This is one of those times of the year when people are either returning to their long lost exercise routines or trying to get active for the first time. It may be clichéd but January is resolution time for a lot of people. Hey whatever your motivation is I’m just glad you’re adding some more healthy behaviors to your life. If that included some gym time or some running for the first time in a long time (or ever) you may be experiencing the phenomenon of Delayed Onset Muscle Soreness (DOMS). DOMS has been known to end many fitness journeys before they even really get going. It can be debilitating in terms of the pain and stiffness it can induce. You likely had to take a few days off, which have turned into a week and consequently killed any momentum you had going in this exercise thing.

First lets learn about what DOMS is, knowledge is power! The muscles in your body are accustomed to and adapted for the activities you normally do. When you do something novel with your muscles such as lifting weights, a new stress is placed on them that they are not adapted for. This new stress will cause microscopic damage to the cells of your muscles. It is this damage that is most commonly believed to be the cause of DOMS[1]. These are like tiny injuries and all injuries lead to an inflammatory response involving swelling, heat, redness, altered function and pain. Why would your body do this to you? Well, this is a necessary and natural process that helps your muscles get bigger and stronger. So while it seems like a bad thing at the time its actually a good thing as long as you are able to continue with your daily life while its happening. The pain from DOMS usually peaks 48 to 72 hours post exercise[2]. The discomfort you feel while actually working out is not DOMS but generally the more discomfort you experience during a workout the worse your DOMS will be. DOMS is most attributed to eccentric muscle contractions or very intense isometric contractions[3]. Eccentric contractions refer to movements where a load is placed on a muscle while it is lengthening. Think the lowering part of a biceps curl. Isometric contractions occur when a muscle contracts against a load but no movement occurs. Think of holding that biceps curl at the midpoint as long as you can. Running downhill places much more eccentric load on the muscles in your legs in comparison to running uphill, hence why you get more sore after running downhill than running uphill. Increased repetitions and increased loads will increase the amount of damage done to muscles.

Now that you know why you’re so sore let’s talk about what you can do about it. Unfortunately this is where the news isn’t so great. Once you have a good case of DOMS going on there is very little evidence that any of the interventions normally prescribed have any real impact on levels of pain or duration of symptoms. Studies done on ice water baths[4] and stretching[5] have shown no real impact on DOMS. NSAID’s such as ibuprofen will reduce pain from DOMS for a period of time but will not decrease the length of symptoms and may negatively impact the necessary healing process that is the underlying cause of DOMS[6]. Low intensity exercise has been shown to decrease discomfort during the exercise and for a short period of time afterward but DOMS symptoms return a short time after[7]. Lastly, massage has been shown to decrease the swelling caused by DOMS thought to be partly responsible for the associated pain. This aids recovery, as with any injury where swelling is present, significant reductions in pain seem to be transient however[8].

So what can you do to ease this painful condition? A certain amount of DOMS is probably unavoidable when beginning novel exercise routines, however it doesn’t have to be debilitating. For resistance exercises, stick to one set of repetitions and don’t go to complete failure the first time you try an exercise. Keep your exercise tempo moderate; mainly you don’t want to do really slow eccentric contractions at first. For instance when doing a squat, don’t go too slow on the lowering part at first. Once you are accustomed to the exercise you can start to play with long eccentrics as they do have a place in weight training. If you are doing some running for the first time in a while or at all, make sure it’s on a flat surface or even uphill as opposed to downhill. Downhill running will make you sore due to the increased eccentric loads placed on your muscles. Essentially, take it easy for the first few workouts back. The temptation is to get back into the gym with a fury. A more moderate approach will allow you to get more work done in that first week than doing one hard workout and then not being able to move for 48-72 hours!

Finally, if you have a raging case of DOMS and you want to feel better for a while, hop on a bike or elliptical for and easy cardio session. You should start to sweat a bit but keep it to 20 minutes or so, it should feel fairly effortless. You’ll be feeling a bit better now so do some very light stretching if you wish. Now head to your favourite RMT and get a light effleurage massage (they will know what to do). After that go for a long walk and stay moving as long as you want to feel better because as soon as you sit down your DOMS will come back until your muscles are healed. Next time just take it easy for the first few workouts!

[1] https://www.acsm.org/docs/brochures/delayed-onset-muscle-soreness-(doms).pdf

[2] https://www.acsm.org/docs/brochures/delayed-onset-muscle-soreness-(doms).pdf

[3] https://www.acsm.org/docs/brochures/delayed-onset-muscle-soreness-(doms).pdf

[4] Gulick D.T. et al. Various Treatment Techniques on Signs and Symptoms of Delayed Onset Muscle Soreness. Journal of Athletic Training. June 1996 P. 145-152. 31(2)

Sellwood K.L. et al. Ice‐water immersion and delayed‐onset muscle soreness: a randomised controlled trial. British Journal of Sports Medicine.

June 2007 p. 392-397. 41(6)

[5] Gulick D.T. et al. Various Treatment Techniques on Signs and Symptoms of Delayed Onset Muscle Soreness. Journal of Athletic Training. June 1996 P. 145-152. 31(2)

[6] Gulick D.T. et al. Various Treatment Techniques on Signs and Symptoms of Delayed Onset Muscle Soreness. Journal of Athletic Training. June 1996 P. 145-152. 31(2)

[7] Gulick D.T. et al. Various Treatment Techniques on Signs and Symptoms of Delayed Onset Muscle Soreness. Journal of Athletic Training. June 1996 P. 145-152. 31(2)

[8] Ernst, E. Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review. British Journal of Sports Medicine. 1998 p. 212-214. 32.