Post-Run Soreness: Should You Be Concerned?

John Miller Physiotherapist

Article by John Miller

Post Running Muscle Soreness

Is it an Injury or just DOMS?

Have you ever finished a big run and felt sore right after it? What about two days afterwards? Do you ignore it, or have it checked out?

The most common causes of post-run pain are either a legitimate muscle injury or delayed onset muscle soreness (DOMS).

Tips to Determine if it is a Muscle Injury or is it DOMS?

Differentiating between a muscular injury and DOMs is essential to ensure you are not overlooking a potentially sport-limiting injury and managing the damage appropriately. Early identification is vital!

What is DOMS?

Delayed Onset Muscle Soreness, or DOMs for short, is an exercise-related muscle condition that arises after intense, unaccustomed physical exercise. The state gets its ‘delayed’ name as symptoms are not usually felt until 24 to 72 hours after the workout, typically peaking at the 48-hour mark after exercise.

Research has demonstrated that DOMS is associated with tearing myofibrils, often at multitudinous junctions – best described as microtrauma. This process is followed by inflammation and a shift in intramuscular fluid and electrolytes. This process, combined with other local factors at the cellular and increased intramuscular pressure promote, causes the soreness and stiffness experienced in DOMS.

The swelling, inflammation, tenderness and pain that arise can manifest as decreased joint range of motion, reduced strength and a reduced ability to absorb shock while exercising. Tenderness is typically felt at the end of the muscle (at the tendon), where it attaches down along the affected limb and then as the condition progress. You can feel this throughout the muscle belly itself.

This alteration in muscle function can last up to 10 days!

Muscle Injuries

Acute muscle injuries are quite different in how they present compared to DOMS. Typically, pain and stiffness are felt immediately in the affected tissue or shortly after. A ‘pop’, twinge, feeling of being kicked – without anyone kicking you – or an immediate collapse to the ground. As expected, the amount of damage to the tissue with a muscle injury exceeds that of DOMS. Any general movement of the muscle will reproduce your symptoms, and if the injury is severe enough – bruising can begin to develop with some associated swelling.

At the time of injury, following the RICE protocol (Relative Rest, Ice, Compression, and Elevation) is your best go-to treatment.

It would help if you also avoided HARM factors. All the HARM factors can potentially increase bleeding, which may exacerbate your damage. No heat should be applied to the affected area. It would be best if you also avoid alcohol consumption, running or other painful movements. Initially, avoiding massage is a good idea until a professional has assessed the injury.

Research suggests no anti-inflammatory drugs following a muscle strain is the best way to go. If you seek pain relief, you should consult your regular GP or a pharmacist for relief options that don’t slow down your healing rates.

More info: How to Treat an Acute Soft Tissue Injury

Benefits of DOMS?

Thankfully yes! The body adapts to the physical exercise you undertook once the DOMS resolves. So when you perform the same routine again, the chance of DOMS onset decreases! However, adaptation to the causative training occurs rapidly after DOMS resolves. This adaptation with repeated activity is called the “repeated-bout effect.”

More info: Delayed Onset Muscle Soreness (DOMS).

How to Tell the Difference?

Your physiotherapist will be your best option for an efficient and accurate diagnosis of the two conditions. However, some simple factors help piece together your injury when deciding whether or not to consult help.

DOMS is more unpleasant when commencing a movement but eases as the muscle is warmed up, whereas a muscle injury will reproduce pain with any movement of the injured muscle.

The most definitive factor is taking a detailed history of the injury. If you experienced pain during or immediately after, you are most likely looking at a muscle injury. If the pain worsens the day later and worsens over the following days, you will most likely deal with DOMS.

What to Do if You Have DOMS or a Muscle Injury?

If you suspect a muscle injury, it is best to consult your physiotherapist earlier rather than later. A thorough assessment is required to ascertain what you have injured and start rehabilitation immediately to help minimise your time out of the sport!

If you suspect you have DOMS, you need to avoid therapeutic interventions that increase muscle pain (e.g. excessive stretching, deep tissue massage), and you should postpone the vigorous physical activity until the resolution of pain and restoration of function due to:

  • Decreased shock absorption
  • Decreased coordination of muscle sequencing motion
  • Compensatory recruitment of uninjured muscle groups
  • Increased relative work intensity of the affected muscles at the same workload
  • Altered strength balance of agonist and antagonist groups
  • Inaccurate perception of functional deficits

Evidence suggests that compression garments, remedial massage and heat packs to increase blood flow will decrease your pain.

If you’re unsure if it is a muscle injury or DOMS – we’re only a call away, and our physiotherapists will happily answer your questions and establish the best plan of attack for you!

At PhysioWorks, we are highly experienced physiotherapists in accurately diagnosing and establishing an individualised rehabilitation program. We will look at what caused it, how bad the injury is, treat the root cause and implement a plan to prevent it from coming back!

If you doubt or require more information, please don’t hesitate to contact your nearest PhysioWorks clinic.

More info: Running Injuries

General Information