Have you ever woke up the next day after a hard workout and could hardly walk to the bathroom? It starts as a dull ache or stiffness when you roll out of bed. We're talking about intense muscle soreness from a novel or hard workout. DOMS: Delayed Onset Muscle Soreness. Some people love it, others fear it. However, there are good reasons for both.
DOMS rears its ugly head 24-72 hours post-workout, hitting hardest in noobs after their first few training sessions (1). Sometimes you can go two days without feeling any soreness then it hits hard on the third day. Even seasoned gym rats still fall prey on occasion - especially when amping up intensity, duration, weight, or introducing new moves. I've been working out consistently for over 35 years and I still experience soreness. However, it is always the worst if I take a few weeks off of training. And some muscles are more susceptible than others. My pectoralis muscles get sore if I look at a bench press whereas my deltoids rarely experience soreness. Individual variability in DOMS is expected. Some muscles appear to be more prone to DOMS than others, and there seems to be a genetic component that causes certain individuals to experience persistent soreness, whereas others rarely get sore at all.
NOTE: Experiencing DOMS does not mean your muscles are growing, and conversely not being sore doesn't mean you didn't have a good workout.
So what exactly causes this physical anguish? You may blame lactic acid buildup, but research doesn’t support that hypothesis (2). In fact, if you have a trainer, PT or doctor that tells you 'lactic acid causes soreness', fire them. We have known for decades this is not true. Lactic acid does not occur in the human body (although lactate does). DOMS is triggered by unaccustomed eccentric contractions during exercise which damage muscle and connective tissues through microtears and cellular stress (3). As part of the natural healing response, swelling, weakness, and soreness then set in.
NOTE: The exact mechanism of DOMS isn’t well understood but the pain is ultimately thought to be a result of microtrauma – mechanical damage at a very small scale – to the muscles being exercised.
Eccentric contractions lengthen the muscles and are achieved typically by lowering weights, or the downward motion of squats, lunges, push-ups and other lifts. Since eccentrics involve forcefully lengthening muscles under tension, they inflict greater tissue trauma and spark more residual pain (4). This is why a bout of slow eccentric movements tend to potentiate DOMS.
Try it: Go to the gym a do a set of eccentric only pullups (jump up and lower yourself for 5s-10s - repeat 5 times). This will likely make your lats or arms considerably sore. Or you do an exercise you've never done before. New movement patterns under load also tend to contribute to DOMS.
The magnitude of post-workout agony depends on factors like genetics, age, flexibility and movement efficiency (5). The better conditioned the body, the lower the DOMS response. So newbies suffer far worse muscle carnage and subsequent soreness compared to seasoned veterans (1). The body has a finite speed at which it can repair itself, and excessive DOMS can indicate exceeding that point temporarily. Eventually, the body will catch up and repair everything (and consequently the soreness will go away), but during that period of "catchup" the body may exceed the capacity for the muscle to undergo repair.
But before you curse DOMS as a side effect of the workout from hell, consider the duality: For all the suffering it causes, DOMS also reassures you that your training sufficiently stresses muscle fibers to spur adaptation (6). In other words, soreness lets you know your effort was adequate to drive progress. It scratches that intrinsic human itch to feel like hard work is meaningful. This validation helps explain why many seasoned lifters still chase moderate muscle soreness almost as a validation badge of honor (7). It taps into our DNA from the days of laborious physical work. Call it physical evidence you gave your blood, sweat and tears. I have lots of people who I work with who enjoy being sore. I do too.
On the flipside, be wary of conflating pain with fantastic fitness gains or muscle growth. While DOMS suggests breakdown did occur, research clearly shows its magnitude doesn’t automatically equal more hypertrophy or strength increases (8). Don't assume you had an ineffective training session just because you feel relatively fresh either. Research clearly shows soreness magnitude doesn’t predict strength and muscle increases. Continuous weekly muscle soreness isn’t a strategy that will optimize muscular strength gains in the long haul. DOMS can inhibit muscle growth and create plateaus in the phases of training. This is because factors such as training status, volume, intensity, and lengths of eccentric contractions are causal of DOMS. This may result in the reduction of range of motion, decreased muscular contractions and altered motor patterns. DOMS can be good and bad....it is the dose that makes the poison.
Your relationship with DOMS walks a fine line between love and hate – agonizing yet affirming. View it as a general sign your workout sufficiently stressed your body to spur adaptation (6) – but don’t let pain or lack thereof mindlessly shape your training mentality. Some soreness can reassure; excessive soreness can sideline you. Find the sweet spot. At the end of the day, your mileage with DOMS comes down to context and perspective. Expect some bumps and bruises as you subject muscles to new challenges, but avoid debilitating pain that hampers function by tailoring training variables appropriately (5). With wisdom and experience, you’ll learn just how much distress those precious muscle fibers of yours can handle.
NOTE: Being sore after exercise doesn’t mean you can't exercise again, and you don’t have to be completely free of soreness before another session of activity. If you do wait for this, those adaptions you earned may be lost and you go back to square one. Consistency and repeated bouts of resistance training elicit muscular adaptations.
Use this chart to determine if you should workout while you are sore:
There is no “cure,” for DOMS and no way to get through it faster. At best, we can relieve the soreness with anti-inflammatory meds (Aleve or Advil). Although data show that NSAIDs may interfere with 'gainz'. The best thing to do is get adequate rest, proper nutrition, decrease stress and stay moving. Rest is the only thing that is guaranteed to alleviate DOMS — if you rest and wait, you will eventually feel better. Don't fear the DOMS.
Let's debunk some common myths about muscle soreness:
Myth: Soreness is caused by lactic acid buildup. In reality, it's believed to be caused by inflammation, which leads to the production of metabolic waste that stimulates the nerves, resulting in that burning pain.
Myth: Stretching reduces soreness. Recent studies suggest that stretching, whether performed before, after, or both before and after exercise, does not significantly reduce soreness.
Myth: Being sore is a sign of progress. You don't necessarily need to experience soreness to make gains in strength and fitness. Individuals can still make progress even if they don't experience DOMS.
Myth: DOMS is always a good sign. Some evidence shows that DOMS may negatively affect workouts by altering motor patterns in subsequent workouts. This could cause reduced activation of the desired muscle. DOMS could actually hinder your next workout. In addition, severe DOMS can decrease force capacity by up to 50%!
References:
(1) MacIntyre DL et al. Delayed muscle soreness. The role of intramuscular calcium during the inset of muscle soreness. Sports Med. 1995.
(2) Cheung K et al. Mechanisms and management of exercise-induced muscle damage. Sports Med. 2003.
(3) Lewis PB et al. The pathophysiology of muscle pain. Ann Behav Med. 2012.
(4) Faulkner JA et al. Injury to skeletal muscle fibers during contractions: conditions of occurrence and prevention. Phys Ther. 1993.
(5) Hyldahl RD et al. Mechanisms and Mediators of the Skeletal Muscle Repeated Bout Effect. Exerc Sport Sci Rev. 2017.
(6) Schoenfeld BJ. The mechanisms of muscle hypertrophy and their application to resistance training. J Strength Cond Res. 2010.
(7) Kerasioti E et al. Pain tolerance predicts male mountain climbers' performance status.Eur J Sport Sci. 2017.
(8) Schoenfeld BJ, Contreras B. Is postexercise muscle soreness a valid indicator of muscle adaptations? Strength & Condit J. 2013.
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