PT Tip of the Month Archive

Delayed Onset Muscle Soreness (DOMS)

Delayed onset muscle soreness (DOMS) is the pain or stiffness felt in a muscle hours or days after unaccustomed or vigorous activity. Typically this pain is felt 24-72 hours after the activity is performed, and is located in the muscle belly, or where the muscle and tendon join together. DOMS is not dangerous to the body, but it can interfere with work performance or athletic performance.

DOMS is thought to occur as a result of microinjury or microtears to the muscle fibers. This is different than a large muscle tear or rupture, which involves complete tearing of any entire muscle fiber. These injuries to the fibers cause several different reactions in the body. One includes increased sensitivity of the muscle fibers brought on by an inflammatory reaction, which in turn causes increased pain with light pressure, touch, or movement. Another hypothesis is that there is a build-up of lactic acid in the muscle causing the soreness, but there is newer evidence showing that this may not be true.

What type of activity can cause DOMS?

As fall descends upon us here in New England, many people seeking those beautiful views of our foliage may decide to spend a day hiking. However, hiking, no matter how easy the trail, is exactly the type of activity that can cause DOMS. In a recent article published in the Appalachian Mountain Club Outdoors Magazine, Paul Ghostlaw, PT in our Brookline office was interviewed regarding the DOMS that can occur as a result of this type of activity (Click here to read the article).

As Paul states, hiking places a huge load on the lower extremities and no matter what shape you are in, your muscles will not be accustomed to performing this repetitive activity. Therefore it is important to begin with short hikes and low elevation gain. Then, you can gradually challenge yourself once you have adapted to the activity and improved your endurance. As always, it is also important to properly warm up prior to vigorous or intense activity.

Treatment of DOMS

It is typical for the pain of DOMS to disappear within 72 hours, though sometimes pain can last up to 7-8 days. There are also different treatments available that may help speed up the pain relief. The use of modalities to increase circulation to the muscle tissue has been shown to be effective. Light massage is one such treatment that will help the body improve circulation and remove waste products from the muscle. Also ice-bath immersion can sometimes quicken relief from DOMS.

Another treatment for relieving DOMS that has been studied and debated is gradually returning to exercise or activity. (However there is some question as to whether the return to exercise simply increases your pain threshold and tolerance.) Also there is a phenomenon known as exercise-induced analgesia, and returning to aerobic exercise (running, biking, swimming) may trigger this and decrease pain associated with DOMS.

DOMS and Physical therapy

Since DOMS is triggered by an increase in activity or adding new activity, it is possible for patients to experience occasional soreness after starting a physical therapy program. However, a physical therapist will slowly increase activity and work closely with a patient to help prevent increased pain. A physical therapist will also be able to help someone differentiate between pain associated with DOMS and pain that may be caused by an acute muscle tear or strain, or a joint sprain. If you are in pain following an intense activity, and are concerned that your pain is more than simple DOMS, and you would like to schedule an evaluation, please call 617-232-PAIN for our Brookline office and 617-325-PAIN for our West Roxbury office.

33 Pond Avenue, Suite 107B Brookline, MA 02445 Tel: (617) 232-PAIN (7246) Fax: (617) 232-5196
1208B VFW Parkway, Suite 202 West Roxbury, MA 02132 Tel: (617) 325-PAIN (7246) Fax: (617) 325-7282