Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness (DOMS) is muscle pain that happens after you do intense exercise. It’s called delayed onset because it starts one to three days after your workout.

DOMS usually happens after you try a new activity, kind of training or a workout that’s more intense than you’re used to.

Most of the time, DOMS is a sign your body is repairing and regrowing your muscle fibers after you use them differently. Feeling sore after a good workout can be a sign that you worked hard and accomplished your goals. But the common phrase “no pain, no gain” isn’t necessarily true. A workout can still be productive if you don’t feel DOMS.

You can usually manage DOMS at home. But visit a healthcare provider if you think you might have an injury, or if you experience pain that’s so severe you feel worried about it.

Symptoms of delayed onset muscle soreness

As you might be able to guess from its name, muscle soreness is the most common DOMS symptom. Everyone experiences pain differently. But DOMS has a few key characteristics. It usually:

• Happens after exercise: This isn’t the same kind of general soreness you might feel after sitting in the car for a long road trip.
• Develops over time: You won’t feel pain during exercise. DOMS builds over several hours. You’ll feel pain one to three days later.
• Affects specific muscles: You’ll feel soreness in the exact muscles you worked. If you do an intense leg day, your legs might be sore. Or if you jumped into a new upper-body routine, your arms and shoulders might hurt.
• Doesn’t last long: DOMS should go away in a few days. If it lasts for a week or more, you might have an injury like a muscle strain.

You might have other symptoms, too, including:

• Your muscles feeling tender to touch
• A feeling of weakness
• Stiffness or a reduced range of motion

Delayed onset muscle soreness causes

Working your muscles too hard causes DOMS. It’s easy to overwork your muscles by accident. This is especially true when you’re starting a new sport or type of workout. Your muscles might not be used to the kinds of stress you’re asking them to go through.

Your muscles are made of thousands of little fibers that stretch and move with you. When you exercise, you can sometimes cause tiny tears in those fibers. That might sound scary. But if you’re working out safely, it can be a good thing. Your muscles grow when your body repairs those tears.

Some movements are more likely to lead to DOMS. These are known as eccentric exercises. This is a motion where you squeeze or tense a muscle while lengthening it. Examples of eccentric exercises include:

• The lowering phase of a bicep curl
• The lowering phase of a pull-up
• Walking or running downhill
• Lunges
• Landing during jumps

Complications of this condition

Most people don’t experience any complications from DOMS. But if you push your muscles too hard before they heal, you might have a higher risk of strains and other injuries.

If you’re overworking your muscles, your body will try to compensate to help take pressure off them. Your form might become unsafe without you noticing. This can shift too much stress to joints and increase your risk of injuries, like sprains.

It’s rare, but forcing yourself to overwork your muscles too often can lead to serious conditions like compartment syndrome or rhabdomyolysis. These are medical emergencies. Go to the emergency room if you think you have symptoms of either.

Pushing through DOMS and other symptoms without letting your body recover can also lead to overtraining syndrome.

How doctors diagnose DOMS

You probably won’t need to see a healthcare provider if you have DOMS. You should be able to recognize the symptoms and manage them at home. But visit a provider if you have pain that’s bad enough to make you worried, or if you can’t move or use part of your body.

Your provider will ask when the pain first started, and which kinds of exercises you usually do. They might use a blood test if they think you have damaged muscles. Enzyme markers and creatine kinase in a sample of your blood can be signs of muscle injuries.

Delayed onset muscle soreness treatment

Rest is usually the best treatment for DOMS. This will give your muscles the time they need to repair themselves.

Everyone’s body heals at a different speed. There’s no hard and fast rule for how long you should take a break. The soreness and other symptoms usually last only a few days. Moving and using your sore muscles in your everyday routine should be OK. But try to avoid using those muscles for intense exercise while they’re sore.

If you’re used to training daily, ease up on the intensity. You can try targeting different muscles while your sore ones recover.

There aren’t any treatments specifically for DOMS. But there are lots of ways to manage muscle pain and stiffness at home. You might try:

• Heat or cold therapy: Heat and cold can manage different DOMS symptoms. Cold reduces pain and inflammation. Heat increases blood flow and relieves stiffness. Cold plunges or soaking in an Epsom salt bath may help.
• Massage: Massaging sore muscles can improve blood flow and manage stiffness. You don’t need to get a professional massage every time you’re sore. Foam rolling is a great option you can do on yourself at home.
• Light exercise: Moving your sore muscles can help loosen them up. But don’t work them out hard. For example, if you have DOMS in your legs, stretching your quads and going for a short walk can help you feel better. Just don’t do another heavy leg day right away.
• Pain relievers: Over-the-counter NSAIDS and acetaminophen reduce inflammation and relieve occasional pain. Don’t take these medicines too often. Visit a healthcare provider if you have DOMS often enough to feel like you need pain medication.
• Magnesium supplements: Magnesium can help reduce inflammation and relax your muscles. Talk to your healthcare provider or a dietitian before starting any new supplements. They’ll tell you if it’s a good idea and recommend the right dose.
• Staying hydrated: Drinking the right amount of water each day is great for your overall health. But it can also help your muscles recover.

When should I see my healthcare provider?

Visit a healthcare provider if you have DOMS that doesn’t get better with rest. See a provider if:

• The pain lasts more than a week
• The pain feels sharp and constant
• You have severe swelling around a muscle
• Your pee is unusually dark or has blood in it

How long does DOMS last?

DOMS usually lasts a few days after the exercise that started it. It rarely lasts more than five days. Everyone’s body heals at its own pace. But the pain should fade gradually. You might notice that it feels better each day until you feel like yourself again.

Can you prevent DOMS?

You probably can’t prevent DOMS all the time. But you can reduce your risk by easing into new activities or workouts. Try to always:

• Warm up: A few minutes of gentle stretches and light cardio can help your muscles get ready for more intensive workouts.
• Start slow: Don’t rush into new workouts or activities. Listen to your body and know when to back off.
• Cool down: Stretching and cooling down after a workout will help your body transition from an active state to a resting state. This gives your muscles more time to recover from activity. Going all out and stopping abruptly can increase your risk of DOMS.

A physical therapist or athletic trainer can help you walk the line between pushing your limits and overdoing it. They’ll help you find the exercises to meet your goals safely over time. Getting stronger takes time. You can’t do it all at once.