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DOMS – Delayed Onset of Muscle Soreness

All of us at some point of 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. The muscles commonly affected are two joint muscles which often undergo eccentric contraction. Eccentric exercises are exercises where the muscles contracts and elongate at the same time – e.g. downhill running, longer distance running, plyometric exercises etc.

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.

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

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


The classic symptoms of DOMS can be describes as

  • A dull muscular ache that develops 24 to 48 hours after the performance of 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 clinical diagnosed. The physiotherapist can easily differentiate DOMS with other more significant injuries such as muscle tears, strains or ruptures.


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 all 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 programme, with gradual increase in 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 its own and have no lasting effects. Most cases of DOMS resolve in 3-4 days.