8 Proven Methods To Beating Delayed Onset Muscle Soreness (DOMS)
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Much like a hangover cure, everyone and their mother has some magical home remedy or strange concoction to overcome delayed onset muscle soreness or DOMS.
Turn around in a counterclockwise circle 3.5 times while spitting pickle juice, align with Ursa Minor, pray to Tom Cruise, and snort a line of black cardamom. Boom!
There’s only one problem -- there are no definitive cures. Like a hangover, you got what you got and it’s your own damn fault. The good news is, there are things that can be done to help alleviate the soreness but it’s an experiment in persistence.
In other words, some things work but not for everybody, and to varying degrees. We are going to explore a few of the more “normal” and commonly used methods to determine what you might try.
Before we Scrooge McDuck into the mound of countermeasures, let’s quickly define DOMS and describe how you get it.
Delayed Onset Muscle Soreness is precisely what the name implies -- the start of muscle soreness after a certain amount of time has passed. Unless you have never moved a muscle, you have experienced DOMS in one way or another. Most notably, you’ll feel sore as soon as that night or the next day with a peak level of soreness between 48-72 hours after performing a new exercise or working particular muscles harder than you have recently.
It should be noted that the soreness you feel during, or just after a workout, is called acute muscle soreness, and it is not the same. That is usually lactic acid buildup and causes that familiar burning sensation that goes away with a few minutes of rest and moving around.
The most common side effects of DOMS are stiffness, dull aches, increased muscle tenderness, swelling, and muscle weakness.
We must understand that when we overexert our muscles, we actually create microscopic tears in the fibers. When we lift big weights, for instance, we are adding a resistance that’s heavier than gravity and the weight of the limb we are lifting. What this entails is that our muscles have to work much harder to move the weight and might not be capable of doing so given our current fitness levels.
When a muscle can’t quite take the strain without overt stress, muscle fibers start to break apart. I think it’s easiest to imagine the end of a rope fraying. It might not fully snap in half, but parts of it start to come apart. In a way, that’s exactly what happens to your muscles, and that’s OK! This is normal to a large extent.
This generally occurs during eccentric movements where the muscle is simultaneously contracting and stretching. If we use the rope analogy again, what happens to your muscle is as if both ends are being pulled on in a game of Tug o’ War. Eccentric movements are characterized by the lowering portion of most lifts (depending on the lift and angle of attack). For those who weight lift, you can think of a “negative”.In the bicep curl, it’s the part where we control the weight going down, or in the bench press, it’s when the barbell is coming back down to the chest. We are resisting the weight simply falling with gravity.
Logically, we can assume that if you are tearing something down or damaging it, no matter how severe, it’s going to create some level of soreness, yes? I bet if you haven’t lifted in a few months and then decided to try and squat your old max even for a rep or two, the next day you would be one sore sumbitch. This is the most accepted theory at least.
With all that said, you might be asking, “If it’s more about the eccentric movements, how is it that athletes like swimmers and cyclists might also get DOMS?”
It should be noted that some more recent research groups have pointed to another potential factor of DOMS [1]. The theory is that it’s not necessarily muscle-related at all, rather neural microdamage. In this theory, what they call the “superposition of compression with cognitive demand-induced acute axonopathy theory” (that’s a mouthful), the researchers at the University of Physical Education in Budapest suggest that the inflammation brought on by the microtrauma in the soft tissue applies pressure to the nerve endings in the muscle spindle. This, in turn, causes long-term soreness or aches.
This is why DOMS is fascinating. We really don’t know the full reasoning behind it, but we drudge ahead in an attempt to quell the beast!
Let’s quickly touch upon that last part. I don’t want to get too in-depth with the physiological makeup of skeletal muscles and whatnot, but you should know that there are two different fiber types. Immediately, I know you’re going to think fast twitch and slow twitch, but those are specific rates of contraction and apply to either of the following. What fibers we are classifying are intrafusal and extrafusal fibers.
If you look at the graphic below, you will see a typical muscle -- that is, a full skeletal muscle belly like a biceps on your arm. What makes up your biceps muscle are many different individual fibers surrounded by sheaths. Much like a Russian Nesting Doll, your muscles are made up of many smaller components.
Each muscle is made up of layers and layers of compartments. At its smallest are individual muscle fibers which contain smaller actin and myosin protein filaments. - Human Vectors by Vecteezy
These muscle fibers are called extrafusal fibers, and in between many of them, hiding in separate bundles, are the muscle spindles we were talking about earlier. To go even deeper, those muscle spindles are made up of the second type of fiber called intrafusal fibers. Now, that’s a lot of material already and it’s not terribly important for this article but we’re trying to paint a more complete picture to better understand what these researchers are suggesting.
Inside those muscle spindles are bundles of intrafusal fibers surrounded by fluid. This fluid is incompressible. Now, we’re getting somewhere. The last thing we need to know is that wrapped like a cord around each intrafusal fiber are sensory nerve endings. Finally, we’ve arrived.
When the extrafusal fibers (spaghetti noodles) are inflamed, they put pressure on the fluid capsule (encapsulated bundles of intrafusal fibers between the noodles), which puts pressure on the nerve endings around the individual intrafusal fibers. Simple right??
So every time we’ve had a particularly intense bout of exercise that creates microtrauma, we create some inflammation during the healing process, those then apply abnormal amounts of pressure against the capsule causing the nerve endings to effectively get sandwiched between the fluid and extrafusal fibers.
Potentially. Remember, this is just a more recent theory, and we love to give you up-to-date research as best we can. Now, on to how we fix it!
Before we jump in, bear in mind that DOMS is a relative feeling and will depend on the individual. This makes it difficult to study with great accuracy because it’s so subjective. The best studies are usually ones that have many test subjects or may comb through and compare many studies to find more of an average result. That’s what we intended to find as well (as best we could). These are not cures, these are viable or inviable things to try if DOMS is something you want to attempt to alleviate quicker than normal. This is also not an exhaustive list of remedies. There are MANY other commonly, and less commonly used methods out there, but this should give us a good start.
If you’ve read our article Why Icing For Injuries Is Killing Your Recovery, you will probably already guess our thoughts on this one. Given ice’s proclivity for hampering the healing process and reducing swelling, this is not a remedy that I can get behind. Because of the fact that it does reduce swelling, you might assume we’d say go for it, but we know that topical cooling solutions can’t really penetrate deep enough or get cold enough to reduce swelling at that level. I will say that an ice bath after a workout feels pretty amazing sometimes and, as stated in the aforementioned article, there’s something to be said about doing something we feel comfortable with.
There’s some decent evidence here and there that suggests it might be useful for DOMS, though, because of the short-term benefits. Inflammatory suppressant effects could back up the “mouthful” theory above. It also reduces pain by slowing nerve conduction velocity. Many point to its ability to remove waste products, but there’s very little real evidence to support that. In fact, most research will point to the predominant benefit of icing, whole-body cold water immersion especially, is that it can help alleviate central nervous fatigue by aiding in sleep and reduce strain on the cardiovascular system.
There is one saving grace for you athletes out there reading this. Most of the negatives found with icing, immersion, and cryotherapy modalities have been with more power-oriented athletes and involving those more intense eccentric damaged muscles. Endurance athletes, on the other hand, might find more benefits and I might be more inclined to suggest continuing to use if you see some decent results.
But, as for a proven accelerated healing method, I’m going to recommend against it. It is rather ineffective generally.
Much like ice baths, massages have been proven time and time again to be impotent for force recovery and repair [3][4][5][6]. Where it does seemingly shine is in DOMS, funny enough. Guo et al. [2] sifted through hundreds of articles but narrowed their results down to 7 different science journal databases and 11 studies on this subject to find that massage could be a relatively effective method of relieving DOMS. This is of course with limitations in many of the studies reviewed, but the findings were pretty solid. The most significant positive decreases in soreness were post-massage at around the 48-hour post-exercise mark. In other words, you might have the best results if you try a massage after two days. Also, for best potential results, most muscles were spent under massage between 6-30 minutes, relative to the size of the muscle.
The reason there’s a belief that it can help with DOMS, in particular, is due to increased muscle and skin temperature, as well as corresponding higher rates of blood and lymphatic flow. The study also points to numerous other possibilities such as the psychophysiological responses to massage such as heightened mood and relaxation among others.
Curcumin is a popular spice used a ton in Indian food, in particular, curry. It is a well-known polyphenol, which makes it a commonly used antioxidant, and for our purposes, anti-inflammatory. It’s been used with great success in cases of pathological pain [7] or pain that is essentially chronic such as those with spinal issues.
Yoon et al. [8] took a look at many studies that attempted to prove the efficacy of curcumin use. I won’t bore you with the details, but from what I can gather, curcumin showed quite significant results. This was regardless of the amount taken in most cases, but almost all studies seem to show taking it post-exercise was always best. As little as 150mg to as much as 500mg was administered, and all did a solid enough job.
As with anything, there were several other studies that demonstrated no effect [9-13]. As the study points out, the variance in how the tests were administered and the particular subject groups could certainly play a key role in the outcomes.
When it comes to anything related to health, one of the most important details is what you consume. With regard to DOMS, several studies have attempted to determine how Omega-3 fatty acids can help lessen the gains pains.
Jakeman et al. [19] launched a study in 2017 that found higher doses of EPA fish oil (750 mg EPA, 50 mg DHA) directly following a muscle-busting workout, showed some promising results in the squat jump and countermovement jump. Within 24 hours, the subjects administered the higher dosages were within 2% of their baseline jump performances. That’s pretty damn good considering one of DOMS's most infuriating and significant downsides is the loss of contractile efficiency.
The Jakeman et al. study is also focused more on the effectiveness of Omega-3 fatty acids on performance, and on the overall quality of soreness, you experience post-ingestion.
Other studies [20,21] demonstrate similar results but point out a need for more data. In particular, the differences between sexes and if supplementation should be continued for long periods of time or if they need to be taken habitually prior to and after. They were able to determine some modicum of success utilizing 1.5-1.8g of EPA/DHA….and found greater results in more untrained subjects than in trained athletes, which is quite possibly due to an athlete’s history of routine and understanding of their body, thus a willingness to get back at it quicker.
Taking 0.55g of EPA and 0.55g of DHA for 6 weeks showed a decrease in muscle soreness and no significant decrease in muscle function [21]. But this was using it for 6 weeks.
Not enough research has gone into ideal supplementation strategies or further data sampling, but there’s some potential here. Be careful with some of these over-the-counter fish oil supplements -- men especially. There have been more recent stories about prostate cancer upsurges for those who take them more heavily.
Current research has shown that whole-body vibration can reduce muscle pain at around 24 to 48 hours [14]. Specifically, down-regulating creatine kinase (CK) levels the most right around the 48-hour mark.
What does that mean? Your best treatment option with vibration, whole-body or local (Theragun), is likely to be used somewhere between 24 and 48 hours after the damaging workout. This is based on using your typical visual analog scale as with most of these studies (imagine those linear scales with faces to show how much pain you’re in at the doctor’s office) and how much CK is in the blood.
The sample pool of good quality data is still pretty small so keep in mind while it has been shown to be effective, there is plenty of data to show it’s also ineffective or not enough to show there’s a lot to really cling on to, as cited in Lu et al. [15,16]. Another study took a look at how whole-body vibration would affect resistance-trained individuals (let’s call them athletes) if performed as a part of the warmup before heavy eccentric exercise [17]. Magoffin et al. determined that the results were just as negligible.
So many are caught up in the compression sleeves craze during exercise. While there’s some evidence of its usefulness about reduced energy expenditure by keeping muscles taught -- as for recovery -- it’s fairly useless. Where there is some light at the end of the tunnel, is perhaps in its use post-exercise.
Post-exercise compression therapy has been more productively studied concerning the prevention of DOMS [18]. In fact, using compression after exercise has shown a speedier return to strength and decreases in CK levels. Two of the studies we referenced [23,24] showed this decrease as well as cited the potential benefits that came from the added reduction in lactate. In conjunction with the researchers, I believe that the less CK that is released into the blood due to compression, the less pain we’ll feel, but it’s the increased blood circulation that helps also move out waste products and reduce inflammation that really does the trick. You see, compressing surface veins forces blood out of the leg veins and back to the heart. The key is that most of these garments are actually graduated, meaning they get less restrictive the closer they are to the main part of your body. This is to assist with blood flow back to the heart where blood has to fight against gravity. Arteries dilate under a little bit of compression as well. The research I’ve seen has prescribed at least an hour or two of compression after exercise, which…seems like a pain in the ass, but it might not be too uncomfortable for some.
Studies such as those by Heiss et al. contraindicate these results and find that intramuscular perfusion is no more than without compression during the DOMS phase, which plays an underwhelming role in muscle soreness [34].
So are they good for recovery? Sounds like there might be some redeeming evidence enough to give it a try. Is it a performance booster? Almost everything I’ve ever read shows no real strong evidence to that claim.
This one is still perhaps my most used and often prescribed. That goes for most coaches out there, I would bet. As a matter of fact, you’ll typically see “Active Recovery“ transcribed on most annual plans as a means to keep athletes moving around without giving full rest. This can come in the form of light biking, jogging, a simple game, stretching, etc.
These forms of low-intensity exercises are commonplace after high-intensity training sessions that would incite DOMS. We know that by moving around we cause mechanical actions in the body that help remove waste products, increase blood flow, break up adhesions, and increase those feel-good endorphins which help alleviate pain [18,25].
It’s very important to understand that not all active recoveries are made equal, so let’s try and see if any are worth your while.
Biking
It appears as though a good amount of analysis has given some insight into the effects of recovery after bouts of isometric contraction. Studies such as the one by Vanderthommen et al. showed almost no difference between passive recovery methods and active ones [26].
What they did find, however, was that pedaling on a bicycle under a moderate load showed marked improvements by removing lactate much quicker than by doing a passive activity such as sustained stretching or nothing at all. Many studies have consistently pointed out that light recovery isn’t enough to do anything other than supply temporary relief at best [27].
Stretching
Your typical stretching routines seem to be less effective than once thought. The idea behind stretching post-exercise, especially for those of you who love yoga, was that it helped bring back range of motion and remove adhesions and lactate. While this is true, in part, the evidence that it actually helps with DOMS is scant, to say the least [25].
Whether done prior to or post-exercise, stretching hasn’t given rise to enough evidence to having benefits in either protecting from DOMS or relieving it long-term [27].
Be careful how you do it and how much because stretching can actually have negative effects on your health.
Foam Rolling
Foam rolling was a fad that took off way back in 2004 and only got hotter as time went on. It’s something I’ve used many times with mixed results and I can honestly say that I’m still on the fence about it for a number of valid reasons. Foam rolling is another form of self-myofascial release and certainly has its roots in some concrete theory.
There’s a lot of more modern research into the fascia as a communications system and recovery through squeezing and pushing out fluid. If you ever want to read a damn interesting book, check out Anatomy Trains by Meyers.
Anyway, most studies have established that foam rolling is great at reducing pain and re-establishing ROM, or perhaps even helping bring back some speed and power faster than other methods of recovery [28]. Another study seemed to back up the results in terms of power generation, but finding that foam rolling reduces neuromuscular exhaustion [29]. Muscle tenderness decreased drastically after 24 and 48 hours in particular, with no significant changes any longer than that.
Pearcey et al. suggested, “A 20-minute bout of foam rolling on a high-density roller immediately postexercise and every 24 hours thereafter may reduce muscle tenderness and decrements in multijointed dynamic movements due to DOMS.”
As for DOMS, foam rolling seems to be one of the more effective strategies, but more information is needed when it comes to other proposed benefits.
We don’t need to go too deep into this one. It’s pretty obvious non-steroidal anti-inflammatory drugs (NSAIDs) such as Advil, Motrin, or Aleve can help with the pain. But they don’t really help to heal as much as to mask the problem by dulling your sensations.
For this reason, and others, I typically tell people to “lay off the drugs.” NSAIDs have been shown to slow down the healing process, though it’s spotty results, and while we want to feel better quicker, that doesn’t mean we want to not be able to actively assess our own bodies.
Lighter drugs that contain acetaminophen like Tylenol and Ibuprofen are better options if you feel you need to use them. If the goal of this article is to give you healthy options to help heal the problem so you can get back to training faster, and you just dull the pain so you can get right back to it and cause more damage without knowing...are you doing your body good?
This has been gaining more traction over the years for numerous applications. Everything from hair loss and collagen rejuvenation to anti-inflammatory purposes, to muscle cell activation. In our case, we look at how red, or near-infrared light can benefit us from a muscle soreness aspect.
Before our results, it should be noted that anything regarding the human body and light depends especially on the particular wavelength. Most studies involving human muscle have found wavelengths of 810-830nm are the best range. This is because the light is absorbed fairly well by our thicker skin and water, etc.
Regardless, using light is nothing new and we’re seeing more studies done surrounding muscle recovery. I’d say a fair amount attribute no significant results when used after exercise, but some have shown possible protective benefits when used before eccentric exercise [30]. Light is cool, that’s why we’ll spend a few extra seconds talking about it before the verdict.
Red or near-infrared light can stimulate mitochondrial activity. Seeing as all our muscles need ATP to fuel our movement, and mitochondria are the little organelles in our bodies that create loads of it, we likely see better results based on the higher levels of ATP synthesis. This aids in further prevention and repair of damaged muscle through increased protein synthesis [31].
We’ve demonstrated successful protocols in humans anywhere from 3-5 minutes before exercise, to 40-60 minutes. In rats, up to 6 hours with significant increases in muscle performance. With humans, we’ve been able to “prevent statistically significant muscle damage measured by CK levels in the bloodstream.”
Unfortunately, there are far too many factors to consider when using low-level light therapy (LLLT) in this capacity. Things like the particular wavelength to use (as discussed), the pulse, how many lights or points to use on the muscle(s), how long to shine the light, how long before exercise should you use it, etc. For that reason, and the fact that it’s difficult enough and prohibitively expensive to try and implement, I suggest finding other alternatives for now.
Panax ginseng is also known as Korean ginseng and many other names. It differs from American ginseng in a few ways. Panax ginseng is usually red, but can be white and has more of a warming effect, and improves blood circulation.
There’s not a ton of studies out there for this particular one but it does pop up often enough I felt we should take a look. Of the studies with the most merit, Panax ginseng either seemed to work OK or not really work for this intended use case well at all.
Kim et al. reviewed studies involving nutritional supplements such as allicin, glutamine, Panax ginseng, and lyprinol and reported inconsistent, or mediocre data [32]. They were quick to assert that most of them seemed to specifically target the inflammatory response in its ability to reduce DOMS but the results were menial. One of those studies used 4g of Panax ginseng 1 hour before exercise followed by another 4 days after and found DOMS was significantly reduced around the 96-hour mark.
Cristina-Souza et al. just recently (2020) did a study with track and field athletes and measured EMG, maximal isometric voluntary contractions, enzyme levels in the blood serum, and more [22]. They found that Panax ginseng deflated the rate of perceived effort and increased EMG results while bringing the maximal isometric voluntary contractions values up faster — at 24 hours rather than 48 hours in the placebo group. They did note that while those were promising for strength return there really was no effect on plasma lactate dehydrogenase (LDH), CK, or DOMS. In other words, probably doesn’t have the biggest change on how your muscles feel. By the way, LDH, for our purposes is similar to CK in that when there are damaged tissues, you will see more of this in the blood.
Bet you didn’t see this one coming! I ran across this gem and thought it would be of interest given that a very large number of people, let alone athletes consume caffeine regularly (coffee, tea, etc). Hopefully, as elite athletes, it’s not in the form of that Starbucks shit, as it brings far more sugar and fat into the equation, which is counter to the point.
Any-who, there was a study by Chen et al. that recently reviewed the effects of caffeine on trained male and female collegiate athletes [33]. It was a small subset (10 men and 10 women) but it showed some promising things.
First, it showed that both sexes had a faster restoration in muscle power output. This is great for those return to workout capacity results we love but what about the DOMS problem?
The interesting part of the study was that for men specifically, ingesting caffeine reduced DOMS quickly. Therefore, as the study suggests, caffeine consumed by men has a more significant performance enhancement than for women. Score for the fellas!
You might be asking about the amount of caffeine ingested, how it was administered, and the timeframes given in the study. Well, 6 mg/kg of a caffeine supplement were given at the 24-hour post-exercise mark. Please keep in mind that caffeine tolerance does exist and each participant was asked to participate only if they normally do not consume caffeine (<200 mg/wk). It would be easy to say that if you’re one of those athletes who consume caffeine regularly, you may require more to see results, might have to start cutting back or may not see similar results.
Moreover, we know that caffeine is similar in structure to adenosine and can block the perception of pain, which is why we used it quite often in drugs for migraines and the like. So it does make a bit of sense that something like caffeine can make it seem like DOMS dissipates more rapidly. If you don’t typically scarf down coffee or tea, it might be worth a shot. Also remember that for all of you NCAA and pro athletes, caffeine is still a banned substance and you need to remain under the allowable limit if you want to remain eligible to compete.
Now we know a little (a lot!) more about specific methods of regulating or even expediting DOMS, or delayed onset muscle soreness.
A good chunk of the explorations above seems to have some decent restorative effects used post-exercise. A few have shown some promise in attenuating the problem if taken prior to eccentric exercise. The most important part of this article is to pick one or two that you feel are doable and cost-effective, and simply give them a try.
Our goal is to find ways of getting us back to work sooner without compromising our own health and allowing for restoration of near-maximal efforts.
Nothing will ever trounce the main triad — the golden triangle. Those are good sleep, good nutritional intake, and water. If those are not at least the basis of everything you do, you’re slapping on band-aids and praying for the best. As long as you aren’t creating more problems for yourself, you might as well stick with something you feel works. In the world of DOMS, whatever makes you feel better or more ready for your next workout, is probably a good idea to keep doing.
Comment below and let us know what your favorite DOMS relief magic pills are. There’s a lot left off the list so let others know what you like so they can do their own experiments and research. Happy hunting!
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