Is It Delayed-Onset Muscle Soreness or an Injury?

Close up of female legs, athlete girl in sportswear massaging aching thigh muscles, feeling pain after sport workout from Delayed-Onset Muscle Soreness

If you’ve just started working out or have been working out for a while and push yourself a little harder than usual, you may develop delayed-onset muscle soreness or DOMS. DOMS is a “normal” response to stressing your muscles in a way they’re not accustomed to. Some motivated weight trainers even think that no muscle soreness means they haven’t worked hard enough. In reality, that’s not the case. Muscle soreness is not the best indicator of muscle adaptation and growth.

Not all discomfort you feel after a workout is delayed-onset muscle soreness. Sometimes, we push our training to the point of injury. What you don’t want to do is confuse an injury with DOMS. You probably won’t hurt yourself if you continue to train when you have delayed-onset muscle soreness, but if you have an injury, you could worsen the injury. How can you tell the difference between the two?

The Timing of the Discomfort Gives You a Clue

You usually won’t experience delayed-onset muscle soreness right away. If you feel the onset of new discomfort while you’re working out or within a few hours after a training session, it’s probably not DOMS.

As the name implies, DOMS is a delayed type of muscle soreness, and if you have it, you probably won’t experience soreness or stiffness immediately. You’ll more likely feel stiff and uncomfortable when you wake up the next morning. It’s possible to experience DOMS discomfort a few hours after a workout but it’s not common.

More commonly, people experience the onset of DOMS 24 to 48 hours after a tough exercise session. Be suspicious of an injury if you feel discomfort WHILE you’re working out. That’s not typical of delayed-onset muscle soreness.

DOMS Often Differs in Character and Intensity

Delayed-onset muscle discomfort feels uncomfortable but it’s typically not a sharp or stabbing pain. It’s also usually not bilateral if you worked the muscles on both sides. Sharp, stabbing pain with movement is usually an indicator of an underlying injury to a muscle, tendon, or ligament, whereas DOMS makes muscles feel tight and stiff but doesn’t cause sharp pain with movement.

Delayed-Onset Muscle Soreness Is Usually Self-Limited

As mentioned, delayed-onset muscle soreness usually comes on after a delay and doesn’t hang around very long. It typically lasts 3 to 5 days before gradually subsiding. In some cases, it lingers for up to a week, but, rarely, longer. Pain or discomfort that persists longer than this is more likely to be injury related.  A 1993 study published in The Journal of Physiology found that muscle soreness with DOMS usually peaks at 2 days and eases up after 3 days and is usually completely gone after a week. Keep that in mind if you have lingering pain. It might not be DOMS after all.

It Usually Gets Better with Movement

Another characteristic of DOMS that distinguishes it from an injury is the pain of delayed-onset muscle soreness eases up after you warm your muscles up. In fact, the discomfort is usually most pronounced when you get out of bed in the morning and after you’ve been sitting for a while. Once you get up and move around or do a light warm-up, some of the stiffness and soreness eases up. Because the discomfort lessens with movement, most people with DOMS can still do a light or modified workout. Yet, you don’t want to work through an injury. Doing so can worsen the injury and prolong recovery. So, make sure you know what the etiology of your soreness is before doing an intense workout.

Treating Delayed-Onset Muscle Soreness

Delayed-onset muscle soreness, unlike an injury, is self-limited. Even if you do nothing, it probably won’t stick around for more than 5 days. Yet, it can still be uncomfortable and limit your activity for a few days. As mentioned, you don’t necessarily HAVE to take a day off with DOMS. In fact, training can improve the symptoms by increasing blood flow to the muscles. So, rather than staying on the couch, lighten up on your workout. Use a lighter resistance for a few days and do a warm-up beforehand. In fact, a longer warm-up is in order when you have achy muscles. After your workout, do light stretching.

What about other treatments for delayed-onset muscle soreness? Some studies suggest that massage helps the symptoms of DOMS, but the results are conflicting. At the very least massaging sore muscles feels good temporarily and that’s a legitimate reason to do it. Another intervention, foam rolling, may offer benefits for some, but, again, results are conflicting. In many ways, foam rolling is similar to self-massage and is something you can do if it makes you feel better.

Then, there are non-steroidal anti-inflammatories. These medications reduce inflammation, but it’s not clear whether DOMS is directly caused by inflammation and studies have not consistently shown benefits. Plus, NSAID, even ibuprofen, has a growing list of potential side effects and risks, especially if you take them for more than a few days.

On a natural note, a study found that drinking tart cherry juice may ease the symptoms of DOMS and, in the study, eccentric strength loss was reduced by drinking tart cherry juice. Another study looked at vitamin C supplementation for preventing delay-onset muscle soreness and found no benefit. Also, taking high doses of antioxidants, like vitamin C, before a workout may interfere with some of the positive adaptations to exercise, so this probably isn’t the best approach, especially considering DOMS is self-limited.  More encouragingly, supplementing with branched-chain amino acids may ease delayed-onset muscle soreness after eccentric exercise, based on the results of one study.

The Bottom Line

Delayed-onset muscle soreness is no fun and it’s important to distinguish it from an injury to avoid doing further damage. As far as treating DOMS, there’s limited evidence that anything significantly shortens the course of delayed-onset, although massage may make the soreness feel better temporarily. Patience is your best bet!



Live Strong. “How Long Does it Take for Soreness to Go Away After Exercise?”
Medscape.com. “Postexercise Muscle Soreness”
J Sports Med Phys Fitness.  2006; 46(3):462-7 (ISSN: 0022-4707)
Br J Sports Med.  2006; 40(8):679-83; discussion 683 (ISSN: 1473-0480)
Adv Exp Med Biol.  2013; 776:179-87.


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How to Work Out When You’re Sore & Why You Should

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Ouch! Should You Work Out with Sore Muscles or Take a Rest Day?

Using Nutrition to Prevent and Relieve Post-Workout Soreness

Does Foam Rolling Reduce Delayed Onset Muscle Soreness?

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