Delayed Onset Muscle Soreness, or DOMS is a condition where your muscles feel pain a day or two after hard or unfamiliar exercise.   DOMS is thought to more likely be worse with exercises that emphasize eccentric muscle contraction, where the muscle lengthens as it contracts.  Examples of eccentric contraction include negative weight lifting (like lowering a curling bar slowly, squatting, and lunges).  It is believed to be the result of microscopic tears of muscle and fascia fibers and consequential inflammation.   Pain from micro injury is generated by inflammatory biochemicals interacting with nociceptors (nerves that transmit pain signals).  In DOMS, the injuries are so small that it takes 12-24 hours before the inflammatory response is enough to generate pain and stiffness.

The muscle pain from DOMS is different in nature than a typical muscle sprain/strain injury.  It generally is more widespread, depending on the muscle groups that were worked out the most.  Contracting the affected muscles will increase symptoms.   For affected muscles that cross a joint such as the knee and shoulder, stiffness reduces joint range of motion.

DOMS, while it can be quite uncomfortable, usually self-resolves in about 7-10 days, with rest and a break from physical exertion.  But for some people, that is too long.

So, what can one do to prevent and treat delayed onset muscle syndrome?

(1) Take it easy, tiger.  If you do not exercise frequently and decide one day to make up for all the months you slacked off by going “all out” you are setting yourself up for pain, stiffness, and movement limitations.   If you haven’t been exercising for months, your muscles won’t be  acclimated to taking loads and repetitions and will likely incur microtears in the fascia, tendons, and muscle fibers.  So, use the 10% rule, which basically is a scaling up of exercise over a week or two depending on how often you go, to re-acclimate your muscles to your normal, maxed workout.   Let’s say you usually curl 40 pound dumbbells.  Start day one with 5 pounds, day two with 10 pounds, day three with 15 pounds, until you get up to your max.

(2) Seek out a professional.  A personal trainer  can show you the right exercises to do for your goals, and the proper technique to get the most out of it, without injuring yourself.

(3) Warm up.  Do about 15 minutes of cardio before you do strength or functional training like Boot Camp and similar, full body exercises.  Jumping jacks, jump rope, treadmill with incline are good choices.

(4) Do some light stretching.  Although recent studies showed that stretching before exercising did not significantly reduce injuries, stretching feels good and can put you in tune with your body.

(5) Hydrate 30 minutes before your workout, competition, or task that will involve heavy lifting (like helping a friend move out of his house).   Most sports drinks are formulated to provide the major electrolytes (sodium, potassium, calcium) that muscle use to contract.

(6) Know your limitations.    As you age, you lose muscle mass; and therefore strength.   Adapt your workout routine accordingly:  lighter weights, exercises that are easier on the joints; more rests in between sets.

Now, if you still get DOMS, congratulations, you weren’t cheating; way to go for it!  But seriously… here are things you can do to minimize it:

(1) Get a Swedish style or lymphatic drainage massage (NOT a deep tissue or acupressure massage) from an experienced, skilled massage therapist.  The long, light pressure strokes towards the heart will increase lymph circulation and help your body clear out the inflammatory products.  If you can find a place in your town that does endermologie (cellulite treatment), that is even better.  Endermologie is a type of negative pressure massage done with a special machine that can increase skin circulation by over 300%, for up to six hours.

(2) Rest, ice, compress, elevate (RICE).  If your whole body is affected, try a cold water bath for 20 minutes.  Epsom salts added to the water, and eucalyptus can be helpful.

(3) Do some light exercise– walking, stretching, yoga.

(4) Take fish oil supplements.  This may reduce the inflammation somewhat.

(5) Get some protein in you:  whey protein drinks, eggs, fish.  This gives the body the amino acids it needs to rebuild torn muscle.

(6)  Rest.   Try to get at least an hour more sleep per day while you are recovering.

And of course, no smoking or over indulging in alcohol during DOMs.  When you are ready to start up exercising again, work up to max gradually over a week.


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