Feeling Sore Days After an Intense Workout? It's Probably DOMS. Here's How To Beat It

Soreness can be a sign of a good workout, but not all soreness is a good thing. When you first begin an exercise program or get back into it after a long break, experiencing a bit of muscle pain later that day or the next is normal. This specific pain should not be so uncomfortable that it limits being able to move around as usual and should subside within a day or so. If the soreness causes you to not be able to lift your arms or go downstairs without severe pain, and lasts longer than two days, your workout may have caused delayed onset muscle soreness (DOMS for short).

Causes and Symptoms

Typically, delayed onset muscle soreness begins within 8 to 12 hours after intense exercise and peaks to its worst symptoms at 24 to 48 hours. The pain from DOMS subsides by around 72 hours, but may last longer for some individuals. This pain is normally felt with active movement and stretching the muscles. Along with muscle pain, other symptoms that come along with DOMS are a temporary loss in muscle strength, decreased range of motion, and possibly swelling in the muscles involved in the exercise. The sore muscles may feel as if “bruised” when touched with light pressure. This combination of symptoms may even last up to 10 to 14 days in severe cases.

What exactly is the “intense exercise” that can causes DOMS? Studies show that the usual type of exercise that causes this condition is eccentric movements, which is when the muscles lengthen during the contraction (think: the movement on the way down from performing a bicep curl). Although this is the most common exercise to cause DOMS, many other forms of workouts can lead to this intense soreness, such as running downhill, high intensity sprinting or plyometrics, and heavy weight lifting. Most of the time, this condition arises after performing new exercises at too high of an intensity that the body is not used to.

What Exactly is DOMS?

In the past, it was believed that delayed onset muscle soreness was the result of the so-called lactic acid buildup in the muscles during exercise. This buildup occurs during any exercise, but returns to normal levels as soon as an hour after the completion of the workout. Therefore, DOMS is not related to the lactic acid accumulation in muscle that occurs during physical activity. Unaccustomed eccentric exercises cause damage beginning at the muscle’s cell membrane, which results in inflammation that expands out to the entire muscle and surrounding areas, creating metabolic waste. This waste product stimulates the nerves surrounding the muscles causing pain. Keep in mind this type of damage occurs with certain forms of exercise as explained above, not with all exercise as with the regular lactic acid buildup.

Treatment

Although the first line of defense used when feeling this kind if pain is to take an anti-inflammatory pill, it may not be the best option. This route may help ease symptoms in most cases, but is shown to have the unattractive side effects of stomach issues and can eventually lead to poor healing capabilities in the future. The best initial treatment options are rest and ice—which is a safe, natural anti-inflammatory agent. Another go-to pain reliever sought out by most athletes is massage. Gentle massage helps ease DOMS pain, swelling and tightness in most individuals, reducing the severity and duration of symptoms. Massage has been shown to help decrease the compound in our muscles that causes inflammation. Deep tissue massage that is typically used by athletes for tight muscles is not advised for this condition due to the intense pressure that may exacerbate the pain.

Another helpful treatment option is light exercise such as cycling, pool exercises, and gentle stretching. These approaches will help maintain good circulation and keep the muscles warm to be more prepared for the addition of intense exercise once the DOMS has subsided. Intense exercise, especially the type of workout that initially caused the pain, should be avoided, as one of the symptoms of DOMS is a temporary muscle weakness. This decrease in strength causes delayed shock absorption, which can lead to injuries such as a muscle strain or tear.

Prevention

Performing a proper warm-up before any exercise is the first thing that should be done to prevent delayed onset muscle soreness. A warm-up, as in its name, basically increases the temperature of muscle, which improves its elasticity, making it more resilient to tearing. The effects of a proper warm-up lead to improved muscle contractions and better performance during the workout. Research states that warming up for an eccentric-type workout with concentric moves is effective in helping prevent DOMS. A good warm-up for running consists of more dynamic moves such as walking lunges, legs swings, and military marches. Static stretches, where you hold a fixed position for several seconds is not recommended, as this will cause muscles to elongate and remain in a more relaxed state. Save these for after your run.

If you are beginning a running or exercise program for the first time or after a long break, it is advisable to gradually ease into the intensity and make sure to include that warm-up. It is important to note the difference between DOMS and other causes of muscle pain. If you are experiencing pain during a specific exercise, it is most likely due to improper form, a muscle strain, or other injury. DOMS symptoms occur between 8 and 12 hours after the completion of exercise. You are able to perform lower intensity exercises with DOMS without continued muscle damage, whereas with a muscle strain, further exercise will continue to impair the muscle.

DOMS is not necessarily a bad condition since it involves a natural effect of new exercise, but it should be avoided when possible as it prevents any higher intensity exercise to be performed for several days or weeks. If you want to go “all-out” during your track day with brand new sprint intervals that you have never done, and you develop DOMS, expect to not be able to get your long run done even if it is a couple of days after the track workout. A good rule of thumb when increasing intensity of your workout program is to increase sets, reps, resistance, or mileage by only 10% or less each week. This is the safest way to help prevent the unwanted limitations of DOMS.

Sources

Miles MP, Clarkson PM, Exercise-induced Muscle Pain, Soreness, and Cramps, Journal, May 6, 2020.

Connolly D, Sayers SP, McHugh MP,Treatment and Prevention of Delayed Onset Muscle Soreness, Journal, May 6, 2020.

Zainab Zainuddin, Mike Newton, Paul Sacco, Kazunori Nosaka, Effects of Massage on Delayed-Onset Muscle Soreness, Swelling, and Recovery of Muscle Function, Journal, May 6, 2020.

Balanced Hormones for Better Performance

The body undergoes several different changes during exercise. As much as non-runners may constantly tell their running friends how bad the sport is for the knees or heart, the fact is quite the opposite. Running produces an extraordinary amount of benefits to the body. From better heart health, to improved lung function and joint mobility, runners have an advantage towards a longer and more satisfying life. Many of the benefits and changes that occur during training are straight forward, while others are harder to understand. The effect on the endocrine system is one of the more confusing topics for runners. The endocrine system is responsible for the secretion and regulation of the body’s hormones, which play a significant role in performance improvement.

It is useful for athletes to understand the function of different hormones in order to train properly and safely for endurance events. In many cases, too much information on the benefits of certain hormones has caused some athletes to go to extremes trying to increase the amount in their bodies. From sleeping in high elevation to using performance-enhancing drugs—there are definitely many ways to ‘artificially’ raise hormone levels in the body, but with negative consequences, and possibly no beneficial outcomes. The key to getting the most benefit from the endocrine system for running performance is to keep hormonal balance. When it comes to training, the most important hormones to pay attention to are growth hormone, insulin-like growth factor, cortisol, and testosterone.

Growth Hormone

The pituitary gland in our brains naturally secretes growth hormone in bursts, usually following stress, exercise, or trauma. Although the levels of this hormone vary throughout the day, it is usually increased during the night. Since growth hormone is responsible for the development of bones and cartilage, it makes sense that more of it is produced during childhood and adolescent years as opposed to adult years. The role of growth hormone for runners, or any athlete for that matter, is to facilitate adaptation to exercise, which naturally occurs during rest and recovery periods. It stimulates protein production and helps the body utilize fat for energy, therefore helping runners last longer during endurance events. This is a commonly used performance-enhancing drug in the bodybuilding world as well, since it helps promote gains in size and strength.

Insulin-like Growth Factor

Insulin is produced by the pancreas and is responsible for storing glycogen and glucose in the body. During exercise insulin is suppressed to ensure that glycogen is used as fuel instead of for storage. Insulin-like growth factor has the same structure as insulin, except it is produced in the liver. This hormone works alongside growth hormone to help repair muscle damage caused by exercise. These factors make artificial supplementation attractive to athletes. Although this hormone is considered a banned substance, many are still using it despite the significantly negative side effects. Since insulin-like growth factor contributes to muscle growth and repair, it has been linked to cell growth as well, allowing tumors to survive and possibly grow, increasing the risk of death from cancer. Making sure to supply the body with adequate food, especially from animal proteins, is helpful in naturally maintaining a proper balance of this hormone.

Cortisol

You have probably heard of this hormone when reading or learning about stress and the “fight or flight” response. Cortisol is a hormone produced in the adrenal glands of the body. The natural response during any stressful situation is for these glands to secrete cortisol temporarily to keep our mental state more alert and our bodies ready for action. Hard training puts the body under a type of stress that creates a similar response. The problem with cortisol is the negative effects from its prolonged elevated levels, which is common during overtraining. Too much cortisol breaks down muscle tissue and stores more fat in cells. This eventually leads to a decrease in performance. One way to combat this imbalance is to include proper rest into training plans and avoid overtraining syndrome, which includes symptoms of exhaustion, poor performance, and irritability.

Testosterone

When it comes to running, testosterone is responsible for supporting the growth of muscles and aiding in recovery. Intense workouts, such as interval training or speed work can increase testosterone in the body leading to muscle mass gains and shorter recovery periods over time. Overtraining and prolonged running can decrease levels. Testosterone is another commonly used performance-enhancing drug by endurance athletes for the shorter recovery benefit and bodybuilders for the massive muscle gain benefit. Negative side effects of high testosterone levels are numerous and include behavioral changes, increased risk of heart attack, impotence, and acne. Balancing testosterone levels to benefit your running naturally is as easy as mixing up your running plan and adding in high intensity sessions.

These four hormones are just a few of the many that are involved in running performance. As with any stressful situation, including trauma, injury, and personal tribulations, running increases and/or decreases the levels of hormones in the body. This response is a natural one. Understanding the effects of hormonal imbalance is important in order to learn ways to manage. Artificially increasing hormone levels for the sake of performance improvement does give athletes an advantage, which is why these practices are banned from sports. It is always best to naturally balance out hormone levels, instead of exaggerating the levels of some, in order to avoid harmful side effects.

Sources

R. R. Kraemer, R. J. Durand, E. O. Acevedo, L. G. Johnson, G. R. Kraemer, E. P. Hebert, V. D. Castracane, Rigorous Running Increases Growth Hormone and Insulin-Like Growth Factor-I Without Altering Ghrelin, Journal, Dec 23, 2019.

K. Karkouliasa, I. Habeosa, N. Charokoposa, M. Tsiamitaa, A. Mazarakisb, A. Poulib, K. Spiropoulos, Hormonal responses to Marathon Running in Non-Elite Athletes, Journal, Dec 23, 2019.

C G Semple, J A Thomson, and G H Beastall, Endocrine Responses to Marathon Running, Journal, Dec 23, 2019.