You wake up to muscles that are so sore that you wince getting out of bed. Then you remember the tough weight training workout you did the day before. You outdid yourself. In fact, you worked your sore muscles far harder than you typically do and even threw in some new exercises. As a result, you now have a condition well-known to bodybuilders called delayed onset muscle soreness or DOMs.
Most people experience DOMs when they first begin weight training but you can also feel its effects when you work harder than usual, work your muscles in a different way, or force your muscles to work in a way they’re not accustomed to. Delayed onset muscle soreness varies in severity from mild to “Help! It’s hard to walk.” DOMs is tricky. You may feel fine when you wake up the next morning after a hard training session, only to develop the symptoms 48 hours later. That’s why it’s called delayed onset muscle soreness – it may not rear its ugly head until 24 to 48 hours after a workout.
Delayed onset muscle soreness is more likely to happen when you emphasize the eccentric portion of an exercise, the “lowering” phase where you’re lengthening your muscle. Running downhill is also an eccentric movement that can trigger DOMs.
Why DOMs Happens
Delayed onset muscle soreness is simply a muscle’s response to being stressed. In response to having to move more weight than it’s accustomed to, the muscle fibers develop tiny tears you can only see with a microscope. Although there’s a lot we don’t know about DOMs, these tears seem to elicit an inflammatory response. Immune cells come on the scene to patch up the injury and remove the tissue debris. The immune cells release chemicals that cause the stiffness and discomfort you feel with DOMs.
What doesn’t appear to cause DOMs, as many people think, is the build-up of lactic acid in muscle tissue. When you work a muscle so hard that it can’t get oxygen quickly enough to support aerobic metabolism, lactic acid builds up in the muscle and enters the bloodstream. Lactic acid plays a role in the fatigue and muscle burning you feel while you’re lifting but it doesn’t contribute to muscle soreness afterward.
Rest or Work Out?
Once you’re sore, you have a dilemma. Should you work out or let your muscles recover? While you might be tempted to lie on the couch and nurse your achy muscles, that’s not necessarily the best approach. At the other extreme, you shouldn’t grab a pair of heavy weights and work out at the intensity you were – if you’re even able to do that. If you take the complete rest approach, you’ll likely feel the stiffness even more. When you don’t move stiff muscles, they feel even stiffer!
A better approach is to do a workout using lighter weights and higher reps, more of a muscle endurance workout. For example, choose a weight that’s around 50% of your one-rep max. The reason? Moving your muscles, instead of completely resting them, delivers blood and oxygen to muscle tissue and helps aid in repair and recovery. Also, if you wait for the muscle stiffness and pain to resolve, you could wait as long as 5 to 7 days before your muscles are pain-free. In fact, your muscles will feel better because you’ve warmed them up. It’s the same principle behind treating back pain. Doctors no longer recommend rest but movement.
Should You Take Ibuprofen?
You might be thinking that ibuprofen would make things easier. It’s true that ibuprofen is an anti-inflammatory and DOMS is associated with inflammation, but studies now question whether inflammation is what’s actually causing the pain. In addition, some research suggests that NSAID, like ibuprofen, may interfere with recovery. Combined with the fact that some studies suggest NSAID prevent some of the adaptations to exercise and you have even more reason not to take it.
With the effectiveness of ibuprofen being questioned, you might wonder whether there’s a natural way to reduce the discomfort or even prevent DOMs. One study showed that runners who drank tart cherry juice 8 days before a long endurance run, experienced less muscle soreness. Tart cherries are rich in antioxidants and there’s some evidence that oxidative damage contributes to delayed onset muscle soreness. One problem is tart cherry juice is high in natural sugar and you need between 8 to 24 ounces daily to get the benefits.
Another potential contender for easing DOMs is curcumin in the spice turmeric. When researchers gave participants a curcumin supplements 2 days before and 3 days after a lower body weight training workout, they reported less muscle soreness and had lower markers of inflammation and muscle injury. One problem is curcumin is poorly absorbed. You can increase absorption by consuming turmeric spice with black pepper. Some studies also suggest that omega-3s from fatty fish and fish oil supplements are beneficial for reducing DOMs after eccentric exercise.
What about Heat, Cold, and Massage?
You’ve probably heard that an ice pack helps DOMS. Conversely, you may have heard that heat is better. Both may be modestly beneficial. Ice helps reduce pain and swelling while heat increases blood flow to your sore muscles to aid n repair and healing. Since both may have modest benefits, you can try alternating heat and cold treatment.
What about massage? Although you often hear people recommend massage for delayed onset muscle soreness, it’s not clear whether it makes a difference. No doubt, massage feels good while you’re getting it but whether it improves the pain once the massage is over or alters the course of DOMs is less convincing. Since some studies show modest benefits, if it feels good to you, there’s no reason not to do it.
The Bottom Line
Should you work out with sore muscles? Yes, but lighten up on the weight you use The goal is to boost blood flow to the injured muscle without causing further damage. Unfortunately, there’s not a lot of evidence to suggest that taking ibuprofen, massage, heat, or cold will substantially change the course of sore muscles and DOMs.
Pain Science. “Delayed Onset Muscle Soreness”
J Int Soc Sports Nutr. 2010; 7: 17.
Eur J Appl Physiol. 2015 Aug;115(8):1769-77. doi: 10.1007/s00421-015-3152-6. Epub 2015 Mar 21.
Medscape. “Treating Sore Muscles and Tendons”
J Athl Train. 2005 Jul-Sep; 40(3): 174–180.
Br J Sports Med 2003;37:72-75 doi:10.1136/bjsm.37.1.72.
Clin J Sport Med. 2009 Mar;19(2):115-9. doi: 10.1097/JSM.0b013e31819b51b3.
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