A brief look into what this exercise related pain actually is!


We hear the term used a lot when referring to exercise induced pain. But what exactly is DOMS?

DOMS is an acronym for delayed-onset muscle soreness. It is an exercise related pain, thought to be caused by small tears within the myofibrils. 

Myofibrils are small, cylinder shaped fibres that help to make up our muscles (in the image above). They are found within striated muscle or ‘skeletal muscle’ capable of voluntary control, for example, the Biceps. 

The small tears occurring within the myofibrils cause micro trauma, leading to an inflammatory response from the body. This has previously been shown with biochemical markers being present in the blood of those suffering with DOMS.


  • Pain is usually experienced around 24 hours after exercise. This exercise will usually be something new or particularly strenuous. The pain is often described as a dull aching which is made worse with movement.
  • Stiffness may be present within the body part affected and trying to stretch the muscle will usually increase the pain.
  • It can occasionally be tender to touch but there will not be any visible bruising. In more severe cases, there can be some swelling.
  • Trying to recreate the movement you did to cause the DOMS will also be very painful! E.g. if you have done loads of jump squats in an exercise class, trying to squat or even just to get in/out of a chair will be painful! It is quite localised pain.
  • At rest, there should not be any or minimal pain.
  • There can be a short term reduction in strength of the muscle. This is thought to be due to the altered muscle firing patterns, secondary to pain and inflammation.


  • The good news is that DOMS is not a serious injury and will usually resolve within a few days without any specific treatment.
  • The use of Ice
  • Gentle low impact exercise such as walking, swimming, cycling can help to reduce the pain.
  • Non-steroidal anti-inflammatories (E.g. Ibuprofen) may help with the pain if severe. 
  • Massage can be useful but should be avoided until at least 48 hours after the onset of the pain. Pressure on the affected muscles may increase pain levels and inflammatory response.
  • Avoid high impact, strenuous and aggressive exercise for a few days until your symptoms begin to improve. This can be detrimental to the healing.

Can I prevent it?

  • Be mindful of how much eccentric exercise you do. Eccentric exercise is when a muscle is lengthening at the same time as contracting e.g. the Quadriceps as you walk downhill. This can be a big trigger for DOMS!
  • Build exercise up gradually. If you are new to it – have a plan together of how you will gradually build up your strength. Remember DOMS will hit you later not whilst exercising!
  • Physiotherapists can help to plan an exercise progression appropriately.
  • A dynamic warm up followed by some static stretching as a cool down can help to prevent injury.
  • Stay hydrated! Water is crucial to enable our cells to regenerate and heal effectively.


  • DOMS is usually diagnosed clinically – there is rarely the need for a scan.
  • It is important that DOMS is differentiated from other more serious injuries such as muscular tears and tendon ruptures.
  • Some things which may mean your injury is not DOMS:

–      The pain came on during exercise, not 24-48 hours after.

–      There is bruising, redness or swelling around the joints

–      You are finding it difficult to put weight through the affected area e.g. the knee.

–      The pain is not just within the muscle – you may feel pain at the joint and find it difficult to move the joint through full range.

–      The pain has not begun to significantly reduce after 2-3 days.

Whilst it is an unpleasant sensation, it will heal. If you are concerned regarding an injury or pain you have sustained during any form of exercise – let us know and we can help get you on the road to recovery. 

Thanks for reading.  

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