By Erick Avila
Whether it’s your first week of working out or you’re an experienced lifter starting a new training program, the achy feeling after a workout that makes you dread walking up a flight of stairs is a familiar experience for all. This sensation is known as muscle soreness and is typically acute or delayed. Acute soreness is felt right after a workout whereas delayed onset muscle soreness (DOMS) may not be noticeable right away. DOMS is characterized as a sensation of reduced muscle force capacity, decreased range of motion, stiffness, and soreness. The pain is thought to be a result of small tears to the muscle fiber followed by inflammation.
DOMS associated soreness normally increases in the first 24 hours following a workout, peaks 1-3 days after a workout, and finally subsides 5-7 days after a workout.
DOMS associated strength loss usually peaks within the first 2 days after a workout with complete recovery generally taking over 5 days. While DOMS associated stiffness peaks within 3-4 days after a workout and subsides within about 10 days. 
Causes, Signs and Symptoms of Delayed Onset Muscle Soreness (DOMS)
DOMS normally occurs after starting a new exercise program that involves lots of eccentric contractions. Eccentric contractions are those where muscles are stretched under a load. Some examples of eccentric movements include downhill running, the descent portion of a barbell squat, and the descent portion of a bench press. Unaccustomed exercise contributes to DOMS but as the “repeated bout effect” takes place, muscle damage is progressively lessened after each repeated workout. You’ll notice this effect in action when you compare the level of soreness you feel when you first workout compared to the soreness (or lack thereof) you experience weeks later doing the exact same workout.
Eccentric contractions can lead to elevated temperatures in working muscles, these elevations in muscular temperature are associated with proportional damages in the proteins found in muscles. Poor hydration may also be a contributing factor to DOMS. In one study examining the effects of hydration and DOMS, researchers divided subjects into two groups, with one group being able to stay normally hydrated during downhill running in hot temperatures while the other group was poorly hydrated while downhill running in hot temperatures. The researchers noted that the test subjects that were poorly hydrated had greater signs and symptoms of DOMS. This is why it’s important to stay hydrated with a refreshing blend of electrolytes like those found in XTEND Original, during workouts.
Scientists don’t know the exact mechanism of DOMS but there have been several hypothesized theories including lactic acid, muscle spasms, inflammation, and structural damage (of muscles, connective tissue, and cell membranes). [6,7]
Some signs of DOMS include tenderness, movement induced pain, reduced range of motion, reduced muscular power, reduced strength, swelling, stiffness in exercised muscles. [8,9]
How to Prevent Post-Workout Soreness
BCAAs, or branched chain amino acids, leucine, isoleucine and valine make up 3 of the 9 essential amino acids. Certain amino acids are deemed essential because our bodies require them to function properly, and we can’t make them on our own, so we obtain them through foods and supplements. BCAAs are popular supplements taken before, during, and after a workout to support recovery. BCAAs may help to alleviate DOMS by supporting a reduction in muscle protein breakdown, increasing muscle protein synthesis, and enhanced scavenging of free radicals. In two different systematic reviews, BCAAs when consistently supplemented at appropriate dosages were found to have a potential beneficial role for reducing muscle damage compared to placebo. [12,13]
Hot and Cold Therapy
Both warm and cold temperatures are used in many athletes training programs to enhance muscle recovery. Some common examples of these modalities include heat packs, ice packs, hot tubs, ice baths, saunas, cold water immersion, and hot/cold showers.
One study compared cold water immersion with active recovery on markers of muscle, soreness, and response to strength training. The researchers saw decreased levels of muscle soreness in the cold-water immersion group compared to the active recovery group. In a previous study by this same research group, scientists observed that after 3 months of resistance training, the cold-water immersion group had reduced gains in strength and muscle mass following strength training compared to the active recovery group. [14,15,16]
In a study on DOMS and heat wraps, low-level heat wraps when applied continuously for 8 hours following heavy exercise was shown to reduce DOMS.  Researchers have found that the application of hot or cold temperatures after exercise can both be effective in reducing DOMS. With the application of heat treatment or cold treatment within 1 hour after exercise both showing effectiveness for reducing DOMS within 24 hours after exercise.  Contrast water immersion involves alternating between hot and cold-water immersion with the goal of stimulating blood flow to sore muscles. In a review of the literature, contrast water immersion was found to improve muscle soreness compared to passive recovery. 
Massages, Vibration Therapy, Foam Rolling for Muscle Aches & Discomfort
Massages are the manual application of movement and pressure to muscle and soft tissue. Sports massages have a long history of use by athletes attempting to improve performance and recovery. The proposed benefits of massages related to recovery include increased skin temperature, increased blood flow, and increased parasympathetic activity.  Meta-analysis research on the effects of sports massages for DOMS have indicated that sports massages are associated with a beneficial effect on subjective ratings of DOMS, flexibility, and muscle performance; with the greatest effects from sports massages on DOMS being seen 48-72 hours after exercise. [22,23] Researchers compared the effectiveness of various recovery modalities including active recovery, compression garments, cryotherapy, contrast baths and massages. They found massages to be the most effective method for reducing DOMS and perceived fatigue.
Vibration treatments utilizes fixed devices or platforms for localized vibration or whole-body vibration to muscles and tendons. Vibration therapy is suggested to support recovery and reduce DOMS by inhibiting pain receptors and stimulating metabolic waste disposal through increased blood flow. Literature reviews from 2012, 2014, and 2019 have concluded that vibration therapy may offer some benefit for DOMS and muscle recovery, with the 2019 study showing a reduction in muscle pain at 24, 48, and 72 hours after treatment.
Self-Myofascial Release (SMR) utilizes tools like foam rollers, sticks, and roller massagers on soft tissue to reduce muscle pain and increase range of motion. One of the proposed mechanisms that self-myofascial release can aid in recovery is by reducing stiffness in muscle and fascia (the connective tissue that holds our muscles in place). In a systematic review on the effects of self-myofascial release with foam rollers or roller massages on recovery, the authors concluded that SMR reduced perceived pain and increased range of motion following exercise. Literature reviews of foam rolling’s effects on muscle recovery have indicated that they may offer small benefits for severity of muscle pain. [28,29]
Stretching for Muscle Stiffness
There are various types of stretching including: active stretching where you actively stretch a muscle group, passive stretching where you remain stationary but place an external load on the muscle to stretch it, and proprioceptive neuromuscular facilitation a dynamic form of stretching popular among athletic trainers that involves contraction and relaxation phases. It’s thought that post-exercise stretching can support increased range of motion and decreased stiffness which could reduce DOMS.
In a review of literature comparing post-exercise stretching to passive recovery, the researchers found insufficient evidence to support a claim that post-exercise stretching was more beneficial than passive recovery. In a septate review of the literature, stretching before, after, or before and after exercise failed to produce a clinically meaningful reduction in DOMS in healthy adults. A third review on the effects of stretching on DOMS concluded that subjects saw a reduction in soreness of 2% over a 72-hour period which was of little to no practical significance.
Active Recovery is a form of low intensity exercise that’s usually done following a high-intensity workout for the purpose of accelerating recovery and performance in future workouts. Some common forms of active recovery include jogging, cycling, swimming, and yoga. Active recovery is often used in many training programs over passive recovery (or inactivity) because it’s thought that movement could promote increased blood flow to working muscles, which may potentially help reduce soreness.
Some studies on active recovery have indicated that it can assist with lactate clearance. [33,34] One study on a single session of yoga following DOMS inducing exercise found yoga to be helpful for promoting recovery.  In an article on different recovery strategies for Olympic distance triathletes, researchers recommended 15 minutes of low intensity cycling as a practical strategy for enhancing recovery. 
Compression Garments for DOMS
Compression in the form of garments (sleeves, shirts, leggings), wraps, and tape have all been used to help aid recovery after exercise. Compression garments are commonly used among athletes trying to enhance performance and recovery. In different meta-analysis studies on the effects of compression garments and delayed onset muscle soreness, the researchers have noted that while studies have shown mixed results, compression garments may be beneficial for enhancing muscle recovery from exercise. [37,38,39]
Kinesio tape is commonly used among athletes for rehabilitation or prevention of injuries from sport. Some of the proposed mechanisms for kinesio tapes benefits on recovery include promotion of blood flow, structural support for joints, ligaments, and weak muscles, and inhibition of pain by stimulating skin tissue. In a systematic review of the effects of kinesio tape on symptoms of DOMS, researchers concluded that the usage of kinesio tape for 48 hours post exercise appeared effective at alleviating muscle pain and improving strength, with the greatest effects being seen after 72 hours.
Frequently Asked Questions about Delayed Onset Muscle Soreness (DOMS)
Can I Continue Exercising with Delayed Onset Muscle Soreness (DOMS)?
The common symptoms associated with DOMS like increased stiffness, decreased range of motion, and decreased strength levels can make working out seem unappealing for most people. But different studies have shown some potential benefits of active recovery workouts for improving recovery. The most common forms of active recovery involve low intensity cardio exercises. Since strength and range of motion are usually reduced when you have DOMS, it’s likely that your performance for high intensity strength training will suffer. So don’t expect to hit PRs if you’re working out with DOMS, instead focus on increasing blood flow to your muscles during your workout.
Does Delayed Onset Muscle Soreness (DOMS) Equal Muscle Growth?
Many people associate DOMS as a sign of a good workout and potential muscle growth. The thought process behind this is that muscle growth occurs as an adaptation to muscle damage and DOMS is a sign of muscle damage. Because of this many people feel that if they don’t experience DOMS, they aren’t building muscle. But this isn’t always the case, one study that compared the effects of muscle damage on hypertrophy by examining the responses of beginners and trained individuals. The researchers noted that hypertrophy could be achieved independently of noticeable muscle damage. While exercise induced muscle damage can contribute to hypertrophy, research suggests that there’s a threshold where damage starts to interfere with hypertrophy, likely due to reduced strength levels and impairment of future training sessions.  The current research indicates that training programs that elicit moderate damage are most appropriate for maximizing hypertrophy. As former IFBB pro Lee Haney once said “stimulate, don’t annihilate”.
There are several strategies that can be used to help enhance recovery and reduce DOMS. In one meta-analysis where authors evaluated some of the most popular recovery techniques, they concluded that active recovery, compression garments, contrast therapy, cryotherapy, and massage were all found to have positive impacts on reducing DOMS. 
Some recovery techniques like cryotherapy or massage may be more costly than others. While others like compression garments or kineso tape may be relatively easy to follow. Most recovery strategies are most effective when they’re done consistently at appropriate dosages. One example of this is using BCAA supplements. As the leaders in recovery, we’ve developed several BCAA based formulas designed to help you repair after a tough workout.
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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.