Muscle soreness

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 10, 2015
StartSymptomsMuscle soreness

Everyone has had it happen to them. They are motivated, go to the gym, put in a good, long workout, and then come home only to find, hours later, the muscle soreness has set in. While some people thrive on the soreness to let them know they had a good workout, others can become easily dismayed. Even though the soreness usually only lasts a few days, this can often completely derail a person’s workout regime. Below is an explanation of what causes muscle soreness, how to treat it, and how to prevent, or at least mitigate, future problems with muscle soreness.


Definition & Facts

Typically, muscle soreness begins to set in about 24-48 hours following a workout. Most commonly, this is Delayed onset muscle soreness, or DOMS. It can also be called muscle fever. DOMS is caused by either physical activity that is strenuous, or an unfamiliar and new physical movement. Muscle soreness is a symptom of exercise induced muscle damage.

If muscle soreness occurs immediately following an exercise, this is classified as acute muscle soreness. Unfortunately, muscle soreness can happen to everyone, whether it is a professional athlete or a person performing their very first workout. Muscle soreness is a completely natural and normal side effect to the way the body grows and strengthens muscles.


Muscle soreness is caused by a build-up of lactic acid within the muscles. This is a normal byproduct of working out and muscle metabolism. The lactic acid sits in the muscle and, over time, irritates the muscle which causes soreness. While the majority of the lactic acid leaves the muscle within hours, or at most a day after the work out, the muscle is then left trying to repair the minor damage the workout has inflicted.

As part of muscle growth, the muscle undergoes a small amount of damage in the form of microscopic tears throughout the muscle. The body’s response is to send an influx of white blood cells, nutrients, and fluids to the affected muscle, causing it to swell. Certain movements have been proven to increase how the muscle is damaged, and thus, swells. Technically, muscle swelling, and thus muscle soreness, occurs when the muscle is lengthened or stretched. An experiment was performed where two groups of athletes were monitored while running. Half of the group ran on a flat surface, while the other half of the group ran downhill. The downhill running motion causes the muscles in the leg to be stretched.

Following the run, both groups of athletes were monitored for swelling. The group of runners that ran downhill exhibited more swelling in the muscles, and thus, more muscle soreness following the workout. The scientists administering the study then concluded that the majority of DOMS occurs from the swelling of the muscle following the workout. This swelling, combined with the irritation from the lactic acid, is what causes muscle soreness.

When to see a doctor

While most muscle soreness is easily self-remedied and cured in a few days, there are occasions when it is necessary to consult a physician. See a doctor if the muscle soreness lasts more than a week. If severe pain is associated with the muscle, or the pain gets worse with exercise, consult a doctor.

It is also necessary to see a medical physician if the muscle exhibits redness, swelling, or is warm to the touch. Muscle soreness that is accompanied by difficulty breathing or dizziness is an immediate concern, and a doctor should be contacted.

Treatment & Therapy

If a person experiences muscle soreness, it is suggested to use ice initially to reduce the swelling within the muscle. Ice can be coupled with a nonsteroidal anti-inflammatory drug, such as Tylenol®, Aspirin, or Aleve® to help reduce the swelling, as well as give the sufferer some immediate relief from pain.

While heat feels good at first, it is recommended that heat is applied after the initial round of ice. Heat helps stimulate blood flow to the area which promotes healing. The heat can be applied via a heating pad, hot bath, or by spending some time in a sauna. Massage therapy and stretching have also been reported to help with muscle soreness following the workout.

While there are some indications that icy baths work to diminish the effects of muscle soreness, attempted experiments to prove this have yielded mixed results, and are inconclusive. Most importantly, rest is recommended to treat muscle soreness. Taking a few days off from the strenuous activity will dramatically improve the soreness and give the muscles time to heal. Typically, muscle soreness will completely go away about four days following the workout.

Prevention & Prophylaxis

There is no real way to prevent muscle soreness completely, but there are ways to mitigate the soreness. As stated before, everyone who participates in strenuous physical activity will experience muscle soreness at one time or another, regardless of if they are an experienced body builder or a new comer to the gym.

Because muscle soreness is caused by a strenuous activity, or by performing an unfamiliar activity, one can lessen muscle soreness by gradually increasing the overall level and difficulty of the physical activity. Also, medical grade compression clothing, such as pants, socks, or sleeves can be helpful in reducing muscle soreness post workout. The theory behind compression clothing is that it helps reduce the isolation of individual muscles, thus reducing the amount of microscopic tears inflicted.

With the reduction of tears, there is less swelling from the body’s effort to repair the muscle. The muscle is then left feeling less sore post workout. Another way to reduce the effects of muscle soreness is to make sure post workout the muscle is receiving the proper nutrients. It is estimated that there is about a two hour window when the body has a chance to absorb valuable proteins to help repair damaged muscles.

It is also very important to stay hydrated because muscle cells rely on plenty of water to repair themselves. Contrary to popular belief, it has been proven repeatedly that static stretching before a workout does not prevent muscle soreness.

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