Delayed onset muscle soreness

Delayed onset muscle soreness (DOMS) refers to next day muscle soreness which comes 24-48 hours after exercise in otherwise healthy people. Peak soreness is at 48-72 hours post-exercise. Athletes will experience DOMS after high intensity exercise work-outs. At low intensity exercise/work-outs the athlete will rarely experience soreness. Lay public believes lactate production is causing DOMS, but this is not correct. Lactate removal from muscles is rapid, typical 60-120 minutes after exercise. The cause of DOMS is microscopic injury to muscle fibres which leads to inflammation.

The damage to muscle cells triggers an inflammatory response which involves neutrophils and macrophages. These cells removes the damaged muscle tissue and release enzymes. The muscle fibers are then repaired.

ME/CFS
Delayed onset muscle soreness is not a symptom of ME/CFS and should not be confused with muscle pain caused by post-exertional malaise or other muscle pain in ME/CFS.

Notable articles

 * 2018, Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics - (Abstract)


 * 2019, Advances in Delayed-Onset Muscle Soreness (DOMS) - Part II: Treatment and Prevention - (Abstract)