Delayed onset muscle soreness (DOMS) is a familiar condition to most runners. Whether you are new to running, a casual runner, or a competitive runner, delayed onset muscle soreness has likely caused you to hobble around for a few days. DOMS is usually experienced within 27 to 48 hours after a high intensity or high mileage effort. Running faster than you are use to, and running downhill fast predispose runners to DOMS. Understanding the cause, how to treat the condition, and how to prevent DOMS is important knowledge for every runner.

The cause of delayed onset muscle soreness is a much debated topic. Lactic acid build is one theory as to the cause of DOMS. Lactic acid is a normal by-product of muscle contraction. Lactic acid, however, leaves the system within approximately thirty minutes of the end of exercise. A more widely accepted theory for DOMS is muscle soreness secondary to repetitive micro-trauma within the muscle tissue itself.

Exercise which involves high-intensity muscle contraction over a long duration is more likely to result in delayed onset muscle soreness. Downhill running places unique demands on the leg musculature. Eccentric muscle contractions place a contractile demand on muscle tissue while in a lengthened position. Running fast downhill requires the leg muscles to absorb and control deceleration forces (gravity, grade, body weight) in a vulnerable state (lengthened muscle fibers). If a runner has not included eccentric training into weekly runs, micro-trauma can result in DOMS.

Treating delayed onset muscle soreness requires time. The inflammation associated with DOMS creates an environment favorable for healing if managed correctly. Taking anti-inflammatory medications is thought to actually hinder the body’s natural healing properties. Rest, elevation, ice, and compression stimulates circulation which is a positive addition to the healing process. Active recovery is also a great treatment for DOMS. Instead of running in the two or three days following the onset of DOMS, ride your bike, do some yoga, do some light stretching, have a light massage, go for a walk, but keep moving if possible. Too much activity (strenuous muscle contraction) too soon may re-injure the healing muscle fibers. Deep tissue massage may also damage healing muscle fibers and will be very uncomfortable. “No pain no gain” does not apply in the delayed onset muscle soreness window. Dry needling is a great modality during DOMS. Dry needling reduces pain, stimulates blood flow, and boosts the body’s natural healing properties if done in the proper, pain-free manner. Give your body the rest is it craving following a race or hard running effort. Your body will respond favorably if given the time to heal with increased strength and vigor.

John Fiore, PT
Sapphire Physical Therapy