DOMS – Delayed Onset of Muscle Soreness B.Pharmacy 7th Semester Novel Drug Delivery System


Delayed Onset of Muscle Soreness

First Described by Theodore Hough who concluded that this type of soreness is fundamentally the result of rupture of muscle. It Occurs 24-48 Hours following intense activity.

Difference Between Acute soreness and DOMS

Soreness is felt during or just after heavy exercise, DOMS on the other hand is symptom if exercise induced muscle damage lasting for 15 days after activity.


Muscle Soreness is the caused by eccentric (Lengthening) exercise Which causes small scale damage called micro trauma to muscle fibers. According to sliding filament theory during muscle contraction actin filament slides over thick (myosin) filaments.

Due to eccentric or lengthening of muscle fibers there is increased muscle tension -> Actin and myosin cross bridge separation prior to relaxation ->  Ultimately cause greater force/tension in remaining active motor units. -> Results in micro trauma occurs in these structure.

— Nocireceptiors within muscle connective tissue are stimulated and cause sensation of pain.

Various other theories to explain its pathophysiology :-

 • Enzyme efflux theory:-

Due to repeated muscular activity following micro trauma -> Calcium accumulates in muscles  -> Accumulation of calcium cause activation of protease and phosphatase -> Causes breakdown and degeneration of muscle protein -> Causes inflammation due to accumulation of histamine PG’s and Potassium

Toxic Tissue Theory:-

  • Disruption of subcellular components
  • Z-line is the weakest link mechanically in the contractile machinery and characterize myofibril damage.
  • There is damage to type-2 fibers resulting in
  • Rupture of micro fibular tissue with release of hydrolase enzyme.

Tissue Fluid Theory:-

Enzyme efflux and due to release of inflammatory mediators.  -> Cause fluid diffusion to extra cellular space. -> Leads to swelling

Lactic Acid Theory:-

According to this theory DOMS are caused by excessive Lactic acid accumulation. This theory is largely rejected as concentric contractions also produces lactic acid unable to produce DOMS.

Note:- Lactic acid have been studied that it returns to normal level within one hours of exercise therefore does not cause pain that occur much later.

Physiological changes in DOMS

  • Increased plasma enzyme (creatine kinase)
  • Increased myoglobin
  • Increased protein metabolites
  • Temporary impairment of muscle function.

Damages would be :-

  • Fragmented sarcoplasmic reticulum.
  • Swollen mitochondria.
  • Dilated T tubules.
  • Tension of plasma membrane.

These damages worsen in days following exercise  -> There is Muscle damage  -> Diffusion of creatine Kinase in plasma membrane of muscle cell.  -> Thus appears in circulation  -> Muscle damage

Signs and symptoms:-

  • Performance deficit.
  • Muscle soreness and muscle damage.
  • Inflammation.
  • Pain.
  • Muscular swelling.


  • Gentle stretching.
  • Hire personal trainer
  • Avoid sudden change in workout.
  • Avoid sudden change in timing of workout.

 Preceding Session:-

  • Gradual, Submaximal aerobic workout.
  • Static Flexibility for target muscle of training.
  • Isotonic Exercise.

Acute sessions components with Eccentrics:-

Early Phase:-

  • Limit training loads to 50 above contractile activity.
  • Begin with exercise in gravity eliminated position.

Later Phase:-

  •  Avoid load increased of > 20% Per week.

Following Session:- 48 Hours of recovery phase.

  • Ice
  • Low Pulse electrical stimulation.
  • Deep massage administered two days after session.


  • Do want, soreness will go away in 3-7 days with no specific treatment.
  • Avoid any vigorous activity that increase pain
  • Use active recovery technique.
  • Low Impact aerobic eg:- to increase blood and decrease muscle soreness.
  • Sometimes gentle stretching improve condition.
  • Gentle massage decrease DOMS by 30% by decreasing muscle swelling but no effect on muscle function.
  • NSAID’S (Aspirin or brufen) have temporary effect.
  • Yoga.
  • Warm-up before next session.

Some Researchers says:-

Warm-up performed immediately prior to eccentric exercise produce reduction of DOMS

  • If pain persists > 2 days consult physician.


    DOMS is self subsiding condition and required no specific treatment. After performing vigorous exercise that exhibit severe soreness the muscle rapidly adapts to reduce further damage for same exercise. 

This is called repeated Bout effect.

Related posts