Delayed Onset Muscle Soreness (DOMS): What It Is, and How to Relieve It
Here's why you feel like you can't move after a really tough workout.
You know the feeling: Two days ago you absolutely rocked that leg workout and now it hurts to get up off the couch, climb up and down the stairs, and well, do pretty much anything.
The soreness, technically called delayed onset muscle soreness (or DOMS), is equal parts torturous and satisfying. On one hand, you feel self-assured that you worked your body really, really hard. On the other, though, you worry that you'll never be able to walk without wincing again.
Despite how common the DOMS struggle is, the soreness is still somewhat shrouded in mystery. Like, what actually causes your muscles to feel like they could practically fall off every time you try to move? Is DOMS truly a sign of a solid workout, or something you should try to avoid? And, of course, how the heck can you ease the discomfort?
Before you put yourself on bed rest until the soreness subsides, check out this expert intel, which covers pretty much everything you need to know about delayed onset muscle soreness. You might just be inspired to get those rusty-feeling limbs moving. Yes, really.
What is delayed onset muscle soreness?
DOMs, or delayed onset muscle soreness, refers to soreness or muscle pain you experience anywhere from a few hours to a few days after exercising, Robert Andrews PT, DPT, a physical therapist at Hospital for Special Surgery, tells Health. Typically, the achiness crops up about 24 hours after your sweat and peaks by 48 hours post-workout—but it can last more than 72 hours.
Your usual walk around the block won't cause this painful sensation, though. Instead, it's usually the result of doing a more intense workout—or using an amount of resistance (like heavier weights or a thicker resistance band)—than your body is used to, says Andrews.
While it might sound like any and all soreness really falls into the DOMS category, that's not quite the case. "You can have more immediate soreness or even soreness during your workout, which is considered more acute muscle soreness," says Andrews. Thing is, that acute sensation is likely due to muscle fatigue—a different culprit than the one behind delayed onset muscle soreness.
What causes delayed onset muscle soreness?
OK, so what the heck is behind that unbearable DOMS? That's actually a good question—one that experts are still trying to figure out.
"Delayed onset muscle soreness is not fully understood," Grayson Wickham PT, DPT, CSCS, founder of the mobility and flexibility platform Movement Vault, tells Health. "There are multiple theories about what causes DOMS, including connective tissue damage, muscle spasms, muscle damage, and inflammation—but the current consensus is leaning toward a combo of two or more of these, including microscopic damage to muscle cells."
That's all a very technical way of saying that experts believe that exercise causes teeny-tiny trauma with our muscles. The more intense the exercise, the more intense the damage—and the more resulting soreness you have to deal with as your muscles recoup.
FYI: In case you've heard the term "lactic acid" thrown around as the evildoer behind DOMS, know that the theory has been debunked. While your muscles do produce lactic acid (which is a waste product your muscles churn out in the process of turning carbs in your body into workout fuel) during intense training), it gets flushed out within a few hours after you stop sweating, so it can't really be to blame for feeling super sore the next day, says Andrews.
Now that we've got that out of the way, know this: It takes working your muscles at a level they're not used to in order to cause enough micro-trauma that you struggle to stand up off the toilet the next day.
"This often occurs when somebody takes a long break from working out or is just starting to work out for the first time," says Wickham. (Talk about a welcoming committee!) "Delayed onset muscle soreness can also happen when you increase the intensity, volume [number of sets], or load [weight] of an exercise during a workout." Even if you're super fit, he says, upping the ante in any of these ways can leave you wobbling later.
Another notorious culprit: Eccentric exercise. "An eccentric contraction happens when you contract a muscle while lengthening it," says Wickham. So, squats in which you lower down super slowly but then stand back up at your normal pace are considered an eccentric exercise. Because these types of movements cause more damage to your muscles than your usual moves, they practically set you up for killer DOMS.
What are the symptoms of delayed onset muscle soreness?
If you're in the thick of DOMS, you'll probably experience "an aching pain in the muscle, stiffness, throbbing, tightness, and that your muscle is painful to touch or rub," says Andrews. "The aching also usually gets worse when you try to stretch or flex your muscle."
Delayed onset muscle soreness typically affects your entire muscle, so if you feel any sharp, shooting pain in a specific point, chances are you're dealing with an injury and not just your run-of-the-mill muscle micro-trauma, adds Andrews. If that's the case, give your doctor or a physical therapist a call.
Is DOMS basically a sign of a good workout?
There's no denying that serious muscle soreness can make you feel like you slayed your latest workout—but it shouldn't be something you aim for.
"You don't always need to be extremely sore the days following a workout for it to be effective. Improving fitness is a long game," says Wickham. "If you approach every workout with the goal of being extremely sore after, you will not be training effectively over the long term."
You see, if you push your body so hard in each and every workout that you're insanely sore for days afterward, you may be doing excessive damage to your muscles, adds Andrews. "Gradual, progressive exercise that challenges the body and causes mild to moderate soreness is a better goal," he says.
That being said, if you're just getting into (or back into) the workout game, don't be surprised—or alarmed!—if you experience more intense soreness for the first two or three weeks as your body adapts to the new stress you're putting on it, adds Wickham. As you grow fitter and stronger, it should taper off.
The bottom line: "Just because you don't feel sore doesn't mean your body isn't getting stronger," says Andrews. "Soreness that affects your daily life shouldn't be the goal."
How can you treat delayed onset muscle soreness?
Should you find yourself strapped with a legit case of DOMS, you can't snap your fingers and make it go away—but you can do a few things to temporarily ease the discomfort.
Doing some gentle movement, like stretching or super-light cardio (think: a bike ride around the neighborhood) can help, says Wickham. Otherwise, spend a few minutes per day in a sauna, take a cold shower each morning, foam roll your sore muscles, or give yourself a massage (or treat yourself to one) to find some temporary relief and support the recovery process.
Can you still exercise with DOMS?
The short answer here: Yes. "You can absolutely work out with delayed onset muscle soreness," says Wickham. "Increasing your blood flow and getting in light activity for the muscle groups that are sore can actually be beneficial by bringing nutrients to your damaged and sore muscles."
That said, "if you have severe DOMS in a specific muscle group, don't put them through another intense workout," he adds. Andrews agrees: "If the soreness is that significant, you likely caused some significant trauma to that muscle and should give it a little more time to repair itself and recover."
Just note that even if you keep your movement light, it's totally normal to feel a little uncomfortable at first. "As you get warmed up and your muscles get activated, though, you typically feel decreased soreness," says Andrews. As long as you don't experience any true pain, you're a-okay.
How can you prevent it in the future? (And should you try to?)
Though DOMS is a normal process (and not a bad thing!), it shouldn't be an ever-present part of your workout routine and life, according to Andrews. So, in order to minimize any unnecessary suffering, the most important thing you can do is gradually increase your workout intensity so that your body has a chance to adapt without being completely rocked.
"Know your current fitness level and what you are capable of—and aligning that with your workout program," says Wickham. If you've never done eccentric exercises, for example, incorporate one set into one of your exercises instead of jumping straight into an all-eccentric-focused sweat.
Is there any case in which you should seek medical attention for DOMS?
Delayed onset muscle soreness might be a real pain, but it's nothing to be seriously concerned about, both Wickham and Andrews agree. All you can really do is ease those aching muscles and bide your time as they bounce back.
However, in some rare cases, people mistake a severe and dangerous condition called rhabdomyolysis as DOMS. "Rhabdo results from significant damage and even death to muscle fibers and can lead to severe complications, such as kidney failure," explains Andrews.
It's worth noting that you have to push your body to a real extreme in order to trigger this condition, but if you experience severe muscle soreness and pain coupled with dark, soda-colored urine, and swelling, call your doctor or seek medical attention ASAP. Don't panic just yet, though; both experts emphasize that rhabdomyolysis is incredibly uncommon; just don't try to go from couch to marathon, okay?
To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter