Muscle pain a day or so after exercise – known as delayed onset muscle soreness (DOMS) – is common among athletes. Do you wonder why this happens – even when your workout went great – or what you can do about it? As its name implies, DOMS has symptoms of muscle tightness, pain and tenderness similar to a strain. Strains happen during or immediately after exercise. For instance, if you are sprinting and suddenly feel a sharp pain in the back of your leg while gutting out that last 10 yards, you likely have a hamstring strain. DOMS, on the other hand, usually starts well after the exercise that caused it, typically around 24 hours later. DOMS often lasts five or as long as seven days. It’s important to recognize the difference between DOMS and other musculoskeletal pain and injury, as strains may take longer to heal and may require you to rest from certain activities.

The pain from DOMS is caused by damage to the muscle tissue and inflammation associated with the damage. Due to this, you may have noticeable weakness or soreness when you move a certain muscle group. Most people notice reduced pain within five to seven days, but you should see your physician if the pain lasts longer than a week or gets worse. Persistent or worsening pain could be due to rhabdomyolysis, which is a different but serious – maybe even life-threatening – condition that includes severe muscle pain with swelling. Other symptoms of rhabdomyolysis may be tea-colored or dark, cola-colored urine. If you notice any of these symptoms, you should see a physician right away.

Can I prevent and/or treat DOMS?

There is limited research on treatments and their effectiveness for DOMS. However, there are some strategies that you can try yourself to help relieve your symptoms of pain and soreness from DOMS (as well as pain experienced shortly after exercise), as well as some you can explore to prevent it.

• Stretching. While widely practiced, stretching has not been proven to help prevent or reduce pain or DOMS after exercise. However, you can give it a try, and if seems to help reduce your symptoms of pain and soreness it may be a good idea for you.
• Recovery drinks: Carbohydrates and protein may help prevent DOMS. Several studies show that protein-based drinks such as chocolate milk can help reduce muscle soreness and fatigue after prolonged exercise. But before you consider a post-workout supplement, research dietary supplements to make sure you aren’t getting things you don’t want. Many products marketed as recovery and sports drinks may contain ingredients that can actually hurt your performance.
• Cold-water immersion: or an “ice bath,” is very uncomfortable, but it can help reduce the pain associated with DOMS. Immersing sore muscles in ice-cold water for 10-20 minutes at 50-60 degrees Fahrenheit, immediately after exercise may improve recovery compared to regular rest and recovery.
• Anti-inflammatory over-the-counter medicines:  Ibuprofen or naproxen can also help reduce inflammation caused by muscle damage, which may also reduce pain. Studies suggest that taking anti-inflammatories also can speed up recovery, but you should limit their use to less than one week. Pain that lasts longer than one week is generally not DOMS, and you should see your doctor. 

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