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‘It Hurts So Good’- Understanding Delayed Onset Muscle Soreness

by Crystal Watson, MA, BKin, CSCS

Have you even wondered why your body ‘hurts so good’ two days after you workout? The muscle pain and stiffness you are experiencing is a result of delayed onset muscle soreness, which is commonly referred to as DOMS.

Certified Strength and Conditioning Specialist, Michael Randone (2014), explained that DOMS is “physical pain or discomfort that can occur as soon as 24 hours after exercise, usually lasts 2–3 days, and can take as long as 8–10 days to fully subside”.

DOMS symptoms generally appear after an intense exercise session where there is a novel stimulus (such as a new exercise that your not accustom to), or when performing eccentric contractions (lengthening of the muscle under load). For example, your muscles contract eccentrically when running downhill, completing plyometric (jumping) exercises, and during most resistance training exercises.

Common Symptoms

Common symptoms of DOMS include:

  • Muscle stiffness
  • Reduced range of motion/loss of functionality
  • Localized pain
  • Swelling/inflammation
  • Decreased strength & power/muscle weakness

The Cause of DOMS

While there are several suggested theories on the cause of DOMS, a single, clear mechanism has yet to be identified and agreed upon by researchers. Nevertheless, the most accepted theory (currently) relates to the combined effects of sustained mechanical damage (of the muscle fibers, connective tissue and collagen), the release and delayed clearing of enzymes, and the inflammatory response, all of which result from exercise.

Breaking it down a bit more, when substantial stress is placed on the muscles during exercise the muscle fibers and connective tissues experience microtrama. It’s this muscle damage that prompts our body to repair itself and adapt to become stronger, hence it elicits positive training adaptations or ‘gains’. However, this exercise-induced microtrama also prompts the muscles to release enzymes (such as creatine kinase and prostaglandin E2). To help repair the damage, our body signals an inflammatory response. Therefore, it is thought to be the combination of these events (mechanic damage, enzyme release and inflammation) that results in DOMS, or the ‘it hurts so good’ feeling.

Strategies for Reducing DOMS

Seeing as the mechanism of DOMS is unclear, the effectiveness of interventions (or strategies) to reduce the symptoms associated with DOMS is limited. However, in what follow I will review some strategies that have potential to be effective, according to the current literature.

  • Aerobic Exercise
    • Preventative- Aerobic exercise is commonly referred to as ‘cardio’. Research has shown that completing 10-20 minutes of cardio prior to resistance training can reduce the severity of DOMS.
    • Active Recovery- Alternatively, participating in active recovery (i.e. aerobic-based movements, at a low-moderate intensity) between sets or for 20 minutes immediately after resistance training is also a viable strategy for reducing the symptoms associated with DOMS.
  • Water Immersion
    • Cold Water Immersion- This strategy is often utilized by athletes to speed up their recovery between training or competition bouts. Research has shown that repeating 1 minute cold water (~15°c) immersion intervals for a total of 6-18 minutes can be beneficial for reducing muscle soreness and swelling, even for recreational exercisers.
    • Hot Water Immersion- 8-10 minutes of full body hot water (~38°c) immersion can reduce muscle stiffness and increase range of motion, countering some of the symptoms associated with DOMS.
    • Contrast Water Therapy- This is when you alternate between hot and cold water immersions, where each immersion lasts for 1 minute. Doing so forces your body to alternate between vasoconstriction (narrowing of blood vessels) and vasodilation (widening of blood vessels) states, which can speed up recovery.

*** Before trying this it is important to consider your tolerance to hot and cold temperatures. Also consider your individual medical history. If you have ever experienced vascular issues you need to talk to your health care professional before participating in cold water immersions.

  • Dietary Intake
    • Protein & Carbohydrate- Consuming foods that have a 3:1 carbohydrate-to-protein ratio immediately exercising it thought to help the body recovery and reduce the symptoms of DOMS. Chocolate milk is one quick and easy substance that meets this ratio requirement and has been used in a number of research studies.
    • Caffeine- Studies have shown that consuming approximately 2-3 cups of coffee (5mg/kg of caffeine) 1 hour before exercising and/or 24-48 hours after exercising can be an effective strategy to reduce DOMS symptoms.
  • Massage & Self-Myofascial Release- The DOMS reducing effects of massage are attributed to raising skin and muscle temperatures. Additionally, both massage and self-myofascial release (foam rolling) increases blood and lymphatic system flow, which helps to decrease muscle tension, soreness and restore range of motion.

If your post-workout pain hasn’t started to decrease after three days, be sure to talk to your coach. If the pain persists it is possible that you have sustained an injury and may need to seek additional treatment from an athletic therapist, physiotherapist, chiropractor, and/or sports medicine practitioner.



Contro, V., Mancuso, E. P., & Proia, P. (2016). Delayed onset muscle soreness (DOMS) management: Present state of the art. Trends in Sport Sciences, 2(23), 121-127.

Guo, J., Li, L., Gong, Y., Zhu, R., Xu, J., Zou, J. & Chen, X. (2017). Massage alleviates delayed onset muscle soreness after strenuous exercise: A systematic review and meta-analysis. Frontiers in Physiology, 8, 1-12.

Randone, M. M. (2014). Attenuating delayed onset muscle soreness in untrained individuals. Personal Training Quarterly, 2(1), 30-33.

Vaile, J., Halson, S., Gill, N. & Dawson, B. (2007). Effect of hydrotherapy on t he signs and symptoms of delayed onset muscle soreness. European Journal of Applied Physiology, 102, 447-455.



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