Delayed Onset Muscle Soreness (DOMS)
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?
DOMS 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 DOMS 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 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 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 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. 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 DOMS?
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.
Muscle Pain InjuriesMyalgia, or muscle pain, can have many sources. Here are some of the more common sources of your muscle pain. Please click the links for more information.
Muscle Strains By Region
Neck & Back:
Systemic Causes of Myalgia
More Information: Myalgia
Muscle Strain TreatmentMuscle strain treatment will vary depending upon an accurate diagnosis from your health professional. The severity of your muscle strain, and what function or loads your injured muscle will need to cope with, will impact the length of your healing and rehabilitation process. Until you’ve been accurately diagnosed with a muscle strain, use the following guidelines:
- Ice and a compression bandage.
- Elevate the injured region if it is swollen.
- If it’s painful to walk you should be using crutches.
- Cease or reduce your exercise or activity level to where you feel no pain.
Common Treatments for Muscle StrainThe following options are available to your physiotherapist to assist the rehabilitation of your muscle strain. Please seek their professional advice prior to self-managing your injury to avoid aggravating your muscle strain. These are general guidelines only and should not be treated as individual treatment advice.
Acute Muscle Strain Treatment
Subacute Muscle Strain Treatment
- Sub-Acute Soft Tissue Injury Treatment
- Acupuncture and Dry Needling
- Soft Tissue Massage
- Kinesiology Tape
- Supportive Taping & Strapping
- Electrotherapy & Local Modalities
- Heat Packs
Later Stage Muscle Strain Treatment Options
- Foam Roller
- Stretching Exercises
- Strength Exercises
- Closed Kinetic Chain Exercises
- Eccentric Exercises
- Proprioception & Balance Exercises
- Agility & Sport-Specific Exercises
Other Factors to Consider
- Biomechanical Analysis
- Joint Mobilisation Techniques
- Gait Analysis
- Running Analysis
- Video Analysis
- Active Release Technique - ART
- Deep Tissue Massage
- Lymphatic Drainage
- Myofascial Release
- Pregnancy Massage
- Relaxation Massage
- Remedial Massage
- Sports Massage
- Sports Recovery Massage
- Swedish Massage
- Therapeutic Massage
- Trigger Point Therapy