The Treatment for Delayed Onset Muscle Soreness

If you haven't worked out in a while, you might experience ​delayed-onset muscle soreness​ soon after exercising. Also known as DOMS, this condition typically occurs when you do something intense or new during your workout. Prevention is the best way to get delayed onset muscle pain relief, but there are also many treatments available. Learning about these remedies will help you avoid muscle pain and lower your injury risk.

Delayed onset muscle soreness involves ​more than just muscle pain.​ You will also have tender, stiff and weak muscles a few hours after exercise.

There's a difference between muscle ​soreness​, muscle ​injury​ and muscle ​swelling​ as well. Medical imaging techniques show that post-exercise swelling looks similar to a muscle injury that disappears in a few hours. In contrast, DOMS is just beginning at this time — and it ​lasts for a few days​.

The symptoms of DOMS have negative consequences, leading to diminished athletic performance and increased injury risk. A 2016 report in the Central European Journal of Sport Sciences and Medicine describes how DOMS is a protective adaption that occurs when you overload your muscles. This type of ​overtraining​ may lead to injuries, so you should proceed with caution if you notice any signs of DOMS.

There are many ways to measure muscle soreness. A 2015 report in published in PLoS One used several of these ways to assess fatigue and recovery after intense exercise. Its authors concluded that it's important to use the proper method for each situation.

Most commonly, scientists simply ask participants about their muscle soreness and have them record it using a rating scale. They may also use ​physiological biomarkers of muscle damage​. For example, the enzyme ​creatine kinase​ is a reliable indicator of post-exercise changes in muscle tissue when properly measured.

​Read more:​ If You Don't Have Muscle Soreness, Does It Mean That Exercise Is Not Working?

Delayed onset muscle soreness follows a unique pattern. Unlike a the immediate effect of a muscle injury, this type of muscle soreness begins a few hours after intense or novel exercise and lasts for a few days. A 2016 paper in the Brazilian Journal of Kinanthropometry and Human Performance demonstrates this time course in male cyclists after a 131-kilometer race.

Researchers asked the cyclists about their muscle soreness every 24 hours. Soreness peaked a few hours after the race, and it stayed up during the first 24 hours. It returned to baseline levels at the 48-hour assessment and 72-hour assessment.

This study tested very fit athletes. Less fit athletes and sedentary people should expect DOMS to last even longer. Age might play a role as well. A 2018 article published in the American Journal of Sports Science and Medicine showed that a 40-year-old man took nearly a week to recover from DOMS.

While it might seem strange, DOMS is actually a beneficial, healthy and normal response to exercise. That response often leads to muscle growth, and blocking it might prevent this positive effect.

Yet, people exercise for other reasons too, and preventing DOMS won't cancel out those benefits.

​Read more:​ Is it Good to Be Sore the Day After a Workout?

You will have less severe DOMS by preparing your body for exercise. Trainers call this phenomenon the ​repeated bout effect,​ and it works even better than a delayed onset muscle soreness treatment. A 2019 report in the European Journal of Applied Physiology nicely illustrates the repeated bout effect in younger men.

The researchers induced self-reported DOMS by having the study participants do 50 repetitions of several common weightlifting exercises. For these exercises, the subjects used a weight corresponding to 80 percent of their maximum strength. Having them pre-train by doing the 50-rep set at ​10 percent of their max​ caused a 36 to 54 percent decrease in DOMS.

You can use the repeated bout effect to prevent muscle soreness by planning ahead. If you know you have a challenging workout at the end of the week, you can practice for that workout using lower weights at the beginning of the week.

You can also decrease DOMS by limiting your range of motion (ROM) while exercising. A 2016 paper in the Journal of Strength and Conditioning Research shows the impact of limiting ROM on DOMS in younger men.

Participants did elbow-flexion exercises in two different ways. For one arm, they did the exercise with a limited range of motion. For the other arm, they did the exercise with a full range of motion. Results indicated that they felt ​30 percent less pain​ in the first arm.

You can use this effect to reduce your DOMS during a normal workout. Simply limit your range of motion during each exercise. If your goal is to burn calories, you will have to increase the number of repetitions. Keeping the total work done constant will let you reach your goals.

Reducing the impact of exercise will also decrease DOMS. Water's buoyancy decreases the ​ground reaction force​ that plays a role in muscle soreness. A 2017 report featured in the journal Human Movement demonstrated this effect in soccer players.

Scientists assigned the players to one of three conditions: 1. land-based training, 2. water-based training and 3. no treatment. Compared to the land-based training, ​water-based training caused less self-reported DOMS​. The authors speculated that the water's buoyancy decreased the ​rate of force development​ by 80 percent, and that this decrease caused the reduction in muscle soreness.

Thus, doing water-based exercises will help you avoid muscle soreness. Simple movements, such as water walking and aquatic jumping jacks, can make a world of difference. They have the added benefit of decreasing your injury risk.

You typically get sore from doing muscle-fiber-lengthening exercises known as ​eccentric contractions​. Doing only muscle-fiber-shortening exercises — ​concentric contractions​ — won't usually trigger DOMS. A 2016 article in Springerplus illustrated this phenomenon in healthy women by using a biochemical marker.

The researchers carefully matched the amount of work done during eccentric and concentric contractions. They had the women either walk downhill (eccentric contractions) or walk uphill (concentric contractions) during a single one-hour testing session. Using creatine kinase as a marker showed that ​eccentric contractions caused greater muscle damage​ than concentric contractions.

You can take advantage of this effect by focusing on concentric contractions during your workout. These types of muscle contractions usually involve moving the weight away from the pull of gravity. Thus, positioning a bench-press machine so that you only have to do the pushing-up part will help you avoid the damage caused by eccentric contractions.

Many professional athletes sit in an ice tub after a game. They believe that this treatment will aid their recovery. A 2017 report from the University of Minnesota Duluth explored this possibility in collegiate football players during off-season training.

The subjects intensely exercised on Mondays, Wednesdays and Fridays. They then received treatment and completed a questionnaire. Results indicated that 10 minutes of cold-water immersion decreased self-reported feelings of muscle soreness.

This finding suggests that ​icing your muscles​ for a few minutes immediately after a workout will decrease feelings of muscle soreness. Following the guidelines in Icing muscles after a workout will help you succeed. Don't apply the ice directly to your skin. Instead, wrap the ice in a damp cloth; a dry cloth won't effectively allow ​cryotherapy​.

​Foam rolling​ is another option for treating DOMS. A 2015 paper in the Journal of Athletic Training demonstrated its effect in younger men. Researchers asked the subjects to do 10 sets of back squats at 60 percent of their maximum strength. That regimen caused muscle tenderness and performance decrements.

Participants in the treatment group did 20 minutes of foam rolling immediately after as well as 24 hours and 48 hours after exercise. Compared to a no-treatment group, adding foam rolling to the routine decreased tenderness and increased performance.

Research the do's and don'ts of foam rolling before trying this method. It's recommended to take a gentle, slow approach. You should avoid overworking any one area, and be sure to do some light stretching or exercise afterward.

Getting a massage offers you many health benefits, and it might also help you combat DOMS. A 2015 paper in the Journal of Bodywork and Movement Therapies tested this hypothesis in long-distance runners immediately after an ultramarathon race, using self reports.

The subjects received a massage immediately after the race. More than 90 percent of them had post-race pain, and it typically affected their legs. The massage decreased their pain and helped them recover.

The participants in this study were very fit and the race was especially demanding, but anyone can reap ​the benefits of​ ​post-exercise massage​. Pain relief, injury prevention and faster recovery are just a few to mention. Massage therapy also boosts your immune system and improves sleep, which can further reduce DOMS.

Supplements might offer you another way to fight muscle soreness. Amino acids, such as ​leucine​, have many health benefits, including faster post-workout recovery. A study published in the 2019 edition of Nutrition and Enhanced Sports Performance evaluated leucic acid as a potential treatment for DOMS in soccer players using self reports.

The subjects received daily doses of leucic acid for four weeks. Compared to a placebo, this treatment decreased muscle soreness and increased muscle mass. While amino acids can enhance athletic performance, this study didn't find that effect.

A 2018 report published in the International Journal of Exercise Science describes a simple protocol for managing DOMS. Participants took 6.6 grams of amino acids each day during an intense exercise routine lasting three days. This treatment decreased muscle soreness and increased muscle strength.

​Read more:​ What You Really Need to Know About Supplements

Muscle soreness is usually a temporary condition that disappears within a few days. However, unusually severe bouts of DOMS might suggest a more serious problem, such as ​compartment syndrome​ or ​rhabdomyolysis​.

Speak with a health care expert before self-diagnosing your symptoms or pursuing a remedy. A doctor might catch an underlying medical condition and can warn you about the side effects that may occur with ​any​ treatment.

​Read more:​ Can't Straighten Your Arms After a Workout? Here's Why (and What to Do About It)