused by tiny tears in muscle fibers due to exercise-induced muscle damage. As the body repairs these tears, inflammation occurs, leading to stiffness and discomfort. This type of muscle pain is common in healthy adults and is a natural part of building stronger muscles. Although DOMS can be uncomfortable, it usually fades with time and improves as the muscles adapt to the activity. Light movement, stretching, and rest can help reduce the soreness.
What can cause DOMS?
Delayed Onset Muscle Soreness (DOMS) happens when you push your muscles harder than usual, especially during eccentric exercise — movements where the muscle lengthens under tension, like lowering a weight or running downhill. This type of exercise causes tiny tears (microtears) within the muscle fibers, leading to an inflammatory response. The body then works to repair the injury to the muscle, which can cause sore muscles, stiffness, and swelling.
DOMS may affect anyone who is increasing the intensity of their workouts or trying new exercises. Common activities that can cause DOMS include weightlifting, sprinting, jumping, and high-intensity training. The soreness is felt 24–72 hours after exercise and can last for several days. While DOMS is a normal part of skeletal muscle recovery in humans, preventing and reducing muscle soreness can be done by gradually increasing workout intensity, warming up properly, and using light movement or massage to aid recovery.
Symptoms and duration of delayed onset muscle soreness. Is it the same as acute muscle soreness?
Delayed-onset muscle Soreness occurs after intense or unfamiliar exercise, affecting specific muscle groups. Common symptoms of DOMS include muscle stiffness, swelling, tenderness, and a temporary loss of strength. Some individuals may also experience muscle spasms. Soreness usually peaks around 48 hours after exercise and can last between five to seven days, however, normal timelines are two to thee days.
DOMS is different from acute muscle pain, which happens during exercise. Instead, it develops hours later as part of the body’s response to muscle strain. Dehydration can worsen symptoms of delayed-onset muscle soreness, so staying hydrated can be helpful. While DOMS usually resolves on its own, treatment options like gentle stretching, massage, and proper rest can help reduce discomfort. Applying ice or heat and using over-the-counter pain relievers may also provide relief.
How can DOMS be relieved and recovery speeded up? Is massage the answer?
To relieve DOMS and speed up recovery, try these practical treatment options:
- Active Recovery & Low-Impact Movement – Engaging in low-impact movements like walking, cycling, or swimming can relieve DOMS by increasing blood flow and reducing stiffness. This form of active recovery supports muscle repair without overexertion.
- Stretching & Foam Rolling – Gentle stretching and foam rolling help alleviate delayed-onset muscle soreness by loosening tight muscles, improving flexibility, and breaking up muscle tension.
- Massage Therapy – Massage alleviates delayed onset muscle soreness by improving circulation and reducing muscle stiffness. Regular massages can also help prevent excessive soreness. A Systematic review and meta-analysis using clinical trials reports that massage is the most effective for reducing DOMS and perceived fatigue (Dupuy at al. 2018)
- Hydration & Nutrition – Proper hydration prevents muscle cramps and dehydration-related symptoms of delayed-onset muscle soreness. Nutrition plays a key role, with protein, healthy fats, and antioxidants aiding muscle recovery.
- Rest & Sleep – Sleep and rest are essential for muscle repair. Prioritizing sleep enhances the effects on performance and overall recovery.
- Cold & Heat Therapy – Cold therapy (cryotherapy) reduces inflammation, while heat therapy relaxes muscles.
- NSAIDs – Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help, but frequent use isn’t recommended.
These recovery strategies support faster recovery and improve long-term exercise performance.
Preventing DOMS: Training strategies and best practices
To prevent DOMS and reduce exercise-induced muscle soreness, follow these simple training strategies:
- Warm-Up & Cool-Down – A proper warm-up prepares muscles for exercise, improving blood flow and reducing the effect of muscle soreness. Dynamic stretching before a workout and a cool-down afterward help prevent muscle stiffness.
- Gradual Intensity & Progressive Overload – Increasing workout intensity too quickly can cause soreness. Follow progressive overload by gradually adding weight, reps, or intensity to help muscle adaptation and improve muscle performance over time. Only increase one of these at a time, do not increase your weight, reps or intensity all in the same session.
- Strength Conditioning – Regular strength training builds muscle strength, reducing muscle soreness in a healthy adult by improving endurance and resilience.
- Stretching – Including stretching in your routine, especially dynamic stretching before workouts, helps prevent muscle tightness and aids recovery.
- Proper Nutrition & Protein Intake – A balanced diet supports muscle repair. Protein intake is essential for rebuilding muscle fibers, while hydration flushes out lactic acid and toxins.
- Compression Garments – Wearing compression garments on delayed-onset muscle soreness areas may help reduce swelling and support recovery.
By focusing on preventing and reducing muscle soreness with these strategies, you can maintain consistency in your workouts and enhance muscular performance without excessive discomfort. Try to track the changes you make around your workout and not randomize them, this can help you determine what is causing any changes.
When to seek medical attention for DOMS
Experiencing muscle pain after exercise is very normal, even in healthy adult populations, but can be shocking the first few times it occurs. Seeking medical attention for normal DOMS is unnecessary, however, if you are experiencing severe DOMS or it is lasting for a prolonged period. Seek medical attention if you experience extreme swelling, persistent weakness, or dark urine, which may indicate rhabdomyolysis, a dangerous condition where muscle protein breaks down and enters the bloodstream. Severe DOMS that lasts more than a week or worsens instead of improving could suggest a muscle injury or damage to connective tissue.
If DOMS symptoms include an inability to use the affected muscle, significant loss of muscle force, or sharp, localized pain, consult a healthcare provider. While anti-inflammatory drugs (NSAIDs) or topical analgesics can help with pain management, they won’t address underlying injuries. Sports medicine specialists can provide guidance for recovery after exercise and long-term injury prevention. Don’t ignore prolonged soreness—early treatment leads to better outcomes.
