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Have you ever stepped out of bed two days after a workout and thought, “Why am I so sore today?” Perhaps the previous day you didn't notice much, and all of a sudden, 48 hours later you notice soreness that is getting progressively worse throughout your day. 

This feeling can actually be a normal response to various exercises and it has a scientific name--delayed onset muscle soreness. Delayed onset muscle soreness, also known as DOMS, typically reaches peak soreness around 48-72 hours after the respective workout. (1) DOMS is commonly reported in those who attempt a new exercise or sport for the first time and it is also reported in elite athletes, usually in pre-season, when a long period of rest has preceded the exercise (usually an eccentric exercise). Eccentric exercises are the most common reason for the onset of DOMS. Eccentric exercises are those that induce micro-injury to the muscle during a “lengthening” phase. (2) Think of negative pull-ups and/or push-ups, deadlifts, and tempo squats.  

How do you tell the difference between DOMS and pain? DOMS muscle soreness typically reduces within about 3-7 days, whereas pain tends to linger for longer periods of time. Pain usually doesn’t change with rest. Muscle soreness usually isn’t physically limiting after a light warm-up, whereas pain often causes people to have poor movement patterns and dysfunction that do limit physical activity. Pain usually doesn’t go away, whereas soreness does. 

If you are experiencing regular muscle soreness or DOMS, here are some research-based guidelines to help point you in the right direction with where you should go with your workout routine. If your discomfort persists at an abnormal intensity and/or period of time--you should absolutely schedule an appointment with your trusted healthcare provider to figure out what is going on. There are severe conditions such as rhabdomyolysis that require urgent care and attention to safely recover from; for conditions such as these, you should schedule an appointment to see your medical doctor for diagnosis and treatment as soon as possible!

References

(1) Freiwald J, Wilhelm Hoppe M, Lutter C, Forst R, Grim C, Block W, Hüttel M, Heiss R. Advances in delayed-onset muscle soreness (DOMS): part 1: pathogenesis and diagnostics. Sportverletz Sportsc. 2018; 32(04): 243-250 

(2) Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness: treatment strategies and performance factors. Sports Med. 2003;33(2):145-164.

(3)  Adams D, Logerstedt D, Hunter-Giordano AH, Axe M, Snyder-Macker L. Current concepts for anterior cruciate ligament reconstruction. A criterion based progression. J Orthop Sports Phys Ther 2012;42(7):601–614.  

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