Delayed Onset Muscle Soreness After Exercise and Massage

Do you ever wonder why it feels like you got hit by a bus the day or two after a deep tissue massage or workout? This is not necessarily a bad thing, but can confuse a lot of people into thinking that the massage or workout was bad for them. This symptom is actually called Delayed Onset Muscle Soreness or DOMS.

DOMS is defined as activity that puts unaccustomed loads onto muscle causing soreness, 24-72 hours after exercise or intense massage. This is considered a normal repair process, in which the soreness is caused by microscopic damage to the muscle fibers during exercise or massage. A variety of cells and substances flock to the muscles to help repair those tears. Anatomically, it is usually caused by eccentric contractions which is when the muscle lengthens while load is applied. An example of this action is using the quad muscles while running downhill.

There is a myth out there that says the soreness is caused by lactic acid, but this is actually not a component of the healing process. No treatment has been shown to be able to decrease the duration of DOMS except for rest and proper hydration. Even though the process might be uncomfortable or slightly painful, after the cycle has been completed, it is shown to make the muscles stronger and more capable to adapt to future strains. Since the more repetitions you do in a given exercise, the more damage and soreness there will be, it is suggested to gradually increase the duration of the exercise and/or intensity of the workout to minimize the likelihood of DOMS. Also, the general advice is to go through a proper warm-up, progress slowly into a new program, and stretch only after the body is warmed up.

If the muscles are not used to massage, they will respond with soreness that should only last a day or two. It is always extremely important and helpful to communicate with the massage therapist what you expect from the session and your tolerance for deeper work so that they do not go over your limits or not be intense enough for your liking. After the massage, the typical take home instructions are to drink plenty of water immediately after and continue that for the next 48 hours. In addition, refrain from strenuous activity for the remainder of the day. Rest as if you just worked out. It is a good practice to either get a longer massage on a day where you are able to relax, or later in the day or at night when your activities have already happened. Shorter soft tissue or massage (<15 minutes) might be more enjoyable to some that do not want any discomfort in their session, and will most likely significantly decrease the likelihood of DOMS.




Ask Well: Why Do Muscles Ache a Day or Two After Exercise? November 2, 2015. Reynolds, Gretchen.



ACSM Information On…Delayed Onset Muscle Soreness (DOMS). American College of Sports Medicine.



Why Am I Sore? 2003. Vanderbelt, Shirley.  


Use of Foam Rollers – Tips and Techniques

Benefits of using a foam roller is comparable to a deep tissue massage, myofascial release and myofascial trigger point therapy. Myofascial trigger points are taut bands or knots in the muscle tissue that can refer pain to other areas. For example, a trigger point in a gluteal muscle may refer pain down the leg. Trigger points can also limit range-of-motion, inhibit muscle strength and cause muscle fatigue. Regular work can increase flexibility and performance while decreasing muscle tension and pain.

Maximize the effectiveness of the foam roller by incorporating it into your daily stretching routine. Use the roller before and after activity, and always roll before you stretch. This will help to warm up cold muscles and prepare them for deeper stretching.
Make sure you roll on soft tissue and not over joints, ligaments or bony protrusions. Start by placing your body on a roller and slowly roll up and down the muscle. If you find a knot or tight band, hold that spot and try to feel the tissue release and soften underneath the pressure. Take deep breaths and try to keep your body as relaxed as possible.

Use of the foam roller can be painful. If an area is too painful to roll, place your body on the roller for 15 seconds before moving on to the next spot. As the tissue starts to loosen up you should be able to roll with less pain.

For low back lumbar extensor muscles:
Position the roller so that it’s in line with your spine. To focus on your right side, roll your body to the left, keeping your spine parallel to the roller and stop on the muscles that run along the length of your spine. Hold and allow your back to relax. Repeat on the left side.

For lateral low back obliques & quadratus lumborum muscles:
Position yourself as shown placing the foam roller between your ribs and hip. Slowly roll backwards until you feel a stretch and pressure in your lower back region. Hold on tight spots until you feel the tissue soften. Do not hold on any one spot for longer than a minute. Be careful not to over-treat. Repeat on the opposite side. 17

For gluteal muscles, piriformis:Start side-lying on the foam roller. Extend your right leg so that it’s in line with your torso and rotate back to position your right gluteal on the roller. Bend and place your left leg behind your right and place both hands on the floor for support. Proceed to roll the right gluteal region along the roller. Repeat for your left side.


Stop in the office and take home your roller today! 802-655-0354

Foam Roller Techniques, OPTP, 2008, Michael Fredericson, MD, Terri Lyn S. Yamamoto, PhD, Mark Fadil, CMT, p. 15, 17, 23.