D.O.M.S. – What’s it all about?

D.O.M.S. (delayed-onset muscle soreness) also called muscle fever, is characterized by dull, aching pain and moderate to severe tenderness in the affected muscle. It can involve loss of strength and range of motion. Normally starting 8 to 24 hours after extreme exercises, peaking with in the following 24-72 hours and subsiding over the next 5-7 days. Some research shows D.O.M.S. to be an inflammatory-repair response to actual muscle cell damage and an elevated release of various metabolites into the tissue. This can lead to the swelling and soreness that is felt a day or two after the event. D.O.M.S. can effect all individuals regardless of fitness levels.


What Causes D.O.M.S.:

Coined in 1902 by Theodore Hough, he referred to D.O.M.S. as “fundamentally the result of ruptures within the muscle”. The type of muscle contraction appears to be a key factor in the development of D.O.M.S. It is caused by eccentric exercise, lengthening contractions. The muscle is actively contracting, attempting to shorten its length, but it is failing. Isometric (static) exercise causes much less D.O.M.S, and concentric(shortening) exercise causes none.



Acute structural damage to muscle tissues initiates the occurrence of D.O.M.S. This causes an increase in hydrogen ions and edema to build up fluid in the tissues. White blood cell count has been shown to increase following strenuous activity. The white blood cells are believed to cause an inflammatory response in the muscles, causing damage to the muscle cell membrane. This inflammatory response leads to the formation of metabolic waste products, which act as a chemical stimulus to the nerve endings that directly cause a sensation of pain. These metabolic waste products also increase vascular permeability and attract neutrophils, a type of white blood cell, to the site of injury. Once at the site of injury, neutrophils generate free radicals, molecules with unshared electrons, which can further damage the cell membrane. The sarcolemma, cell membrane, may be ruptured allowing the contents of the cell to seep between other muscle fibers. Other factors, which play a role in D.O.M.S, are muscle stiffness, contraction velocity, fatigue, and angle of contraction. My head hurts…

Symptoms of D.O.M.S.:

Typical symptoms associated with D.O.M.S include strength loss, pain, muscle tenderness, stiffness, and swelling. Loss of strength usually peaks within the first 48 hours after exercise, pain and tenderness peak within 1-3 days after exercise and typically subside within 7 days. Stiffness and swelling can peak 3-4 days after exercise and will usually resolve within 10 days. It is important to note that these symptoms are not dependent on one another and do not always present at the same time.

D.O.M.S. vs Muscle Strain:

When dealing with D.O.M.S it is important to differentiate it from muscle strains, recognizing that continued exercise is still possible with D.O.M.S, but not with muscle strain. With D.O.M.S, the pain is felt only when the muscle is stretched, contracted or put under pressure, not when it is at rest. This difference is important because with muscle strain vigorous exercise, particularly eccentric exercise, it can severely worsen the injury.

Muscle Strain Symptoms:

Bruising, redness or open cuts as a consequence of the injury
Pain at rest
Pain when the specific muscle or the joint in relation to that muscle is used
Weakness of the muscle or tendons
Inability to use the muscle at all

Lactic Acid?:

Many people believe D.O.M.S has been attributed to the buildup of lactate in the muscles after an intense workout. Recent studies have shown this to not be the case at all. It has been shown that lactic acid is removed from the muscle within an hour of intense exercise. D.O.M.S normally begins about a day later. Studies have also shown blood lactate returns to resting levels within one hour of exercise. Also concentric exercise, which does not case D.O.M.S, produces two-thirds more lactate than eccentric exercise. So there!

Repeated-bout effect:

After eccentric exercise and feeling severe D.O.M.S, the muscle rapidly adapts to prevent further damage from the same exercise. This is called the “repeated-bout effect”. It’s a progressive adaptation to eccentric exercise. Because of the repeated-bout effect your body can do the same exercise with a faster recovery of strength and range of motion and increase resistance to damage. The effect lasts for at least several weeks.

There are three parts to the repeated-bout effect:

Neural adaptations – improved use and control of the muscle by the nervous system

Mechanical adaptations – increased muscle stiffness or muscle support tissue

Cellular adaptations – adaptation to inflammatory response and increased protein synthesis

Treatment and Prevention:

No one treatment has proved dominant in consistently preventing or treating D.O.M.S. Here’s a breakdown of pros and cons of different treatments people have tried in the past.


PROS – reduce muscle soreness

CONS – may slow the ability of the muscle to repair the damage, gastrointestinal distress, and hypertensive effects.


PROS – warms up the muscles

CONS – found not to prevent D.O.M.S, over stretching can cause D.O.M.S


PROS – reduce the proliferation of free radicals

CONS – has not been shown to effectively treat D.O.M.S, and may even worsen symptoms, too much can be harmful


PROS- shown to be effective in reducing symptoms of D.O.M.S, increase muscle temperature, leading to greater muscle elasticity, an increased resistance of muscle tissue to tearing, more relaxed muscles, an increased extensibility of connective tissues within muscle, and decreased muscle viscosity

CONS – ?


PROS – increase blood flow, effective in reducing both soreness and tenderness,

CONS – no effects on muscular strength or function

CONTINUED EXERCISE (exercise-induced analgesia)

PROS – increases pain thresholds and pain tolerance, temporarily suppress D.O.M.S

CONS – ?


PROS – Constrict blood vessels and flush waste products out of the affected tissues, decrease metabolic activity, slow down physiological processes, reduce swelling and tissue breakdown

CONS – not shown to affect D.O.M.S, and IT’S COLD!!

In conclusion D.O.M.S hurts, but it seems the best way to deal with it is to just keep getting better at what you’re doing AND allow your body to recover. It will go away in a few days. Do some stretches (but not too many) get a massage if you feel like it and keep working out.

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