Delayed Onset Muscle Soreness (DOMS) – What you need to know.

Delayed Onset Muscle Soreness (DOMS) is one of the most common things people will experience after exercise, yet one of the least well-understood.

What is Delayed Onset Muscle Soreness (DOMS)?

I often hear people who chase this feeling as a way to quantify how hard they worked during their workout in the days that precede it. Yet, they may struggle to get up and sit down off the toilet due to the soreness they are feeling, or render whatever limb they have trained as useless due to the severe discomfort they are experiencing for the remainder of the week.

Nonetheless, DOMS is part of the training process, however, it is not a way to quantify the work you are doing. DOMS is more profound in those who are unaccustomed to a particular exercise modality or are new to training. It is a result of muscle damage, usually caused by doses of eccentric contractions over a period of time. This is then followed by temporary inflammation in order to repair the damaged tissue, with muscular soreness peaking between 24-48 hours after exercise.

“DOMS is part of the training process, however, it is not a way to quantify the work you are doing.”

DOMS is not necessarily a good thing, especially if it debilitates whatever muscle or limb you use in the days that follow the workout. If you are unable to use that muscle or limb again for the rest of the week, whether it be in or out of the gym, chances are, you have done too much. It would be smarter to gradually work your way up to the desired level you wish to achieve. For example, rather than doing 10 sets in your first week, do 2, then 3 in the following week, then 4, and so on. This will ensure your body gets enough of a stimulus to grow, as it was more difficult than the previous week but not too difficult that you are unable to recover for the next session.

DOMS should not be used as a way to quantify the amount of work you have done in a workout. If you are someone new to the gym, or doing a particular exercise for the first time, you will be a lot more sore than someone who has been doing the same thing for a while. This is because your body adapts to the stimulus, so the work you do is not as damaging over time, this is a good thing, it shows you are hopefully getting stronger and bigger. Furthermore, you may get to a point in your training where some exercises don’t give you DOMS at all, and that is perfectly fine as well, remember your body is adapting, and this is good.

What helps to alleviate DOMS?

Active Recovery

Now, if you are training frequently there are some things you can do that may help alleviate DOMS. It is a given that you should be getting ample sleep (see blog post on sleep) and proper nutrition in order to help you recover. Contrary to popular belief, rest is probably not the answer. And by rest, I mean, sitting around doing nothing on the days that follow your workout. The best thing you can do is move, also known as active recovery. My preference is walking, however, you can do anything that doesn’t worsen your level of fatigue but improves blood flow (ie, light swimming, cycling, etc). My reason for walking is that it promotes blood flow, without causing further damage to the muscles. Blood flow is the answer to our DOMS problem. Blood flow to the damaged muscles ensures they are getting the nutrients they need in order to repair, get stronger, and grow. Blood is the transporter of nutrients, increasing the amount of blood flow to your muscles, will increase the amount of nutrients transported needed to help in repair.

“The best thing you can do is move, also known as active recovery.”


Another commonly used modality to help alleviate DOMS is massage, which is a type of passive recovery. The potential effects of massage indicate that it is useful in improving muscle temperature, and blood and lymphatic flow, therefore, reducing muscle tension and soreness. As it can increase blood flow, this is an awesome way to help with DOMS, plus, it feels good. Despite there being little to no change to the muscle tissue itself, this feeling alone may alter the perceived level of soreness you experience after training. The reason behind this is that the perceived level of pain is often overshadowed by the euphoric feeling associated with a massage. Additionally, the constant pressure on the muscles during a massage can alter the feedback the receptors in the muscle provide to the brain. In saying this, I would use massage sparingly and most definitely not base my recovery regimen around it. I believe anything that increases your heart rate and gets you moving is likely more beneficial than lying on a massage table.


Stretching is another common modality I see people use for muscle recovery, however, from what the evidence suggests, you are likely doing more damage than good. Stretching does not cause an increase in blood flow, although it can be challenging and cause you to sweat, the nature of the movement, making your muscles longer can cause more damage and increase fatigue. Stretching, similar to massage, can play a role in changing the perceived feeling of soreness in the muscle. Although there are no physiological benefits to this form of recovery, the feedback provided to your brain may diminish the discomfort you are feeling temporarily. If it does this for you, this could be enough of a reason to continue using it, however, I would consider trying other modalities to see if the benefit is really noticeable.

Hot and Cold therapy

Another form of DOMS recovery that I will only briefly touch on is hot and cold therapy. I believe hot baths or saunas are really good for increasing body temperature, however, they don’t make enough of a dramatic change in blood flow to improve recovery. Alternatively, cold therapy or cryo decreases peripheral blood flow, lowering the amount of nutrient transport to the muscle, and slowing the DOMS healing process. The benefits often felt by temperature therapy are more related to perceived feelings of fatigue, the muscle numbing sensation, and mental euphoria associated with emerging from an ice-cold tub or hot sauna makes you feel good. In addition to this, evidence suggests the sooner you use these modalities after training, the more effect they can have, however, the effect they have is minimal or insignificant in most cases. Nevertheless, if it makes you feel better and more keen to smash your next workout, by all means, continue to do so.


Exercise does not need to be painful and be a source of agony in your day-to-day life. It is supposed to be enjoyable and support you in your endeavors to improve. If having DOMS for days and an inability to get up off the toilet is holding you back from enjoying your life or coming to the gym, you may want to rethink your program or get someone to help you who knows what they are doing. Findings suggest the best tools to decrease DOMS are food, sleep, and increased blood flow (active recovery). There are many other forms of recovery that people use that I have not listed, however, if you nail the basics, you should not need much else. Ensure you have a gym program that reflects your training experience, adequate nutrition, and good sleeping habits and the rest should sort itself out.



Costello, J., Baker, P., Minett, G., Bieuzen, F., Stewart, I. and Bleakley, C., 2016. Cochrane review: whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Journal of Evidence-Based Medicine, 9(1), pp.43-44.

Dupuy, O., Douzi, W., Theurot, D., Bosquet, L. and Dugué, B., 2018. An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-analysis. Frontiers in Physiology, 9.

Herbert, R., de Noronha, M. and Kamper, S., 2011. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database of Systematic Reviews,.

Petrofsky, 2013. Moist Heat or Dry Heat for Delayed Onset Muscle Soreness. Journal of Clinical Medicine Research.

Tiidus, P., 2018. Skeletal Muscle Damage And Repair. Champaign: Human Kinetics.



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