

Our experts answer real-life questions

Posted: 9 September 2000
by Nick Critchley

Q Why is it that almost exactly 48 hours after a long training run, and particularly after completing a marathon, my leg muscles hurt most? If the race is on Sunday, then I always dread Tuesday because I cannot walk down the stairs without adopting an unusual gait, and my thighs absolutely kill me!

A It sounds like a classic case of delayed onset muscle soreness (DOMS). DOMS is commonly experienced after unaccustomed strenuous exercise. The muscle tenderness usually becomes apparent the day after activity and peaks at 24 to 48 hours, subsiding over the next few days.

Over the years several theories have been proposed to explain DOMS, including muscle lactate accumulation, muscle spasms and inadequate cool-downs. However, the generally accepted explanation is that moderate to high intensity exercise causes microtrauma (small tears) in the muscle tissue.

This microtrauma causes a normal inflammatory reaction in which fluid accumulates outside the muscle cells and a slow, gradual build-up of tissue pressure ensues. This pressure soon reaches a level that stimulates nerve endings and the pain becomes perceivable. It continues to rise until around 48 hours, by which time the damaged tissue regenerates and the pain eases.

DOMS is usually worse after an unaccustomed muscle activity. Typically, it occurs in the gluteals, quadriceps and shin muscles, especially after running downhill or sprinting. It’s always advisable to cool down with slow running and stretch after exercise, but this won’t necessarily prevent DOMS if there is sufficient muscle damage.

Some athletes use non-steroidal anti-inflammatory drugs (such as ibuprofen) and ice packs or even ice baths to help reduce the inflammation.

The other important thing to remember is that while you have muscle soreness, and often for several days after it has gone, the muscles are weaker than they were, and therefore susceptible to further microtrauma.

Nick Critchley, chartered physiotherapist with Medifit medical and fitness centres

Previous article
Next article
Which Injury Specialist: Podiatrists

DOMS, delayed onset muscle soreness, soreness

Discuss this article

I'm aching after a very long run this Sunday and looked for the problem in the health section. I found exactly what I'm suffering from: DOMS. Unfortunately, it's not stated wether I should rest, how long for, or, can I run through the pain, as I tried yesterday? What is the answer to that?
Posted: 25/03/2003 at 09:55

I wouldn't run through the pain. I believe (though no expert) that its minor tears in your muscles recovering.

I would wait till the pain had gone. For me thats usually 2 days but depends on the run.

On my last long run I hosed my legs down with icy cold water for as long as I could bear and hey presto no aching muscles at all (even though it was my longest run to date)

Hope someone else can give you a more definate answer
Posted: 25/03/2003 at 11:39

thanks for that, I'll remember that for next time.
Posted: 25/03/2003 at 11:46

I'd rest but maybe take some vit C maybe 1g
Posted: 25/03/2003 at 13:32

I'll definately remember the cool water trick. I've heard it before but wasn't expecting to ache after this run. From now on, cool showers after EVERY run! Thanks for reminding me.
Posted: 25/03/2003 at 14:09

not sure if i'm suffering DOMS or ITBS a few hours after a run of 5 or more miles i get a sharp pain from my right knee up to almost the top outer side of my right leg,subsiding to a dull ache on outer upper leg area after a day or two.not sure whether i should continue running or not-it never seems to clear up completely,have got an appointment to see my gp tomorrow,but can anyone offer any advice?
Posted: 08/06/2003 at 19:41


Doms hits all your muscles not just one..let your GP/Physio advise you.

DOMS is based on microtears to the muscles and 48 hours is a good rest period. The good news is that the same effort next time( with in 6 weeks) will not result in DOMS however increased effort will. This is how we get fitter stronger. Vitamin e has been known to help with DOMS in some cases... but the best thing is good nutrition and REST. Try both and eat sweet potatoe which is full of vitamin e.
Posted: 09/06/2003 at 12:08

Thanks fergalk,went to see GP today,he seems to think i have damaged a muscle in the upper outer leg/lower hip area,been prescribed anti-inflamatory drugs&7-10 days rest from running.However i can swim/cycle or maybe row or other low impact exercise,so hopefully i wont get too unfit in the meantime!
Posted: 09/06/2003 at 14:02

Bad news Richard but folow his advice, eat well rest the muscle and you'll soon be back.

Posted: 09/06/2003 at 15:54

Thanks for your ecouraging advice,will heed what you say&when its ok again i'll resist the temptation to blast off on a 10-miler,but will do as doc says and build up slowly again.
Posted: 10/06/2003 at 14:01


Smart Coach