DOMS or Delayed Onset Muscle Soreness for fitness buffs and gym junkies is possibly the most delicious ache ever! Indeed it’s one we wear with great pride, almost like a badge of honor and brag about to our peers. Just last week I sat in my corporate office and was telling my colleague how sneezing and deep breaths were excruciating. The awestruck sympathy you receive is incredible validation – “definitely ‘beasting’ it out in my ab workouts.”

But whilst I was elaborating and detailing the pain of DOMS I suddenly realized that the person in front of me seemed to think I was injured and was plainly horrified that after just a day of rest I was going to hit training hard the next day. For you Mr. A.G and for all the rest who don’t know how to differentiate between DOMS and other gym-related aches and pains … this Medically Fit is for you!

the What

Before I delve into DOMS and the way it presents, let’s first focus in on the fact that this is a SYNDROME. A ‘syndrome’ is a collection of signs and symptoms and differs from a disease in that there is not just one aspect that produces an abnormal result. A syndrome is quite ‘loopy’ in that several things may be going on at the same time. To explain with logic, cause A may produce result B but it may also give rise to situation C that in turn will produce result D. 

In a syndrome, there may be only one sign/symptom or there may be more than one or there may be all the documented signs and symptoms that present. This is seen in DOMS. DOMS, sometimes referred to as muscle fever, has several characteristic features. Pain, muscle stiffness, localized tenderness, swelling and decrease in muscle strength are most commonly experienced. 

The muscle soreness occurs because the eccentric/unfamiliar exercise causes microtrauma to the muscles fibres. Previously, it was thought that DOMS resulted due to a build up of lactic acid during exercise. This theory has now been completely debunked as evidence shows that the lactic acid is clearly within 30-60 minutes after exercise and so cannot be causal of DOMS.  

The minute mechanical damage that occurs to the muscle fibres results in calcium being accumulated in the damaged muscles. This calcium degenerates muscle protein, which in turn causes muscle inflammation and swelling. Whilst the inflammatory response is necessary and useful for muscle repair and recovery, it is what sensitizes the nerves in the muscle and this is why one experiences pain/soreness/stiffness. 

DOMS is actually a protective mechanism for the body. What happens through the trauma to the muscles is that the muscle(s) is forced to recover, repair and adapt rapidly to the kind of stress it experienced. It then evolves into a stronger form of itself to offer protection so that the next time it is placed under the same stress, it is well-equipped and more than able to take on the tension head-on. The phenomenon is termed “repeated-bout effect” and the protection offered can be for several weeks after the exercise.

the Why

DOMS occurs as a result of eccentric or unfamiliar muscular activity. So for instance whilst you may be a spin-demon and regularly pull-off some seriously spectacular pedaling in your indoor cycling class, you will find you experience DOMS following a pole-dancing workout that you’ve never done before. Simply put, different muscles are used for both the workouts and the muscles aren’t used to being contracted and put under tension the way they’re required to for pole-dancing. 

The severity of symptoms however experienced varies from person to person and depends on factors like age and how seasoned an athlete is. The younger you are and the more conditioned your body is to exercise, the less susceptible you are to DOMS. The other side of the coin is that the older you are, the ‘older’ your muscles are and this shifts your hormonal status and decreases your recovery response; ergo greater susceptibility to DOMS. Generally speaking though, DOMS is unbiased and sans prejudice – it affects all. Further, symptoms and signs don’t necessarily present together and can occur at different times post exercise. 

DOMS pain is exacerbated when the muscle in question is stretched, contracted or put under pressure. At rest, pain is usually not experienced. 

Some evidence does support that DOMS does occur if proper form isn’t maintained during exercise. It is vital to ensure you are wearing the correct sporting gear during your workouts and that your form is accurate and isn’t causing excess, unnecessary strain to your body. For correct form refer to Haute Body Directory.

the When

DOMS does not occur immediately after the eccentric exercise. The muscle soreness takes anywhere from 24 to 72 hours to develop post workout. Pain experienced soon after a workout is NOT DOMS and should be investigated and managed appropriately. 

DOMS subsides and disappears usually within 5-7 days after the workout. Any symptom that persists for longer is safe to say not DOMS and requires attention. 

the How (to diagnose?)

DOMS pain is unique in that further activity of the sore muscles helps alleviate the soreness after some initial pain. DOMS is also unique in that this continued use of the pained muscles does not hamper its recovery nor worsens the muscle damage. 

It is easy to distinguish DOMS from muscle injury, which usually occurs at the very instant that the muscle receives trauma. Any pain or swelling that occurs during the exercise at the instant of contraction is not DOMS and must be viewed with an index of suspicion. Another way to differentiate between DOMS and muscle soreness from injury is that at rest, DOMS doesn’t produce pain whilst an injured muscle will ache/throb even at rest. 

the What to do

DOMS is not a cause for concern and resolves on its own in a matter of days following exercise. It is highly recommended that the day after the eccentric/unfamiliar exercise should be a day of rest and that exercise be resumed the day after at a slightly decreased intensity. Yes folks, I am saying go back to working out after a rest day (or two)! This ensures that muscle memory is preserved and yet that the damaged muscle isn’t overloaded with stress. 

That said, there’s no denying that at times the muscle soreness can be sorely uncomfortable and may hinder your daily activities. (Try sitting on a toilet seat following a day of 300 squats!)

To relieve inflammation and soreness, anti-inflammatories and sports massages have been found to be effective. Non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuproffen and topical Voltaren gel definitely take the edge off and well, a sports massage is just harmony to aching, fatigued muscles. Be careful when taking Ibuproffen though as it is known to cause gastric irritation. Consult a physician. 

Just like the massage increases blood flow to the damaged muscles, a sauna steam or hot bath too offers the same therapy and can be helpful for DOMS pain. 

A good warm-up pre-workout and regular static stretching is thought to offer some protection against DOMS. While the literature on this is controversial stretching is good for muscle elasticity and flexibility and should be incorporated into your routine. Regular stretching is thought to improve muscle function and decrease muscle viscosity thereby allowing for more efficient muscle contractions.

Finally, there is a great deal of research going into different muscle enzyme therapies. For the most part the research is primitive and rather than taking synthetic drugs and enzymes, be sure that your diet is well balanced and that you’re consuming good amounts of protein from lean meats, vegetables and eggs. Also be sure to eat antioxidant rich foods like berries, which will help combat the inflammation and reduce swelling.

the What nots

If repetition of the eccentric exercise after a rest day does not alleviate DOMS then do NOT continue. It is essential that a distinction is made between muscle injury and DOMS (see “the How to diagnose?” section) and if not done accurately can intensify the injury. For the most part continued exercise is NOT possible with muscle injury. 

If you suspect muscle injury, do NOT indulge in sports massages, as it will exacerbate the muscle damage. Consult a physician!

Finally, don’t get obsessed with DOMS (I know I did when I was struck by the fitness fad). I found myself trying to push myself till I was battered, bruised, crippled and crushed (BBCC) after a workout. DON’T! If you are indeed BBCC then you’ve pushed too hard and chances are you’re injured. Ease yourself slow and steady into a new exercise. Going hardcore on day 1 will achieve nothing and do more harm than good.

DOMS is not a measure of how good your workout has been. With time your muscles will adapt and get stronger and repetition of the exercise won’t cause DOMS. This is why it is important to mix-up your workouts and trick your body time and again. Do not let it get used to any one activity. A good workout and a good fitness regime is where you constantly challenge your muscles and your body through different means and where at the end of the hour you are well and truly sweaty. 

As for DOMS, you’ll learn to LOVE THAT BURN 😉