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Delayed onset muscle soreness: a guide to DOMS

Laura Harcourt

Written byLaura Harcourt

gareth_stables

Reviewed byGareth Stables

athlete running up a flight of stairs with speed, sporty young man in fluorescent t-shirt training or working out outdoors
Have you ever wondered why you wake up feeling so sore the day after a workout? Meet DOMS. Here we learn what it is, what causes it and how to prevent it.

Summary

1What is DOMS?

If you’ve ever exercised, you’ve probably felt the aches in your legs that make it hard to walk up the stairs without grimacing. This is DOMS at work.

2What causes DOMS?

DOMS occurs when you exercise differently from your normal routine – if you start working out harder, or for longer without any build-up...

3How to prevent DOMS

To keep DOMS at bay, or reduce its impact, here are some of our top tips: get a caffeine hit, stay hydrated, build up slowly, prioritise sleep...

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Have you ever wondered why you wake up feeling so sore the day after you’ve smashed a workout? Well, this is known as delayed onset muscle soreness, or DOMS for short. 

DOMS refers to the aching, stiffness or pain you sometimes feel in your muscles in the days after you’ve exercised.

Commonly associated with a variety of myths and misconceptions, this has led to the causes of DOMS being either misunderstood or confused by a lot of us over the years, which is why we’ve put together this guide.

In this article, we take a closer look at DOMS, explaining exactly why it comes about and what you can do to ease your post-workout pains.

What is DOMS?

If you’ve ever exercised, you’ve probably felt the aches in your legs that make it hard to walk up the stairs without grimacing. This is DOMS at work.

This well-known ache comes on around 12 to 24 hours after exercising and can last for a few days, with peak soreness around the 24 to 72-hour mark.2 

Whether you exercise regularly, every now and then, or are switching up your routine, anyone can experience DOMS. While it’s nothing to worry about in most cases, DOMS can wear you out, so it’s helpful to try to ease your symptoms.

What causes DOMS?

You might have heard on the grapevine that DOMS is caused by a build-up of lactic acid in the muscles. This isn’t the case.
DOMS occurs when you exercise differently from your normal routine – if you start working out harder, for example, or for longer without any initial build-up. This unfamiliar activity causes microscopic damage in the form of microtears in your muscles. And it’s these tiny tears, and their repair process, that cause your post-workout aches and pains.2

While this might sound a bit scary and dramatic, don’t fret – it’s just your body’s natural response whenever your muscles undergo work and become strained.3

DOMS can also happen after eccentric exercise. This is basically any type of exercise where your muscles contract and lengthen at the same time, such as running downhill, jumping, going down stairs or doing deep squats.2,4

Is it DOMS or another type of muscle pain?

While we can sometimes think of DOMS as ‘good pain’, and a sign that we’ve done an epic workout, it’s important not to go too hard or too quickly as this can lead to injuries.
Knowing the difference between DOMS-pain and muscle injury-pain can help you figure out the best way to care for your body, and whether you need to see a healthcare professional for treatment.

The first questions you need to ask yourself are: when did your aches and pains start? And how long have you had them?

Pain caused by DOMS is usually a dull aching with some stiffness and tenderness. It’ll also typically come on 12 to 24 hours after exercise and be gone after two to five days.1,2

Pain caused by an injury, on the other hand, often comes on straight away. It can also worsen over time, affect your ability to move in certain ways and last for weeks or months. It’ll also normally cause some swelling, bruising and/or stiffness in the area that’s sore.1

The best thing to do if you’re worried about your symptoms or think you have an injury is to speak to a healthcare professional for advice.

How to prevent DOMS

To keep DOMS at bay, or reduce its impact, here are some of our top tips:
  • get a caffeine hit – if you’re a coffee lover, you might be in luck! A few small trials have found that having caffeine (alongside continuous hydration) in the days after exercising may help reduce DOMS. The research is inconclusive however as benefits have not always been observed.5,6 Regardless if you already drink coffee or love that caffeine hit, this might be one to keep in mind.7
  • stay hydrated – dehydration can cause muscle cramps, so it’s more than likely that dehydration during your workout will only worsen any DOMS that’s on the horizon. So remember to stay hydrated and take breaks to keep yourself cool8
  • build up slowly – exercise that you’re not used to is one of the main causes of DOMS. If you’re looking to switch things up, do so slowly, and you’ll be less likely to have intense soreness after your workouts
  • prioritise sleep – it’s so simple but so effective. Making sure you get lots of good quality sleep helps your muscles repair, grow and get stronger, reducing the impact of DOMS9

How to treat DOMS

While you wait for your body to do its thing, there are a few self-care bits and bobs you can do to help soothe your achy muscles.

Treat your muscles to a massage

 

Stretch it out

 

Get hot, get cold

 

Beat inflammation

Anti-inflammatory foods, drinks and supplements might help with post-exercise recovery by reducing soreness. So try incorporating some more of the following things into your diet to see if they help you:
  • good-quality protein foods – eggs, milk, fish, chicken and turkey are high in good-quality protein, which may help reduce exercise-induced muscle damage14
  • tart cherry juice – some research has found that the polyphenols in tart cherry juice may improve muscle force and functional recovery as well as decrease post-exercise muscle soreness15
  • omega-3 fatty acids – research shows that taking an omega-3 supplement long-term can not only decrease the inflammation caused by eccentric exercise but may also reduce post-exercise muscle soreness.15 Foods high in omega-3s include oily fish, green leafy vegetables and nuts but you can also consider taking a supplement
  • colourful vegetables – fruit and vegetables like avocado, broccoli, berries, citrus, dark green leafy lettuce and sweet potato are full of the antioxidant vitamins A, C and E, which can all help reduce inflammation. Taking a daily multivitamin supplement can help you top up your intake if you’re struggling to get enough through your diet alone16 but shouldn’t be used as a replacement for a healthy, balanced whole food diet – get those greens in.
  • vitamin D – this nutrient plays an important role in many functions of the body, and helps keep our muscles healthy. While you can get vitamin D from fish, egg yolks and fortified dairy products, current NHS advice states that everyone in the UK 'should consider taking a daily vitamin D supplement during the autumn and winter'17
  • taurine – a small study has shown that supplementation of this amino acid may help protect against muscle damage and significantly reduce post-exercise soreness.18 Taurine is found in meat, fish, seafood and dairy products, but is best absorbed by the body in a powder or capsule supplement form. You can find out more about the influence of taurine on exercise in our guide
 

The final say

We hope that our helpful tips and advice have left you feeling confident about how to prevent and treat DOMS in the future.

The key thing to remember is that, even if you do run into a bad case of DOMS, it should be over in just a few days.

For more helpful guidance and articles just like this one, head over to our Bone, Joint and Muscle Health hub.

Disclaimer

The advice in this article is for information only and should not replace medical care. While we strive for accuracy and balance, please be aware that this article may discuss products available for purchase through Holland & Barrett. Consult a healthcare professional before making any health-related decisions.
 

Sources

  1. 1. NHS. Pain and injuries after exercise. [Internet]. 2022. [cited 2024 March 11]. Available from: https://www.nhsinform.scot/healthy-living/keeping-active/before-and-after-exercise/pain-and-injuries-after-exercise.
  2. 2. American College of Sports Medicine. Delayed Onset Muscle Soreness (DOMS) [Internet]. [cited 2024 March 11]. Available from: https://www.acsm.org/docs/default-source/files-for-resource-library/delayed-onset-muscle-soreness-%28doms%29.pdf.
  3. 3. Cheung K, Hume PA, Maxwell L. Delayed Onset Muscle Soreness. Sports medicine [Internet]. 2003 Jan 1 [cited 2024 May 29];33(2):145–64. Available from: https://pubmed.ncbi.nlm.nih.gov/12617692/
  4. 4. Hody, S., et al. Eccentric muscle contractions: risks and benefits. Front Physiol. 2019;10:536. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510035/.
  5. 5. Hurley CF, Hatfield DL, Riebe DA. The Effect of Caffeine Ingestion on Delayed Onset Muscle Soreness. Journal of strength and conditioning research [Internet]. 2013 Nov 1 [cited 2024 May 29];27(11):3101–9. Available from: https://pubmed.ncbi.nlm.nih.gov/24164961/
  6. 6. Leonardo Carvalho Caldas, Rafael Barreira Salgueiro, Neil David Clarke, Tallis J, Valerio Garrone Barauna, Guimaraes-Ferreira L. Effect of Caffeine Ingestion on Indirect Markers of Exercise-Induced Muscle Damage: A Systematic Review of Human Trials. Nutrients [Internet]. 2022 Apr 23 [cited 2024 May 29];14(9):1769–9. Available from: https://pubmed.ncbi.nlm.nih.gov/35565741/
  7. 7. Muljadi, JA., et al. Effect of caffeine on delayed-onset muscle soreness: a meta-analysis of RCT. Bulletin of the National Research Centre. 2021;45(1):197. Available from: https://doi.org/10.1186/s42269-021-00660-5.
  8. 8. Better Health. Exercise - the low-down on hydration. [Internet]. 2022. [cited 2024 March 11]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/Exercise-the-low-down-on-water-and-drinks
  9. 9. Brinkman, JE., et al. Physiology of sleep. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from: http://www.ncbi.nlm.nih.gov/books/NBK482512/.
  10. 10. Guo, J., et al. Massage alleviates delayed onset muscle soreness after strenuous exercise: a systematic review and meta-analysis. Front Physiol [Internet]. 2017;8:747. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623674/.
  11. 11. Córdova, A., et al. Impact of magnesium supplementation in muscle damage of professional cyclists competing in a stage race. Nutrients. 2019;11(8):1927. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723322/.
  12. 12. Na, HS., et al. The role of magnesium in pain. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507245/.
  13. 13. Wang, Y., et al. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021;48:177–87. Available from: https://pubmed.ncbi.nlm.nih.gov/33493991/.
  14. 14. British Heart Foundation. Protein and exercise. [Internet]. [cited 2024 March 11]. Available from: https://www.bhf.org.uk/how-you-can-help/events/training-zone/nutrition-for-sporting-events/protein-and-exercise
  15. 15. O’Connor, E., et al. Nutritional compounds to improve post-exercise recovery. Nutrients. 2022;14(23):5069. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9736198/.
  16. 16. Better Health. Antioxidants. [Internet]. 2022 [cited 2024 March 11]. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/antioxidants
  17. 17. NHS. Vitamin D. [Internet]. 2022 [cited 2024 March 11]. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
  18. 18. McLeay, Y., et al. The effect of taurine on the recovery from eccentric exercise-induced muscle damage in males. Antioxidants (Basel). 2017;6(4):79. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745489/.
 

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