Muscle Soreness

Last Updated: September 7, 2023

Muscle soreness refers to the percieved soreness or tender state of muscle tissue following physical exercise, usually manifesting after a short delay (and hence its common name of 'delayed onset muscle soreness' or DOMS).

What is DOMS?

Delayed Onset Muscle Soreness (DOMS) is muscle soreness that occurs 12–24 hours after performing an unfamiliar exercise or exercising with increased intensity or duration. It does not cause pain during exercise.

What are the main signs and symptoms of DOMS?

People typically experience muscle weakness, swelling, stiffness, and tenderness 12–24 hours after exercise, lasting up to 5–7 days. Depending upon the exercise's novelty, duration, and intensity, symptoms can range from mild to moderate.

How is DOMS diagnosed?

There are no tests to diagnose DOMS. A healthcare provider will instead conduct a thorough examination to rule out other possible causes of symptoms, such as rhabdomyolysis, compartment syndrome, or muscle strains. If the assessment indicates a condition other than DOMS, blood tests or imaging may be performed for further evaluation.[2][4]

What are some of the main medical treatments for DOMS?

Usually, DOMS does not require medical treatment. With rest and/or lowering the intensity of exercise, symptoms should subside within 5–7 days. Acetaminophen or oral and/or topical nonsteroidal anti-inflammatory drugs may decrease soreness; however, prolonged use of these medications is not recommended.[5][6]

Have any supplements been studied for DOMS?

Curcumin, Branched-Chain Amino Acids, Tart Cherry Juice, Fish Oil, Taurine, Vitamin C, and Beetroot may be helpful for treating the symptoms of DOMS. However, there is mixed evidence regarding the efficacy of dietary supplements for DOMS.[9] Furthermore, because DOMS will resolve without treatment, using dietary supplements may not be worth the potential risks associated with dietary supplements, such as potential drug interactions or unlisted ingredients.

How could diet affect DOMS?

One study comparing the effects of a high and low carbohydrate meal on DOMS found no difference between the two groups.[10] Thus, if an individual is experiencing DOMS, it is best to follow the basics of recovery from exercise (i.e., adequate fluids, calories, protein, and sleep).[11]

Are there any other treatments for DOMS?

Massage,[12] compression garments,[13] cold therapy,[14] local heat pack therapy,[14] vibration therapy,[15], foam rolling,[3] and intermittent compression therapy[16] have mild to moderate effects in reducing DOMS. However, popular recovery tools such as saunas,[14] stretching,[17] and acupuncture[18] have not been found to be effective in treating DOMS.

What causes DOMS?

Although the exact mechanism of DOMS hasn’t been determined, DOMS tends to occur after eccentric (muscle-lengthening) or novel exercises. Other factors, such as muscle damage, neutrophil accumulation, oxidative stress, inflammatory compounds (histamine, bradykinins, and prostaglandins), and fluid accumulation may also contribute to the symptoms of DOMS.[4] However, if a person performs an exercise that causes DOMS, they may feel less sore when they perform the same exercise during future workouts; this is known as the repeated bout effect.[8]

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  1. ^Stanley M, Chippa V, Aeddula NR, Quintanilla Rodriguez BS, Adigun RRhabdomyolysisStatPearls.(2022-08)
  2. ^Lewis PB, Ruby D, Bush-Joseph CAMuscle soreness and delayed-onset muscle soreness.Clin Sports Med.(2012-Apr)
  3. ^Heiss R, Lutter C, Freiwald J, Hoppe MW, Grim C, Poettgen K, Forst R, Bloch W, Hüttel M, Hotfiel TAdvances in Delayed-Onset Muscle Soreness (DOMS) - Part II: Treatment and Prevention.Sportverletz Sportschaden.(2019-Mar)
  4. ^Thilo Hotfiel, Jürgen Freiwald, Matthias Wilhelm Hoppe, Christoph Lutter, Raimund Forst, Casper Grim, Wilhelm Bloch, Moritz Hüttel, Rafael HeissAdvances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and DiagnosticsSportverletz Sportschaden.(2018 Dec)
  5. ^Schoenfeld BJThe use of nonsteroidal anti-inflammatory drugs for exercise-induced muscle damage: implications for skeletal muscle developmentSports Med.(2012 Dec 1)
  6. ^Prior MJ, Lavins BJ, Cooper KA randomized, placebo-controlled trial of acetaminophen extended release for treatment of post-marathon muscle soreness.Clin J Pain.(2012)
  7. ^Kellmann M, Bertollo M, Bosquet L, Brink M, Coutts AJ, Duffield R, Erlacher D, Halson SL, Hecksteden A, Heidari J, Kallus KW, Meeusen R, Mujika I, Robazza C, Skorski S, Venter R, Beckmann JRecovery and Performance in Sport: Consensus Statement.Int J Sports Physiol Perform.(2018-Feb-01)
  8. ^Hyldahl RD, Chen TC, Nosaka KMechanisms and Mediators of the Skeletal Muscle Repeated Bout Effect.Exerc Sport Sci Rev.(2017-01)
  9. ^Tanabe Y, Fujii N, Suzuki KDietary Supplementation for Attenuating Exercise-Induced Muscle Damage and Delayed-Onset Muscle Soreness in Humans.Nutrients.(2021-Dec-24)
  10. ^Close GL, Ashton T, Cable T, Doran D, Noyes C, McArdle F, MacLaren DPEffects of dietary carbohydrate on delayed onset muscle soreness and reactive oxygen species after contraction induced muscle damage.Br J Sports Med.(2005-Dec)
  11. ^Bonilla DA, Pérez-Idárraga A, Odriozola-Martínez A, Kreider RBThe 4R's Framework of Nutritional Strategies for Post-Exercise Recovery: A Review with Emphasis on New Generation of Carbohydrates.Int J Environ Res Public Health.(2020-12-25)
  12. ^Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué BAn Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis.Front Physiol.(2018)
  13. ^Hill J, Howatson G, van Someren K, Leeder J, Pedlar CCompression garments and recovery from exercise-induced muscle damage: a meta-analysisBr J Sports Med.(2014 Sep)
  14. ^Yutan Wang, Sijun Li, Yuanyuan Zhang, Yanru Chen, Fanghong Yan, Lin Han, Yuxia MaHeat and cold therapy reduce pain in patients with delayed onset muscle soreness: A systematic review and meta-analysis of 32 randomized controlled trialsPhys Ther Sport.(2021 Mar)
  15. ^Lu X, Wang Y, Lu J, You Y, Zhang L, Zhu D, Yao FDoes vibration benefit delayed-onset muscle soreness?: a meta-analysis and systematic review.J Int Med Res.(2019-Jan)
  16. ^Stedge HL, Armstrong KThe Effects of Intermittent Pneumatic Compression on the Reduction of Exercise-Induced Muscle Damage in Endurance Athletes: A Critically Appraised Topic.J Sport Rehabil.(2021-Jan-08)
  17. ^José Afonso, Filipe Manuel Clemente, Fábio Yuzo Nakamura, Pedro Morouço, Hugo Sarmento, Richard A Inman, Rodrigo Ramirez-CampilloThe 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 TrialsFront Physiol.(2021 May 5)
  18. ^Chang WD, Chang NJ, Lin HY, Wu JHEffects of Acupuncture on Delayed-Onset Muscle Soreness: A Systematic Review and Meta-Analysis.Evid Based Complement Alternat Med.(2020)
  19. ^Robergs RA, Ghiasvand F, Parker DBiochemistry of exercise-induced metabolic acidosisAm J Physiol Regul Integr Comp Physiol.(2004 Sep)
  20. ^Hall MM, Rajasekaran S, Thomsen TW, Peterson ARLactate: Friend or Foe.PM R.(2016-Mar)
  21. ^Schwane JA, Watrous BG, Johnson SR, Armstrong RBIs Lactic Acid Related to Delayed-Onset Muscle Soreness?Phys Sportsmed.(1983-Mar)
Examine Database References
  1. Blueberry - McLeay Y, Barnes MJ, Mundel T, Hurst SM, Hurst RD, Stannard SREffect of New Zealand blueberry consumption on recovery from eccentric exercise-induced muscle damageJ Int Soc Sports Nutr.(2012 Jul 11)
  2. Bromelain - A F Walker, R Bundy, S M Hicks, R W MiddletonBromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adultsPhytomedicine.(2002 Dec)
  3. Citrulline - Andrew J Chappell, Daniel M Allwood, Trevor N SimperCitrulline Malate Fails to Improve German Volume Training Performance in Healthy Young Men and WomenJ Diet Suppl.(2020)
  4. L-Carnitine - M A Giamberardino, L Dragani, R Valente, F Di Lisa, R Saggini, L VecchietEffects of prolonged L-carnitine administration on delayed muscle pain and CK release after eccentric effortInt J Sports Med.(1996 Jul)
  5. HMB - Hoffman JR, Cooper J, Wendell M, Im J, Kang JEffects of beta-hydroxy beta-methylbutyrate on power performance and indices of muscle damage and stress during high-intensity trainingJ Strength Cond Res.(2004 Nov)
  6. Leucic Acid - Antti A Mero, Tuomo Ojala, Juha J Hulmi, Risto Puurtinen, Tuomo AM Karila, and Timo SeppäläEffects of alfa-hydroxy-isocaproic acid on body composition, DOMS and performance in athletesJISSN.()
  7. Ginger - Black CD, Oconnor PJAcute effects of dietary ginger on quadriceps muscle pain during moderate-intensity cycling exerciseInt J Sport Nutr Exerc Metab.(2008 Dec)
  8. HMB - Nunan D, Howatson G, van Someren KAExercise-induced muscle damage is not attenuated by beta-hydroxy-beta-methylbutyrate and alpha-ketoisocaproic acid supplementationJ Strength Cond Res.(2010 Feb)
  9. Ashwagandha - Ziegenfuss TN, Kedia AW, Sandrock JE, Raub BJ, Kerksick CM, Lopez HLEffects of an Aqueous Extract of Withania somnifera on Strength Training Adaptations and Recovery: The STAR TrialNutrients.(2018 Nov 20)
  10. MSM - Kalman DS, Feldman S, Scheinberg AR, Krieger DR, Bloomer RJInfluence of methylsulfonylmethane on markers of exercise recovery and performance in healthy men: a pilot studyJ Int Soc Sports Nutr.(2012 Sep 27)
  11. Anatabine - Jenkins ND, Housh TJ, Johnson GO, Traylor DA, Bergstrom HC, Cochrane KC, Lewis RW Jr, Schmidt RJ, Cramer JTThe effects of anatabine on non-invasive indicators of muscle damage: a randomized, double-blind, placebo-controlled, crossover studyJ Int Soc Sports Nutr.(2013 Jul 22)
  12. Citrulline - da Silva DK, Jacinto JL, de Andrade WB, Roveratti MC, Estoche JM, Balvedi MCW, de Oliveira DB, da Silva RA, Aguiar AFCitrulline Malate Does Not Improve Muscle Recovery after Resistance Exercise in Untrained Young Adult MenNutrients.(2017 Oct 18)
  13. L-Carnitine - Volek JS, Kraemer WJ, Rubin MR, Gómez AL, Ratamess NA, Gaynor PL-Carnitine L-tartrate supplementation favorably affects markers of recovery from exercise stressAm J Physiol Endocrinol Metab.(2002 Feb)
  14. Vitamin C - Bryer SC, Goldfarb AHEffect of high dose vitamin C supplementation on muscle soreness, damage, function, and oxidative stress to eccentric exerciseInt J Sport Nutr Exerc Metab.(2006 Jun)
  15. Taurine - Ra SG, Miyazaki T, Ishikura K, Nagayama H, Suzuki T, Maeda S, Ito M, Matsuzaki Y, Ohmori HAdditional effects of taurine on the benefits of BCAA intake for the delayed-onset muscle soreness and muscle damage induced by high-intensity eccentric exerciseAdv Exp Med Biol.(2013)
  16. Fish Oil - Tartibian B, Maleki BH, Abbasi AThe effects of ingestion of omega-3 fatty acids on perceived pain and external symptoms of delayed onset muscle soreness in untrained menClin J Sport Med.(2009 Mar)
  17. Phosphatidylserine - Kingsley MI, Kilduff LP, McEneny J, Dietzig RE, Benton DPhosphatidylserine supplementation and recovery following downhill runningMed Sci Sports Exerc.(2006 Sep)
  18. Branched-Chain Amino Acids - Shimizu M, Miyagawa K, Iwashita S, Noda T, Hamada K, Genno H, Nose HEnergy expenditure during 2-day trail walking in the mountains (2,857 m) and the effects of amino acid supplementation in older men and womenEur J Appl Physiol.(2012 Mar)
  19. Rhodiola Rosea - Shanely RA, Nieman DC, Zwetsloot KA, Knab AM, Imagita H, Luo B, Davis B, Zubeldia JMEvaluation of Rhodiola rosea supplementation on skeletal muscle damage and inflammation in runners following a competitive marathonBrain Behav Immun.(2014 Jul)
  20. Saffron - Meamarbashi A, Rajabi APreventive effects of 10-day supplementation with saffron and indomethacin on the delayed-onset muscle sorenessClin J Sport Med.(2015 Mar)
  21. Panax Ginseng (Korean Ginseng) - Gislaine Cristina-Souza, Ana C Santos-Mariano, Adriano E Lima-Silva, Poliana L Costa, Pablo R Domingos, Sandro F Silva, Wilson C Abreu, Fernando R De-Oliveira, Raul OsieckiPanax ginseng Supplementation Increases Muscle Recruitment, Attenuates Perceived Effort, and Accelerates Muscle Force Recovery After an Eccentric-Based Exercise in AthletesJ Strength Cond Res.(2020 Apr 29)
  22. Ginger - Black CD, Herring MP, Hurley DJ, O'Connor PJGinger (Zingiber officinale) reduces muscle pain caused by eccentric exerciseJ Pain.(2010 Sep)
  23. Branched-Chain Amino Acids - Shimomura Y, Inaguma A, Watanabe S, Yamamoto Y, Muramatsu Y, Bajotto G, Sato J, Shimomura N, Kobayashi H, Mawatari KBranched-chain amino acid supplementation before squat exercise and delayed-onset muscle sorenessInt J Sport Nutr Exerc Metab.(2010 Jun)
  24. L-Carnitine - Barry A Spiering, William J Kraemer, Jakob L Vingren, Disa L Hatfield, Maren S Fragala, Jen-Yu Ho, Carl M Maresh, Jeffrey M Anderson, Jeff S VolekResponses of criterion variables to different supplemental doses of L-carnitine L-tartrateJ Strength Cond Res.(2007 Feb)
  25. Bromelain - Stone MB, Merrick MA, Ingersoll CD, Edwards JEPreliminary comparison of bromelain and Ibuprofen for delayed onset muscle soreness managementClin J Sport Med.(2002 Nov)
  26. Citrulline - Pérez-Guisado J, Jakeman PMCitrulline malate enhances athletic anaerobic performance and relieves muscle sorenessJ Strength Cond Res.(2010 May)
  27. Spirulina - Aggelos Pappas, Athanasios Tsiokanos, Ioannis G Fatouros, Athanasios Poulios, Dimitris Kouretas, Nikos Goutzourelas, Giannis Giakas, Athanasios Z JamurtasThe Effects of Spirulina Supplementation on Redox Status and Performance Following a Muscle Damaging ProtocolInt J Mol Sci.(2021 Mar 30)
  28. Betaine - Hoffman JR, Ratamess NA, Kang J, Rashti SL, Faigenbaum ADEffect of betaine supplementation on power performance and fatigueJ Int Soc Sports Nutr.(2009 Feb 27)
  29. Fish Oil - Lenn J, Uhl T, Mattacola C, Boissonneault G, Yates J, Ibrahim W, Bruckner GThe effects of fish oil and isoflavones on delayed onset muscle sorenessMed Sci Sports Exerc.(2002 Oct)
  30. Green Tea Extract - Kerksick CM, Kreider RB, Willoughby DSIntramuscular adaptations to eccentric exercise and antioxidant supplementationAmino Acids.(2010 Jun)
  31. Fish Oil - Bloomer RJ, Larson DE, Fisher-Wellman KH, Galpin AJ, Schilling BKEffect of eicosapentaenoic and docosahexaenoic acid on resting and exercise-induced inflammatory and oxidative stress biomarkers: a randomized, placebo controlled, cross-over studyLipids Health Dis.(2009 Aug 19)
  32. Theaflavins - Arent SM, Senso M, Golem DL, McKeever KHThe effects of theaflavin-enriched black tea extract on muscle soreness, oxidative stress, inflammation, and endocrine responses to acute anaerobic interval training: a randomized, double-blind, crossover studyJ Int Soc Sports Nutr.(2010 Feb 23)
  33. L-Carnitine - Ho JY, Kraemer WJ, Volek JS, Fragala MS, Thomas GA, Dunn-Lewis C, Coday M, Häkkinen K, Maresh CMl-Carnitine l-tartrate supplementation favorably affects biochemical markers of recovery from physical exertion in middle-aged men and womenMetabolism.(2010 Aug)
  34. Tart Cherry Juice - Bell PG, Stevenson E, Davison GW, Howatson GThe Effects of Montmorency Tart Cherry Concentrate Supplementation on Recovery Following Prolonged, Intermittent ExerciseNutrients.(2016 Jul 22)
  35. Tart Cherry Juice - McCormick R, Peeling P, Binnie M, Dawson B, Sim MEffect of tart cherry juice on recovery and next day performance in well-trained Water Polo players.J Int Soc Sports Nutr.(2016)
  36. Tart Cherry Juice - Morehen JC, Clarke J, Batsford J, Barrow S, Brown AD, Stewart CE, Morton JP, Close GLMontmorency tart cherry juice does not reduce markers of muscle soreness, function and inflammation following professional male rugby League match-play.Eur J Sport Sci.(2021-Jul)
  37. Tart Cherry Juice - Meghan A Brown, Emma J Stevenson, Glyn HowatsonMontmorency tart cherry (Prunus cerasus L.) supplementation accelerates recovery from exercise-induced muscle damage in femalesEur J Sport Sci.(2019 Feb)
  38. Tart Cherry Juice - Phillip G Bell, Ian H Walshe, Gareth W Davison, Emma J Stevenson, Glyn HowatsonRecovery facilitation with Montmorency cherries following high-intensity, metabolically challenging exerciseAppl Physiol Nutr Metab.(2015 Apr)
  39. Tart Cherry Juice - Bowtell JL, Sumners DP, Dyer A, Fox P, Mileva KNMontmorency cherry juice reduces muscle damage caused by intensive strength exerciseMed Sci Sports Exerc.(2011 Aug)
  40. Tart Cherry Juice - Quinlan R, Hill JAThe Efficacy of Tart Cherry Juice in Aiding Recovery After Intermittent Exercise.Int J Sports Physiol Perform.(2019-Oct-15)
  41. Tart Cherry Juice - Drummer DJ, Many GM, Pritchett K, Young M, Connor KR, Tesfaye J, Dondji B, Pritchett RCMontmorency Cherry Juice Consumption does not Improve Muscle Soreness or Inhibit Pro-inflammatory Monocyte Responses Following an Acute Bout of Whole-body Resistance Training.Int J Exerc Sci.(2022)
  42. Tart Cherry Juice - Abbott W, Brashill C, Brett A, Clifford TTart Cherry Juice: No Effect on Muscle Function Loss or Muscle Soreness in Professional Soccer Players After a Match.Int J Sports Physiol Perform.(2020-Feb-01)
  43. Tart Cherry Juice - Kupusarevic J, McShane K, Clifford TCherry Gel Supplementation Does Not Attenuate Subjective Muscle Soreness or Alter Wellbeing Following a Match in a Team of Professional Rugby Union players: A Pilot Study.Sports (Basel).(2019-Apr-05)
  44. Tart Cherry Juice - Wangdi JT, O'Leary MF, Kelly VG, Jackman SR, Tang JCY, Dutton J, Bowtell JLTart Cherry Supplement Enhances Skeletal Muscle Glutathione Peroxidase Expression and Functional Recovery after Muscle Damage.Med Sci Sports Exerc.(2022-Apr-01)
  45. Tart Cherry Juice - Lamb KL, Ranchordas MK, Johnson E, Denning J, Downing F, Lynn ANo Effect of Tart Cherry Juice or Pomegranate Juice on Recovery from Exercise-Induced Muscle Damage in Non-Resistance Trained Men.Nutrients.(2019-Jul-14)
  46. Magnesium - Reno AM, Green M, Killen LG, O'Neal EK, Pritchett K, Hanson ZEffects of Magnesium Supplementation on Muscle Soreness and Performance.J Strength Cond Res.(2022-Aug-01)
  47. Magnesium - Steward CJ, Zhou Y, Keane G, Cook MD, Liu Y, Cullen TOne week of magnesium supplementation lowers IL-6, muscle soreness and increases post-exercise blood glucose in response to downhill running.Eur J Appl Physiol.(2019-Dec)
  48. Creatine - Kenji Doma, Akhilesh Kumar Ramachandran, Daniel Boullosa, Jonathan ConnorThe Paradoxical Effect of Creatine Monohydrate on Muscle Damage Markers: A Systematic Review and Meta-AnalysisSports Med.(2022 Feb 26)
  49. Creatine - Bethany Northeast, Tom CliffordThe Effect of Creatine Supplementation on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention TrialsInt J Sport Nutr Exerc Metab.(2021 Feb 24)
  50. Red Light Therapy - Nampo FK, Cavalheri V, Ramos Sde P, Camargo EAEffect of low-level phototherapy on delayed onset muscle soreness: a systematic review and meta-analysis.Lasers Med Sci.(2016-Jan)