Delayed onset muscle soreness (DOMS)

Delayed onset muscle soreness (DOMS) is the pain and discomfort clients feel 24 to 48 hours after starting a program or trying new exercises.^{1Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 21.} Once blamed on lactic acid, it most likely follows damage to muscle and connective tissue, mainly from eccentric muscle actions, and inflammation that activates pain receptors.^{1Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 21.} It can last for days and reduce range of motion, strength and the ability to produce force quickly.^{1Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 21.}

Mild DOMS is generally harmless for performance, but moderate to severe soreness can impair strength in later sessions and hold back progress.^{2Schoenfeld, Science and Development of Muscle Hypertrophy, 2nd ed., p. 155.}

In practice

• Ease new clients in: taking beginners or deconditioned clients to failure can increase soreness and discomfort, hurting retention, motivation and exercise adherence.^{3Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 420.}
• Exercise itself may be the best way to relieve DOMS pain, though the relief is temporary.^{1Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 21.}
• In one meta-analysis, massage reduced DOMS symptoms most; compression garments, cold therapies and active recovery helped too, while stretching didn’t.^{2Schoenfeld, Science and Development of Muscle Hypertrophy, 2nd ed., p. 155.}
• Limit cold-water immersion when the goal is hypertrophy, since it appears to work against long-term muscle growth.^{4Schoenfeld, Science and Development of Muscle Hypertrophy, 2nd ed., p. 156.}

Where sources differ

Israetel and colleagues use soreness as a rough gauge of an effective session, suggesting that some tightness on the day through to DOMS lasting a few days is likely best practice for growth.^{5Israetel et al., Scientific Principles of Hypertrophy Training, p. 51.} NSCA’s Essentials of Personal Training emphasizes the cost of extra soreness in beginners, particularly the risk to adherence.^{3Schoenfeld and Snarr (eds.), NSCA’s Essentials of Personal Training, 3rd ed., p. 420.}