How To Pevent DOMS?

DOMS is one of the enigmas of the Physiotherapy world. Just what exactly is it? We’ve all been there for sure. Maybe you’ve played football for the first time in a year. Perhaps you’ve gone for it too much in the gym. Or maybe you’ve just started running and got a bit carried away or expected too much of yourself. Or the ultimate. Having to walk backwards down the stairs after a marathon! So what exactly is this mysterious DOMS?

In this article we’ll discuss everything you need to know to prevent it, understand it and deal with it if you get it. Before we start we need to clear something up…

What Does DOMS Stand For?

Delayed Onset Muscle Soreness. It’s the post exercise muscle soreness that if you’re reading this you’ll be sure to have experienced. If you’ve never experienced it then you’re lucky. And probably don’t need to read on. For the rest of us mortals carry on…

What Is DOMS?

You get DOMS basically when you have done more than your muscles are adapted to do. Effectively you are not suitably conditioned for what you have done and DOMS is the feeling you get as your muscles are recovering or adapting.

It can be mild or severe in nature. At its mildest it is simply unpleasant. At its most severe it can be quite debilitating and seriously affect your mobility and impair muscle function.

What Causes DOMS?

Not lactic acid! This is one of the biggest myths going and has been out there for years. This one was fairly easy to refute simply by assessing blood lactate levels post exercise. Most lactic acid has been removed from muscles within 2 hours of exercise and all of it within 24 hours. Lactic acid is a normal by product of anaerobic respiration i.e. when your muscles work without enough oxygen. It’s not as efficient as normal respiration but it gets the job done when you’re tired.

That’s not to say this process doesn’t have any effect on DOMS. It’s just not the lactic acid that causes the pain. A more widely held theory is that it is micro-trauma to the muscle fibres that causes the pain. If you want to get technical it’s thought to be temporary damage to the z-lines within the actin and myosin. These are the molecules that makes the muscles fibres contract.

There’s also some evidence to suggest that Free Radicals have a role to play in the pain that we feel after intense exercise. For those without a chemistry degree and want to know what free radicals are there’s a great simple article here that you don’t need a brain the size of a planet to understand.

How Long Does DOMS Last?

DOMS can last anything from 2-5 days depending on severity of the training done and the relative lack of conditioning of the person doing the training. In our formative years DOMS usually starts within 24 hours. As we gain in maturity (get old!) this moves more towards 48 hours and sometimes beyond.

It’s not only age that is a factor. It’s you! Everyone is different. There seems to be some genetic factor in how quickly you feel it. I personally have always been within 24 hours kind of guy. At the ripe old age of 47 this has yet to change. I’d like to say that’s due to my excellent conditioning… but that would be a lie! Maybe a lifetime in average level sport means I don’t train hard enough.

Will I Always Get DOMS?

If you do the same routine again it will feel better after the second time simply because you are adapting. Your muscles will be fitter, stronger and more conditioned off the back of getting DOMS in the first place. That’s not say you won’t get DOMS. But if you do it should be milder and quicker to ease. Unless you go for the session a bit more. In which case that’s your own fault!

Should You Be Concerned By DOMS?

In a word no. Whilst DOMS can cause reduced performance due to a reduction in range of motion, shock absorption and maximal muscle contraction it is generally considered a normal symptom of muscle recovery. That said if you are still struggling 4 or 5 days after the offending exercise then you might need to “review” the situation. Especially if the soreness is not reducing or is asymmetrical, as in, more on one side than the other.

It may also be of mild concern if you have DOMS in muscles you didn’t exercise. For example, if have done lots of calf raises in the gym and not only were your calves sore your quads were sore too. This would suggest that your quads were compensating for a weakness in your calves. Not a national emergency but certainly a movement pattern worth ironing out to reduce the risk of injury in the future.

For the most part DOMS is simply a warning sign that you trained harder than you have done previously. Which so long as you recover well is no problem at all. But, if you find yourself always with DOMS this may cause problems.

This may be news to certain gym goers. It can be a badge of honour that you have DOMS. So all of your gym buddies know you have been training hard. But prolonged periods of DOMS suggests not enough recovery time which can actually mean your muscles are getting weaker not stronger. Sometimes less is more.

We talk more about finding this balance and how to train optimally over prolonged periods in our previous article Peak Performance.

How To Prevent DOMS

So how do you avoid DOMS? Firstly don’t train too hard and build your training up gradually. If you’ve had some time off exercise or trying something new leave your ego in the changing room and lower your expectations. When we’re rehabilitating our clients from injury we often advise reducing your load by as much as 50% in the gym.

In running terms this could equate to starting with a 10 minute run even for experienced runners and less for those starting from the couch.

Avoid doing the same kind of training on consecutive days unless you’re really conditioned to do so. Allow yourself time to get fitter. Mix your training up by all means but allow time for recovery and adaptation.

Hydration can be a factor too so stay well hydrated. It is thought that an active cool down may reduce your DOMS symptoms in subsequent days. Possibly due to the continued gentle use of muscles helping to flush away the by-products of all that hard training.

That said this research suggests that cool down does not reduce DOMS symptoms. Yet warm up does. Suggesting that our DOMS are worse if we start training with muscles that aren’t quite ready to go. This article is somewhat conflicting and suggests that cool down does indeed help prevent DOMS. I would say give a warm down a go and if you feel it helps stick with it. If you don’t, don’t.

Sleeping is also important. So be careful when training fatigued or run down. I had a recent reminder of this myself after one session in the gym recently where I did pretty much my normal programme but was sore for 5 days afterwards. I was run down, a young family will do that to you!

I took a week off training. Took it easy and doing the same programme a week later no problems. With this experience in mind if you do feel yourself feeling a little more tired than usual maybe cut yourself some slack and do some lighter training than normal.

Sadly stretching before and after exercise has minimal impact on DOMS as per this article here. That said, if it makes you feel good afterwards then go for it. It must do something otherwise gymnasts and ballerinas wouldn’t be so bendy!

The kind of training you do is also important. Your muscles simply find eccentric and plyometric training harder and as such are more likely to give you DOMS.

Nutrition plays a role too. Post exercise some kind of mix of protein to help with muscle repair and carbohydrate to replenish your glycogen stores (energy held within the muscle). Anti-oxidants are thought to help too so blueberries, for example, post exercise may help too.

How to Get Rid Of DOMS

What do you do if you don’t manage to prevent DOMS? How do you get rid of the muscle soreness? Many theories and suggestions have been made to aid DOMS recovery which we’ll dissect now by considering the findings of this excellent piece of research.

Does Movement Help DOMS?

The research suggests that exercise is the most effective way to alleviate the pain, but the pain killing effects are temporary as in they only last until a short while after the exercise. Personally I usually feel better after some light exercise when everything is stiff and sore. I wouldn’t recommend training hard again!

Does Hot Or Cold Therapy Help DOMS?

It completely goes against the use of hot and cold water therapies. Which, as is normal in the field of research, is completely contradicted by this piece of research! I wonder if the striking difference is in relation to when hot and cold is applied. I would expect hot and cold to be helpful when done just after exercise but to have less impact if you are trying to recover from the symptoms of DOMS.

Do Anti-Inflammatories Help DOMS?

It would appear that they do. But dosage and timing need to be correct. This makes sense if the proposed theory that DOMS is at least in part caused by low level inflammation as part of muscle recovery.

Does Massage Help DOMS?

Having massaged many people with DOMS over the years I do believe that it does help. Perhaps by gently removing the waste products of the old training. Or perhaps just by calming the sensitivity of the muscles down. Possibly both.

This research suggests that massage administered 2 hours post exercise did not improve function but did reduce the intensity of soreness 48 hours after training. Which is possibly why post event massage is so popular.

Does Biomechanics Affect DOMS?

I would say yes. Many times I have treated people with DOMS in their quads from recent training. When we release off their hip flexors through which the nerve that gives sensation in the quads passes we will usually see an improvement in the soreness in the quads. This nerve (femoral) running from the hip flexor to the quadricep is shown in the diagram below:

We find this biomechanical correction followed by gentle massage to be the most effective way of relieving DOMS in the clinic.

What’s The Best Thing To Recover From DOMS?

Time and patience! Give your body time to do what it needs to do to recover and modify your training if it’s happening too intensely too often.

Should You Workout With Sore Muscles?

So should you be exercising with DOMS? Depends how sore. Generally light exercise will be good as mentioned above. Care should be taken when considering doing heavy training again. Due to the muscle inhibition of severe DOMS discussed above this could make you more susceptible to injury if you do train heavy again.

If you really need that buzz of an intense workout change what you’re doing. If you’re in the gym train different muscles. If you are a triathlete for example and have sore legs do a swim session instead of bike or run, or perhaps an easy spin on the bike.

Final Thoughts On DOMS

So there is lots you can do to affect DOMS. Firstly consider how hard do you need to train. If it is a regular severe occurrence in your life I would suggest you’re training a bit too hard. Or you have an underlying issue that needs addressing – you know where we are!

Always build up your training gradually. Rome wasn’t built in a day. It’s about being able to train sustainably rather than in a boom or bust manner. Train smarter, not harder. If you know you go a bit gung-ho maybe follow and a specific training programme that will hold you back a bit. Or if you’re new to running for example follow the couch to 5k which has lots of adaptation built into it.

What exactly works to reduce DOMS and doesn’t is complex. I would say consider all of what we have mentioned above for yourself. Make a few tweaks to your training that sound most interesting to you and experiment with them. If they work great. If they don’t try something else.

Above all else don’t fear your training or DOMS, make sure you are training in a sustainable manner and enjoy it.