What You Should Know About Muscle Soreness After Training (DOMS)
For those of us who are keen on health and fitness, muscle ache after a workout is likely something that we have all experienced. Delayed onset muscle soreness (DOMS) is excessive muscular ache that usually presents one to two days after a workout. Like many others, I previously thought that it meant that I had had a really effective workout. However the research on the topic suggests otherwise.
The ache is thought to be caused by microscopic damage to your muscle fibres, and the corresponding tissue inflammation. This process is thought to be a normal part of muscle hypertrophy (growth process). However, when caused in excess it can result in a temporary reduction in muscular force and physical performance and an increased risk of injury.
So alongside not being sign of a ‘good workout’, DOMS may actually be a sign of increased injury risk and slowing your training progress. Your body may be telling you that you are increasing weights/resistance too quickly (particularly on new exercises), or not resting enough between sessions.
The role of gradual load increase and appropriate rest cannot be replaced. However, for coaches and athletes, knowing how to speed up recovery be invaluable. This can enable the athlete to perform effectively during the next training session feeling strong, rested, and free of injury.
Over the last 20-30 years, a number of interventions have been proposed to optimise recovery after exercise. These include (but are not limited to):
Compressive techniques, such as massage and compressive garments
Stretching
Cryotherapy or cold water immersion
Active recovery.
A 2018 systematic review of the research carried out in last 15 years looked at studies using these techniques after a single exercise session. The outcomes assessed for was reduction in DOMS and/or perceived fatigue. (I have also used information from recent individual studies to reinforce the following information).
Massage seems to be the most effective for both DOMS and perceived fatigue. Foam rolling can also be an effective substitute for massage. The research on foam rolling for DOMS suggests 10-20 minutes straight after the exercise then again once a day for 2-3 days following.
Water immersion and the use of compression garments were also shown to have positive impact on both DOMS and/or perceived fatigue but with a less pronounced effect.
Interestingly stretching was found to have no positive effect on DOMS and/or perceived fatigue. It has also been shown in some studies that stretching may even lead to an increase in DOMS.
The evidence on cryotherapy (cold) is mixed. most recent studies including a 2020 syestematic review and meta-analysis, reported no reduction in functional deficits or acceleration of recovery. However there may be some benefit in reducing perceived pain.
Active recovery was shown to only be effective in a short period after exercise. Therefore light exercise as a cool down after a heavy session may help to reduce circulating levels of inflammatory chemicals.
So in summary, massage and other compressive techniques seem to be the most effective for reducing DOMS and perceived fatigue. Cryotherapy seems to do little to help and stretching has been shown to potentially exacerbate the issue.
Most importantly, you can reduce your chances of suffering DOMS by warming up properly before your workout, building up the intensity of your exercise over time. Also adequate rest between sessions where you work the same muscle groups is key to injury prevention and muscle growth. So remember DOMS probably isn’t a sign of an ‘effective/good’ workout. Your body is likely trying to tell you something and the real skill is knowing how to listen.
-Derry
Brighton based specialist musculoskeletal physiotherapist and online fitness coach
References
Cheung K., Hume P., Maxwell L. (2003). Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med. 33, 145–164.
Dupuy, O., Douzi, W., Theurot, D., Bosquet, L., & Dugué, B. (2018). 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. Frontiers in physiology, 9, 403.
Herbert R. D., de Noronha M., Kamper S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database Syst Rev. CD004577. 10.1002/14651858.CD004577.pub3
Nogueira, N.M, Felappi, C.J., Lima, C.S. et al. Effects of local cryotherapy for recovery of delayed onset muscle soreness and strength following exercise-induced muscle damage: systematic review and meta-analysis. Sport Sci Health 16, 1–11 (2020).
Soligard T., Schwellnus M., Alonso J. M., Bahr R., Clarsen B., Dijkstra H. P., et al. . (2016). How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury. Br. J. Sports Med. 50, 1030–1041.