After a more intense workout, a session that is different from usual, or after a period of inactivity, it is common to experience muscle soreness in the following hours or days.
But a question often arises: is this simply a normal response to exercise, or could it be a sign of injury?
Delayed onset muscle soreness: what is it?
So-called delayed onset muscle soreness (DOMS) usually begins 12 to 24 hours after an unfamiliar or demanding effort, reaches its greatest intensity between 24 and 72 hours, and then gradually improves over the following days.
It is particularly common after exercises with a greater eccentric component, such as downhill running, squats, strength training, or movements that are new to the body.
Muscle tenderness, stiffness, and some discomfort with movement may occur. This does not necessarily mean there is an injury that requires all activity to stop.
How can we distinguish it from a possible injury?
It is not always possible to do so based on pain intensity alone, but there are some differences worth paying attention to.
Typical post-exercise muscle soreness tends to appear some time after exercise and gradually improve.
A muscle injury, on the other hand, may occur more suddenly during a specific movement and may be associated with localised pain, loss of function, swelling, or bruising.
It is advisable to seek an assessment when there is:
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severe or highly localised pain;
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significant loss of strength or function;
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marked swelling or bruising;
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difficulty bearing weight or moving the area normally;
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pain that does not improve or continues to worsen.
Can I train again while I am sore?
It depends on the intensity of the symptoms and the type of training.
When soreness is mild, lighter activity may be well tolerated. If movement is clearly restricted or the pain is intense, it may make sense to reduce the load and allow more recovery before placing the same demands on the area again.
More important than simply deciding whether to “train or not train” is understanding how the body is responding to the effort.
A gradual progression in training load remains one of the most important strategies for reducing episodes of excessive soreness after unfamiliar or demanding sessions.
Does stretching relieve muscle soreness?
Not necessarily. Although it is a very common practice, a systematic review found no convincing evidence that stretching after exercise significantly reduces delayed onset muscle soreness or accelerates recovery.
There are several strategies that may provide temporary relief, but the evidence supporting many of them varies. A review including more than one hundred studies found possible benefits from some interventions, although the overall quality of the evidence was generally low.
In summary
Experiencing some discomfort after a new or more demanding workout can be part of the body’s adaptation to exercise.
But pain is not synonymous with progress, and it should not simply be ignored.
When symptoms are intense, highly localised, affect function, or do not improve as expected, an assessment can help determine whether this is a normal response to training or an injury that requires a different approach.
At Physioclem, we aim to help each person train, recover, and return to activity progressively and safely.
References
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Hody S, Croisier JL, Bury T, Rogister B, Leprince P. Eccentric muscle contractions: risks and benefits. Front Physiol. 2019;10:536. doi:10.3389/fphys.2019.00536.
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SantAnna JPC, Pedrinelli A, Hernandez AJ, Fernandes TL. Muscle injury: pathophysiology, diagnosis, and treatment. Rev Bras Ortop. 2022;57(1):1-13. doi:10.1055/s-0041-1731417.
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Afonso J, Clemente FM, Nakamura FY, Morouço P, Sarmento H, Inman RA, et al. The 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 trials. Front Physiol. 2021;12:677581. doi:10.3389/fphys.2021.677581.
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Nahon RL, Lopes JSS, Magalhães Neto AM. Physical therapy interventions for the treatment of delayed onset muscle soreness (DOMS): systematic review and meta-analysis. Phys Ther Sport. 2021;52:1-12. doi:10.1016/j.ptsp.2021.07.005.
