Medical and fitness professionals call sore muscles after exercise delayed onset muscle soreness or DOMS. It’s a common complaint of many athletes, but also of anyone who puts their muscles to greater use than is typical for them. The condition stems from exercise-induced muscle damage, or inflammation of the muscle as a result of microtears of muscle fibers. Many treatment options exist for muscle pain relief.

DOMS sets in the day after hard exercise, typically after a night’s sleep, and peaks from 24 to 72 hours after activity before subsiding. Symptoms can include muscle aches, as well as swelling and stiffness. Severity can range from annoying to painful.

Treatment focuses on reducing inflammation and allowing the sore muscle to heal properly. Some treatments recommended for muscle soreness have a scientific basis, others do not. Even those commonly used by athletes may not have been well studied, though some may swear by them.¹

 

Here are some common treatments and the rationale for their effectiveness.

Rest

The simplest and most reliable treatment for sore muscles is rest. This allows microtears in the muscle fibers to heal, which makes the muscle stronger. Most people with muscle soreness improve with no specific treatment within five to seven days.

Active Recovery

Many active people, particularly competitive athletes, don’t like to rest as long as recommended, however. In such cases, active recovery may be an option.

Active recovery means performing less-intense exercise while recovering from an aggressive workout. It’s helpful to do a different activity than what you did to get sore.

Active recovery stimulates blood flow to the muscles and may help reduce muscle pain while maintaining an athlete’s conditioning. The key is “light” so as to not do further damage to damaged muscles.¹

Ice

Treating inflammation with ice application is common and most effective when initiated in the first 48 hours of exercise-induced muscle soreness, and probably less effective thereafter.

Cold water immersion (ice bath) has also become a common recovery method for athletes, with some research showing it to be effective against DOMS.

Massage

Massage is thought to stimulate blood flow to sore areas and diminish swelling within the muscle.

One technique that many athletes enjoy is ​foam rolling, a type of self-massage where you use a high-density styrofoam roll to place body weight pressure on the muscles for a type of myofascial release. Many find this relaxes and stretches affected muscle groups.

Gentle Stretching

Studies have shown that stretching probably does not make a difference in preventing or reducing muscle soreness. That said, many athletes find a stretching routine to be their key to quick recovery, and there is no evidence that stretching is harmful or contributes to muscle soreness.

If you want to try some gentle stretching, it may help and probably won’t hurt.

Anti-Inflammatory Medications

Anti-inflammatory medications like ibuprofen can help relieve some of the discomforts of muscle soreness, but will not affect the length of time needed for muscle recovery. Early administration of anti-inflammatory medications may bring the best results.

Heat

Heat application can help relax a tense, stiff muscle. When participating in active recovery, heat application before exercise can also help ensure the muscle is warm and loose.

Topical Creams

Topical analgesic heat rubs include Aspercreme, BenGay, and IcyHot. These medications are called counterirritants and do not actually warm the muscle, but rather cause the sensation of warmth and/or cooling of the skin.

These rubs have no effect on the muscle and do not change the temperature of the skin. Rather, they can encourage the perception of pain relief by essentially distracting from the underlying issue.

The application of these topical creams is fine, but use caution as the medication can be absorbed into the body.

Smart Eating

Research continues to show that what you eat can have positive effects on muscle soreness. Examples:

• Caffeine an hour before a workout and the day after may help reduce DOMS symptoms. Don’t overdo it, however. Eight ounces of coffee will suffice.
• Omega-3 fatty acids (fish and fish oil supplements) have anti-inflammatory properties that could decrease DOMS.

• Polyphenols, antioxidants found in fruits and veggies, can also deliver anti-inflammatory effects against DOMS.

 

Sources for this article

1. Cheung K, Hume PA, Maxwell L. Delayed Onset Muscle Soreness. Sports Medicine. 2003;33(2):145-164. doi:10.2165/00007256-200333020-00005
2. Hohenauer E, Costello JT, Deliens T, Clarys P, Stoop R, Clijsen R. Partial-body cryotherapy (-135°C) and cold-water immersion (10°C) after muscle-damage in females. Scand J Med Sci Sports. 2019; doi:10.1111/sms.13593
3. Guo J, Li L, Gong Y. Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis. Front Physiol. 2017;8:747. Published 2017 Sep 27. doi:10.3389/fphys.2017.00747
4. Herbert RD, De noronha M, Kamper SJ. Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database Syst Rev. 2011;(7):CD004577. doi:10.1002/14651858.CD004577.pub3
5. Petrofsky J, Berk L, Bains G, Khowailed IA, Lee H, Laymon M. The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness. Clinical Journal of Sport Medicine. 2017;27(4):329-337. doi:10.1097/jsm.0000000000000375
6. Singla N, Desjardins PJ, Cosca EB. Delayed-onset muscle soreness: a pilot study to assess analgesic study design features. Pain. 2015;156(6):1036–1045. doi:10.1097/j.pain.0000000000000109
7. Kim J, Lee J. A review of nutritional intervention on delayed onset muscle soreness. Part I. J Exerc Rehabil. 2014;10(6):349-56. doi:10.12965/jer.140179