Delayed Onset Muscle Soreness (DOMS)

John Miller Physiotherapist

Article by John Miller

What is DOMS?

Delayed Onset Muscle Soreness

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 an exercise where the muscles are contracting while lengthening – e.g. downhill running, long-distance running, plyometric exercises, and landing drills.

What Causes DOMS?

Delayed onset muscle soreness is 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 in the blood of sufferers, which is consistent with muscle fibre disruption.

Swelling, altered muscle firing patterns and pain are the reasons why muscle strength, motions and function is impaired in 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?

Physiotherapy session for DOMSrelief with professional physiotherapist.
Effective Relief From Delayed Onset Muscle Soreness

The classic DOMS sufferer describes a dull muscle ache that develops 24 to 48 hours after the performance of a 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, a 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 begin to feel less painful. But, you will find walking downstairs troublesome if it’s your quadriceps that are suffering!

How is it 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. An ultrasound scan is unreliable in the diagnosis of DOMS but may assist determine a more substantial 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). Research on heat therapy for back muscle DOMS with a definite pain reduction. (Mayer et al. 2006)

NSAIDs may provide 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 not occur during the first 24 hours. Also, avoid excessive muscle stretching in this early phase.

You should avoid aggressive exercise during the recovery phase. This avoidance 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 m ease DOMS pain temporarily. (Zainuddin et al. 2005)

How Can You Prevent It?

Minimise DOMS by following these suggestions:

  • Take it slow and gradually build up the amount of exercise you do in your program – remember that Rome wasn’t built in a day.
  • Only increase your sets, reps and weights by more than 10% per week.
  • Be aware of the amount of eccentric exercise you include in your workouts.
  • Ensure you do a thorough cool down following your workout – many of us would have seen sportspeople doing gentle running and cool down drills after their games – this is one of the reasons why.
  • Long-distance runners should incorporate eccentric quadriceps training into their training.

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.

  • The pain is still present and not resolving more than 48 hours post-exercise.
  • The pain came on during the exercise (not the day after) and was more sudden in onset.
  • The pain is located in and around the joints and not just limited to muscles.
  • There are swelling and discomfort in and around the joints.

Related Articles

  1. Common Tendinopathies: An Overview of Tendon Injuries: This article provides insights into various tendon injuries and their management, crucial for those experiencing tendon-related issues alongside muscle soreness.
  2. Physiotherapy Treatment: Strategies for Healing and Mobility: It covers a range of physiotherapy treatments and techniques, helpful for anyone looking to understand the broader scope of physiotherapy in muscle and joint care.
  3. Sports Physiotherapy: This is an informative piece on sports physiotherapy, especially relevant for athletes or individuals engaged in regular physical activity who might experience DOMS.
  4. Common Muscle Injuries – A Physiotherapist’s Guide: This guide explores different muscle injuries, offering valuable information for understanding and managing muscle pain, including DOMS.
  5. Sports Injury Management: For readers interested in a broad understanding of sports-related injuries, this article could be highly informative, especially in relation to muscle soreness and injuries.
  6. Overuse Injuries: Since DOMS is an overuse injury, this article on overuse injuries and related conditions might be beneficial for a comprehensive understanding of avoiding muscle soreness and overuse injuries.
  7. Stress Fractures: Another overuse injury is stress fractures. Read this article for early warning signs and things to consider.

Common Muscle Injuries

A Physiotherapist's Guide

Introduction

Muscle injuries, presenting as muscle strain, pain or myalgia, are prevalent health issues affecting a wide range of individuals. This detailed guide, from a physiotherapist's perspective, delves into various muscle injuries, elaborating on their management, prevention, and the importance of professional advice. Explore the linked articles for an in-depth understanding of muscle injuries and their effective treatment.

Common Muscle Injuries

Neck & Back Muscle Injuries: Causes and Solutions

  1. Back Muscle Pain: This pain often results from prolonged poor posture or physical overuse. Key to relief is engaging in exercises that strengthen the core muscles and improve posture, thereby alleviating the strain on the back.
  2. Neck Sprain: Caused by sudden, awkward movements, a neck sprain can benefit from a combination of gentle stretches and targeted strengthening exercises to restore flexibility and strength.
  3. Text Neck: A modern ailment resulting from extended mobile device use, text neck can lead to chronic pain. Regular breaks, posture-awareness, and neck-strengthening exercises are essential for prevention.
  4. Whiplash: Commonly occurring in car accidents, whiplash requires a careful approach including neck stabilisation exercises and controlled movement to encourage healing and prevent further injury.

Lower Limb Muscle Injuries: Understanding and Treating

  1. Hamstring Strain: Particularly common among athletes, particularly runners, this strain demands rest initially, followed by a carefully structured rehabilitation program focusing on gradual strength building and flexibility.
  2. Thigh Strain: Often seen in sports involving sprinting and jumping, thigh strains need a combination of rest, ice, compression, and elevation (RICE) in the initial stages, followed by carefully planned strengthening exercises.
  3. Groin Strain: This injury requires a nuanced approach, including sufficient rest and targeted exercises, to ensure a safe and effective recovery.
  4. Calf Muscle Tear: Key to recovery is a balance of rest, gentle stretching exercises, and a gradual return to full activity, ensuring the muscle heals correctly and strength is regained.

Upper Limb Muscle Injuries: Prevention and Care

  1. Golfer's Elbow and Tennis Elbow: Both these conditions involve inflammation of the tendons and require a rest period, followed by ice therapy and specific exercises tailored to strengthen the affected muscles.
  2. Corked Thigh: Resulting from direct impacts, these injuries demand immediate application of ice and a controlled, gradual exercise regime for recovery.
  3. DOMS, Fatigue-Related Cramps & Myalgia: Adequate rest, good hydration, and gentle stretching are crucial in alleviating these conditions.
  4. RSI: Regular stretching, ergonomic workplace adjustments, and taking breaks are key preventive measures for repetitive strain injury.

Systemic Causes of Muscle Pain: A Holistic View

  1. Fibromyalgia: This complex condition demands a holistic treatment approach, including exercise routines, stress management techniques, and sometimes medication.
  2. Rheumatoid Arthritis: Effective management combines medication, gentle exercise, and regular physiotherapy sessions.

Prevention and Management Strategies

  • Regular Exercise: Regular physical activity helps maintain muscle strength and flexibility, reducing the risk of muscle injuries.
  • Posture Improvement: Good posture, both in motion and at rest, is crucial for preventing muscle strain.
  • Proper Warm-up and Cool-down: Adequate warm-up before and cool-down after physical activity is vital in preventing muscle strains and injuries.
  • Ergonomic Adjustments: Making ergonomic adjustments at work and during daily activities can significantly reduce the risk of repetitive strain injuries and other muscle-related issues.
  • Maintaining a Healthy Weight: Keeping a healthy weight reduces the strain on muscles, particularly in weight-bearing joints.

What to Do? Seeking Professional Advice

Consult a physiotherapist or doctor for personalised advice and treatment plans. Remember, early intervention can significantly improve recovery outcomes and prevent chronic problems.

Conclusion

While muscle injuries are common, effective management and prevention are achievable with the right approach and knowledge. Understanding the causes, symptoms, and various treatments available empowers individuals to take proactive steps in their recovery and prevention. For the most tailored and effective treatment, always seek the guidance of a professional physiotherapist.

Common Muscle Injury FAQs

Managing and Recovering from Muscle Injuries

Welcome to our Muscle Injury FAQs. It's your comprehensive guide for understanding, treating, and bouncing back from muscle injuries.

We'll discuss the different muscle injury types, grasp the concept of muscle trigger points, and discover the reasons behind muscular pain post-exercise. Learn about effective treatments to speed up recovery, and explore the benefits of stretching exercises and foam rollers. Embrace the therapeutic effects of various massage therapies including remedial, relaxation, trigger point, acupressure, and sports massages. Gear up to play an active part in your journey towards recovery from muscle injuries.

For more detailed information simple the question hyperlinks below.

common muscle injuries
Muscle Injury Faqs

Diagnosing Muscle Injuries

  1. How Do You Know If It’s A Muscle Injury? - Understand how to identify a muscle injury, distinguishing it from other types of pain.
  2. What are the 4 Types of Muscle Injuries? - Explore the four main categories of muscle injuries, including strains and tears.
  3. What are the Most Common Muscle Injuries? - Learn about the most frequently occurring muscle injuries and how they affect your body.
  4. What is a Trigger Point in a Muscle? - Discover what trigger points are and their role in muscle pain.
  5. What Causes Post-Exercise Muscular Pain? - Uncover the reasons behind the muscular discomfort you feel after exercising.
  6. How Do You Know If Your Back Pain Is Muscular? - Find out how to determine if your back pain is due to a muscle injury.
  7. Tendinopathy vs Muscle Tear: What's the Difference? - Understand the differences between tendinopathy and muscle tears.
  8. Muscle vs Ligament Injury? - Learn the distinctions between injuries to muscles and ligaments.

early muscle injury treatment

Early Muscle Injury Treatment

Muscle Treatment & Recovery

  1. What is the Best Early Muscle Injury Treatment? - Discover the most effective initial treatments for muscle injuries.
  2. How Long Does it Take for a Muscle Injury to Heal? - Find out the typical healing times for various muscle injuries.
  3. How Does Dry Needling Help Muscle Injury? - Explore the benefits and process of dry needling in muscle injury recovery.
  4. How Can You Speed Up Muscle Recovery? - Learn strategies to accelerate the healing process of muscle injuries.
  5. What’s the Benefit of Stretching Exercises? - Understand the importance of stretching exercises in muscle recovery.
  6. How Do Foam Rollers Help Muscle Recovery? - Discover how foam rollers aid in the recovery of muscle injuries.
muscle injury treatment
Foam Rollers Are Excellent For Injury Prevention And Performance Improvement

Massage & Muscle Injuries

  1. Muscle Injury? What are the Benefits of Getting a Massage? - Explore the therapeutic advantages of massage for muscle injuries.
  2. What Is The Difference Between Remedial & Relaxation Massage? - Learn the distinctions between remedial and relaxation massage techniques.
  3. How Does Trigger Point Therapy Help? - Understand the role of trigger point therapy in treating muscle injuries.
  4. How Does Acupressure Help Muscle Injury? - Discover how acupressure can aid in the recovery of muscle injuries.
  5. What is Sports Massage? - Explore the specifics and benefits of sports massage for athletes and active individuals.
  6. When is the Best Time to Get a Pre-Event Massage? - Learn the optimal timing for a pre-event massage to enhance performance.
  7. When is the Best Time for Your Post-Event Massage? - Find out the ideal time to receive a post-event massage for effective recovery.

Conclusion

In conclusion, this FAQ article on managing and recovering from muscle injuries offers a wealth of information, from understanding different types of injuries like muscle strains and tears, to exploring various treatment and recovery options. Whether you're dealing with a recent injury, seeking preventive advice, or exploring therapeutic methods like massage and acupressure, this guide serves as a valuable resource.

Remember, the journey to recovery is unique for each individual, and this guide aims to empower you with knowledge and tools to aid in your healing process. Stay informed, listen to your body, and seek professional advice when needed, as you navigate the path to recovery and optimal muscle health.

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