Muscle Soreness after workout – Delayed-Onset Muscle Soreness

Muscle Soreness after workout – Delayed-Onset Muscle Soreness


« When I do my workout, I’m worried about doing too much. Sometimes afterwards, I feel bad for three days. It’s painful, and I feel so weak… »



Maybe it’s something you said recently; A conversation you had with your fitness trainer, or you physical therapist. And probably he was glad about it! No, it’s not because he’s a sadistic. Let me explain :



When we talk about muscle soreness that appears couple of hours after your training (about 24-48 hours), we talk about delayed-onset muscle soreness.



What does it mean?


It is sore, and sometimes painful. Some people may feel fatigue, or weakness. It disappears after two or three days.



Is it normal?


Rest reassure, it is normal, and it disappears on its own, without having to do anything particular about it. It is normal to feel muscle soreness (in your calf, thigh, etc.), and especially when you move (not when you rest). But that is not normal to feel pain or soreness in your articulation (knee, ankles, elbows, etc.). If you do, it is not delayed-onset muscle soreness, and you’d better ask for a specialist’s advice to review your training methods.



Yes, but why being glad about it?


Studies associated muscle soreness to hypertrophy of muscles. It is sore? It means your muscle is getting bigger, and stronger(1). It was the objective, wasn’t it?



Why does it happen?


Delayed-onset muscle soreness is a phenomenon known for a long time. But, surprisingly, the exact cause has not been established yet.



A couple of years ago, we believed it was due to an accumulation of lactic acid in the muscles. Actually, lactic acid is responsible for soreness in the end of the exercises. You know, those though last repetitions (1)!



Studies found a link between eccentric exercises and delayed-onset muscle soreness(1). What is an eccentric exercise? Forget about that man dressed in pink with a feather hat running on a treadmill; Eccentric – for exercises – is a strengthening exercise while you muscle is getting stretch. Like if you unbend your elbow, controlling your movement to drop something heavy on the table. It is the opposite of bending the elbow to lift that same heavy thing (concentric exercise). Another example: Bending your knees slowly down to put a weight on the ground (squat).



It appears to be caused by muscle damage; microscopic tears in the muscle (1-2-3-4), in response to an unfamiliar or vigorous physical activity. It heals fast, but you shouldn’t do strengthening exercise for that period. It is why we recommend to do those exercise every two days. The muscles need time to heal.



Good new : There is a protective effect observed, called the repeated-bout effect (3-4). The muscle would protect itself against damage. The more you workout, the less you’ll get sore. So you don’t have to avoid eccentric exercises : you should do more! Don’t give up : The more you keep on training, the easier and less uncomfortable it will get. Come on, a little nerve!


Yes, but for me, it’s not the same. I have a neurological condition.


What is the link between neurological conditions and delayed-onset muscle soreness? No study has been published about the way people with neurological issues (multiple sclerosis, stroke, parkinson disease, spinal cord injury, etc.) deal with it. Is it felt in a different way? Does the soreness last for a longer time? Is it more incapacitating? Good questions!



A study found some links between delayed-onset muscle soreness and neurology. On rats observations, it seems that a soreness can be felt without any sign of muscle damage or inflammation. That would reject the theory of the micro-traumas. However, there would be a greater presence of neurotrophic factors (chemical substance secreted by muscle to activate neural cells). The conclusion would be that not only hypertrophy of muscle provoke soreness, but activation and development of neural system around too (5-6).



Would delay-onset muscle soreness be felt differently by a person with a neurological issue? Because in rehabilitation and physical training, we work on the muscle strengthening as well as on reinforcement of the neural signals to the muscles, and that the greater presence of neurotrophic factors seems to be linked with muscle soreness, it would be an interesting hypothesis to explore.



What is efficient to get rid of the muscle soreness?


Time to rest is what seems to work the best. Like I said, it disappears on it’s own. Also, the repeated-bout effect is not to be neglected; The more you workout, the more comfortable you’ll get. The stronger and less tired you’ll feel. Hold on, don’t give up!



Anyway, some interventions has been demonstrated efficient to decrease (but not get rid) of the muscle soreness. Sorry, it’s unavoidable!



Some examples: Functional electrical stimulation (7), massage (would not be so efficient, and only with few people. But it cannot harm, and it feels so good!)(8), heat applied right after the exercise(9), and eat curcumin(10)!



You would like to know more ? A long blog, very complete about delayed-onset muscle soreness:




(1) Croisier, J., Camus, G., Forthomme, B., Maquet, D., Vanderthommen, M., & Crielaard, J. (2003). Delayed onset muscle soreness induced by eccentric isokinetic exercise. Isokinetics & Exercise Science11(1), 21-29.

(2) Schoenfeld, B.J. et Contreras, B. (2013) Is post exercise muscle soreness a valid indicator of muscular adaptations? National strenght and conditioning association, 35(5), p.16-21.

(3) Hody, S., Rogister, B., Leprince, P., Laglaine, T., & Croisier, J. -. (2013). The susceptibility of the knee extensors to eccentric exercise-induced muscle damage is not affected by leg dominance but by exercise order. Clinical Physiology & Functional Imaging33(5), 373-380. doi:10.1111/cpf.12040

(4) Nosaka, K. Newton, M. (2002) Repeated eccentric exercise bouts do not exacerbate muscle damage and repair. J Strength Cond Res ; 16: 117–122.

(5) Mizumura, K. Taquchi, T. (2016), Delayed-onset muscle soreness : Involvement of neurotrophic factors, Journal of Physiologic Sciences, 66(1), p. 43-52.

(6) Ayles, S. Graven-Nielson, T. Gibson, W. (2011), Vibration-induced afferent activity augments delayed-onset muscle allodynia, Journal of Pain, 12(8), p. 884-891.

(7) FERGUSON, R; DODD, M; PALEY, V. Neuromuscular electrical stimulation via the peroneal nerve is superior to graduated compression socks in reducing perceived muscle soreness following intense intermittent endurance exercise. European Journal of Applied Physiology. 114, 10, 2223-2232, Oct. 2014.

(8) Jay, K., Sundstrup, E., Søndergaard, S. D., Behm, D., Brandt, M., Særvoll, C. A., & … Andersen, L. L. (2014). SPECIFIC AND CROSS OVER EFFECTS OF MASSAGE FOR MUSCLE SORENESS: RANDOMIZED CONTROLLED TRIAL. International Journal Of Sports Physical Therapy9(1), 82-91.

(9) PETROFSKY, J; et al. The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness. Clinical Journal of Sport Medicine. 27, 4, 329-337, July 2017.

(10) Nicol, L., Rowlands, D., Fazakerly, R., & Kellett, J. (2015). Curcumin supplementation likely attenuates delayed onset muscle soreness (DOMS). European Journal Of Applied Physiology115(8), 1769-1777.