What is DOMS? Delayed-Onset Muscle Soreness (DOMS) is exercise-related muscle pain. It develops after excessive and unaccustomed exercise. It is particularly prevalent if that exercise has an eccentric component. Eccentric exercise is an exercise where the muscles are contracting whilst lengthening – eg downhill running, long distance running, plyometric exercises, and landing drills. What Causes DOMS? DOMS is caused by myofibril tears (muscle strains). The microtrauma results in an inflammatory response with intramuscular fluid and electrolyte shifts. We do know that biochemical markers (such as creatine kinase and lactic dehydrogenase) are found in the blood of DOMS sufferers, which is consistent with muscle fibre disruption. Swelling, altered muscle firing patterns and pain is thought to be the reason why muscle strength, motions and function is impaired in DOMS sufferers. What are the Symptoms of DOMS? The classic DOMS sufferer describes a dull muscle ache that develops 24 to 48 hours after the performance of a new or strenuous exercise. It is localised to the involved muscles and will result in muscle stiffness plus tenderness. Passive stretching will increase your symptoms which is one of the reasons why you feel stiff. DOMS can also result in a short-term loss of muscle strength, a reduced joint range of motion and possibly swelling of the affected muscle groups. The good news is that once you start moving your sore muscles they will actually start to feel less sore. But, you will find walking downstairs troublesome if it’s your quadriceps that are suffering! How is DOMS Diagnosed? DOMS is a clinical diagnosis. Your physiotherapist is an expert in the diagnosis of DOMS and excluding other more significant injuries such as muscle tears, strains or ruptures. An ultrasound scan is unreliable in the diagnosis of DOMS but may assist determine a more significant muscle tear. What is DOMS Treatment? DOMS should be treated initially with active rest and anti-inflammatory measures such as ice. (Bleakley et al 2012). heat has also been researched on back muscle DOMS with a positive pain reduction. (Mayer et al 2006) NSAIDs may be used for pain relief but long-term use may impair satellite cell healing in DOMS. (Schoenfeld 2012). Gentle massage and pressure garments have been shown in research studies to provide a reduction in the duration and severity of DOMS. (Valle et al 2014, Hill et al 2013, Nelson N. 2014.) However, deep tissue massage should be avoided during the first 24 hours. Excessive muscle stretching in this early phase should also be avoided. You should avoid aggressive exercise during the recovery phase. This is due to your muscles reduced capacity to cope with shock absorption, in-coordination, altered muscle recruitment patterns, reduced strength balance and contraction intensity. Cycling has been shown to temporarily ease DOMS pain. (Zainuddin et al 2005) How Can You Prevent DOMS? To minimise the development of DOMS the following suggestions need to be followed: Take it slow and gradually build up the amount of exercise you do in your program – remember that Rome wasn't built in a day. Only increase your sets, reps and weights by more than 10% per week. Be aware of the amount of eccentric exercise you are including in your workouts. Ensure you do a thorough cool down following your workout – many of us would have seen sportspeople doing gentle running and cool down drills after their games – this is one of the reasons why. Long distance runners should incorporate eccentric quadriceps training into their training. What is the Prognosis of DOMS? The good news is that most cases of DOMS gradually subside and have no lasting effects. Most cases of DOMS will resolve within one to three days. However if the following applies to you then it is best to seek the advice of your physiotherapist. the pain is still present and not resolving more than 48 hours post-exercise. the pain came on during the exercise (not the day after) and was more sudden in onset. the pain is located in and around the joints and not just limited to muscles. there is swelling and discomfort in and around the joints.