DOMS: What Helps Muscle Soreness and What Does Not

You feel fine the evening after a new workout, then wake up two days later barely able to walk down the stairs. That is delayed onset muscle soreness, or DOMS, and almost everyone who exercises meets it sooner or later. It is usually harmless, but it can be uncomfortable, and some recovery products promise more than they deliver.

Short answer: DOMS is muscle soreness that starts 12 to 24 hours after unfamiliar or intense exercise, peaks around 24 to 72 hours and fades within about a week. Gentle movement, sleep, good nutrition and time are what help most. Massage may ease the feeling of soreness. Severe pain, major swelling or dark urine are warning signs that need medical care.

Why DOMS happens

DOMS follows exercise your muscles are not used to, especially eccentric movements, where a muscle lengthens under load. Think running downhill, the lowering phase of a squat, or a first ski day of the season. These movements cause microscopic damage to muscle fibres and a local inflammatory response. The soreness is part of how muscles adapt, which is why the same workout hurts much less the second time. Lactic acid, often blamed, is not the cause; it clears within an hour of exercise.

What helps

• Gentle movement. Easy walking, cycling or swimming increases blood flow and often eases stiffness.
• Massage. Research suggests massage can reduce perceived soreness for a day or two. Registered massage therapy is a good option after a big event.
• Sleep. Muscle repair depends on it.
• Protein and carbohydrates. They supply building blocks and energy for repair.
• Fluids. Staying hydrated supports general recovery.
• Heat. A warm bath or heat pack can make stiff muscles feel looser.
• Gradual progression. The best prevention is increasing new training slowly.

What helps less than you might think

• Static stretching before or after exercise has little effect on DOMS.
• Anti-inflammatory medicines may slightly reduce pain but can upset the stomach and are not recommended routinely. Ask a pharmacist or clinician first.
• Cold water immersion may reduce soreness a little but, used routinely after strength training, may blunt some gains.
• Supplements marketed for soreness, such as tart cherry or curcumin, have small or mixed evidence.
• IV drips do not repair muscle damage. They can help if you are also dehydrated and depleted after a big event, which is a different problem.

DOMS versus injury

DOMS is a dull, diffuse ache on both sides of the body in the muscles you worked, worse with movement and better with gentle activity. An injury tends to be sharp, localized, one-sided, sudden in onset and may come with swelling, bruising or weakness. If pain does not follow the DOMS pattern, or does not improve after a week, a physiotherapy assessment is worthwhile.

When soreness is serious

Rarely, extreme exercise can cause rhabdomyolysis, a breakdown of muscle that releases proteins into the blood and can damage the kidneys. Seek urgent care for severe muscle pain out of proportion to the workout, marked swelling or weakness, and especially dark tea-coloured or cola-coloured urine. Risk is higher with very intense new workouts, heat, dehydration, some medications and some supplements.

Where a recovery drip fits

If you are both sore and depleted after a marathon, a hot tournament or a long event, a Performance and Recovery IV can help you catch up on fluids, electrolytes and nutrients while you rest. It will not erase DOMS, but rehydration often helps you feel better overall. Every first drip includes a health screen, and anyone with signs of rhabdomyolysis needs hospital assessment instead. Read muscle recovery after hard training and IV therapy for athletes for the bigger picture.

Easing back after a hard session, step by step

DOMS is usually a sign that your muscles met a new or harder challenge. These steps help most people move through it comfortably.

1. Keep moving gently. A walk, an easy bike ride or a light swim increases blood flow and often eases stiffness more than complete rest.
2. Eat a proper meal. Protein and carbohydrates help muscles repair and refuel.
3. Drink to thirst. Dehydration does not cause DOMS, but it can make you feel worse overall.
4. Sleep well. Much of muscle repair happens during deep sleep.
5. Train a different area. If your legs are sore, an upper body or core session can keep you active.
6. Return gradually. Repeat the same exercise at a lower load first. The second time usually causes much less soreness.

Preventing DOMS next time

Progress slowly

Increase weight, distance or volume by small steps, particularly with downhill running, lunges, squats and lowering movements, which tend to cause the most soreness.

Warm up properly

Five to ten minutes of light activity and movements that match your session prepare the muscles you will use.

Plan around big events

Avoid trying a new class or a much harder workout in the days before a race, a game or a physically demanding work week.

Who should check in with a clinician

• Anyone with soreness that is getting worse after three days instead of better.
• People with sharp pain in one spot, swelling, bruising or trouble moving a joint.
• Anyone with dark brown urine, severe weakness or extreme muscle pain after a workout, which needs urgent care.
• People who take statins and notice new muscle aches.
• Those who feel sore and exhausted for weeks, which can point to under-recovery, low iron or another cause.

Questions to ask about soreness and recovery

• Is this normal muscle soreness or an injury?
• Which hands-on therapy could help, and when?
• How should I change my program so this does not happen every week?
• Is there any reason to check my blood work?

What the research does not cover yet

Scientists still debate exactly what causes DOMS, though small muscle fibre changes and inflammation play a part. Research on massage, compression and cold water shows modest, short-lived relief. IV drips have not been shown to shorten DOMS in healthy adults who can eat and drink normally.

If what you feel is a sudden tight cramp rather than delayed soreness, read our guide to exercise muscle cramps, and for fluid and salt questions see electrolytes for athletes. Active adults in Woodbridge, Vaughan and Richmond Hill can book massage or physiotherapy to help with stubborn soreness.

Related care at AuraWell

• Shockwave therapy for stubborn tendon and heel pain

Sore, drained and ready to recover? Call 905-207-7000 to book massage, physiotherapy or a recovery drip at AuraWell Health, 4600 Hwy 7, Unit 105, Woodbridge, ON L4L 4Y7.