The saying “No Gain, without Pain” is true to a certain extent. Although pain followed by exercise can be attributed for many reasons.Unaccustomed activities regardless of the fitness level of an individual may cause DOMS.

Delayed onset muscle soreness (DOMS) is described as a sensation of pain experienced 8-12 hrs post-exercise, peaking between 24-48 hrs and may last up to 96 hrs. It is particularly associated with eccentric exercise.

Cardinal signs of DOMS are:-

  • Pain with swelling,
  • Stiffness,
  • Loss of range of motion
  • Muscular tenderness and
  • Strength loss.

Strength loss typically peaks right away after exercise or within the first forty-eight hours. Recovery of strength loss usually takes place over 5 days.

DOMS is frequently seen in beginners, athletes or fitness freaks dropping out of physical activities and athletes with a new exercise program.

Examples of activities include:-

Fit India

Strength training exercise

Eccentric exercise eg.bicep curl exercise or the lengthening of the thigh muscles

• Walking downhill

• Jogging

   Step aerobics/ Jumping

DOMS Impact on Athletic performance

An investigation based on research was used to prove whether it has an impact on one's performance or not.

But it may restrict the performance of the athletes as it causes low muscle power output leading to poor performance during the competition.

However, DOMS is not exclusive to sports; it also has a prevalent occurrence in unaccustomed non-sporting activities.

How to reduce muscle soreness post-exercise?

  • Take it slow
  • To progress slowly in a new exercise regime to reduce the severity.
  • Pain that occurs during exercise (i.e., acute) signals a problem with the exercise being intense, bad form, etc.) and should be halted or altered before any muscle or joint damage occurs.

Anti-inflammatory drugs

It appears that anti-inflammatory drugs such as ibuprofen, or ketoprofen have shown some potential in alleviation in certain DOMS symptoms.

Also, NSAIDs (Non-Steroidal Anti-inflammatory Drugs) are not very effective management of DOMS.

Warm-up, Stretch pre and post Exercise

Proper warm-up before exercising and stretching after a workout/exercise may help prevent the symptoms and makes the muscles strong.


  • Cryotherapy and Compression
  • Applying ice and compression are already in clinical practice to relieve pain, diminish inflammatory responses, and reduce swelling for various types of injuries. For instance, as per a study, a compression sleeve garment was worn for 5 days after eccentric elbow flexor exercises. It proved to be effective in reducing the strength loss, soreness, swelling, and stiffness.

 Superficial heat:

Superficial heat can be given to the patient by using modalities like a hot pack, hot water immersion, paraffin wax bath, etc.

Soft tissue massage

Massages can help relieve muscle soreness and stress.

Therapeutic exercises

Certain exercises practiced under professional supervision can help lessen muscle soreness and reduce stiffness.

Nutrition supplements

It is believed that pre supplementation before exercise may induce a preventive effect.

Giamberardino et al. administered 3 g/d of L-carnitine to 6 untrained subjects for 3 weeks before eccentric exercise. They reported decreased pain, tenderness, and other markers of inflammation scores vs. placebo group. It was believed that the vasodilatory effects of L-carnitine might have enhanced recovery.

Pre supplementation of Vitamin C and Vitamin E may help resist symptoms DOMS, although it is still not proven.

In conclusion, DOMS can result from strenuous, unaccustomed physical activity. Physiotherapy is one of the best interventions available for the prevention and management of DOMS. Efficacy is not established yet for other discussed treatments.


Connolly, D.A.J., S.P. Sayers, and M.P. McHugh. Treatment and prevention of delayed onset muscle soreness. J. Strength Cond. Res. 17(1):197–208. 2003Zubia Veqar(2013)Causes and Management of Delayed Onset Muscle Soreness: A ReviewElixir Human Physio. 55 (2013) 13205-13211

DOMS (2011)American College of Sports Medicine

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