Delayed Onset of Muscular Soreness, or DOMS as it is more commonly known, is a frequently occurring phenomenon in the sporting world, regardless of your fitness level or chosen activity. With this in mind, you would have thought that most individuals who regularly undertake exercise would have an awareness of DOMS. In reality, however, it is a largely unknown and mistaken concept.

Have you ever undertaken an intense training session and then felt the full effects several days later? It could have been a leg session at the gym, in which you didn’t realise how hard you had actually worked until several days later when you tried to walk down the stairs!

DOMS should not be mistaken or confused with a muscular strain. These are two completely different concepts and their differences will be further dissected later. DOMS can be best described as: “a state of muscular pain and discomfort that begins several hours after a period of intense exercise, particularly with eccentric muscle actions; state usually persists from 24-48 hours; thought to be due to micro-trauma to muscle fibres” (Medical Dictionary, 2012).

DOMS can be seriously debilitating and as a result impairs or prevents any further sporting activity until a state of recovery has been achieved. With symptoms often peaking around 48 hours, this could prove costly to individuals who train and compete on a regular basis and is typically avoided (or at least reduced) at all costs.

With this in mind, the purpose of this article is to provide an information summary regarding the topic of DOMS. Initially, its cause will be considered before moving on to the commonly occurring symptoms and treatment options available. More often than not, DOMS cannot be avoided, so consider this article a contingency plan for when you do experience its full effects…

The Cause Of DOMS

DOMS and the proceeding exercise induced muscular damage often results from unfamiliar exercise, with particular emphasis on eccentric muscle actions. This effect can be brought about in different ways, dependant on your fitness level and training status. For example, a novice who has not previously exercised may experience DOMS through gentle exercise, whilst a regular gym goer might only experience this phenomenon after a particularly intense leg session, involving eccentric squats and downhill running (Connolly et al, 2003).

Previous research has identified a three stage approach to the development of DOMS. Initially, as a result of exercise, mechanical damage is caused to the target muscle itself, often resulting in disruption to the sacromeres (Warren et al, 1993). This creates both inflammation and swelling within the target muscle and brings about the release of several key substances. The release of these chemicals and the presence of swelling at a muscular level leads to the final stage in which free radical proliferation and a pain response result (Connolly et al, 2003).

Before moving on, it’s important to differentiate between DOMS and a muscular strain. So what is the fundamental difference? The effect of DOMS does not usually extend across a whole muscle fiber, meaning that adjacent fibers will appear relatively normal. In contrast, a muscular strain is often the result of an isolated disruption of the muscle-tendon junction, extending across the fibers (Nikolaou et al, 1987). This becomes more relevant when you start to consider treatment options for each.

The Symptoms of DOMS

For those of you that have previously experienced DOMS, more likely than not, you can afford to bypass this section; the reason for this is that once you’ve experienced it, you don’t tend to forget the pain and discomfort it causes any time soon! For everyone else, typical symptoms include some or all of the following: strength loss, pain, muscle tenderness, stiffness and swelling (McHugh et al, 1999).

The type of symptoms experienced and their intensity will often depend upon individual characteristics and type of training undertaken to bring about DOMS initially. Some or all of the symptoms can be present at any one time and can take up to ten days to fully resolve themselves (Connolly et al, 2003).

DOMS - Muscle SorenessDOMS can strike anywhere on the body

DOMS - Muscle SorenessDOMS can strike anywhere on the body

Treatment Options Available

So far, this article has provided an introduction to DOMS and contemplated the cause and symptoms of this training phenomenon. It is now time to consider the various treatment options available and on offer. To some extent, this can be considered the most important section. After all, there’s nothing worse than under-performing or having to miss a training session due to muscular soreness.

There have been various pre- and post-exercise interventions put forward in an attempt to prevent and/or treat the effects of DOMS. These treatment options can be considered under three distinct categories: pharmacological treatments, therapeutic treatments and interventions using nutritional supplements. These will now be considered in further detail.

Pharmacological Treatments

Pharmacological treatment options focus around the use of non-steroidal anti-inflammatory drugs such as ibuprofen and aspirin, to name but a few.

The scope of research for this treatment option could not be more ambiguous. Previous research has demonstrated everything from positive effects and an enhanced recovery rate, through to no effect and even negative effects on the symptoms of DOMS. Howell et al (1998) actually noted that the maximal force generated was significantly lower in the group that sampled the flurbiprofen drug at fourteen days post exercise.

Verdict: hit and miss.

Therapeutic Treatments

The next treatment category is that of therapeutic treatments, which include a broad spectrum ranging from warming up, stretching and massage to cryotherapy and compression techniques.

With regards to the former, despite a general consensus that activities such as warming up, stretching and massage prove beneficial in assisting to combat DOMS, there is very little evidence whatsoever to support this notion. In fact, a conclusive hypothesis for why these treatment variables would even impact upon DOMS has yet to be established. With this in mind, the ability to link any real cause and effect relationship through research findings is almost impossible.

Conversely, in relation to cryotherapy and compression treatments, there actually is some evidence to suggest that these methods have the ability to provide pain relief, lessen the inflammatory response and reduce swelling within any given muscle (Swenson, 1996). Previous research has demonstrated that the application of a sleeve, worn for five days post exercise, reduced strength loss, soreness, swelling and stiffness in the elbow region following a period of exercise (Kraemer et al, 2001).

Verdict: cryotherapy and compression techniques shown to reduce DOMS.

  • Under Armour Heatgear® Sonic Compression Long SleeveUnder Armour Heatgear® Sonic Compression Long Sleeve
  • Under Armour Heatgear® Sonic Compression ShortsUnder Armour Heatgear® Sonic Compression Shorts
  • Under Armour Heatgear® Sonic Compression SleevelessUnder Armour Heatgear® Sonic Compression Sleeveless
  • Under Armour Evo Coldgear® Compression LeggingsUnder Armour Evo Coldgear® Compression Leggings
  • Under Armour Heatgear® Sonic Compression Short SleeveUnder Armour Heatgear® Sonic Compression Short Sleeve
  • Under Armour Heatgear® Sonic Long Compression ShortsUnder Armour Heatgear® Sonic Long Compression Shorts
  • Nike Pro Combat Core Compression 2.0 23cNike Pro Combat Core Compression 2.0 23c
  • Nike Pro Combat Core Compression 2.0Nike Pro Combat Core Compression 2.0
  • Nike Pro Combat CompressionNike Pro Combat Compression
Nutritional Supplements

Finally, we move onto interventions using nutritional supplements. Due to the huge interest in sports nutrition and supplements, this final category is rapidly gaining interest with supplements offered both pre- and post-workout in an attempt to hamper DOMS.

As previously mentioned, free radical proliferation is hypothesised to be responsible for the pain response in DOMS; consequently, antioxidants have been put forward as a possible supplement to counteract this. Vitamin C and E have been utilised within a number of studies, however findings have been both insignificant and inconsistent.

Other aforementioned supplements falling into this remit include Arnica and L-Carnitine, although further research is required to fully establish their effects on DOMS.

Verdict: antioxidants said to help reduce DOMS but more research required.

  • Vitamin C With Bioflavonoids 1000mgVitamin C With Bioflavonoids 1000mg
  • Vitamin E Capsules 100iuVitamin E Capsules 100iu
  • Coenzyme Q-10 Tablets 30mgCoenzyme Q-10 Tablets 30mg
  • Myprotein L CarnitineMyprotein L Carnitine
  • Myprotein Acetyl L CarnitineMyprotein Acetyl L Carnitine
  • Clikpak Arnica 30cClikpak Arnica 30c
Final Word

DOMS results following a bout of intense exercise and has the ability to seriously hamper your training and performance efforts for the proceeding time period. This can impact upon you not only physically but mentally too; quickly leading to frustration. As a result, it should be lessened or eliminated where possible.

Various treatment options have been highlighted, both pre- and post-workout, to help prevent or limit the effects of DOMS. These include pharmacological treatments, therapeutic treatments and interventions using nutritional supplements. With the exception of cryotherapy and compression treatments, all of these suggested treatments have produced little or no effect during controlled trials. In some cases, it has been evidenced that these treatment options might even impact negatively upon an individual.

The majority of this research should be taken with a pinch of salt, due to the various research and experimental flaws which make any findings almost impossible to gage. It is evident that further research is required to either prove or disprove the various treatment options on offer. In the mean time, you as the athlete can only be led by your body with regards to which treatments work best for you and are most successful in the fight against DOMS.

Let us know in the comments section how you combat DOMS and what techniques and/or supplements you have found most beneficial.