Delayed Onset Muscle Soreness

It’s the day after a good run and you find it difficult to walk downstairs … sound familiar?

All runners, from elite athletes to complete beginners will have experienced Delayed Onset Muscle Soreness (DOMS) at some point. It can be painful but DOMS is a normal adaptive response to a change in your training and it doesn’t last long.

Symptoms such as aching, pain, joint stiffness, mild swelling and decreased muscle strength start about 24 hours after unfamiliar or intense exercise, peaking around 3 days afterwards and subsiding by 7 days.

There are lots of theories trying to explain DOMS but the truth is no one knows exactly why it happens. It’s probably a combination of factors but the easiest explanation is to think of DOMS as a very low-grade muscle strain.

There are even more theories about both treatment and prevention and as a rule the more theories there are out there, the less definitive the answer actually is!

The best advice available, based on reasonable levels of scientific scrutiny, for the treatment and prevention of DOMS includes:

• Continuing light levels of the same type of exercise that caused the DOMS. This helps to suppress the soreness temporarily and helps your body to adapt so the next time you train you are less likely to experience DOMS. It’s called the ‘repeated bout’ effect.

• Foam rolling for 20 minutes immediately after exercising and every 24 hours thereafter until the symptoms subside.

• Massage applied vigorously and for up to 30 minutes early on (2 hours) after training to improve blood flow and reduce pain.

• None Steroidal Anti-inflammatories (NSAIDs) taken preventatively before training may have a role to play but the adverse side effects of taking NSAIDs regularly probably outweighs the minimal benefits. NSAIDS are sometimes also recommended therapeutically after training to reduce pain but speak to your GP first before you consider taking any form of medication.

• Muscle compression garments worn during training seem to offer some benefit in prevention.

There’s very little evidence that stretching slowly (static stretches) either before or after exercising makes any difference to DOMS. The same is true for immersion in cold baths or using ice packs.

Having said all of that, one of the main issues is not how best to treat DOMS but how to avoid the risk of causing genuine injury during the recovery period.

As DOMS is so common and will settle without treatment, it’s easy to underestimate its impact. There might be a temptation to train too hard through the pain and end up causing an actual injury either to the affected muscle or the surrounding ligaments or tendons as they try to compensate for the weakened muscle.

There’s definitely mileage in trying the more evidence-based treatment and prevention advice. However, when DOMS hits, the key thing is to give your body time to recover. Run much less intensely for at least 2-3 days, build up your miles gradually to give your muscles time to adapt and take care on the stairs!

Rowan Wilson


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