Delayed Onset Muscle Soreness (DOMS): Causes, Myths, and Recovery Tips
Lifting heavy weights and training intensely in the gym often leaves us with a dull ache in our muscles, with many gym-goers believing that some degree of next-day muscle soreness is the tell-tale sign of an effective workout.
This feeling is usually most noticeable 12-48 hours after the session but in severe cases, some soreness and tenderness can persist for up to a week. This common sensation is known as delayed onset muscle soreness, or DOMS.
However, as more research emerges around the condition, more people in the scientific community are questioning whether DOMS is desirable or even beneficial.
DOMS theory
While there are many explanations for this next-day soreness, the exact cause has been hard to pinpoint.
Early theories suggested that a build-up of lactic acid caused DOMS. However, more recent theories suggest that exercise causes damage to soft tissue – muscle fibres and connective tissues – and that the resultant inflammatory response to this micro-trauma causes soreness and pain.
The main DOMS theories include:
- Lactic acid
- Muscle damage
- Inflammation
- Connective tissue damage
- Enzyme efflux
Lactic acid theory:
Lactic acid levels increase shortly after intense exertion, which led researchers to believe that these molecules were a primary cause of DOMS. However, later studies discredited this theory after proving that lactic acid levels return to pre-exercise levels within an hour after exercise¹. As such, it cannot serve as the primary molecule driving the DOMS process at its peak. Additionally, research shows that concentric exercise, which shortens muscles and involves greater metabolism, very rarely leads to DOMS².
Muscle damage and inflammation theory:
Studies³ confirm that weight training, especially “unaccustomed exercise” and eccentric loading (muscle lengthening under load) causes muscle damage, which results in inflammation after exercise. For these reasons, these theories are the most commonly accepted causes of DOMS. However, subsequent research⁴ has identified a disconnect between the time course of the damage, degenerative changes and inflammation, which do not always align exactly with the natural progression of DOMS. Another question mark that hangs over the inflammation theory is the ineffectiveness of anti-inflammatory drugs like NSAIDS in preventing DOMS-related pain.
Connective tissue damage theory:
According to this theory, the reason for the pain is the body’s immune response to the damage that occurs to the connective tissue that binds muscle fibres together, not in the actual muscle fibres themselves. This damage releases various chemicals and other substances into the chemical environment surrounding the muscle cell, which results in inflammation and creates sensations of sensitivity or pain. In this instance, research² findings support the hypothesis that “DOMS originates in the muscle-associated connective tissue rather than in the muscle itself”.
Enzyme efflux theory:
The enzyme efflux theory⁵ suggests that calcium held in the fluid that fills the spaces between cells (called interstitial liquid) accumulates in injured cells. This build-up impacts metabolism and activates enzyme activity that causes further damage by degrading contractile proteins, potentially resulting in the pain we experience.
An integrated model
As each theory has at least some merit, and inflammation is a common denominator in most, the cause likely involves two or more theories, with inflammation a primary driver.
Ongoing research seems to suggest that the next-day muscle soreness we experience stems from a cascade of physiological effects in response to microscopic trauma sustained during intense exercise, including inflammation in muscle and connective tissues in response to the micro-trauma.
We also know that performing new or unfamiliar exercises, eccentric exercises, or significantly increasing your training load, intensity or volume can cause more severe DOMS. Also, untrained athletes tend to suffer more severe DOMS than well-trained or seasoned athletes.
Treating and managing DOMS
The best way to promote muscle growth and strength development is to focus on progressive overload and proper nutrition, rather than trying to maximise DOMS.
When it comes to managing and reducing any DOMS you may experience, a systematic review⁶ suggests that active recovery, massage, compression garments, immersion, contrast water therapy, and cryotherapy are effective in improving DOMS.
The same study outlines certain supplements that can support recovery from DOMS, with products that support collagen production a vital addition to any plan aimed at minimising DOMS and supporting connective tissue repair.
Another study found that “a combination of 3.2 g BCAA and 2.0 g taurine, three times a day, for two weeks prior to and three days after exercise may be a useful nutritional strategy for attenuating exercise-induced DOMS and muscle damage”.
A product like Primal BCAA + Collagen Carbonated Drink provides two of these nutrients in a convenient ready-to-drink product while Primal Amino Force combines 4.8 g of BCAAs and 1g of taurine for an ideal DOMS-diminishing pre- or intra-workout drink.
Primal BCAA 12:1:1 is another source of BCAAs, delivered in an optimal ratio to provide these amino acids to recovering muscles, with added vitamin C to possibly reduce oxidative stress, which may help to limit inflammation.
References:
- Jonathan Myers, Euan Ashley, Dangerous Curves: A Perspective on Exercise, Lactate, and the Anaerobic Threshold, Chest, Volume 111, Issue 3, 1997, Pages 787-795, ISSN 0012-3692, https://doi.org/10.1378/chest.111.3.787.
- Wilke J, Behringer M. Is “Delayed Onset Muscle Soreness” a False Friend? The Potential Implication of the Fascial Connective Tissue in Post-Exercise Discomfort. Int J Mol Sci. 2021 Aug 31;22(17):9482. doi: 10.3390/ijms22179482. PMID: 34502387; PMCID: PMC8431437.
- Peake JM, Neubauer O, Della Gatta PA, Nosaka K. Muscle damage and inflammation during recovery from exercise. J Appl Physiol (1985). 2017 Mar 1;122(3):559-570. doi: 10.1152/japplphysiol.00971.2016. Epub 2016 Dec 29. PMID: 28035017.
- Mizumura, K., Taguchi, T. Delayed onset muscle soreness: Involvement of neurotrophic factors. J Physiol Sci 66, 43–52 (2016). https://doi.org/10.1007/s12576-015-0397-0.
- Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness : treatment strategies and performance factors. Sports Med. 2003;33(2):145-64. doi: 10.2165/00007256-200333020-00005. PMID: 12617692.
- Dupuy O., Douzi W., Theurot D., Bosquet L., Dugue B. An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review with Meta-Analysis. Front. Physiol. 2018;9:403. doi: 10.3389/fphys.2018.00403.