DOMS - Delayed Onset Muscle Soreness
Article by John Miller
What is DOMS?
Delayed-Onset Muscle Soreness (DOMS) is exercise related muscle pain. It develops after excessive and unaccustomed exercise. It is particularly prevalent if that exercise has an eccentric component.
Eccentric exercise is exercise where the muscles are contracting whilst lengthening – eg downhill running, longer distance running, plyometric exercises, and landing drills.
What Causes DOMS?
DOMS is caused by myofibril tears (muscle strains). The microtrauma results in an inflammatory response with intramuscular fluid and electrolyte shifts.
We do know that biochemical markers (such as creatine kinase and lactic dehydrogenase) are found in the blood of DOMS sufferers, which is consistent with muscle fibre disruption.
Swelling, altered muscle firing patterns and pain are thought to be the reason why muscle strength, motions and function is impaired in DOMS sufferers.
(Black et al 2008, Cleak et al 1992, MacIntyre et al 2001, Cheung et al 2003, Dutto and Braun 2004, Paschalis 2007).
What are the Symptoms of DOMS?
The classic DOMS sufferer describes a dull muscular ache that develops 24 to 48 hours after the performance of new or strenuous exercise. It is localised to the involved muscles and will result in muscle stiffness plus tenderness. Passive stretching will increase your symptoms which is one of the reasons why you feel stiff.
DOMS can also result in a short term loss of muscle strength, reduced joint range of motion and possibly swelling of the affected muscle groups. The good news is that once you start moving your sore muscles they will actually start to feel less sore. But, you will find walking down stairs troublesome if it’s your quadriceps that are suffering!
How is DOMS Diagnosed?
DOMS is a clinical diagnosis. Your physiotherapist is an expert in the diagnosis of DOMS and excluding other more significant injuries such as muscle tears, strains or ruptures. Ultrasound scan is unreliable in the diagnosis of DOMS but may assist determine a more significant muscle tear.
What is DOMS Treatment?
DOMS should be treated initially with active rest and anti-inflammatory measures such as ice. (Bleakley et al 2012). heat has also been researched on back muscle DOMS with a positive pain reduction. (Mayer et al 2006)
NSAIDs may be used for pain relief but long-term use may impair satellite cell healing in DOMS. (Schoenfeld 2012).
Gentle massage and pressure garments have been shown in research studies to provide a reduction in the duration and severity of DOMS. (Valle et al 2014, Hill et al 2013, Nelson N. 2014.) However, deep tissue massage should be avoided during the first 24 hours. Excessive muscle stretching in this early phase should also be avoided.
You should avoid aggressive exercise during the recovery phase. This is due to your muscles reduced capacity to cope with shock absorption, in-coordination, altered muscle recruitment patterns, reduced strength balance and contraction intensity. Cycling has been shown to temporarily ease DOMS pain. (Zainuddin et al 2005)
How Can You Prevent DOMS?
To minimise development of DOMS the following suggestions need to be followed:
What is the Prognosis of DOMS?
The good news is that most cases of DOMS gradually subside and have no lasting effects. Most cases of DOMS will resolve within one to three days.
However if the following applies to you then it is best to seek the advice of your physiotherapist.
For more specific information, please contact your physiotherapist or massage therapist.
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