What is delayed-onset muscle soreness (DOMS)?

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DOMS symptoms usually peak 24–48 hours after strenuous activity and resolve within 4 days. Muscle pain and tenderness can make everyday activities difficult, such as walking, running, or even sitting comfortably.

Symptoms of DOMS include:

• muscle stiffness
• pain when moving the muscle
• tenderness
• swelling

A person may also have reduced strength and range of motion in the affected muscles.

Researchers have proposed various causes of DOMS but do not agree on one definitive cause. The most likely explanation is that DOMS results from microtrauma to the muscles.

When people use their muscles in an unusual way, they can cause microscopic tears in the muscle fibers. This, in turn, leads to inflammation. The inflammatory response releases prostaglandin E2 and leukotriene hormones, which can cause pain and contribute to swelling.

DOMS may be more likely after exercises involving eccentric contractions. During these exercises, a muscle stretches and contracts simultaneously.

Factors that may affect DOMS include:

• muscle stiffness
• contraction velocity
• fatigue
• angle of contraction

Various techniques may shorten the duration of DOMS or reduce its severity. They include:

Massage

An analysis from Frontiers in Physiology indicates that a massage after strenuous exercise can relieve muscle soreness and improve muscle performance.

Self-myofascial release is a technique that relieves tension and promotes blood flow. It involves applying pressure to the muscles using tools such as a foam roller or roller massager.

A 2017 review in the International Journal of Sports Physical Therapy concludes that self-myofascial release could reduce pain and muscle tightness after an intense exercise session.

Learn 6 of the best myofascial release tools.

Cold water immersion

Full-body immersion in a cold water bath may improve muscle recovery after exercise slightly better than not using a recovery technique.

Research finds that immersion in 51.8–59°F (11–15°C) water for 11–15 minutes may be the most beneficial.

Heat therapy

Applying heat to stressed muscles may reduce DOMS by increasing tissue flexibility and blood flow.

A small, 60-person study observes how 8-hour heat therapy may impact DOMS after exercise. In the study, applying heat wraps immediately after exercise reduced muscle soreness and stiffness. Applying heat 24 hours after exercise for the same duration was not as beneficial.

Find 8 of the best heating pads for pain relief.

Supplements

Some evidence suggests that taking certain supplements can help relieve DOMS.

In one study, 21 college students received a D-ribose supplement or placebo before or after strenuous exercise. The students who took D-ribose had less soreness and faster recovery times than those in the placebo group. The effect was similar whether they took the supplement before or after exercise.

A 2020 review examined the effects of curcumin supplementation on DOMS. Curcumin is the compound in turmeric that gives it its yellow color. While studies show mixed results, the researchers conclude that supplementing 150–1500 milligrams (mg) of cucurmin per day might help reduce DOMS. They suggest that curcumin helps reduce the inflammatory response that causes pain and stiffness.

Find 8 natural supplements to help fight inflammation.

Topical analgesics or pain relievers

Pain relieving gels, creams, and patches may help ease the symptoms of DOMS. In some self-reported studies, topical pain relievers help reduce pain by at least 50% in some people. The topical medications were nonsteroidal anti-inflammatory drugs (NSAIDs), including diclofenac (Voltaren) and ketoprofen gels.

DOMS is not necessarily an indication of a good workout, and it can be counterproductive. People experiencing DOMS may skip workouts to avoid further discomfort.

DOMS is a common physical response to intense or unfamiliar exercise. However, some practices may help prevent it, reduce its severity, or shorten its duration. They include:

Warming up

Warming up before exercise prepares a person mentally and physically for their activity. Dynamic and static stretching may improve range of motion by activating the connections between the nerves and muscles. However, there is no conclusive research to show that warming up reduces DOMS.

Cooling down

People often choose to perform dynamic or static stretches to cool down after exercise. However, there is no reliable evidence that this helps reduce DOMS. A 2018 review in Sports Medicine notes that active cooldowns may speed up cardiovascular and respiratory recovery. For this reason, active cooldowns may promote a sense of calm that people may find beneficial. However, the review notes that active cooldowns do nothing to prevent muscle soreness or recovery.

Go slow

Easing into new forms of exercise can help prevent DOMS. Gradually increasing the intensity or duration of a workout can help reduce a person’s muscle strain and post-exercise soreness.

Learn more about dynamic stretching.

Although DOMS can be painful, it rarely requires a trip to the doctor. DOMS typically goes away on its own after a few days.

People may wish to consult a doctor if their pain is severe and their symptoms do not improve after a few days. A doctor may refer them to a specialist, such as a physical therapist.

People should also seek medical attention if they experience sharp pain. This type of pain could signify an actual injury rather than just DOMS.

DOMS is a common condition that can happen to anyone, regardless of fitness level. Experts are unsure of the exact cause. However, it likely results from unfamiliar or strenuous exercise causing microtears in the muscle fibers.

The muscle soreness and stiffness characteristic of DOMS usually peaks within 1–2 days and resolves after 4 days. However, this can vary.

People can try topical pain relievers, heat packs, and massages to soothe sore muscles.