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DOMS – Delayed Onset of Muscle Soreness

What is Delayed Onset of Muscle Soreness

All of us at some point in time must have experienced Muscular pain a day or two after sudden sporting or unaccustomed activity. This delayed onset of muscular pain is known as DOMS or Delayed Onset of Muscle Soreness. The muscles commonly affected are two joint muscles that often undergo eccentric contraction. Eccentric exercises are exercises where the muscles contract and elongate at the same time – e.g. downhill running, long-distance running, plyometric exercises, etc.

Causes of Delayed Onset of Muscle Soreness

DOMS is caused by myofibril tears (muscle strains). The micro-trauma results in an inflammatory response in intramuscular fluid and electrolyte shifts.

The presence of biochemical markers, creatine kinase, and lactic dehydrogenase, in the blood of DOMS sufferers, predicts muscle fiber disruption.

The inflammatory response in the muscle fibers makes it stiff, alters firing patterns and pain reduces muscle strength, alters neuromuscular coordinated motions and function.

Symptoms of DOMS

The classic symptoms of DOMS can be described as:

  • A dull muscular ache that develops 24 to 48 hours after the performance of the new or strenuous exercise.
  • It is localized to the involved muscles and will result in muscle stiffness and tenderness.
  • Passive stretching will increase the symptom which is one of the reasons why one feels stiffness.

DOMS may also result into-

  • A short term loss of muscle strength,
  • Reduced joint range of motion and
  • Swelling of the affected muscle groups.

But the best part is on continuing the sporting or unaccustomed activity over few days the muscles will start to feel less sore and gradually pain disappears.


DOMS can be clinically diagnosed. The Physiotherapist can easily differentiate DOMS from other more significant injuries such as muscle tears, strains, or ruptures.

Treatment of Delayed Onset of Muscle Soreness

DOMS can be treated with active rest, gentle massage, and means like ice or hot water fermentation depending on the severity. More importantly, while treating DOMS is to understand what not to do. Deep tissue massage during initial 1-2 days, overtraining, and stretching exercises should be avoided. They may aggravate the symptoms.


A graded exercise program, with a gradual increase in the intensity of exercise particularly eccentric exercises, and with proper warm-up and cool down regimes shows reduced rates of athletes with DOMS.


Most cases of DOMS gradually subside on their own and have no lasting effects. Most cases of DOMS resolve in 3-4 days.

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