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Delayed Onset Muscle Soreness (DOMS): What Is It and How to Deal With It?

Man with sprain thigh muscles.

Exercise does a body good, right? Yes, your body benefits in multiple ways from all types of exercise. However, sometimes your body has a funny way of thanking you for all that hard work:  DOMS or Delayed Onset Muscle Soreness.

DOMS is classified as a Type I muscle strain. Symptoms can range from tenderness or stiffness to palpation or movement of the muscle. DOMS is brought on by unaccustomed bouts of exercise, especially eccentric exercise. (JAT 2015) Soreness typically begins 8-10 hours post exercise and peaks at 24-48 hours. (JCDR 2014)

Unfortunately, there is no proven preventative measure to help avoid this uncomfortable condition. The only way to help lessen the effects of DOMS is to train properly. If you build your exercise program by increasing the intensity, duration, and/or load slowly, you can potentially lessen the wrath of DOMS.

Weathering the Storm
Every athlete’s body handles DOMS differently, so there is no magic remedy. However, there are a few treatments which have been proven to help lessen DOMS while your body recovers from the muscle damage:

  • Post-Exercise Massage
    There is conflicting research on the actual physiological effect of massage on DOMS. But there is evidence that massage decreases subjective measures of muscle soreness. Massage can help you manage the soreness through the recovery period, but does not speed up the process.
  • Foam Rolling
    That dreaded question all athletes cringe at: “Have you been foam rolling?” Every athlete, professional or weekend warrior level, needs to learn to love this torturous 3 foot long piece of foam. Who would have thought that material as light as foam could cause so much discomfort?! Painful as it may be, it has been proven to decrease the soreness of DOMS and also reduce the athlete’s decrements in performance (JAT 2015).
  • Cold Water Immersion
    Cold water immersion, aka “ice bath,” has been shown to help reduce the intensity of DOMS. An ice bath of 8?C water (AJSM 2011) reduces the overall blood flow or inflammation a muscle will experience after an intense work out. This inflammation prolongs recovery time and increases muscle soreness. So prepare yourself for the polar plunge and get those legs in a tub of ice cold water.
  • Vibration Therapy
    Vibration therapy has also been proven to help reduce the intensity of DOMS. However, it is not nearly as accessible as the other preventative measures. If you have access to vibration therapy, by all means use it.

Quick Tips

  • Foam roll for 20 minutes post exercise and every 24 hours after.
  • Make an ice bath. Sit in the ice bath for 5 minutes 2x with a 2 minute break (I use my daughter’s plastic kiddie pool).
  • Increase your workouts slowly. Too much, too quickly is bad.
  • Become a regular client of your Massage Therapist.
  • If the soreness lasts more than 72 hours, have a professional evaluate you. It may be more than just DOMS.

Patrick-Vignona-200-240Patrick Vignona is a Board Certified Clinical Specialist in Sports Physical Therapy and Certified McKenzie Practitioner, with a Masters in Physical Therapy. He is an Advanced Clinician at the James M. Benson Sports Rehabilitation Center at Hospital for Special Surgery. Patrick has 10+ years of experience in Sports Medicine and Rehabilitation. His primary interests are the Overhead Athlete, Hip Arthroscopy, Ligamentous Knee Injuries, and Return to Play for upper and lower extremities. He has played Division 1 Soccer and is an avid runner/triathlete, and is co-author on several baseball mechanics research articles

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.