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Delayed Onset Muscle Soreness - The Basics

by Jaydee Vykoukal, PT, DPT August 12, 2021 0 Comments

Woman doing exercise using acupressure mat

Whether you’re a seasoned fitness enthusiast or just getting started, delayed onset muscle soreness (DOMS) can affect you.. The reality is that DOMS is a pretty normal part of working out. Understanding what it is and why it happens can help you to lessen symptoms and give you peace of mind when you’re feeling sore after a workout. Keep reading to learn more about delayed onset muscle soreness.

What is Delayed Onset Muscle Soreness?

Also known as “muscle fever,” DOMS occurs after a workout to local skeletal muscle. Unlike acute soreness, which occurs during or right after a form of exercise, DOMS typically occurs within 12 to 48 hours following exercise. In fact, your muscles might continue to feel even more sore within that 48 hour window. Which form of exercise, the level of soreness, and other factors related to this signature type of muscle soreness will depend on the individual. DOMS is a normal phenomenon that typically isn’t any cause for concern.

What Causes DOMS?

The onset of delayed muscle soreness is most often related to two primary factors: a brand new exercise program or a novice exerciser. When the body’s muscles undergo unique new movements that they aren't used to, the muscles are more likely to experience extensive soreness. This is especially true with high intensity training and eccentric muscle contractions, where the muscle is lengthening while it is being used. This is common with running downhill or in the “return” phase of a weight lifting movement. For example, the straightening phase of a bicep curl.

At a microscopic level, DOMS is caused by microscopic tears and inflammation within the muscle fibers that ultimately cause local tissue damage. This is seen as a good sign, since the muscle will repair itself and become stronger in the process. This allows for muscle adaptation and strengthening over time. It’s important to note that there is no connection between the buildup of lactic acid and DOMS as there is with more acute forms of muscle soreness.

How Common is DOMS?

DOMS is very common among all levels of fitness enthusiasts, even elite athletes. Thankfully, while muscle soreness can be uncomfortable for a few days, it poses no risk to your health. In fact, it’s a sign that you are building strength and pushing yourself to new limits. If you are feeling concerned about experiencing DOMS, you can rest easy and know that you will recover soon enough. For tips and tricks on recovering quicker, see our full DOMS treatment guide.

How to Treat DOMS

Who's at Risk for DOMS?

If you decide to try a new type of workout or are brand new to an exercise program, there is a much higher chance of developing prolonged muscle soreness. With strenuous exercises, anyone can experience delayed onset muscle soreness regardless of how athletic, in, or out of shape they are. This is particularly true with high intensity exercise and eccentric exercise as mentioned above. In fact, anytime an athlete significantly increases their workload to push themselves or cross trains with intense exercise, there is a chance of experiencing DOMS.

Signs & Symptoms

There are a few telltale signs of DOMS that you can be on the lookout for. The most obvious sign, as the name indicates, is muscle soreness and pain that develops after a workout and sticks around for a few hours, days, or even up to a week.

  • Tenderness to the touch within an affected muscle belly and surrounding connective tissue
  • Difficulty tolerating full range of motion secondary to stiffness and/or muscle pain
  • Muscle spasms
  • Mild to moderate muscle tissue swelling due to an inflammatory response
  • Rapid onset of muscle fatigue with exercise
  • Temporary loss of muscle strength and muscle function due to pain inhibition
  • A change in movement mechanics secondary to pain and stiffness (aka limping or movement that appears awkward and painful)
  • Difficulty completing tasks that are typically easy

Developing these symptoms can be frustrating and put a damper on your workouts for a few days. However, it’s important to keep moving and stretching to help with recovery. However, if you notice your symptoms aren’t starting to improve over a few days or getting worse it may be a sign of a bigger problem, such as a muscle strain.

Rarely, it may also be a sign of a more serious muscle injury, known as rhabdomyolysis. If you experience dark urine, severe pain, and/or excessive swelling seek medical help immediately or talk to your sports medicine doctor for further advice.

How is Muscle Soreness Measured?

Muscle soreness is a subjective measure and cannot be uniformly assessed. Thus, many healthcare professionals use a scaling system to help their patients decide on the severity of their pain from 0 to 10. Typically, 0 is described as no pain and 10 is described as the worst pain an individual has ever experienced. Of course, this can be very subjective since we have all experienced different levels of pain in our lives. Alternatively, using mild, moderate, or severe to describe pain and muscle soreness can also be used to describe and “measure” pain.

Measuring muscle soreness subjectively can be particularly hard to gauge when a person is new to exercise. Since they don’t know what to expect they will be more likely to feel concerned and frustrated with their level of muscle soreness. However, over time they will come to recognize muscle soreness as a normal part of working out, although the frequency and severity of soreness should reduce over time as well.

Does Onset Signal Good Workout?

The onset of DOMS during a workout is simply an indicator that the muscles were worked hard or in a movement pattern atypical to that individual. Since pain tolerance and level of fitness will play a role, experiencing DOMS isn’t necessarily a good or bad indicator. For a novice exerciser, developing DOMS does imply that they will make progress as they recover and continue with a program. On the other hand, with a higher level of fitness DOMS is less likely.

It’s important to note that a lack of delayed muscle soreness does not mean that an individual isn’t making progress. Rather that their muscles are adjusting and coping well. There are advantages to mixing up workouts with new movement and cross training to avoid a fitness plateau and continue adequately challenging the different muscle groups. Ultimately, this will help an individual reach peak athletic performance over time. Thus, overall DOMS is not necessarily a good indicator of whether workout was efficient.

Preventing DOMS

DOMS is a normal part of exercising. However, too much soreness can throw off your workouts for the rest of the week and leave you feeling totally uncomfortable. To prevent the onset of DOMS or minimize the severity, it is always important to warm up properly and choose a level of intensity that is manageable for your current fitness level. When DOMS does hit and you’re feeling miserable, there are recovery strategies to help you get back to your full workout routine as quickly as possible too. These include stretching, continued physical activity for blood flow, massage (for example with the hands or foam rolling), pain modalities such as cryotherapy (ice), and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Continue through our guide on DOMS to learn more about these affective treatments.





Next Pages:

DOMS Treatment


Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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