Delayed-onset muscle soreness (DOMS) is a painful condition that affects every lifter and athlete at some point. No matter if it's your first time experiencing delayed muscle soreness or your millionth, you're probably wondering how to relive it, and how to prevent it.

Here's what causes sore muscles, and what you can do before and after your workout to find relief!

What Is DOMS?

Delayed-onset muscle soreness is that dull, aching soreness in a muscle group that has been the target of hard training in recent days. If you find yourself limping down the stairs two days after leg day, or struggling to brush your teeth the day after a shoulder workout, that's DOMS, and it’s definitely not limited to lifters—runners, yogis, and athletes of all types can experience DOMS when they try an activity that stretches or works their muscles in new ways or from new angles.[1]

Delayed-onset muscle soreness can be an especially big problem for lifters who are either trying out a new training program, or getting into strength training after a long time (or a lifetime) away from it.

Thought to be caused by the eccentric portion of a movement, which is when your muscle is being stretched by a weight—like lowering a dumbbell in a biceps curl, lowering yourself from a pull-up bar, or sinking into a squat—DOMS should not be confused with acute muscle soreness, which can start just a minute or two after you finish an activity or a particularly intense set in the weight room. That type of soreness can result from accumulating hydrogen ions or lactate, from muscle fatigue, or just from an intense muscle pump. [2]

It used to be thought that delayed-onset muscle soreness was similar to acute muscle soreness, specifically in the buildup of lactic acid in muscle tissue, but recent research has disproved this hypothesis, and it is now clear that DOMS is not just post-workout soreness but an inflammatory response to exercise-induced muscle damage, as well as to connective tissue such as tendons and ligaments, and requires different treatment.[3]

DOMS takes hours to kick in, and is usually felt most intensely 24 to 72 hours post-workout. In severe cases, it can last for another several days![1]

DOMS Affects Everybody

Younger and less conditioned athletes may be more likely to initially experience DOMS, since they are exposing their muscles to unfamiliar stress and damage. However, older and more experienced athletes will also frequently experience delayed-onset muscle soreness, despite their muscular maturity and conditioning.

If there’s a moral here, it’s that, no matter what your age, gender, or level of experience is, DOMS is an equal opportunity, post-workout affliction!

How to Prevent DOMS

Don't skip that warm-up! As Krissy Kendall, PhD, explains in her article "Sore No More: 3 Proven Muscle Recovery Tips," even something as simple as walking or cycling for 10 minutes pre-workout can significantly reduce soreness in the coming days.[4]

A little foam rolling is also a great idea, since research has shown it can enhance range of motion before training, relieving stiffness.[5] After rolling for a period, you can then gently ease into lifting with some warm-up or ramp-up sets. "This allows your joints to work through a full range of motion while also increasing blood flow and nutrient delivery to the working muscle groups," Kendall says.

When you're warm and feeling strong, you can do your heavy lifting—but not before. Remember, DOMS is related to muscle fiber damage, and if you lift heavy before you've warmed up properly, you'll likely inflict more of it—and perhaps injure yourself in the process.

A good nutritional tool to have in your arsenal is branched-chain amino acids (BCAAs), but there's a catch: You have to take them at the right time! "Research has found that BCAA supplementation before your workout can help increase rates of protein synthesis, suppress muscle protein breakdown, reduce markers of muscle damage, and lessen the symptoms of delayed onset of muscle soreness," Kendall writes in her article, "Ask the Science Chick: Should I Drink BCAAs During My Workout?"

While there’s nothing wrong with drinking aminos during or after a workout, if you're expecting them to help once you're sore, you may be sorely disappointed! Take them before a workout that you expect to be tough, and you'll have a better chance of avoiding delayed onset muscle soreness.

How to Treat DOMS

It used to be thought that speeding recovery and preventing DOMS was as simple as increasing protein, fats, and carbohydrates intake. This can certainly help overall recovery, but won’t have a dramatic impact on soreness.

Until recently, the most popular anti-DOMS recourse for athletes has been to use nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen. Unfortunately, as Guillermo Escalante writes in "Can Pain Pills Kill Your Bodybuilding Gains," chronically using these over-the-counter pain killers can impair muscle protein synthesis and can damage the liver.[6] What's more, they're not thought to be particularly effective at combating the specific type of inflammation that creates DOMS.[7]

HMB, a popular bodybuilding supplement that is a metabolite of the crucial amino acid leucine, has shown promise in its ability to limit muscle damage.[8] However, as Kendall notes, it should be taken consistently for at least a month before you can expect significant effects.

Using protease enzymes to combat DOMS has been a common practice since the 1950s and has been shown to be effective in recent years, as well.[9,10] Unfortunately, absorption issues and the destruction of enzymes in the gut have severely limited the effectiveness of traditional anti-DOMS enzyme therapy.

To solve these absorption difficulties, scientists added the ingredient piperine to enzyme mixtures. They found that piperine—an extraction from black pepper—increased enzyme absorption by up to 60 percent, making this a more viable approach. If you're going to try enzymes for DOMS, make sure they have piperine included.[11,12]

How to Combat DOMS With Activity

The "hair of the dog that bit you" approach to fighting DOMS may be your best approach. It may not sound like much fun, but lightly training the muscles that are sore has been shown to help boost blood flow to the region and decrease soreness. It’s antithetical but works!

"Training while still sore from your previous workout can actually help to decrease future soreness and allow the body to adapt at a faster rate, a phenomenon known as the 'repeated-bout effect,'" says Kendall.[1]

If a leg workout made you sore, avoid squatting heavy again the next day—it won’t feel good—but some light leg work, or a half-hour on a bike or elliptical, could be just the thing, writes strength coach Dean Somerset in "6 Ways to Dominate Doms."

Another strength coach, John Rusin, also recommends foam rolling (although post-workout) to help alleviate DOMS. In his article, "Most of You Are Foam Rolling Wrong; Here's How To Do It Right." Rusin advises doing a few dedicated minutes of foam rolling, 4 to 6 hours or even a full day after any hard training, to create what he calls a "healing pump" of blood and nutrients into your muscles, offering relief from common stiffness and soreness, and even from the dreaded DOMS.

You may never be able to completely eliminate muscle soreness, but you have tools at your disposal—Now go use them!

References

1. Nosaka, Ken (2008). "Muscle Soreness and Damage and the Repeated-Bout Effect". In Tiidus, Peter M. Skeletal Muscle Damage and Repair. Human Kinetics. pp. 59–76.
2. Michael Kjaer; Michael Krogsgaard; Peter Magnusson; Lars Engebretsen; Harald Roos; Timo Takala; Savio Woo (2008). Textbook of Sports Medicine: Basic Science and Clinical Aspects of Sports Injury and Physical Activity. John Wiley and Sons. p. 722.
3. Armstrong, R. B. (1984). Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Medicine and Science in Sports and Exercise, 16(6), 529-538.
4. Law, R. Y., & Herbert, R. D. (2007). Warm-up reduces delayed-onset muscle soreness but cool-down does not: a randomised controlled trial. Australian Journal of Physiotherapy, 53(2), 91-95.
5. Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. (2015). The Effects of Self‐Myofascial Release Using a Foam Roll or Roller Massager on Joint Range of Motion, Muscle Recovery, and Performance: A Systematic Review. International Journal of Sports Physical Therapy, 10(6), 827.
6. Trappe, T. A., White, F., Lambert, C. P., Cesar, D., Hellerstein, M., & Evans, W. J. (2002). Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis.a> American Journal of Physiology-Endocrinology and Metabolism, 282(3), E551-E556.
7. Schoenfeld, B. J. (2012). The Use of Nonsteroidal anti-inflammatory drugs for exercise-induced muscle damage. Sports Medicine, 42(12), 1017-1028.
8. Knitter, A. E., Panton, L., Rathmacher, J. A., Petersen, A., & Sharp, R. (2000). Effects of beta-hydroxy-beta-methylbutyrate on muscle damage after a prolonged run. Journal of Applied Physiology, 89(4), 1340-1344.
9. Innerfield, I. (1957). The Anti‐Inflammatory Effect Of Parenterally Administered Proteases. Annals of the New York Academy of Sciences, 68(1), 167-177.
10. Miller, P. C., Bailey, S. P., Barnes, M. E., Derr, S. J., & Hall, E. E. (2004). The effects of protease supplementation on skeletal muscle function and DOMS following downhill running. Journal of Sports Sciences, 22(4), 365-372.
11. Atal, C. K., Zutshi, U., & Rao, P. G. (1981). Scientific evidence on the role of Ayurvedic herbals on bioavailability of drugs. Journal of Ethnopharmacology, 4(2), 229-232.
12. Velpandian, T., Jasuja, R., Bhardwaj, R. K., Jaiswal, J., & Gupta, S. K. (2001). Piperine in food: interference in the pharmacokinetics of phenytoin. European Journal of Drug Metabolism and Pharmacokinetics, 26(4), 241-247.