DOMS - what can help?

Ever struggled to walk down the stairs after leg day? Delayed onset muscle soreness (DOMS) is commonly experienced after strength training or strenuous exercise. But is there anything that is scientifically proven to help prevent or manage DOMS?

What causes DOMS?

DOMS is caused by microscopic muscle tears and damage, typically from performing eccentric muscle contraction movements, high intensity exercise or after doing exercises not accustomed to. Eccentric contractions involve lowering a weight slowly, with control and maintaining tension through the muscle (for example, lowering your arm in a controlled motion during a bicep curl).

DOMS usually starts a day after exercise and can last several days. The main symptoms are muscle pain, muscle stiffness, reduced range of movement and/or muscle weakness. DOMS can affect anyone, from elite athletes, to beginners, to those who haven’t exercised in a long time.

Is DOMS a sign of a good workout?

Some may think that DOMS is a sign of an effective workout, resulting in strength/fitness gains. However, if following a well-structured training programme that gradually progresses in weight/intensity, your body should be adapting over time. Not experiencing DOMS does not necessarily mean you're not working hard enough or adapting.

Preventing and managing DOMS

There are many supplements and methods thought to help with DOMS. Here is what research has found:

• Circumin/turmeric supplements - although there is some indication that circumin supplements may reduce DOMS, findings across studies have been inconsistent. (1)

• Antioxidant supplements - chronic supplementation with antioxidant vitamins (i.e., Vitamin C and E) does not have beneficial effect on muscle soreness after eccentric exercise. (2)

• Omega-3 supplements - there is some evidence that omega-3 polyunsaturated fatty acid supplements do not result in a clinically important reduction of muscle soreness after eccentric exercise. (3)

• Branched-chain amino acids (BCAA) - studies have shown that BCAA supplements can reduce DOMS 24-72hrs after mild to moderate exercise induced muscle damage among trained individuals, with doses of up to 255 mg/kg/day. However, due to high variability between studies, there is no conclusion as to whether they are efficient in untrained individuals. (4)

• Stretching - a recent systematic review found that post-exercise stretching has no effect on DOMS 24, 48, or 72hrs post-exercise compared to passive recovery (just resting). (5)

• Cold water immersion (CWI) - research suggests that CWI is effective in reducing DOMS immediately after exercise, but not for prolonged periods of time (24-48hr). (6)

• Physical therapy - there is low quality evidence suggesting that cold and heat therapy (contrast therapy), cryotherapy, phototherapy, vibration, ultrasound, massage and active exercise can help with management of DOMS-related pain. (7,8)

• Electrical stimulation - electrical stimulation does not help to prevent nor manage DOMS and muscle recovery in athletes and untrained adults. (9)

Summary

• DOMS is the muscle soreness experienced after strenuous exercise or eccentric exerices. It can last for several days.

• There are currently no methods with strong research evidence for reducing/managing DOMS. It's best to listen to your body - you may find that light movement during the days of soreness may help to ease and enhance recovery.

  
  

References

1. Oxley RA, Peart DJ. The effect of curcumin supplementation on functional strength outcomes and markers of exercise-induced muscle damage: A systematic review and meta-analysis. Nutr Health. 2024 Mar;30(1):77-92.

2. Torre MF, Martinez-Ferran M, Vallecillo N, Jiménez SL, Romero-Morales C, Pareja-Galeano H. Supplementation with Vitamins C and E and Exercise-Induced Delayed-Onset Muscle Soreness: A Systematic Review. Antioxidants (Basel). 2021 Feb 12;10(2):279.

3. Lv ZT, Zhang JM, Zhu WT. Omega-3 Polyunsaturated Fatty Acid Supplementation for Reducing Muscle Soreness after Eccentric Exercise: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biomed Res Int. 2020 Apr 20;2020:8062017.

4. Weber MG, Dias SS, de Angelis TR, Fernandes EV, Bernardes AG, Milanez VF, Jussiani EI, de Paula Ramos S. The use of BCAA to decrease delayed-onset muscle soreness after a single bout of exercise: a systematic review and meta-analysis. Amino Acids. 2021 Nov;53(11):1663-1678.

5. Afonso J, Clemente FM, Nakamura FY, Morouço P, Sarmento H, Inman RA, Ramirez-Campillo R. The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Physiol. 2021 May 5;12:677581.

6. Xiao F, Kabachkova AV, Jiao L, Zhao H, Kapilevich LV. Effects of cold water immersion after exercise on fatigue recovery and exercise performance--meta analysis. Front Physiol. 2023 Jan 20;14:1006512.

7. Wang Y, Li S, Zhang Y, Chen Y, Yan F, Han L, Ma Y. Heat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trials. Phys Ther Sport. 2021 Mar;48:177-187. doi: 10.1016/j.ptsp.2021.01.004. Epub 2021 Jan 14.

8. Nahon RL, Silva Lopes JS, Monteiro de Magalhães Neto A. Physical therapy interventions for the treatment of delayed onset muscle soreness (DOMS): Systematic review and meta-analysis. Phys Ther Sport. 2021 Nov;52:1-12.

9. Menezes MA, Menezes DA, Vasconcelos LL, DeSantana JM. Is Electrical Stimulation Effective in Preventing or Treating Delayed-onset Muscle Soreness (DOMS) in Athletes and Untrained Adults? A Systematic Review With Meta-Analysis. J Pain. 2022 Dec;23(12):2013-2035.