What Is It | DOMS or delayed onset muscle soreness

A runner experiencing muscle ache, most likely DOMS

Last year’s lockdowns saw gyms shut and us in our homes, couch- or desk-bound. Most of us who have not touched a dumb-bell or run a few kilometres for months are getting back into the swing of things only now. But when the body is unaccustomed to working out, this can cause a ‘delayed onset of muscle soreness’ better known as DOMS, also dubbed ‘muscle fever.’

DOMS leaves muscles feeling tender to the touch, the person affected having a reduced range of motion due to pain and stiffness when moving, and even short-term loss of muscle strength. Just think of that scene in Bridget Jones’ Diary where she falls off the elliptical.

Dr (Maj) S Bakhtiar Choudhary, consultant in sports medicine and occupational health, explains DOMS occurs in those who have not exercised in a long time as neuromuscular coordination gets very used to inaction. So when you do work out, he says, “DOMS may happen, and it can be very painful, creating micro-tears in the muscles which can bleed.”

How to treat it

But what if you have DOMS already? “There’s no medication for DOMS, so do avoid paracetamol and such. Take it easy for the next four to five days; do not encourage further tears, but do some selectively gentle stretches,” he advises. He also suggests keeping a cold pack of 0 to 10 degrees Centigrade handy, elaborating, “This form of cryotherapy reduces swelling, the bleeding in the micro-tears and the inflammation, and also acts as a local anaesthetic and numbs the area.”

In some cases, DOMS can be a concern. Dr Choudhary says, “If one does not recover within seven to 10 days, seek medical help from a sports medicine doctor or a highly-qualified physiotherapist.” The physio can offer massage to the strained muscle.

Dr Choudhary states that preventative measures against DOMS are possible. “Nutritionally, one must focus on carbohydrates, not proteins. Complex carbohydrates refill glycogen stores, helping replenish the muscle.” Stay hydrated, neither under-hydrating or over-hydrating. Both may further throw the body off the hydration level to which it is accustomed. Athletes also recommend oily fish, nuts and even tart cherry juice to reduce the chances of DOMS.

A good routine

The exercise programme from start to finish matters, too, he points out. Flexibility and mobility training (exercises to increase range of motion) provides a reduced risk of injury, enhanced athletic performance, and in some cases, transient relief. “A warm-up followed by a well-paced exercise (nothing that makes you strain over 50%), followed by a cool-down reduces lactic acid buildup and lowers your chance of muscle cramps and stiffness,” he says. “The body is like a machine; it cannot function starting in just fourth or fifth gear, you have to follow the proper routine.”

While the muscle takes a few days to repair itself, the key, he concludes, is to pace yourself from the start. “Do not dive right into an intense endurance training, but rather let your body’s muscles build up the tolerance to the new activity levels.”

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