Everything You’ve Ever Wanted to Know About Delayed Onset Muscle Soreness (DOMS)


Even if you don’t know what DOMS stands for, you’ve most likely experienced it. DOMS stands for “Delayed Onset Muscle Soreness” and is typically associated with an individual experiencing mild to severe muscle pain within 24-48 hours of exercising. While some people view DOMS as a sign of a good workout, others dread it. Regardless, understanding what causes DOMS and how to manage it is important for endurance athletes.


For many years Delayed Onset Muscle Soreness was a mystery and not fully understood. Many studies have been published on this subject, yet most did not fully explain what DOMS really is. In 1981, Jan Frieden published his findings that were based on taking muscle biopsies from subjects who walked repeatedly down flights of stairs. This was the first real evidence of what DOMS is and what it is not. 

Jan Frieden discovered that DOMS primarily results from eccentric contractions of muscles. An eccentric contraction is when a muscle contracts to decelerate a limb that has a load applied to it. Essentially, an eccentrically contracting muscle acts as a brake. For example, after performing a bicep curl, the bicep muscle must contract to decelerate the weight on the way back down to the starting position (arm extended downward). During an eccentric contraction, the muscle fibers get pulled lengthwise to the point where damage occurs at a sub-cellular level. This damage induces an inflammatory response of a muscle.

Eccentric contractions involve fewer motor units than concentric contractions (shortening of a muscle) to elicit the same force production. Therefore during an eccentric contraction, there is greater stress per muscle fiber than during a concentric muscle contraction. This added stress per muscle fiber may contribute to DOMS because of disruption of the structures of the muscle.

Delayed Onset Muscle Soreness is one of many exercise/running misconceptions that United Endurance Sports Coaching Academy discusses within their running coach certification, as it’s important to understand the origins and truths sport and running-related concepts. 


Not really. While DOMS doesn’t feel great, the pain felt correlates to the muscle rebuilding, rather than breaking down. One way to look at DOMS is to relate it to the flu. While most people view the side effects of the flu as negative because they feel horrible because of high body temperature, chills, and aches, the side effects of the flu represent the recovery phase. The high temperature is the body’s protective response to infection and injury.


While to some degree, it depends on the severity of the DOMS, it’s probably not the best idea. As the soreness is representative of the healing phase, if you stress the muscles affected by DOMS, this will inhibit healing and further break down the muscle fibers. Many athletes and coaches subscribe to the “no pain, no gain”’ philosophy. However, when it comes to DOMS, if you try to push through DOMS by exercising the affected muscles, you will end up doing more harm than good.

Because of the pain-reducing and anti-inflammatory properties of NSAIDs, they are commonly used by those who experience DOMS and musculoskeletal injuries. However, research has shown that NSAIDs actually slow healing and muscle growth. The evaluation of healing speed was not just focused on muscle, but on bones and tendons as well.


A marker for muscle damage (i.e., DOMS) is the enzyme creatine kinase (CK) in the blood. Research has shown that estrogen may affect muscle enzymes that result in lower blood CK levels. Therefore it can be theorized that women may have less severe bouts of DOMS than men.


The prevailing thought is that DOMS-related muscle weakness is due to sub-cellular muscle damage. However, research has discovered that undamaged muscle fibers can exhibit muscle weakness. Therefore, muscle weakness is likely due to a muscle’s inability to activate contractile structures due to the over-stretching of sarcomeres.

As the time course of inflammation is typically the same as for muscle soreness, the soreness that is felt during DOMS is likely attributable to the inflammation response.


The popular purported benefit of cooling down is to allow muscles to gradually return to normal tension levels.

It is theorized that warming up before exercise can slightly reduce DOMS while a cool-down does not reduce DOMS. According to Dr. Hirofumi Tanaka, an exercise physiology professor at the University of Texas, the cool-down is largely a myth that like most myths in the fitness and exercise realms keeps getting passed along without much thought given to its validity.

While this is a good reason to implement some form of cool-down (prevent blood pooling in the legs – especially after running) there does not seem to be any other physiological reason (i.e., faster recovery) for one.

Therefore, one could deduce that lying down with the legs elevated to reduce or eliminate blood pooling would be just as, if not more, effective than a short cool-down after intense exercise.


Because of the pain-reducing and anti-inflammatory properties of non-steroidal anti-inflammatory drugs (NSAIDs) like Advil, they are commonly used by those who experience DOMS and musculoskeletal injuries. However, research has shown that NSAIDs actually slow healing and muscle growth. The evaluation of healing speed was not just focused on muscle, but on bones and tendons as well.

Myosatellite cells, or satellite cells, are found in muscles, and their job is to attach to existing muscle fibers to form new fibers. This process occurs during normal muscle growth as well as during recovery from injury. It is theorized that NSAIDs greatly reduce the spread of these cells, thus hampering muscle recovery and growth.

Another issue in taking any sort of pain-reducing medication is that it allows an individual to potentially train past what the person’s body can physically handle because of the medication-induced reduction of pain. This can lead to greater injury down the road.



Rick Prince is the founder/director of United Endurance Sports Coaching Academy (UESCA), a science-based endurance sports education company. UESCA educates and certifies running, ultrarunning and triathlon coaches (cycling coming soon!) worldwide on a 100% online platform.

Click on the one of below links to learn more about our certifications and to get $50 OFF the purchase price!


Click here to download the UESCA Triathlon Course Overview/Syllabus


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Friden, J. “Changes in human skeletal muscle induced by long-term eccentric exercise”. Cell and Tissue Research. Volume 236, Number 2, 365-372.

T.A. Trappe, J.D. Fluckey, F. White, C.P. Lambert, J.W. Evans, “Skeletal Muscle PGF2α and PGEin Response to Eccentric Resistance Exercise: Influence of Ibuprofen and Acetaminophen”. The Journal of Clinical Endocrinology and Metabolism. 2001 Oct: 86 (10): 5067.

U. R. Mikkelsen, H. Langberg, I. C. Helmark, D. Skovgaard, L. L. Andersen, M. Kjær, A. L. Mackey. “Local NSAID infusion inhibits satellite cell proliferation in human skeletal muscle after eccentric exercise” J Appl Physiol November 2009 107:1600-1611. 10

D. S. Patel, B.A. Adrian. “Do NSAIDs Impair Healing of Musculoskeletal Injuries?”. J Musculoskel Med. 2011;28:207-212)

Natale VM, Brenner IK, Moldoveanu AI, Vasiliou P, Shek P, Shephard RJ. “Effects of three different types of exercise on blood leukocyte count during and following exercise.” Sao Paulo Med J. 2003 Jan 2;121(1):9-14.

Law RYW and Herbert RD (2007) “Warm-up reduces delayed-onset muscle soreness but cool-down does not: a randomised controlled trial.” The Australian Journal of Physiotherapy 53: 91–95

Child RB, Brown SJ, Day SH, Saxton JM, Donnelly AE. “Manipulation of knee extensor force using percutaneous electrical myostimulation during eccentric actions: effects on indices of muscle damage in humans.” Int J Sports Med. 1998. Oct;19(7):468-73.

Hesselink MK, Kuipers H, Geurten P, Van Straaten H. “Structural muscle damage and muscle strength after incremental number of isometric and forced lengthening contractions.” J Muscle Res Cell Motil. 1996 Jun;17(3):335-41.

Morgan DL1, Allen DG. “Early events in stretch-induced muscle damage.” J Appl Physiol (1985). 1999 Dec;87 (6):2007-15.

Lieber RL, Schmitz MC, Mishra DK, Fridén J. “Contractile and cellular remodeling in rabbit skeletal muscle after cyclic eccentric contractions.” J Appl Physiol (1985). 1994 Oct;77(4):1926-34.
Rick Prince

Rick Prince

Founder/Director of United Endurance Sports Coaching Academy (UESCA).

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