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DOMS (aka Delayed Onset of Muscle Soreness)

Raise your hand if you have been personally victimised by DOMS after starting your new activity?

Yeah, we have all been there.

So why are our bodies punishing us for 2-3 days after exercise?

We call it “Delayed Onset of Muscle Soreness”, or “DOMS”, if you want to be in with the cool gym kids. If you haven’t heard of DOMS, you are in for a treat.

Even though it may feel like your body is punishing you for exercising, it is a normal response to new or strenuous exercise. In saying that, we don’t want to repeatedly get ourselves in a state of DOMS, especially those of us who are athletes. Read on for more info on why.

What is happening in my body?

Just as the name suggests, DOMS is a delayed onset of muscle soreness, that usually presents 24 hours after exercise, and peaks within 24-72 hours. Typically, DOMS occurs after you have started a new exercise program, or you have increased the duration or intensity of your regular activity. You will be happy to know that anyone can experience DOMS, even athletes.

The symptoms of DOMS usually involve muscle discomfort, weakness, stiffness or aching pain in the muscles that were used during exercise. But, if you are unlucky, sometimes DOMS can be very painful and makes it difficult to do simple tasks like sitting on a chair, picking your keys off the ground, or even putting on your pants. But have no fear, you (usually) only have to put up with DOMS for 1-3 days.

Although the exact cause of DOMS remains unclear, there are some scientific reasons for the pain you are experiencing.

Initially, DOMS was hypothesised to be as a result of a build-up of lactic acid and toxic metabolic waste products in the muscles (proven false). Now it has been identified that the main cause of DOMS is from the disruption of homeostasis within the muscles fibers, as a result of repetitive eccentric forces. Eccentric forces are those that simultaneously contract and lengthen the muscle during activity, for example your quadriceps whilst running downhill.

The continuous contracting and lengthening of your muscles, causes small microscopic tears in your muscles, this is followed by inflammation, sensitisation of the muscles nociceptors (nerves that recognise pain), resulting in pain in your muscles (DOMS), during activities that would not normally be painful eg picking up keys off the ground.

To put simply:

Repetitive muscle firing and lengthening = micro trauma to muscles = inflammation = sensitivity = DOMS

DOMS for the beginner

Before you let DOMS deter you on your health journey, there are ways to minimise the amount of DOMS you experience. The first tip would be, gradually start your new activity to give your muscles time to adapt to the new stressors. Gradually building on your activity allows your muscles to slowly condition to the new physical demands, and therefore decrease your DOMS severity.

DOMS for the athlete

If you are training for a competition or game, it’s best to try and prevent the occurrence of DOMS leading up to your event by altering your training (aka tapering). It has been shown that DOMS can interfere with the performance of athletes, as it can decrease the maximum power and range of motion available in your muscles, just when you need them to be performing at their best.

Does DOMS = muscle growth?

Without opening a can of worms, this is very debatable. As mentioned, muscle damage is linked to DOMS, but it is also linked to muscle hypertrophy (muscle growth). With that said, you do not always need to have muscle damage to achieve muscle hypertrophy, as it can occur through other mechanisms such as mechanical tension or metabolic stress. In that case, you should not be aiming to reach a state of DOMS each time you workout, as it is not a reliable indicator of muscle growth. In fact, severe DOMS can be detrimental to subsequent work outs as you can not produce as much force during exercise due to a decrease in strength and range of motion. See Dan’s blog on SRA curves for more details.

Self-management for DOMS

There are a few things you can do to before, during and after exercise to reduce the amount of DOMS you experience after exercise.

1. Before exercise

Get hydrated!

There is an element of dehydration in your muscles during physical activity, so make sure your body is well hydrated before your activity. LINK WHY WATER IS IMPORTANT OR HOW DEHYDRATION IS DETREIMENTAL

Warm up

Your old P.E teachers was right with this one. Take the time before your exercise to properly warm up your muscles with movements that assimilate the exercise you are about to perform. This will help reduce DOMS, and more importantly, also prevent injuries from occurring.

2. During exercise:

Stay hydrated

This one is simple, your body is using water to create energy for your activity, plus there may be an element of sweating (if you are working hard enough), thus you must drink water throughout.

Approach Exercise Consciously

In the wise words of the Governator, when we exercise, we want to "put our minds in our muscles". This helps us to make sure we are using the correct muscles (and not overloading or compensating) and monitor for overload (especially when fatigued).

3. After exercise:

There is a lot of evidence out there to suggest the benefits of massage, foam rolling, cold water immersion, contrast water therapy, compression garments and the list goes on. You do not have to do them all at the same time, so have a read and find out which one will be most suitable to you.


Massage after exercise is a great place to start. In fact, it is shown that massage 48 hours after strenuous exercise is most effective. Massage increases blood flow to the area (bringing all the nutrients for muscle recovery), increases lymphatic flow (helps clear lactate) and modulates the activity of our parasympathetic nervous system to help decrease the pain sensitivity in the muscles.

Foam rolling

If you haven’t invested in a foam roller, now’s the time. A foam roller is a lifetime investment that is affordable, easy to use (most of the time), and can be done from the comfort of your own home. It is shown that foam rolling the exercised muscle for 20-minutes immediately after exercise and every 24 hours after can reduce DOMs. Similar to massage, foam rolling increase blood flow, increases lymphatic flow and modulates the parasympathetic nervous system.

Cold water immersion and contrast water therapy

There is evidence to suggest cold-water immersion and contrast water therapy can help reduce the severity of DOMS. For the bold, cold water immersion involves immersing your muscles in 11-15 degree water for 11-15 minutes. Cold water immersion causes the blood vessels to contract, decreasing the amount of blood supply to the area, helping to reduce the amount of inflammation in muscles and works as a natural analgesic (pain relief).

In comparison, contrast water therapy involves alternating between cold and warm water immersion. By using contrast water therapy, this helps induce peripheral vasoconstriction and vasodilation (blood vessel closing and opening respectively) to help reduce oedema (swelling), inflammation and decrease the feeling of pain your muscles.

As there is quality evidence for both, we will let you pick your poison.

Compression garment

Wearing a compression garment for up to 24 hours after exercise has been shown to decrease the amount of DOMS, as it reduces the space available for swelling and oedema in the area being compressed.

Light exercise

To help combat the short-term effects of DOMS, it is a good idea to continue LIGHT exercise in between your usual activity, such as walking or swimming, to keep your muscles active, pump the lymphatic system and reduce stiffness.

Injury or DOMs?

Now that you have some strategies to help reduce DOMS, it’s important to listen to your body and understand the difference between an injury and DOMS.

Usually, you will recover from DOMS without medical treatment, but if you have any of the following, it is best to get in contact with the team at Retrain Health for an assessment:

  • Pain that occurred during the exercise not 24-48hours post exercise

  • Pain present at the beginning, during and after exercise

  • Pain at rest

  • Excessive redness or swelling

  • Aggravated or new neurological symptoms


1. Mizumura K, Taguchi2 T. Delayed onset muscle soreness: Involvement of neurotrophic factors. The journal of physiological sciences. 2016;

2. Jianmin G. Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis. Front Physiology. 2017;.

3. Schoenfeld B. The mechanisms of muscle hypertrophy and their application to resistance training. J Strength Cond Res. 2010;.

4. Gregory E. Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures. J Athl Train. 2015;.

5. Dupuy O. An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Frontiers in physiology. 2018;.


Retrain Health is based in the Northern Rivers, NSW. From our Byron Bay and Ballina clinics, our team provides a range of quality healthcare services and products.

Retrain Health offers osteopathy, remedial massage and strength and conditioning sessions with qualified practitioners.

If you are interested in finding out more information or would like to book an appointment, please contact the clinic by phone (02) 6680 7447, send us an email or click here to book an appointment online.

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