We’ve all experienced the agony. The pain of trying to get out of your car, wobble up the stairs, or move normally after a hard workout. This soreness is called delayed onset muscle soreness (DOMS). If you’ve been exercising long enough, you’ve probably felt it. Some lifters relish this pain as an indicator of success, but is that really the case?
What is DOMS?
I frequently see DOMS occur after a daunting leg day. It can also occur in experienced lifters after taking a few weeks off. Studies show (1) that it’s not restricted to any particular muscle group, but some people tend to experience it more in certain muscles.
Technically speaking, DOMS is (primarily) caused by a type 1 muscle strain – some degree of fiber damage, but nothing too serious – predominantly as a result of unaccustomed exercise. As you may have experienced, DOMS can range from slight muscle discomfort to severe pain that limits range of motion. Generally, muscle soreness becomes noticeable ~8 hours post-workout and peaks 48-72 hours later, although the exact time course can vary.
There is little doubt that DOMS is correlated with exercise-induced muscle damage to some degree; however, measures of muscle damage at a microscopic level are poorly correlated with reports of soreness. Basically, if you’re really sore, it doesn’t mean you completely “shredded” your muscles. This is supported by MRI images showing little damage to some muscles post-exercise. Not only do the time course of changes in the markers of muscle damage differ from one another, but they also don’t match the time course of muscle soreness (Newham, 1988). It is possible for severe DOMS to develop with little or no indication of muscle damage, and for severe damage to occur without DOMS.
Certain types of exercise can cause significant muscle damage. The image below is taken after an extensive eccentric exercise protocol. As you can see, the muscle fiber just looks messed up. The majority of studies examining exercise-induced muscle injury and DOMS use untrained subjects undertaking large amounts of unfamiliar eccentric exercise. This model is unlikely to closely reflect the circumstances of most people who workout. However, it does give us some insight into what happens in the muscle.
Another DOMS-inducing stimulus that occurs during exercise is metabolic stress (and I’m not talking about the build-up of lactic acid, which does not cause DOMS. Thinking that lactic acid causes muscle soreness is a dogmatic idea that is thoroughly outdated and flat-out wrong). After high-intensity exercise, rest alone will return blood lactate to baseline levels well within the normal time period between training sessions. However, there is some evidence that hydrogen ions and reactive oxygen species – both of which increase in concentration during exercise – may contribute to DOMS (2). Metabolic stress during exercise can cause changes on a structural level at the cell membrane (sarcolemma). The damage allows fluids and other factors to enter the cell, which promotes inflammation (3).
Does DOMS mean more muscle growth?
Some studies show the presence of DOMS after long-distance running, which indicates it doesn’t just occur during resistance training. This should be an anecdotal indicator that DOMS isn’t a good gauge of muscle growth since running causes minimal hypertrophy.
People who are new to working out often have the most pronounced DOMS. They also happen to grow the most, so you can see how the two may be intertwined. This is due to the new stimulus that exercise provides. Again, they get sore because they aren’t accustomed to exercising – not because they are growing like monsters. Interestingly, there is no difference in DOMS between sexes even for beginners (4).
There is some evidence to show DOMS may negatively affect workouts by altering motor patterns in subsequent workouts. This could cause reduced activation of the desired muscle (5). Hence, DOMS could actually hinder your next workout. In addition, severe DOMS can decrease force capacity by up to 50% (6). This causes functional deficits that may impair training at a certain level, which could hinder muscle growth in the long term.
Exercising while having DOMS does not seem to make muscle damage worse (7), but it may interfere with the recovery process. In extreme cases, exercise-induced muscle damage can cause rhabdomyolysis, a serious condition that can lead to renal failure. So be careful when throwing a newbie into an advanced program – especially if they’ve never exercised. You could do some serious damage.
The “No pain, No gain” theory is wrong – at least for muscle growth. Click To TweetHow do I feel DOMS?
So if you aren’t destroying your muscles or burning them up with lactic acid, then why do they hurt? I recently discussed this concept with a member of my lab.
Nociceptors are free nerve endings that respond to damaging stimuli by sending pain signals to the brain. In muscle tissue, these receptors can sense chemical stimuli such as inflammation or disturbances in microcirculation to blood vessels. These receptors are not inside the muscle because muscle cell death is not painful. In comparison, tearing a muscle can be extremely painful. The pain is due to the release of muscle substrates into the space where nociceptors are located. This also helps us appreciate that DOMS probably doesn’t occur due to something inside the muscle (i.e., in the contractile apparatus) (7).
How can I reduce DOMS?
One of the best ways to decrease the risk of DOMS is to slowly progress into a new exercise program. If you’ve ever had an advanced program, you’ll notice the first week or two may have reduced volume. The “prep” phase of programs has two purposes: 1) allowing the muscle time to acclimate to a new movement, and 2) leaving room for more adaptation.
We all know we should warm-up properly. This is probably one of the only times you’ll hear it doesn’t help. While it may prepare you for exercise (I highly suggest it), neither warming up nor stretching before exercise has been shown to reduce or prevent DOMS.
Something a lot of people use to relieve DOMS is foam rolling. However, it has only been shown to improve DOMS in some studies. During foam rolling, you use your own body mass on a foam roller to exert pressure on an area of soft tissue. The motion places direct pressure on an area, which stretches it. It is considered self-induced massage because the pressure somewhat resembles the pressure exerted on muscles by a massage therapist. Again, there are only a few studies that have measured the effects of foam rolling on performance. These studies found foam rolling can enhance recovery after DOMS and alleviate muscle tenderness. Self-massage through foam rolling could benefit people wanting to recover in an affordable, easy, and time-efficient way.
Another intervention commonly used is massage. Some researchers have shown decreases in pain associated with DOMS after a massage (8). However, massage has no effect on muscle metabolites such as glycogen or lactate. One study found massage decreased the production of the inflammatory cytokines by mitigating cellular stress resulting from muscle injury (8). Many people believe massage can provide increased blood flow to specific areas, reduced muscle tension, and mood enhancement. Massage produces direct pressure, which may increase ROM and decrease stiffness. These benefits are expected to help athletes by enhancing performance and reducing injury risk. The effects of timing of massage (pre- or post-exercise) on performance, injury recovery, or injury prevention are not clear because the mechanisms of each massage technique have not been widely studied.
Supplements to reduce DOMS
Caffeine has long been known to increase alertness and endurance, shown by the the average person’s morning grumpiness before drinking the black gold. Interestingly, a recent study by Hurley et al., reported caffeine has the ability to reduce DOMS. They mesured perceived soreness in males consuming caffeine one hour before a workout. They found a lower level of soreness in the biceps on day 2 and 3 compared to a placebo after subjects completed a bicep curl protocol. Using a dosage of 5mg/kg bodyweight they found a beneficial effect of caffeine on soreness. For comparison, a 185lb (~84kg) male would take about 420mg of caffeine preworkout. That is a ton of caffeine! An 8oz Red Bull contains roughly 85mg. Does your preworkout supplement have that much caffeine? Probably not. If you’re wondering when caffeine peaks in the blood, it’s about one-hour post ingestion. Caffeine is an adenosine antagonist and affects the activity of central nervous system (CNS) by blocking adenosine receptors, thus resulting in decreased levels of soreness. This suggests that short-term caffeine ingestion before a strenuous workout may decrease overall soreness levels. However, the subjects who took caffeine were able to perform more reps than the control group, which could be a confounder.
Taurine is found in muscle and has multiple biological functions. Remember that Red Bull I mentioned earlier? Well, it has about 1,000mg of taurine. For reference: Up to 3,000mg a day of supplemental taurine is considered safe. One double-blind study (10) of males completed over 21 days measured the effects of 50mg of taurine (20x less than the content in a Red Bull) after 7 days of eccentric exercise. The researchers found a reduction in DOMS and oxidative stress markers after exercise; however, there was no effect on inflammatory markers. Could this be a way to battle the other side? If inflammation is one component to DOMS and oxidative stress is another component, we need a study to combine the two. That probably won’t happen soon, but it would be fun to see if they were synergistic.
Omega-3 fatty acid is found in fish and is becoming increasingly used to fortify foods. You can also find EPA/DHA in those lovely pills that make you burp fish all day. Several studies reported positive effect of omega-3 fatty acids on DOMS, presumably due to the decrease in pro-inflammatory factors such as IL-6 and TNF-alpha. There are a ton of studies to show taking an omega-3 supplement is good for you in many ways, and this seems to hold true for DOMS. If you’re interested in the results, the main table from Jouris et al 2013 is below.
Cryotherapy, on the other hand, probably doesn’t reduce DOMS. This goes directly against the current trend of athletes jumping in a tube surrounded by liquid nitrogen to help recovery. Whole body cryotherapy exposes athletes to cold, dry air below -100C for between two and four minutes in a specialized chamber. A recent Cochrane Review by Costello et al., found that there was insufficient evidence to determine whether cryotherapy can reduce muscle DOMS or improve recovery.
No guidelines currently exist for its clinical effectiveness or for safe usage. Cryotherapy is thought to work by reducing temperature in the skin, muscle, and core. The theory is muscle soreness is relieved by reducing muscle metabolism, skin microcirculation, nerve conductivity and receptor sensitivity. In addition, it could have a placebo effect by reducing the subjective feeling of DOMS post-exercise. Using a meta-analysis based on four eligible studies, it seems cryotherapy does not reduce DOMS or improve recovery. Furthermore, insufficient evidence exists on whether this therapy could actually be harmful. We do know, however, that cold water emersion post-exercise can decrease rate of muscle growth. For the time being, cryotherapy and cold water emersion are probably two things you should avoid – you probably won’t recover any faster, and you may not build as much muscle.
Conclusion
Soreness can provide some insight, but don’t use it as a marker for a good workout. High levels of soreness indicate the lifter has exceeded the capacity for the muscle to undergo repair. Indeed, soreness can impede the ability to train properly, and it may decrease motivation.
The consensus among researchers is that there is no single component that causes DOMS. Instead, there are a number of complex events that may explain this phenomenon. It is the main cause of reduced exercise performance including decreased muscle strength and range of motion for both athletes and non-athletes. Common supplements to combat DOMS include caffeine, omega-3 fatty acids, and taurine.
Sources
- Sikorski EM, Wilson JM, Lowery RP, Joy JM, Laurent CM, Wilson SM-C, Hesson D, Naimo MA, Averbuch B, and Gilchrist P. Changes in perceived recovery status scale following high volume, muscle damaging resistance exercise. J Strength Cond Res 27: 2079–2085, 2013.
- Close, Graeme L., Tony Ashton, Tim Cable, Dominic Doran, and Don P. M. MacLaren. “Eccentric Exercise, Isokinetic Muscle Torque and Delayed Onset Muscle Soreness: The Role of Reactive Oxygen Species.” European Journal of Applied Physiology 91, no. 5–6 (May 2004): 615–21. doi:10.1007/s00421-003-1012-2.
- Stauber WT, Clarkson PM, Fritz VK, and Evans WJ. Extracellular matrix disruption and pain after eccentric muscle action. J Appl Physiol 69: 868–874, 1990.
- Flores, Débora F., Paulo Gentil, Lee E. Brown, Ronei S. Pinto, Rodrigo L. Carregaro, and Martim Bottaro. “Dissociated Time Course of Recovery between Genders after Resistance Exercise.” Journal of Strength and Conditioning Research / National Strength & Conditioning Association 25, no. 11 (November 2011): 3039–44. doi:10.1519/JSC.0b013e318212dea4.
- Trost Z, France CR, Sullivan MJ, and Thomas JS. Pain-related fear predicts reduced spinal motion following experimental back injury. Pain 153: 1015–1021, 2012.
- Paulsen, G, Mikkelsen, UR, Raastad, T, and Peake, JM. Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise? Exerc. Immunol. Rev. 18: 42-97, 2012.
- Cheung, Karoline, Patria Hume, and Linda Maxwell. “Delayed Onset Muscle Soreness : Treatment Strategies and Performance Factors.” Sports Medicine (Auckland, N.Z.) 33, no. 2 (2003): 145–64.
- Proske U and Morgan DL. Muscle damage from eccentric exercise: Mechanism, mechanical signs, adaptation and clinical applications. J Physiol 537: 333–345, 2001.
- Zainuddin, Zainal, Mike Newton, Paul Sacco, and Kazunori Nosaka. “Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function.” Journal of Athletic Training 40, no. 3 (September 2005): 174–80.
- Crane, Justin D., Daniel I. Ogborn, Colleen Cupido, Simon Melov, Alan Hubbard, Jacqueline M. Bourgeois, and Mark A. Tarnopolsky. “Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage.” Science Translational Medicine 4, no. 119 (February 1, 2012): 119ra13-119ra13. doi:10.1126/scitranslmed.3002882.
- Sikorski, Eric M., Jacob M. Wilson, Ryan P. Lowery, Jordan M. Joy, C. Matthew Laurent, Stephanie M-C Wilson, Domini Hesson, Marshall A. Naimo, Brian Averbuch, and Phil Gilchrist. “Changes in Perceived Recovery Status Scale Following High-Volume Muscle Damaging Resistance Exercise:” Journal of Strength and Conditioning Research 27, no. 8 (August 2013): 2079–85. doi:10.1519/JSC.0b013e31827e8e78.
Mark says
That is an excellent article on this subject. Perhaps the best I’ve encountered.
Brandon Roberts says
Thank you! I appreciate it.
Eric says
Very informative article. The studies on Omega-3 fatty acids lend some credence to fish oil pill-poppers (I never loved the fishy smelling burps so I haven’t dedicated a significant period of time to using them). And like all things biological, our macroscopic symptoms seem to reflect a complex interconnection of multiple microscopic events.
One small critique I have is that the article needed at least one more edit – the temperature of cryotherapy is below *negative* 100 C. I read 100C that and thought “how could cryotherapy involve the temp that water boils at?”
Either way, great read! I’ll be sure to share it.
Greg Nuckols says
Thanks for the catch!
Antti, from Finland says
Hi. I have been using Labrada Hica-Max, 3 chewies 20min before workout and 2 chewies right after workout. It has bee nvery helpful for DOMS. After hard bench press day´s i have DOMS about 3-4 day´s, but with HICA i have on DOMS about 1-2 days after,
Chris Boucher says
Hi Eric, My copy has the negative sign on it.. So it does say -100C. It might just be what your reading it on. I agree, great article.
john says
So basically chug red bull before a high volume workout, that’s what I got from that
Greg Nuckols says
Can’t hurt. Go big or go home.
Doug Peacock says
There was a recent article which may have been in Science Daily that claimed a recent discovery showed that soreness is mitigated by T cells and that regular exercise causes an increase in t cells and that that is why we do not experience much soreness when we work out regularly.
Greg Nuckols says
Do you have a link? I’m skeptical, because novel stimuli are what tend to cause soreness. If you take someone who exercises regularly and have them try a new lift, they’re probably still going to get sore from it.
Albert says
Thank you for an enlightening article. No to Cryotherapy…requesting a refund tomorrow.
Pam says
Interesting article! I was surprised to see no mention of using turmeric for DOMS. It seems to help me, now I’m wondering if it’s placebo. At any rate, it can’t hurt and has other good qualities. But I’d love to know if there’s more research on it.
Greg Nuckols says
Since it primarily functions as an antioxidant, I’d be concerned that it may hinder hypertrophy (as high dose vitamin E and C can), but at the moment I don’t know if there are any human strength training studies on it.
Chris says
I have heard about high dose Vitamin C and antioxidants reducing muscular growth/beneficial change by reducing the oxidative stress exercise induces, and the subsequent repair/adaptation. So does Taurine work in a different way? If it also reduces oxidative stress wouldn’t that be a negative thing for the same reasons as high dose Vitamin C or E?
Greg Nuckols says
I may be wrong here, but I’m pretty sure taurine works a bit differently than vitamins C and E in the way they scavenge free radicals (selective vs. indiscriminate; the former for taurine, and the latter for vitamins C and E).
Steven Shuster says
I think that I’ve read that turmeric works differently as an antioxidant and isn’t part of the chain of events that lead to muscle growth, but I’ll have to look to find the article.
Romas says
Than you for brief explanation of the DOMS. I think that for the strength training DOMS may be dangerous, But for the hypertrophy is one of the stimulus of muscle growth.. Old bodybuilders theory suggest us – please change something in yours exercises sometimes (each 4-5 weeks). As we know DOMS arises if exercise is new ( example-after vacation all exercises are “new” )or really is new or has a heavy eccentric movement (example-cheating). All these are in the hypertrophy fans arsenal…..
Sanjay says
”found that there was insufficient evidence to determine whether cryotherapy can reduce muscle DOMS or improve recovery. ”
There is sufficient data that it actually counterbacks recovery and keeps you in pain/ sore longer! Gary Reinl has a great a book on this and Dick Hartzell also has a great book on this!
There is NO scientific data that has ever proven that ice works for recovery!
Manuel says
One thing that wasn’t mentioned is the entire ‘walk it off’ thing. Many of my friends advocate light cycling sessions after leg day and so on. Which could make a lot of sense: Increasing the blood flow should have positive effects on the recovery rate, right?
Greg Nuckols says
yep, active recovery can definitely be helpful
Nathanael says
Great Article!
Does this mean I can train with DOMS? I’ve had DOMS for the last 5 days following my first workout in about 8 months (I know, I need more discipline).
Greg Nuckols says
Yep, training with some DOMS is fine.
Tim says
Great article on DOMS, thanks for writing it! Also thanks for mentioning that cryotherapy seems to inhibit muscle growth in the long run. I always hated ice bathing. After reading a few articles like the link below, cryotherapy post workout seems to inhibit glycogen re-synthesis quite a bit. Not good for a sprint cyclist, 400 runner, or just about any athlete..
http://europepmc.org/abstract/med/22525651
Scott says
I would suggest to those who dismiss the benefits of foamrolling on DOMS to undergo an intense workout and aggressively foamroll only one side of their body afterwards.
The unrolled side will act as a control arm and, in my case, showed an amazing difference in DOMS that was still evident at least 3 days later. On that particular workout, I would have ranked the rolled side as having a DOMS of 3/10 in intensity and the unrolled side as 7-8/10.
Subject = 50 y/o male with 5 months heavy lifting training, doing a Wendler BBB program.
Daniel says
I’m sorry, but that’s not how science works.
Have you ever considered your reduction of DOMS is a result of placebo?
At the end of the day, if it works for you, kudos.
But when it comes to science to prove if foam rolling works for DOMS or not, your method is NOT the way to do it.
Scott says
LOL…you way, way over-estimate the very limited capacity of the placebo effect.
Henrik Holst says
Limited capacity? People can be cured from severe illness due to placebo. There is nothing limited about the effect.
Chris says
First, there ARE some preliminary effects of foam rolling on recovery. So noone is “dismissing” any effects of foam rolling – we just need more evidence to be able to state the effects with good conscience, or as convinced as you are by personal experience.
The placebo, and other confounding effects, are the very reason science is not conducted with N=1. I guess everyone would like to save those billions of dollars in research by always just recruiting one person. And by foregoing all those tedious procedures with exact measurements. 🙂
But of course your experience can be a valuable hint for you – even it was the placebo effect. Because all that matters in the end for you is that youre feeling well. Because foam rolling – apart from time and very little money invested – has no drawbacks.
Thats different to other treatments in medicine that are argued with personal experiences (homeopathy) as well.
JD says
N=1 anecdote isn’t science for the general population, but it sure makes a relevant experiment for the 1 in question. Doesn’t everyone self-experiment to a degree in fitness, let alone every other venture in life? The roller experiment is a great idea, if DOMS is primarily what one is using it for.
Chris says
Sure JD, just try and do what “seemingly” is working for you. In practice, thats not even a bad idea for a single person and I agree in the foam rolling thingy it would probably work ok.
But lets look at it a bit more deeply: I wrote “seemingly”. Why? Because its not just the sample size that is different if you want to know if an effect is real or not: science has some other tools to assure youre actually discovering an effect.
For example, homeopathy works very well according to all the n=1 “experiments”. So with millions of n=1 case reports – isnt that like an experiment with a large sample size and therefore scientific and therefore homeopathy works? No, of course not. Because every single “experiment” wasnt an experiment at all in the first place! Because it didnt feature the constituting principles of science (objectivity, reliability, validity), let alone an experiment: randomization, standardization, manipulating of one, and ONLY the variable you want to study (in this case: fake pill vs homeopathic pill), group comparison, statistical data assessment.
So if you think you are immune to placebo and all the other confounding biases and effects (theres a whole reasearch branch busy just with methodology) in the foam roller self-experiment – then it will give you a correct answer if theres an effect. And if you can conduct an experiment with N=1 in the first place, which is theoretically impossible simply because of time effects: youre not the same as you were some weeks or days ago when you foam-rolled the one side, because you certainly have to reverse the sides for a second foam rolling to exclude the possibility of left-reight body side differences. You see, its not that simple once you begin to learn more about methods. That was just the iceberg of experimental pitfalls, there are textbooks full of many more.
If youre just like any other human being on this planet prone to perception and cognitive biases (I know we have another bias telling us we are not – after all Im a unique snowflake totally different to my peers as well 🙂 ) – then its very hard to be sure.
Shane MCLEAN says
Brandon, I agree with Mark. This is the best article I’ve read on this subject. Congtrats on making the articles of the week mate.
Greg or Brandon can either of you tell me my Cryotherapy is so hot right now? Pardon the pun, well not really. 🙂
Greg Nuckols says
It got a big boost from LeBron. There were a couple big profiles during the NBA finals last year about how he used it daily to keep his body ready to go with the heavy minutes he was playing.
Augusto says
Excellent article!! Very much instructive!!
Cindy says
What do you think about BCAAs for help with recovery and DOMS? I’ve had many people asking about them
Greg Nuckols says
I seem to remember one study that showed BCAAs work synergistically with Taurine for reducing DOMS, but I don’t think there’s a robust body of literature backing that up.
Jesse McMeekin says
Nice to see you guys digging into the research a bit. Some good stuff for sure.
Geoffrey says
Hi Greg,
I have been doing your pre-made programs for a few weeks now. Before I tried your program, one of the most difficult I have with DOMS is:
When the DOM is at its peak, I usually get hives.
The most evident symptoms that hives are starting is when my eye bags start to look like they have pebbles coming out from them.
Second most evident is the warmest parts of my body get itchy.
I only experience them during the second or third day after an intensive weight training. Intensive is relevant to my capability of course.
I have found a forum that the solution is to drink Glutamine. It actually worked for me. But I do not know if that is a long term solution.
Would you be able to share some insight about this?
Thanks!
Greg Nuckols says
Inflammation increases with soreness, which can temporarily weaken the immune system somewhat. That may be why you’re getting hives. However, that’s a very atypical response. That may be worth getting checked out by a doctor.
Florian says
Hey Geoffrey,
I used to have the same problem for a couple weeks/months after starting to work out excessively.
No doctor could find anything, but after a lot of research on my own I found the solution for it: glutamine supplementation.
Made it go away completely.
Best regards
Kelly says
I’ve noticed decreased DOMS when I’m in a caloric surplus. Even though in caloric surplus I feel stronger lift heavier and maybe longer (feel more like working out), so you’d think I should have more doms. But in fact I have less.
James says
”increase ROM and stiffness” Sorry to be pedantic but did the author mean to write decrease stiffness? Also my understanding of massage is that a lot of the benefits also come from human contact, would self massage machines/foam rolling confer the same benefits?
Greg Nuckols says
Probably so. This article is pretty old, but I’ll ask him